Understanding what matters most to patients is the cornerstone of delivering high-quality care. Clinicians can only align treatments with patients’ priorities and values through effective communication and engagement. Two foundational pillars of patient-centric care are critical in this process: shared decision-making and informed choice.
Shared Decision-Making
Shared decision-making is a collaborative process where healthcare providers and patients collaborate to choose the most appropriate treatment. This approach uses three key criteria:
- Best available evidence
- Clinical expertise
- Patient values, preferences, and circumstances
Moving conversations from “What’s wrong with me?” to “What matters to me?” is vital. Understanding patients’ preferences, needs, and values requires open patient-clinician communication.
Informed Choice
Informed choice, previously known as informed consent, is essential for patients to make well-informed decisions about their treatment options. This involves clear communication of:
- Benefits: Potential positive outcomes
- Risks: Potential adverse outcomes
- Alternatives: Other treatment options
- Nothing: Consequences of no treatment
According to the Joint Commission, only one in four consent forms currently include all these elements. The BRAN framework (Benefits, Risks, Alternatives, Nothing) transforms informed consent into a more comprehensive informed choice, ensuring patients fully understand their options.
Impact on Patient Experience, Outcomes, and Cost
Research indicates that informed consent and shared decision-making improve patient satisfaction, enhance treatment plan adherence, and improve health outcomes. Patients who are well-informed and actively involved in their care choices experience fewer regrets and perceive better communication with their healthcare providers. Additionally, shared decision-making can reduce unwarranted variation in clinical practice and help decrease the overall cost of care by steering patients towards more conservative and less costly treatments when appropriate.
Effective Communication of Risks
Communicating risks effectively is crucial. Clinicians must present absolute numbers for the risk and its inverse to frame it appropriately, ensuring patients understand the full context. Understanding the patient’s life conditions, such as their living situation, access to transportation, literacy, and numeracy, is critical for meaningful conversations about risks, benefits, and alternatives.
By addressing these key issues, clinicians can better engage with patients and provide high-quality care that truly aligns with their needs and preferences.
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