Publications and Resources

Learning from Early Adopters: Improving Patient Safety Through Informed Consent in Limited English Proficiency/Low-Literacy Populations

Purpose

This project will investigate the barriers to, and strategies for, successfully implementing the NQF-endorsed Safe Practice 10, "ask each patient or legal surrogate to recount what he or she has been told during the informed consent discussion." The goal of the project is to evaluate the experiences of early adopters of the practice and provide guidance to providers and plans that wish to improve patient safety by implementing this practice. The project will focus on patients undergoing non-investigational, invasive procedures in either inpatient or outpatient settings and be applicable to all patients, but have a particular emphasis on providers serving large limited English proficiency (LEP) and low-literacy populations.

Background

Fully informed consent to medical interventions is critical not only to ensure meaningful patient participation in decisionmaking, but also to act as a safeguard against unintended harm to the patient if an error occurs. Asking patients to recount what they consented to is one way to assure that informed consent has occurred. Although this practice was recently endorsed by the NQF as a "safe practice," its use is not yet widespread. Implementing this practice is especially challenging for providers serving low-literacy and LEP populations, yet these are precisely the patients at greatest risk of being harmed or incompletely informed.

Scope

The study will focus on the experiences of three collaborating providers who have implemented the NQF practice or a similar one and serve large low-literacy/LEP populations. The project will include:

  • Detailed self-assessments by each collaborating provider regarding their experiences in implementing the practice with their low-literacy/LEP patients.
  • Interviews with "non-adopting" providers that have not implemented this practice.
  • An analytic case study describing and comparing the collaborators’ experiences.
  • An interactive workshop held in the fall of 2004 to discuss and expand on the experiences that includes the collaborators, other providers, and consumer and purchaser representatives.

Funding

This project is supported by a grant from The Commonwealth Fund.

For more information, please contact Helen Wu, MSc. at 202.783.1300 or email at hwu@qualityforum.org.