Getting Started In Patient Priorities Aligned Decision-Making
Frame clinic visits around patients’ health priorities
Review the patient’s health priorities template. Make sure the information is accurate and current.
Acknowledge and reinforce the information when other members of the team did the invitation or health priorities identification.
Initial visit after patient completes their health priorities template:
“You identified the health outcome goals that matter most to you, what you think is working well about your current health care, and what you find difficult or unhelpful. I see that the outcomes that matter most to you are (health outcome goals). You think that (care items that patient finds helpful and doable) are helpful and doable while (care items that patient finds difficult or unhelpful) are difficult or unhelpful and you want to discuss what we can do about them. Did I get that right? Is there anything you want to add and change?”
In follow up visits:
“I want to continue to focus on what is most important to you. Let’s start by reviewing what you previously shared about what mattered most to you about your health and healthcare. You had said (health outcome goal) matters most to you and (health care items that patient finds helpful and doable) are helpful and doable while (care items that patient finds difficult or unhelpful) are difficult or unhelpful. Is there anything you want to add and change?”
“I understand you met with our care coordinator (or other Facilitator). I see that the outcomes that matter most to you are watching your grandchildren after school and volunteering in the library handling books a couple of times each week.” “You think that exercise, physical therapy, bloodwork, imaging, and acetaminophen are helpful and doable while taking so many medications, using the CPAP, and doing fingersticks are difficult or unhelpful and you want to discuss what we can do about them. Did I get that right?”
Mrs. B: “Yes, that is correct.”
Acknowledge that health priorities may change. Discuss that this will be an ongoing process, during which you will review their health outcome goals and healthcare preferences and use them in making decisions.
“Don’t worry, I know that your health priorities may change. We will check in regularly about them. Knowing what matters to you helps me recommend the best care for you at every point. We will work together to see what works best for you.”
This will simplify the visit while focusing on what matters most to the patient.
Ask the patient to fill in:
Your most important health goal is (insert most important health goal). From among the symptoms or health problems, burdensome health tasks or medications, fill in The One Thing you most want to focus on so that you can do (insert most important health goal) more often or more easily.
“This is what I am hearing from what we have discussed…”
“To make sure that we are on the same page about what we discussed and agreed on, could you please tell me what we discussed in your own words?”