Wednesday, April 3, 2013

Consumer Health Forum Workshops - Informed Consent & Quality Use of Medicines in Hospitals, March 2013

On the 25 and 26 of March, the Consumer Health Forum held two workshops; one on informed consent and the other on quality use of medicines in hospitals. Joanne Baumgartner, a HCCA member, attended on both days. Joanne completed this report to share with other consumers.

Workshop 1:  Informed Consent

This followed on from a previous workshop on Informed Financial Consent and discussion was focussed on the forms signed by consumers prior to their procedure or operation.

The general consensus was that patients/consumers need to be provided with substantially more information regarding
  • The procedure itself;
  • Who would conduct the procedure;
  • The likely outcomes;
  • Risks involved;
  • Discharge and rehabilitation processes;
  • Support options available, e.g. supported accommodation 
Consumers felt that these issues were not properly considered by health professionals and were rarely, if ever, discussed. In particular, rural consumers are often transferred to major city hospitals without their Informed Consent paperwork and are expected to simply accept whatever procedures were carried out at those hospitals. There was also no access to adequate post-discharge care in rural areas.

Treatment of mental health consumers was also an area of concern with regard to consent, as consumers felt that unnecessary force was being used too often with Involuntary Patients. This was considered to be an abuse of human rights. New procedures and protocols are required to ensure that all consumers are treated with dignity and respect.

Papers were presented by a range of health care professionals, including medical specialists and university researchers in the area as well as the Health Care Complaints Commissioner. These professionals agreed with consumers that more information needed to be provided to patients during the consent process. The suggestion was made that both consumers and clinicians could be required to check boxes indicating that sufficient information had been provided before signing off on a procedure.

Workshop 2: Quality Use of Medicines in Hospitals

This workshop specifically focussed on the lack of continuity of care and poor record keeping with regard to prescriptions in hospitals. The gaps between the emergency department and inpatient wards as well as poor communication on discharge were discussed. Consumers identified one of the main issues to be that many consumers, especially the elderly, did not have adequate knowledge or understanding of their medications to keep track of their own prescriptions.

A study has found that patients experienced fewer adverse effects from medications when they were able to keep them in a cabinet drawer by their bed and able to follow their medication regime on their own. However, consumers are rarely afforded this level of trust by clinicians with regard to administering their own medications.

Consumers also agreed that the use of generic medications is often confusing in hospitals, as it is hard for them to check whether they are being given the correct medicine and dosage. A hospital pharmacist explained to the group that hospitals were now using generic medications to save money, making it unlikely that consumers would receive the medications that they were used to at home. In this case, hospital staff need to ensure that consumers are told which medication is which to help them keep track of what they are taking.

Five ‘Rights’ for Quality Use of Medicines were identified as follows:
·         Right Patient
·         Right Drug
·         Right Dose
·         Right Route
·         Right Time

The workshop attendees agreed that all consumers have the right to receive information regarding their medications in an understandable format, rather than the many pages of unrelated information that is currently provided.

Joanne Baumgartner
HCCA Member and Consumer Representative 

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