RACGP Standards for general practices 4th edition
Criterion 1.2.2 Informed patient decisions
Our practice gives patients sufficient information about the purpose, importance, benefits, risks and possible costs associated with proposed investigations, referrals or treatments, to enable patients to make informed decisions about their health.
Indicators
► A. Our clinical team can demonstrate how we provide information to our patients about the purpose, importance, benefits, risks and possible costs of proposed investigations, referrals or treatments.
► B. Our clinical team can describe how we use leaflets, brochures or written or electronic information to support our explanation of the diagnosis and management of conditions when appropriate.
► C. Our clinical team can describe how we provide information (printed or otherwise) about medicines and medicine safety to patients.
Explanation
Key points
- Patients have the right to make informed decisions about their health
- Practices need to provide information in ways that are easy for individual patients to understand to support informed decision making
- This criterion cross references to Criterion 1.7.1 Patient health records, Criterion 1.2.4 Costs associated with care initiated by the practice and Criterion 4.2.1 Confidentiality and privacy of health information.
Appropriate and sufficient information
It is important that patients have sufficient information to make appropriate decisions about their own healthcare. Information about the purpose, importance, benefits, risks and possible costs of proposed investigations, referrals or treatments needs to be tailored to the individual patient’s needs.
This information needs to be delivered in appropriate language and format – avoid the use of jargon or complicated terms – and where necessary include clear diagrams and written information. Consideration also needs to be given to the patient’s physical, visual and/or cognitive capacities, which may impact on their ability to understand the information, make decisions or provide consent.
Consideration needs to be given to the way information is communicated in relation to potentially sensitive investigations or tests (eg. sexually transmissible infections, blood borne viruses, fetal abnormality screening and pregnancy tests).
If working with patients from a different cultural background, special care is needed to ensure there is a shared understanding between the GP and the patient about the information provided.
In situations where patients are dependent on a third party for their ongoing care it is important to ensure all appropriate information is also provided to carers.
Although it is not necessary for the practice to know the exact costs of referred services, patients need to be advised of the potential for out-of-pocket costs before a referral is made. Where patients require exact information about the costs of referred services they can be invited to make their own enquiries. If the patient indicates that such costs pose a barrier to the suggested referral, alternatives may need to be discussed (eg. referral to public services).
Informed consent also applies to any research being undertaken by a member of the practice team, in accordance with the NHMRC ‘National statement on ethical conduct in human research’ (www.nhmrc.gov.au/publications/synopses/e72syn.htm).
Patient-doctor collaboration
The Australian Commission on Safety and Quality in Health Care encourages patients to actively discuss with their healthcare provider the purpose, importance, benefits and risks associated with their care. The publication ‘10 tips for safer healthcare’ is available at www.health.gov.au/internet/safety/ publishing.nsf/content/10-tips and provides further detail. Practices may find it useful to refer patients to this information to help create an understanding of shared responsibility between the patient and the practice.
If a GP is aware that a patient has decided not to follow the advice of the GP after receiving sufficient information to make an informed decision about their care, their refusal and their awareness of its implications, as discussed with the GP, should be documented in the patient health record (see Criterion 2.1.1 Respectful and culturally appropriate care).
Medicines
The provision of information about medicines and medicine safety including consumer medicines information (CMI) may assist patients to make informed decisions about their medicines. Consumer medicines information provides an online version of leaflets produced by pharmaceutical companies and is available to the general public at www.nps.org.au/consumers.
Gps could offer to discuss any issues about medicines that could be confusing to patients and could also usefully suggest that patients obtain information about their medicines from their pharmacist.