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Analyses have identified inadequate informed consent communication between the surgeon and the patient/family as a top factor contributing to claims against orthopedists. The informed consent discussion requires an open dialogue to afford the patient an opportunity to ask questions and voice concerns.
Consider the patient’s needs and priorities when discussing healthcare options. Try the following communication techniques to achieve a patient-centered informed consent:
Establishing patient understanding is critical to ensuring valid disclosure and patient consent:
Patients can feel betrayed if an unexpected complication or adverse outcome occurs and it was not disclosed or was inadequately addressed. The top five major injuries in claims against orthopedists are infection, pain, malunion/nonunion, nerve damage, and death. Complete disclosure informs the patient how each of these injuries (and other risks of the procedure) might occur and what actions the patient and surgical team can take to reduce risk.
At the time the patient makes the decision to have the procedure, execute procedure-specific disclosure and consent forms printed on your own letterhead. This should be done in addition to completing the required hospital or surgical facility forms that are not specific to your practice. For sample forms, visit our Informed Consent Resource Center at www.thedoctors.com/informedconsent.
Although the informed consent doctrine remains dynamic, building a skillset that is patient-centered in the orthopedic specialty will enhance the therapeutic relationship while mitigating risk in the process of informed consent.
By Robert Morton, ARM, CPHRM, Director, Patient Safety, The Doctors Company, and Dana Faber, RN, BS, Patient Safety/Risk Management Account Executive, The Doctors Company.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.