The story of Michael Skolnik drove home the importance of informed consent and the need to move from informed consent to shared decision making and having meaningful conversations with families. As noted, informed consent is written at the level of scientific journals! Time taken to have meaningful conversations to engage patients in developing their plan of care can can prevent unnecessary procedures that are life altering in so many ways. Shared decision-making incorporates the elements of an informed consent; moreover, it includes identifying patients’ needs, preferences, values and goals, as well as discussing uncertainties and costs. It is a two-way conversation between patients and their health care providers. Time must be spent to engage with families and not see the consent process as one more thing to do on the to do list of our busy days as we are asking patients and families to make really serious decisions that impact their lives. Empower patients to feel that it is okay to ask us questions, to be unsure, to ask for a second opinion and to even include other family members in this decision making process. This supports our patients being drivers of their health decisions.
It is imperative that health care place patients at the center of all we do, so that our focus will be on ensuring patient safety and quality. By doing, this greater focus may be placed on designing systems that support quality and safety such as employing human factor engineering principles that will mitigate and reduce risks of errors as well as remove a culture of blame that leaves many health care workers demoralized.