Negotiating outcomes with patients and families.

Negotiating outcomes is a complex skill that is crucial to attaining quality care, particularly in an environment characterized by an accelerated speed of care and regimented options for care. In this environment, patients and their families need a realistic view of achievable outcomes. Caregivers must be able to reformulate and renegotiate outcomes quickly with patients and their families. Caregivers act as a catalyst in the outcome-achievement process and, to be successful, seek new and creative strategies to accomplish this. Being a catalyst also involves determining the patients' personal feelings about their illnesses and the proposed interventions, assisting patients in planning how to translate their new knowledge into behaviors, and to build in feedback mechanisms.