Do printed information leaflets improve recall of the procedure and risks in adult tonsillectomy? How we do it

Siau, Derrick; List, R.J.; Hussin, Nadia Atalah; Woolford, T. J.

doi:10.1111/j.1749-4486.2010.02227.x

Cited by 7 publications

(7 citation statements)

References 7 publications

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“…When used, they need to be supported by contemporaneous notes as evidence that the discussion with the patient occurred. In order to further support the consent process, written patient leaflets for ENT procedures have been shown to improve patients’ recall of risks 23 . Documenting that an information leaflet has been provided, and importantly read and understood by a patient, provides strong evidence of a robust and effective consenting process.…”

Section: Discussionmentioning

confidence: 99%

Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Navaratnam¹,

Hariri

Ho³

et al. 2020

Clinical Otolaryngology

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Introduction: Litigation against the National Health Service (NHS) in England is rising. The aim of this study was to determine the incidence and characteristics of otorhinolaryngology clinical negligence claims in England. Methods: A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to otorhinolaryngology between April 2013 and April 2018. Analysis was performed using information for cause, patient injury and claim cost. Where claim information was adequately detailed, the authors categorised claims by subspecialty, diagnosis and surgery. Results: A total number of 727 claims were identified with an estimated potential cost of £108 million. Out of these, 463 were closed claims. Including open claim reserves, the mean cost of a claim was £148 923. Head and neck surgery was the subspecialty with the highest number of claims (n = 313, 43%) and highest cost (£51.5 million) followed by otology (n = 171, £24.5 million) and rhinology (n = 171, £13.6 million). Over half of claims were associated with an operation (n = 429, 59%) where mastoid surgery (n = 46) and endoscopic sinus surgery (n = 46) were equally associated with the greatest number of claims. The most frequent causes for clinical negligence claims included failure or delay to diagnose (n = 178, 25%), failure or delay to treat (n = 136, 19%), intra-operative complications (n = 130, 18%) and failure of the consent process (n = 107, 15%). Discussion: Clinical negligence claims in otorhinolaryngology are related to several different components of patient management and are not limited to postoperative complications. This study highlights the importance of robust pathways in outpatient diagnostics and the consenting process in order to deliver better patient care and reduce the impact of litigation.

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Section: Discussionmentioning

confidence: 99%

Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Navaratnam¹,

Hariri

Ho³

et al. 2020

Clinical Otolaryngology

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“…Similarly, in our study waiting time is not a factor between groups (average wait time to surgery of 33 days). Siau et al reported that patients prefer to receive information leaflets and reading them subsequently demonstrated improved recall of the nature of the procedures and risks in adult tonsillectomy [ 13 ]. With regards to patient satisfaction, a cohort of patients with no significant differences between control and intervention groups for the Hospital Anxiety and Depression Scale, Clode-Baker et al found that patients were more satisfied with information they had received and they felt less confronted by information on arrival for the hospital stay [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Informed consent: do information pamphlets improve post-operative risk-recall in patients undergoing total thyroidectomy: Prospective randomized control study

Alsaffar

Wilson

Kamdar

et al. 2016

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundInformed consent consists of basic five elements: voluntarism, capacity, disclosure, understanding, and ultimate decision-making. Physician disclosure, patient understanding, and information retention are all essential in the doctor-patient relationship. This is inclusive of helping patients make and manage their decisions and expectations better and also to deal with any consequences and/or complications that arise. This study investigates whether giving patients procedure-specific handouts pre-operatively as part of the established informed consent process significantly improves overall risk-recall following surgery. These handouts outline the anticipated peri-operative risks and complications associated with total thyroidectomy, as well as the corrective measures to address complications. In addition, the influence of potential confounders affecting risk-recall, such as anxiety and pre-existing memory disturbance, are also examined.MethodsConsecutive adult (≥18 years old) patients undergoing total thyroidectomy at a single academic tertiary care referral centre are included. Participants are randomly assigned into either the experimental group (with pamphlets) or the control group by a computerized randomization system (Clinstat). All participants filled out a Hospital Anxiety and Depression Scale (HADS) and they are tested by the physician for short-term memory loss using the Memory Impairment Screen (MIS) exam. All patients are evaluated at one week post-operatively. The written recall questionnaire test is also administered during this clinical encounter.ResultsForty-nine patients are included - 25 of them receive verbal consent only, while another 24 patients received both verbal consent and patient education information pamphlets. The overall average of correct answers for each group was 83 % and 80 % in the control and intervention groups, respectively, with no statistically significant differences. There are also no statistically significant differences between the two groups, in both interview duration, in time between interviews, and in recall tests. No correlation is also apparent between the pre-op HADS score and the recall questionnaire overall score.ConclusionsA pre-operative thyroid surgical information pamphlet alone might not be sufficient to enhance patient test scores and optimally educate the patient on their expected care pathway in thyroid surgery. Supplementation with alternative means of patient education perhaps using emerging technologies needs to be further investigated.Electronic supplementary materialThe online version of this article (doi:10.1186/s40463-016-0127-5) contains supplementary material, which is available to authorized users.

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“…An a priori statistical power analysis was performed to determine sample size for superiority. Previous research indicated a mean recall of 25% to 80% for standard oral informed consent discussions (Nadeau et al, 2010;Siau et al, 2010;Alabi et al, 2011;Saigal et al, 2015). A mean recall of 3 out of 9 for the control group and 5 out of 9 for the intervention group with a standard deviation of 2 was selected.…”

Section: Discussionmentioning

confidence: 99%

“…Relying on a discussion alone, however, may be inadequate as information conveyed verbally tends to be retained poorly and crucial pieces of information may be omitted from the discussion (Leclercq et al, 2010). Previous studies in otolaryngology in both pediatric and adult populations have shown that providing a written document in addition to a standard verbal discussion improves understanding of a procedure and its specific associated risks (Nadeau et al, 2010; Siau et al, 2010; Alabi et al, 2011; Papsin et al, 2014). Furthermore, written material may help reduce parental anxiety, and lead to improved satisfaction with treatment (Chan et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Written Information on Recall of Surgical Risks of Primary Cleft Palate Repair: A Randomized Controlled Study

Al-Taha

Butler

Hong

et al. 2018

The Cleft Palate-Craniofacial Journal

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Objective: To investigate parents’ understanding of the risks of primary cleft palate surgery after counseling with and without the use of a written informational aid. Design: Prospective, randomized, single-blind trial. Setting: Academic tertiary care center. Participants: Parents of children undergoing primary cleft palate surgery. Interventions: Parents were randomized to receive a standard informed consent discussion with or without provision of a written informational aid in the form of a pamphlet. Main Outcomes Measure: Parents’ recall of 9 specific surgical risks 3 weeks after informed consent discussion. Results: Forty parents enrolled in and completed the study (20 participants each in the control and intervention groups). There were no statistically significant differences between groups in terms of baseline demographics. The mean number of risks recalled were 3.7 (1.6) for the control group and 4.2 (1.9) for the intervention group (P = .37). The most commonly recalled risks were fistula formation and bleeding, while the least frequent were facial growth restriction and need for further surgery. No differences in risk recall were observed based on participant’s gender, level of education, or income. Conclusion: Parents of children undergoing primary cleft palate surgery recall less than 50% of counseled risks. The use of a written aid in the form of a pamphlet did not significantly improve recall in this sample. These results demonstrate that surgeons should implement additional measures to improve comprehension of surgical risks.

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Do printed information leaflets improve recall of the procedure and risks in adult tonsillectomy? How we do it

Cited by 7 publications

References 7 publications

Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Otorhinolaryngology litigation in England: 727 clinical negligence cases against the National Health Service

Informed consent: do information pamphlets improve post-operative risk-recall in patients undergoing total thyroidectomy: Prospective randomized control study

The Effect of Written Information on Recall of Surgical Risks of Primary Cleft Palate Repair: A Randomized Controlled Study

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