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Thursday, August 25, 2011

A really informative consent

I started reading Safe Patients, Smart Hospitalson the plane back to Boston yesterday until my battery died.  I'm still not done, so I'll save the review to a later post.  The author, Peter Provenost quotes statistics that I found rather disturbing.

One study concluded that there were 1.7 errors per patient day in America's ICUs.  Of these errors, 29 percent could have caused significant harm or death.


He points out that the average stay is about 3 days.  That means just over 5 errors.  The chance of leaving the ICU without suffering from such an error means that you need need to succeed on five rolls on a pair of dice without rolling a 2, 3, 4 or 5.  You'll manage that less than 1 time in five (about 18% of the time).

Many of us have seen informed consent forms.  They list the significant risks of a surgical or diagnostic procedure.  But what they don't do is list the actual chances associated with that risk.

What if, on being asked to consent to a procedure you were told:

There is a significant risk of ____.  In similar procedures performed (by your surgeon/at this institition), patients were X% likely to incur this risk.  This is [significantly][above|below] the national average of Y% in similar institutions and procedures.

Even better yet, it could use one of those pictures like Energy Star uses.

Wouldn't that actually say something relevant to patients and incent institutions and providers to do better?