What is best practice when conducting decision-making capacity assessment of patients in the hospital?

Abstract

Decision-making capacity in health care is central to optimise person-centred care. Impaired decision-making capacity is prevalent in hospital settings, leading to suboptimal care. This scoping review aimed to summarise current literature on practice and assessment of decision-making capacity in hospital settings with a focus on speech and language pathology. Four databases (Psychinfo, CINAHL, Scopus, and Medline) were searched for the period 2010 to March 2020, using search terms related to “assessment”, “decision-making capacity” and “patient”. Fifteen studies were included in the final analysis. Findings indicated doctors commonly assessed decisionmaking capacity with an informal patient interview with error rates up to 58%. Decision-making capacity assessments also rely heavily on patient communication abilities. Health care services should formalise decision-making capacity assessments and provide training to support improved assessment practices. Communication assistance should also be provided to patients, especially those with complex communication needs requiring speech and language pathology services.

Keywords:

• Decisionmaking Capacity
• Delivery of Health Care
• Health Care Professionals
• Speech Language Pathology

Additional information

Notes on contributors

Tracy Sheldrick

Tracy Sheldrick is Manager of Speech Pathology and Audiology at Bendigo Health in Australia currently studying Masters of Healthcare Leadership through Southern Cross University.

Alex Barwick

Dr Alex Barwick is a podiatrist and lecturer at Southern Cross University.

Paul Butterworth

Dr Paul Butterworth works in the School of Health and Human Sciences, Southern Cross University.

Nasim Salehi

Dr Nasim Salehi works in the School of Health and Human Sciences, Southern Cross University.