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ACOG Issues Patient-Centric Committee Opinions

Last Updated on Wednesday, August 03, 2011

The American College of Obstetricians and Gynecologists (ACOG) recently issued a series of what they call “Committee Opinions.”  These papers do not dictate an exclusive course of action, but provide “emerging concepts” by 55,000 board-certified OB/GYN physicians.  I’m not sure how “emerging” this concept is, but we certainly encourage all health care providers to treat their patients as partners, incorporating these recommendations into their practices.

We believe that many preeclampsia outcomes could be improved with greater emphasis on patient-provider partnerships. This approach is a central strategy in patient safety, reducing near misses and medical errors amongst other benefits. A “partnership” means you are truly engaged in your prenatal care and feel like you and your health care provider have open communication, a “good working relationship” and that, while they may know preeclampsia best, you know your body best and thus bring critical data to the exam table.

Your compliance with home monitoring of your blood pressure or keeping more frequent prenatal appointments also indicate that you and your provider understand and trust one another. Finally, if your baby must be delivered early, an often anxiety-provoking situation, if a trusted patient-provider relationship exists, this decision will be met with greater confidence and less fear.

In addition, any medical decisions are not a fait accompli by the provider, but a shared decision process that incorporates medical evidence, the provider’s recommendation and a patient’s personal preferences, especially in a pregnancy situation where a mother must consider both her and her baby’s health.

For the pregnant woman, these ACOG Committee Opinions can be helpful in examining the patient’s role in an effective partnership. Read our quick list of 10 Things You Can Do to Be a Partner with Your Health Care Provider or read on for more indepth look at these concepts.

Partnering with Patients to Improve Safety (Committee Opinion No. 490) is a description for building a positive physician-patient partnership through attention to information sharing, health literacy, informed consent and follow up. Takeaway message:  Doctors expect patients to have a role in their care!

Patients are responsible for providing their physicians with the information that is necessary to reach an accurate diagnosis or treatment plan. In practical terms, this means using the “Ask Me 3” formula  as follows:

  1. What is my primary problem?
  2. What do I need to do?
  3. Why is it important for me to do this?

(Questions developed by the Partnership for Clear Health Communication at the National Patient Safety Foundation and adopted by the World Health Organization. Available at: http://www.npsf.org/askme3)

Other staff, such as nurses and physician assistants, play an important role in ensuring appropriate communication especially since today’s health care environment demands increased physician productivity and less time with each patient. Takeaway message: seek an effective relationship with all your care providers.

The paper concludes that partnership with patients to improve communication results in increased patient satisfaction, increased diagnostic accuracy, enhanced adherence to therapeutic recommendations, and improved quality of care. We couldn’t agree more.

Other Committee Opinions including Effective Patient-Physician Communication (No. 492) also convey specific recommendations. As the patient part of the partnership, you can support many of these proven strategies:

  • Write down your questions in preparation for appointments. If you didn’t have a chance before you arrived, skip the 3-month old magazines in the waiting room and use your time to jot down your questions and concerns.
  • Repeat back in your own words any instructions or new information that was provided to you, confirming that you understand (or don’t!) what has been explained.
  • Bring a relative or close friend to your prenatal appointments to help you understand health information and to help advocate for you if you and your provider are not communicating effectively.
  • Ask for written materials to reinforce oral explanations. If they don’t have good descriptions about preeclampsia, encourage them to order our free materials.
  • Expect timely results and do not assume that results are normal if you are not informed in a reasonable time frame. Test results are important for preeclampsia diagnosis and management. Because preeclampsia can progress very quickly, you should know exactly when to expect results and you should not delay following up if they are not communicated when expected. 

Health Literacy (Committee Opinion No. 491), is also recognized as an important contributor to improving patient safety and outcomes.  50% of adults are estimated to have marginal to low health literacy skills. Multiple studies have demonstrated the seriousness of the problem, despite the fact that our current health care system assumes a high level of health literacy. Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.  Most importantly, years of education and reading ability do not necessarily translate into adequate health literacy.

We are increasingly expecting more “engagement” from patients in their own health care; this burden of knowledge and decision-making can be overwhelming to you if you’re faced with medical jargon, an overabundance of information or a lack of a support system to understand and process it all. What can patients do? Ask questions! Make sure you leave understanding what was explained and have written materials – either your notes or printed materials – reinforcing the message(s).

Did you and your health care provider have a “partnership”?

If not, what more can you do? What more can they do? Consider printing out this article and taking it to your health care providers. If you think they’re doing a good job as your partner, thank them. If they could do better, consider providing a few specific suggestions and also take responsibility for your own part in this very important relationship.

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