Person-centred care is described as: an approach to the planning, delivery and evaluation of health care that is founded on mutually beneficial partnerships among clinicians and patients. Person-centred care is respectful of, and responsive to, the preferences, needs and values of patients and consumers. Key dimensions of person-centred care include respect, emotional support, physical comfort, information and communication, continuity and transition, care coordination, involvement of carers and family, and access to care.
VARTA’s Guidance on Person-Centred Care
This Guidance has been prepared by VARTA in response to Recommendation 20 of the Final Report of the Gorton Review of Assisted Reproductive Treatment. The Review found that the overarching message from people with experience of fertility treatment was that ‘one size does not fit all’ and that there was a clear need for comprehensive information and good communication to allow people to make the best choices for themselves and their families. It also found that patient support and inclusive practices are critical components of person-centred care, and that services should be accessible and responsive to the needs of all people. To address these matters, the Review recommended that the Regulator develop guidance for person-centred care in ART. In 2019 the then Minister for Health asked VARTA to produce guidance.
VARTA is grateful to all the people who participated in the consultation processes to produce this guidance. To provide feedback, please email email@example.com.
To assist with the implementation of the Guidance, clinics may find the following resources useful. VARTA is keen to build on these and welcome ideas for additional resources. Please contact us at firstname.lastname@example.org if you have a suggestion for other resources to include here!
Tailored experience map example
Patients value having a clear roadmap of their treatment options and the journey ahead. One example of an interactive and tailored experience map of key stages developed by Rowboat Human-Centred Design is available here.
Surveys focusing on patient care
VARTA is working with Monash University to develop a survey focused on person-centred care in Australia. Further information about this project and ways for clinics to be involved will be available on this webpage shortly.
Other resources which can help clinics develop appropriate surveys of patients’ experience include:
- CARE Patient Feedback Measure
- Patient-centeredness questionnaire on infertility (PCQ-infertility) survey
- Quality from the patients’ perspective of in vitro fertilization treatment (QPP-IVF) survey
Self-assessment tool to review patient management practices and implement the Guidance
VARTA encourages clinics to review the Guidance and use the self-assessment tools to benchmark how they are tracking currently, and where they see strengths, opportunities and challenges. Clinics wanting to quickly review their person-centred care policies and practices can achieve that by using the abbreviated self-assessment tool. Those wanting to more comprehensively review their current practices and to strive for a more person-centred practice in the longer term should consider using the full self-assessment resource.
Resources to support LGBTQIA+ patient inclusion
The Guidance highlights the importance of effective and inclusive communication with key patient groups, including members of the LGBTQIA+ community. VARTA encourages clinics to:
- benchmark and measure their LGBTQIA+ inclusion annually via the free National Health + Wellbeing Equality Index.
- measure LGBTQIA+ patient experience annually through the HWEI client surveys, to assess discrepancies between expectation and experience of care.
Clinics wishing to partner with an LGBTQIA+ health service can contact:
ART providers may also wish to be accredited against the Rainbow Tick standards developed by La Trobe University. This is a national accreditation program for organisations that are committed to safe and inclusive practice and service delivery for LGBTQIA+ people and is audited by Quality Innovation Performance.
Protocol for communicating bad news
VARTA encourages clinics to consider how adverse outcomes are communicated to patients and to explore opportunities for improving processes and staff training to best support patients for these situations. While there is no resource which is specific to the ART setting, protocols developed for other areas of medicine can provide useful insights. For example, this six-step protocol has been developed for delivering bad news. Read more here.
Shared decision making and decision aids to assist patients
Shared decision making is a process by which decisions are made by the patient (and their partner) and the treating specialist using the best available evidence and patients’ informed preferences. The effectiveness of an organisation’s approach to shared decision making should be reviewed, monitored and adapted as part of a continuous quality improvement cycle with further improvements considered on an ongoing basis.
Decision aids can be valuable for supporting patients to understand their options, including the potential benefits and harms or disadvantages. This can assist with informed decision-making. An effective decision aid identifies the decision to be made, provides information about the options, sets out the pros and cons for each option (including best available evidence) and assists the patient to clarify their values for each option.
There are a range of valuable tools and resources about shared decision making in healthcare developed by La Trobe University here.
The Ottawa Hospital Research Institute (OHRI) has developed Personal Decision Guides designed for health-related and social decisions to help people identify their decision making needs, plan the next steps, track their progress, and share their views about the decision. While these guides are not specific to fertility treatment, they can be a useful starting point for patient discussions and decisions about treatment. The OHRI also maintains a global inventory of decision aids that meet their minimum standards.
The Ask Share Know GP network have also developed a range of resources which provide useful examples of decision aids, such as the guide to Making decisions about screening for Down syndrome in pregnancy. It provides context, options, a summary of key information to aid decisions, a personal worksheet, questions to ask a health professional and details of further information and support services.
- VARTA’s Conditions of Registration
- RTAC Code of Practice
- The National Health and Medical Research Council (NHMRC) Ethical guidelines on the use of assisted reproductive technology
- Australian Commission on Safety and Quality in Health Care: National Safety and Quality Health Service (NSQHS) Standards
- Australian Charter of Healthcare Rights
- Safer Care Victoria’s Partnering in healthcare framework
- European Fertility Society Fertility Patients Care Guidance