Authors' recommendations: Following this rich data collection drawn from the scientific, ethical and legal literature and consultation among Québec healthcare institutions and with the general public, INESSS, in collaboration with its partners representing healthcare professionals and users of health services, states the following findings. - LMI practices are a key element in the exercise of health service users' rights and have a direct impact on the clinical management and quality of care provided to a large share of the Québec population. - There is a lack of uniformity in LMI practices in Québec, which can lead to unequal opportunities for patients. - There are unmet needs in the area of LMI practices in Québec, which have been expressed by healthcare professionals and by members of the public. - There are issues regarding complementarity, with application of the AELC in particular. - Practices with "patients as partners" in the determination of LMI are emerging in several regions of Québec, and have been shown to be feasible and relevant. Given these findings, INESSS, with the support of its partners, concludes the first part of this project by formulating the following two proposals. Considering the need to harmonize LMI practices with a view to improving the quality of care throughout the care continuum, INESSS suggests developing, diffusing and promoting the use of a guide on norms and quality standards with respect to LMI for healthcare institutions and clinicians. This guide will define the essential elements for initiation of the discussion, determination, documentation, communication and application of LMI and will contain a prototype of a harmonized form adaptable to all care settings. Considering the importance of harmonious implementation of LMI practices in a context where there is likely to be confusion about the different mechanisms by which treatment wishes can be expressed and, more specifically, with advance medical directives that will be implemented at the same time, INESSS proposes to develop and implement a communication and knowledge transfer plan on LMI adapted to the target clients concerned, taking care to coordinate these activities with those of the MSSS and other partners involved in related topics.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/OrganisationsSoins/INESSS_Niveaux_intervention_medicale.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: ©Gouvernement du Québec/Institut national d'excellence en santé et en services sociaux