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Informed Consent powerpoint

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Informed Consent powerpoint

  1. 1. Reminders Turn off all pagers, cell phones, and computers during this educational session. You are required to participate in the group debriefing session when you have completed the Standardized Patient (SP) encounter. Please complete the “Pre-Program Self Assessment: Confidence Level” form
  2. 2. Informed Consent Module development supported by a grant from thePicker Institute / Gold Foundation 2010 Challenge Grant
  3. 3. Learning Objectives Describe the basic principles of shared decision- making Demonstrate key elements of the informed consent conversation Identify some potential challenges in the informed consent conversation 3
  4. 4. Expected Outcome Obtain informed consent consistent with professional standards and shared decision-making principles 4
  5. 5. Informed Consent Conversation 5
  6. 6. What did you think? 6
  7. 7. Setting the Environment Provide privacy Introduce self Determine who else should be present Ensure no interruptions Provide comfortable space Create welcoming environment. 7
  8. 8. Shared Decision-making Overview Identify that problem requires a shared decision- making process. Assess the patient’s information preferences and level of involvement in decision-making. Discuss management options and patient’s wishes. Confirm patient’s understanding and choice. 8
  9. 9. D-H Informed Consent Policy Overview Remember to perform hand hygiene Conversation  Introduce yourself & explain why you are there  Verify patient’s identity  Use plain language & avoid medical jargon  Discuss:  nature & purpose of procedure  risks, expected benefits  possible alternatives,  right to refuse treatment & possible consequences of refusal  Check for understanding 9
  10. 10. D-H Informed Consent Policy Overview Documentation includes both:  Consent Form:  Provider’s signature signifies that the conversation took place  Patient’s signature indicates consent & questions were solicited & answered  Must be dated & timed  Valid for 90 days  Recurring procedures-valid for one year  Note in record:  Summary of the conversation  Risks & benefits  Alternatives  Special circumstances or concerns  Patient decision regarding procedure / intervention 10
  11. 11. Challenges What are some challenges you have seen in obtaining informed consent? 11
  12. 12. Common Challenges: Incapacitated or Incompetent Patient Is there an Advance Directive? If not, who is legal next of kin? Is there time to go through guardianship process? Is the procedure urgent? Care Management can help! ALWAYS do what is in best interest of the patient! 12
  13. 13. Common Challenges: Treatment Refusal Competent patients have right to refuse interventions Confirm patient’s capacity to understand  Get help from another physician  Consider psychiatry consult  Consider ethics committee consult Medical staff provides medical information Involve Care Management as needed  Financial assistance 13
  14. 14. Common Challenges: Language Barrier Use an Interpreter unless patient refuses  Interpreter Coordinator may be reached at ext. 5-5792 during daytime hours (8am-5pm)  Call on-call Care Management staff during nights and weekends If patient refuses an interpreter, a family member may be used  Physician may request interpreter if uncomfortable 14
  15. 15. Consents for Minors Parents must legally consent for their children under 18 years of age Important to have assent from the adolescent patient 15
  16. 16. Partnering with Patients to Improve Safety Hand hygiene Two patient identifiers  Inpatient  Outpatient Verify  Procedure  Site Time out 16
  17. 17. What’s Next? Expectations Reminders(Mahmud, 2008) 17
  18. 18. References1. Pellerin M, Elwyn G, Rousseau M, Stacey D, Robitaille H, Legare F. Toward Shared Decision Making: Using the OPTION Scale to Analyze Resident-Patient Consultations in Family Medicine. Acad Med. 2011;86(8):1010-1018.2. Weiss BD. Removing Barriers to Better, Safer Care, Health Literacy and Patient Safety: Help Patients Understand, Manual for Clinicians. 2nd ed. American Medical Association Foundation and American Medical Association. 2007; http://www.ama-assn.org/ama1/pub/upload/mm/367/healthlitclinicians.pdf. Accessed December 15, 2009.3. Dartmouth Hitchcock Medical Center (DHMC). Informed Consent (Policy No. OCA.0007). DHMC Clinical Operations Policy Library. 2011; http://policy.hitchcock.org/PolicyStore/193/193_83639.pdf. Accessed November 18, 2011.4. Henry Ford Health System Department of Medical Education. Informed Consent. [DVD]. Detroit, MI: Henry Ford Health System; 2009.5. Henry Ford Health System Department of Medical Education. Sharing Bad News. [DVD]. Detroit, MI: Henry Ford Health System; 2009.6. Mahmud A. File: Serious Discussion image by Ashfaq.JPG. Dhaka University Institute of Fine Arts; 2008. Wikimedia Commons. http://commons.wikimedia.org/wiki/File:Serious_Discussion_image_by_Ashfaq.JPG. Accessed December 6, 2010.7. Wind LA, Van Dalen J, Muijtjens AMM, Rethans JJ. Assessing Simulated Patients in an Educational Setting: The MaSP (Maastricht Assessment of Simulated Patients). Medical Education, 39-44; 2004. 18

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