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Reconceptualizing the Informed Consent Process at Eight Innovative Hospitals

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Background: Hospitals struggle to make informed consent processes understandable for patients. Amid "promising practices" for patient-centered communication, there is debate over how to handle consent processes for patients with limited literacy, health literacy, or English proficiency.

Methods: In 2005, the American Medical Association's Ethical Force Program and the American Hospital Association's Health Research and Educational Trust conducted eight site visits to determine how hospitals use patient-centered communication to improve health care.

Findings: Each of the eight hospitals noted a number of problems in the traditional informed consent process, sparking a broad set of efforts to improve. Disagreements about how to do so often focused on whether to attempt simplification and translation of informed consent documents. Specifically, hospital leaders held widely divergent views on legal and accreditation requirements for these forms. However, several other promising practices met with widespread approval.

Discussion: Overall, informed consent in the eight hospitals was becoming more patient centered and integrated. The significant variation across states makes it difficult to provide overarching policy guidance on the informed consent process. Greater regulatory clarity is needed so that policies and practices can be more closely aligned with the ethical foundations of informed consent.

Document Type: Research Article

Publication date: 2008-03-01

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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