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How do you include patient values in care decisions?

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How do you include patient values in care decisions? This is a crucial question for patient advocates, who aim to empower and support patients in navigating the complex and often overwhelming health care system. Patient values are the preferences, beliefs, goals, and expectations that patients have about their health and well-being, and they may vary depending on their culture, background, religion, lifestyle, and personal experiences. Including patient values in care decisions means respecting and honoring the patient's autonomy, dignity, and voice, and ensuring that they are informed, involved, and supported throughout the process. In this article, we will explore some strategies and tools for including patient values in care decisions, and how they can benefit both patients and health care providers.

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Visible patient preferences:

Displaying individual patient preferences prominently, such as on a whiteboard, keeps the whole care team aligned with what matters most to the patient. It's a simple way to ensure personalized care.
Assess cultural context:

Taking the time to understand a patient's cultural background can greatly influence the care provided. It fosters trust and ensures that treatment plans are respectful and appropriate.

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Dr. Kamila Alammar

PhD, MSN, PGdip, BSN| Chief Nursing…
Citadel Rafols

MSN, RN, CMSRN

1 Ask and listen

The first step to include patient values in care decisions is to ask and listen to the patient. This may seem obvious, but sometimes health care providers may assume that they know what the patient wants or needs, or may overlook the patient's perspective in favor of clinical guidelines or protocols. Asking and listening to the patient means using open-ended questions, active listening skills, and empathic responses to elicit the patient's views, concerns, hopes, and fears. It also means acknowledging and validating the patient's emotions, and creating a safe and trusting space for the patient to express themselves freely.

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Citadel Rafols

MSN, RN, CMSRN
(已编辑)
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In my experience, we ask our patients on admission and at least every shift, “What matters most to them” or “What is the most important to them,” which can be their goal or care preferences. The responses that we got varies. Ex: bible in the room, a “hot” tea for breakfast, female care only, manage pain, and to know whats going on and what makes me sick. We write the patient’s response on the whiteboard for every team members to see. Patients are allowed to write the response themselves. We honor the things that matter most to them and incorporate them in the plan of care. Knowing what matters to the patient enables the team to individualize the care and partner with the patient for better outcomes.

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2 Educate and inform

The second step to include patient values in care decisions is to educate and inform the patient. This means providing the patient with accurate, relevant, and understandable information about their condition, diagnosis, prognosis, treatment options, benefits, risks, and outcomes. It also means explaining the evidence and rationale behind the recommendations, and clarifying any doubts or misconceptions that the patient may have. Educating and informing the patient means using plain language, visual aids, and teach-back methods to ensure that the patient comprehends the information, and checking for their consent and agreement before proceeding.

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Phill Tsingos CN

Nurse Phill - Helping Care for All Australians in Need
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Research what the patients goals are to find how we can help them achieve those goals. No such thing as smooth sailing. There are always challenges to overcome and being persistent and disciplined is key to making a patient's goal successful.

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3 Collaborate and negotiate

The third step to include patient values in care decisions is to collaborate and negotiate with the patient. This means involving the patient as an equal partner in the decision-making process, and respecting their right to accept or decline any intervention or service. It also means exploring the patient's values, goals, and preferences, and how they align or conflict with the available options. Collaborating and negotiating with the patient means finding a balance between the patient's wishes and the best evidence, and offering guidance and support without coercion or judgment.

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4 Document and communicate

The fourth step to include patient values in care decisions is to document and communicate the patient's values and decisions. This means recording the patient's values, preferences, goals, and choices in their medical record, and sharing them with other health care providers who are involved in their care. It also means ensuring that the patient has access to their own information, and that they can update or change their values or decisions at any time. Documenting and communicating the patient's values and decisions means respecting their privacy and confidentiality, and facilitating their continuity and coordination of care.

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5 Evaluate and follow up

The fifth step to include patient values in care decisions is to evaluate and follow up with the patient. This means monitoring the patient's progress, outcomes, and satisfaction with the care they receive, and soliciting their feedback and input. It also means reviewing the patient's values and decisions periodically, and adjusting them as needed based on the patient's changing circumstances, preferences, or goals. Evaluating and following up with the patient means measuring the impact and quality of the care, and ensuring that the patient's values are honored and met.

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6 Advocate and empower

The sixth step to include patient values in care decisions is to advocate and empower the patient. This means supporting the patient's rights, interests, and needs, and defending them from any barriers, biases, or discrimination that may affect their care. It also means empowering the patient to take an active role in their own health and well-being, and to access the resources and services that they need. Advocating and empowering the patient means fostering their self-efficacy, confidence, and resilience, and enhancing their quality of life.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Dr. Kamila Alammar

PhD, MSN, PGdip, BSN| Chief Nursing Officer | Assistant professor| CBAHI Surveyor| Researcher| Learning and development| Assessment | Talent acquisition | Healthcare leader | Hospital preparation and commissioning
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Assess and understand. Assessing the patients backgrounds, believes, and understanding his/her cultures as providing the care that built based on best evidence requires close assessment and attention to the patients.

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How do you include patient values in care decisions?

1

2

3

4

5

6

7

1 Ask and listen

2 Educate and inform

3 Collaborate and negotiate

4 Document and communicate

5 Evaluate and follow up

6 Advocate and empower

7 Here’s what else to consider

Patient Advocacy

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How do you include patient values in care decisions?

1

2

3

4

5

6

7

1 Ask and listen

2 Educate and inform

3 Collaborate and negotiate

4 Document and communicate

5 Evaluate and follow up

6 Advocate and empower

7 Here’s what else to consider

Patient Advocacy

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