Question

how to facilitate the health care decision- making process for patients and their families

Answer 1

DECISION MAKING is central to health policy and medical practices ..decisions in health care are of two types

1.Decisions made by providers on behalf of patients

2.Shared decisions between providers and patients

SHARED DECISION MAKING:

It is a key component of patient centered health care

It is a process in which clinicians and patients work together to make decision and select tests,treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values

FACILITATING HEALTH CARE DECISION MAKING:

BASIC REQUIREMENTS and ADVANTAGES:

• Health care team should be motivated to engage patients on ethical imperative that many patients prefer to be engaged in some way or form
• SHARED DECISION MAKING (SDM) has a moral component which needs to be considered in decision making
• it is conductive to reducing information asymmetry
• It is a mediator and moderator of healthcare quality

COMMUNICATION:

• Having a good communication is a good solution to all the problems
• talk to the patient in a approaching manner
• Involve the family members and care givers if patient is willing
• Explain the current situation,treatment options available,outcome,prognosis,role of patient and family in the betterment of situation,health care team duties in this process
• Provide them with all the available options with their pros and cons
• give some time to patient and family to decide and once they are done proceed with their decision
• have empathy in your communication
• Do not compare with other patients because each patient is different and each outcome is different
• Explain patient and family that their involvement will fasten up the results
• Appreciate their efforts then and there
• Encourage them and make them aware that they can take the best decisions
• Respect all their feelings and limitations
• Be clear in explanation....explain everything until they understand
• Ask patient to repeat the content because it is ultimately the patient who needs to understand the situation
• Do not hurry them or force them to select a particular decision
• If they want a clinician to take decision for them please help them out by providing what they need

HEALTH EDUCATION:

• Leverage patient education techniques
• Assess the knowledge of patient and family
• Educate the patient and family together if patient is willing to involve the family
• Use appropriate,simple,understandable words
• Use proper AV aids to make them understand the concept better
• We can gather the family and patient in the digi room (if available in the hospital) to show them digitally about all the things
• After educating make sure to ask them to repeat...this helps us to know how far they have understood and if any corrections are needed we can make it then and there
• Health education should always be the problem centered

CULTURAL DIFFERENCES:

• Know about their cultural preferences and respect it
• Few cultures may want their head of the family to make decisions
• Few may want patient himself to decide
• Few cultures do not want the ladies of the family to involve in decision making
• Few people may want their friend or a close person to take decision for them
• In case of small children parents are the decision makers
• Consider and respect all these things
• Educate the patient about importance of involving family in decision making
• Understand what patients and family are more fearful of and most concerned about and what they need to talk about and go according to it

ENGAGING FAMILY AND CAREGIVERS:

• Patients lean on their loved ones when their health is ailing and at times of uncertainty.Involving family is a key strategy to support care and deriving positive outcome
• When patient and family is involved outcome would be better and there would be no regrets
• Offer ample education on matter at hand and support a patient-family centered approach
• Talk to the patient ,take his willingness and involve family in all the decisions if pt is willing but make sure that pt decision is ultimate
• In case of children ,parent's decisions ultimate
• Understand patient preferences for family involvement.In few cases patients may not want high levels of family involvement
• If we find that patient and families have contrasting wishes ,remember that patient is fundamental incharge
• While there are good intentions ,there must be a balance between honoring what patient wants and what family wants
• Use strong communication and education skills ,incorporate patient preferences and support family
• Admire them for the co efforts they put

SHARED DECISION MAKING HELPS IN FAST RECOVERY

FAMILY INVOLVEMENT IS NEEDED BECAUSE THEY ARE ONES WHO THINK GOOD FOR US AND WHO CAN BE TRUSTED MORE

EVEN AFTER DISCHARGE FAMILY HAS TO TAKE CARE OF PATIENT...SO INVOLVING THEM RIGHT FROM INITIAL STAGES HELPS IN BETTERMENT OF PATIENT CONDITION