I’d love to point suggest some changes the institution has to make regarding patient-centered treatment, evidence-based care, and the theory of preference-sensitive care. I understand that the code of medical ethics requires practitioners to exactingly respect the principle of informed consent. Practitioners must explain to the patients the medical facts accurately and then give professional opinions or make recommendations that can be used to address a certain medical condition as per the ‘good medical practice’ doctrine. The principle of shared decision making (SDM) has its basis on this premise. At this institution, we need to create an atmosphere that will allow patients to have a chance to assess options and make decisions according to personal values, and preferences.
SDM process has a chance of improving patient-centered care that can greatly improve the quality and efficacy of the healthcare delivery system. Patients will be better contented and will be comfortable with their choice. Furthermore, the increased involvement of patients in decision making, allowing them to take responsibility for their health in developing the healthcare delivery regimes will increase adherence and long-term results cut down extravagant expenditure. When patients engage in SDM, they tend to develop more realistic expectations of the health outcomes and the implications of the treatment.
The SDM strategy will also reduce patient-doctor tensions thus reduce the feeling by patients that the physician may have made a wrong treatment option particularly when the outcome is unsatisfactory or unanticipated. There will be reduced conflict when it comes to making critical decisions, the patients will have a greater knowledge of treatment alternatives, more patients will be decisive rather than undecided and there will be conformity between patient values and the available option.
Changes
The facility should give decision aids which will help patients to be able to clarify their preferences, attitudes, and values then can choose which one is important about the perceived benefits or damage. This institution must give patients evidence-based medical information regarding certain health conditions, the alternative, and the benefits related to them, the harms, and the probabilities of every alternative. We institution will need to develop decision guidance in the steps of a decision-making process, by sequential questions that profile the preferences of the patients. Physicians should give the patients truthful advice as per the best healthcare options available.
Barriers
Many obstacles will come in the way as we try to implement SDM policy. I highlighted just a few. Patients can easily opt for alternative treatments that are not evidence-based for various personal reasons. For instance, the cost, family decisions, the quality of life, uncertainty, and lifestyle.
Considering that physicians are usually held responsible for health-related issues from quality of care, patient adherence, to patient preference for non-standard treatment, physicians often fear lower reimbursements or low-quality ratings.
Competent adult patients often claim their right of choice even when they are making a decision that does not meet healthcare guidelines or and demand the physician to incorporate such choices in their treatment plans.
Recommendations
The process of SDM has to comply with the following aspects;
- Offer explicit information about medical conditions, treatment alternative, and the expected outcomes
- Provide the decision aid of tools to assist patients in identifying and articulating their values and priorities when making medical decisions and alternatives
- There has to be structured guidance to assist patients to integrate the clinical aspects and personal values to settle on informed treatment decision
The management of the institution should support the development of projects that increase knowledge and understanding of the SDM process. Even though the needs of the patients and the quality or the standard of healthcare delivery can conflict, physicians should take responsibility for giving sound advice based on the best available treatment options regardless of the consequences.