7 Colo. Code Regs. § 1101-3-17-08-6
Recommendation 42. Patient education is required as a primary component of treatment, beginning with the expected natural history of the injury or condition. Education about the injury or condition and associated disability may involve the patient, patient's family, employer, insurer, policymakers, and community.
Recommendation 43. In the setting of benign clinical examination, it is strongly recommended that the provider educates and reassures the patient that there is a high likelihood their condition will improve and that it is essential to self-manage their symptoms.
Recommendation 44. Patients should be educated regarding restriction of activities, including the following:
* The detrimental effects of immobility versus the efficacious use of limited rest periods. Adequate rest allows the patient to participate in active treatment and benefit from the rehabilitation program.
* Avoidance of complete work cessation, if possible, since it often further aggravates the pain presentation and promotes disability.
* Modified return to work is almost always more efficacious than work cessation and rarely contraindicated in the vast majority of injured workers.
Recommendation 45. Patient education should include a thorough discussion of how behavioral health evaluation and treatment is an essential component to support recovery from physical injury.
Recommendation 46. Shared decision making by the provider and patient, including the exchange of ideas and collaboration in the decision, is required, regardless of whether the degree of risk is high or low. Discussions should be tailored to the patient's health literacy. Elements of shared decision making must include the following:
* the patient's experience with treatment; and
* creation of individualized functional goals of treatment and anticipated barriers to success; and
* documentation of expected results of diagnostic testing and possible plan of action in response to test results; and
* a discussion of the continuum of treatment from the least invasive to the most invasive, with the intent of identifying a treatment along this continuum that most completely addresses the condition; and
* expectation regarding the functional impact of the proposed treatment, including a discussion regarding return to work and expected time frame for treatment; and
* specific measurable and clinically meaningful criteria for determining treatment success or failure; and
* confirmation of the patient's commitment to perform active therapy to optimize treatment outcomes; and
* documentation and consideration of the patient's unique risks and benefits based on comorbid medical conditions.
Recommendation 47. Informed consent is required when a high-risk treatment is under consideration. It includes the following elements:
* discussion of the proposed treatment's purpose; and
* benefits, limitations, and risks of the proposed treatment, alternative treatments, and nontreatment; and
* explicit patient agreement or refusal.
7 CCR 1101-3-17-08-6