Abstract No. 569 Understanding systemic barriers to adequate informed consent in interventional radiology: an important area for quality improvement

Consent in Interventional Radiology—How Can We Make It Better?

“…In addition to variations in patient/decision maker needs and preferences, there is also substantial variability in clinicians’ practices and understanding of consent in IR. 9,10 The dynamic, often fast-paced nature of IR makes it not uncommon for patients within a single practice to have consent conversations in multiple locations (e.g., clinic vs. ward vs. pre-op) and with multiple care team members who may not be directly involved in the case or necessarily the most experienced to be facilitating those conversations. For example, trainees and advance practice providers are often tasked with obtaining and documenting consent.…”

“…An estimated 1 in 4 inpatients lack decision making capacity, yet a study showed that clinicians failed to adequately determine capacity in more than half of these patients. 23 Likewise, a recent study of an academic IR practice found that capacity assessments were variable and often inadequately understood as the patient being “A&Ox3.” 10 Thus, it is important to ask oneself “when and for what” when thinking about capacity and to reassess often. Table 1 summarizes criteria for capacity, which can be used for reference.…”

“…8 Likewise, other studies have found that consent practices in IR were highly variable in terms of where they occurred, who had these discussions, and what forms or information were provided. 9,10 This is important not only because large numbers of IR patients may not be empowered with the ability to make an informed decision, but also because inadequate consent and communication around procedures are common causes of dissatisfaction, medical errors, and lawsuits. 5,11,12 As such, this article will review common barriers to informed consent, ideal practices, and potential interventions to improve consent practices in IR.…”