Risk-Benefit Data Does Not Always Lead To Informed Decision-Making

From the 15 April 2011 Medical News Today article

Giving patients data about the risks and benefits of a medical intervention is not always helpful and may even lead them to irrational decisions, according to an article in the Hastings Center Report. That finding calls into question whether it is essential to disclose quantitative data to patients to help them make informed decisions. An accompanying commentary calls for experimental evidence to determine the best way to provide information to patients.

The analyses come at a time when many patient advocates and others are embracing the “quantitative imperative” – the obligation to disclose risk-related data to patients to ensure informed consent and promote shared decision-making. Because patients often do not get information about all of their options by talking to their health care providers, decision aids – pamphlets, videos, and computer programs – increasingly are being used to convey such data more comprehensively. There are more than 500 decision aids and more than 55 randomized controlled trials studying their impact. A recent review concluded that decision aids increase patient knowledge and the feeling of being informed while decreasing indecision and passivity. ….

…However, disclosure of quantitative data can backfire. ..

…One problem is that more than half of adults have significant difficulty understanding or applying probabilistic and mathematical concepts. National surveys suggest that at least 22 percent of adults have only the most basic quantitative skills, such as counting, while another 33 percent fare only slightly better and are able to do simple arithmetic.

But even people who have a good grasp of probability and math are prone to biases in how they interpret data on risks, Schwartz says, citing 30 years of psychology literature. They may give exaggerated importance to small risks or, conversely, exhibit “optimism bias” and exaggerate the chance that they will be in the “lucky” group. …

An abstract of the report (Questioning the Quantitative Imperative: Decision Aids, Prevention, and the Ethics of Disclosure)
may be found here.

For suggestions on how to get this article for free or at low cost, click here.

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Compassion, Not Sanctions, Is Best Response To Workplace Anger

From the 15 April 2011 Medical News Today article

Challenging traditional views of workplace anger, a new article by a Temple University Fox School of Business professor suggests that even intense emotional outbursts can prove beneficial if responded to with compassion.

Dr. Deanna Geddes, chair of the Fox School’s Human Resource Management Department, argues that more supportive responses by managers and co-workers after displays of deviant anger can promote positive change at work, while sanctioning or doing nothing does not.

“The trouble with sanctions: Organizational responses to deviant anger displays at work,” co-authored with University of Baltimore’s Dr. Lisa T. Stickney, states that “when companies choose to sanction organizational members expressing deviant anger, these actions may divert attention and resources from correcting the initial, anger-provoking event that triggered the employee’s emotional outburst.”…

(Obama Administration) Partnerships for Patients: Better Care, Lower Costs

From the HealthCare.gov Web page

Doctors, nurses and other health care providers in America work incredibly hard every day to deliver the best care possible to their patients.  Unfortunately, an alarming number of patients are harmed by medical mistakes in the health care system and far too many die prematurely as a result.

The Obama Administration has launched the Partnership for Patients: Better Care, Lower Costs, a new public-private partnership that will help improve the quality, safety and affordability of health care for all Americans.  The Partnership for Patients brings together leaders of major hospitals, employers, health plans, physicians, nurses, and patient advocates along with State and Federal governments in a shared effort to make hospital care safer, more reliable, and less costly.  The Partnership will help save 60,000 lives by stopping millions of preventable injuries and complications in patient care over the next three years and has the potential to save up to $35 billion, including up to $10 billion for Medicare.  Over the next ten years, it could reduce costs to Medicare by about $50 billion and result in billions more in Medicaid savings.  Already, more than 500 hospitals, as well as physicians and nurses groups, consumer groups, and employers, have pledged their commitment to the new initiative.

The two goals of this new partnership are:

• Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010.  Achieving this goal would mean approximately 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years.

• Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010.  Achieving this goal would mean more than 1.6 million patients will recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge….

…To see which organizations have already joined the Partnership, visitpartnershippledge.HealthCare.gov. …

…For more information about the Partnership for Patients, visitwww.HealthCare.gov/center/programs/partnership.  For more information about the Community-based Care Transitions Program funding opportunity visit: www.cms.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1239313.

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• Improving Care for People with Medicare (whitehouse.gov)
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