Action 8.3

Clinicians use organisational processes from the Partnering with Consumers Standard when recognising and responding to acute deterioration to:

a. Actively involve patients in their own care

b. Meet the patient’s information needs

c. Share decision-making

Intent

Clinicians understand the systems for partnering with consumers and use them when recognising and responding to acute deterioration.

Reflective questions

What processes from the Partnering with Consumers Standard do clinicians use to involve patients in planning and making decisions about recognising and responding to acute deterioration?

How does the health service organisation collect feedback from patients about information provided on recognising and responding to acute deterioration?

Key tasks

  • Review strategies in the Partnering with Consumers Standard to inform the implementation of actions in the Recognising and Responding to Acute Deterioration Standard
  • Provide information to patients about recognition and response systems tailored to their specific needs and level of health literacy.

Strategies for improvement

Hospitals

The Partnering with Consumers Standard has specific actions (Actions 2.32.10) relating to health service organisations’ processes for involving patients in their own care, shared decision making, informed consent and effective communication.

Seek consent for non-urgent treatment in line with policies that reflect relevant legislation, as outlined in the guidance for the Partnering with Consumers Standard.

Although clinicians are not legally required to seek consent from substitute decision-makers for urgent treatment, it is recommended that they consult them, if possible, to avoid starting treatment that is contrary to a person’s expressed wishes.

If patients have the capacity to take part in the decision-making process when an episode of acute deterioration occurs, ensure that clinicians use the processes for involving patients in their own care, shared decision making, and meeting patients’ information needs that are described in the Partnering with Consumers Standard.

If patients do not have the capacity to participate and do not have a documented advance care plan, but a substitute decision-maker is available, ensure that clinicians seek information from the substitute decision-maker about the patient’s previously expressed preferences for care. Use this information to decide how to respond.

When patients lack the capacity to take part in decision-making and a substitute decision-maker is not available, clinicians should decide how to respond to acute clinical deterioration using documented information such as current advance care plans, goals of care, treatment-limiting orders, and information from carers and family.

If the treating team is responding to an acute deterioration in a person’s mental state, and the person is refusing treatment or is otherwise unable to consent to treatment, decide if the person will be treated as an involuntary patient under mental health legislation. Provide access to legal advice for the workforce to ensure that they practise within this legislation. When a person is an involuntary patient under mental health legislation, members of the workforce should still seek to involve the person in decision-making about their care as much as possible, consistent with maintaining safety.

Provide information to patients about recognition and response systems in a format that is easily understood and meaningful, and ensure that patients are given the opportunity to ask questions. Ensure that the information for patients is current and that clinicians have ready access to it.

Day Procedure Services

The Partnering with Consumers Standard has specific actions (Actions 2.32.10) relating to health service organisations’ processes for involving patients in their own care, shared decision making, informed consent and effective communication.

Seek consent for non-urgent treatment in line with policies that reflect relevant legislation, as outlined in the guidance for the Partnering with Consumers Standard.

Although clinicians are not legally required to seek consent from substitute decision-makers for urgent treatment, it is recommended that they consult with them, if possible, to avoid starting treatment that is contrary to a person’s expressed wishes.

If patients have the capacity to take part in the decision-making process when an episode of acute deterioration occurs, ensure that clinicians use the processes for involving patients in their own care, shared decision making, and meeting patients’ information needs that are described in the Partnering with Consumers Standard.

If patients do not have the capacity to participate and do not have a documented advance care plan, but a substitute decision-maker is available, ensure that clinicians seek information from the substitute decision-maker about the patient’s previously expressed preferences for care. Use this information to decide how to respond.

When patients lack the capacity to take part in decision-making and a substitute decision-maker is not available, clinicians should determine how to respond to acute clinical deterioration using documented information such as current advance care plans, goals of care, treatment-limiting orders, and information from carers and family.

Provide information to patients about recognition and response systems in a format that is easily understood and meaningful, and ensure that patients are given the opportunity to ask questions. Ensure that the information for patients is current and that clinicians have ready access to it.

Examples of evidence

Select only examples currently in use:

  • Policy documents about gaining patient consent or consulting with substitute decision-makers for treatment in response to acute deterioration
  • Observation of clinicians’ practice that shows use of the health service organisation’s processes for partnering with consumers
  • Records of interviews with clinicians that show that they understanding the health service organisation’s processes for partnering with consumers
  • Information resources for patients, carers and families about recognition and response systems
  • Examples of clinical documentation of shared decision making in relation to recognising and responding to acute deterioration (such as advance care plans; documented goals of care; comprehensive care plans; and documented discussions with patients, carers and families).
MPS & Small Hospitals

The Partnering with Consumers Standard has specific actions (Actions 2.32.10) relating to health service organisations’ processes for involving patients in their own care, shared decision making, informed consent and effective communication.

Seek consent for non-urgent treatment in line with policies that reflect relevant legislation, as outlined in the guidance for the Partnering with Consumers Standard.

Although clinicians are not legally required to seek consent from substitute decision-makers for urgent treatment, it is recommended that they consult them, if possible, to avoid starting treatment that is contrary to a person’s expressed wishes.

If patients have the capacity to take part in the decision-making process when an episode of acute deterioration occurs, ensure that clinicians use the processes for involving patients in their own care, shared decision making, and meeting patients’ information needs that are described in the Partnering with Consumers Standard.

If patients do not have the capacity to participate and do not have a documented advance care plan, but a substitute decision-maker is available, ensure that clinicians seek information from the substitute decision-maker about the patient’s previously expressed preferences for care. Use this information to decide how to respond.

When patients lack the capacity to take part in decision-making and a substitute decision-maker is not available, clinicians should determine how to respond to acute clinical deterioration using documented information such as current advance care plans, goals of care, treatment-limiting orders, and information from carers and family.

If the treating team is responding to an acute deterioration in a person’s mental state, and the person is refusing treatment or is otherwise unable to consent to treatment, decide if the person will be treated as an involuntary patient under mental health legislation. Provide access to legal advice for the workforce to ensure that they practise within this legislation. When a person is an involuntary patient under mental health legislation, members of the workforce should still seek to involve the person in decision-making about their care as much as possible, consistent with maintaining safety.

Provide information to patients about recognition and response systems in a format that is easily understood and meaningful, and ensure that patients are given the opportunity to ask questions. Ensure that the information for patients is current and that clinicians have ready access to it.

Last updated 30th May, 2018 at 01:40am
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