Validating older adult patient's Medical Treatment Decision Maker's (MTDM). A retrospective observational study with follow-up phone interview transcript

•Increasing number of patients visit emergency departments in delirious state, thereby lacking cognitive capacity for treatment decision making.•In the Australian state of Victoria, clinicians are expected to comply with Medical Treatment planning and Decisions Act 2016 in relation to consenting for treatment.•Patients who lack cognitive capacity for decision making on treatment rely on pre-appointed Medical Treatment Decision Maker or surrogate decision makers facilitated by the Victorian Civil and Administrative Tribunal. A Medical Treatment Decision Maker (MTDM), also referred to as surrogate decision maker, by law, is to be appointed to make medical treatment decisions on behalf of a person who cannot make such decisions for themselves. In the Emergency Department (ED) and acute healthcare services, the clinicians’ (nurses and doctors) ability to contact MTDMs is essential for patient care, particularly in time-critical situations. Our primary objective was to review the verification process and assess the accuracy of MTDM contact numbers in the Health Information System (HIS) to assess compliance with legislation. We used a quantitative method with retrospective observational study design and follow-up phone interview transcript. One hundred and fifty-nine participants were randomly selected of whom 76 % had MTDM. Patient advancing age had statistically significant association with the number of call attempts made to reach the listed MTDM (P = 0.043; CI, -3.541 to -0.057) and the MTDM's consent to participate (p = 0.023).