Improving consent form documentation and introduction of procedure-specific labels in a district general hospital

Bajada, Stefan; Dwamena, Samuel; Abdul, Z.; Williams, R. G.; Ennis, O.

doi:10.1136/bmjquality.u211571.w4730

Cited by 15 publications

(13 citation statements)

References 6 publications

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“…The goal of these resources was to provide a uniform approach to documenting risks, and their use has been shown to produce an improvement in quality of consenting (24). Similar bene ts were found when using pre-printed consent labels for consenting patients (7,25).…”

Section: Introductionmentioning

confidence: 84%

“…In order to reduce the variation in the admission and consenting process, several approaches have been evaluated, ranging from enhanced training to the use of procedure-speci c proformas (6) and consent stickers with pre-printed risks (7). Although these have demonstrated bene t, their usage remains limited and best practice is still unknown.…”

Section: Introductionmentioning

confidence: 99%

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Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project

Singh

Assaf

Bayley

et al. 2020

Preprint

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Background: Consenting patients for trauma procedures following hip fracture is a key stage in the treatment pathway from admission to the operating theatre. Errors in this process can result in delayed procedures which may negatively impact patient recovery. The aim of this project was to identify and reduce errors in our consenting process for patients with capacity. Methods: Consent forms for all adult patients with capacity admitted for surgical repair of traumatic hip fracture were reviewed over a 4-week period. The baseline measurement (n=24), identified errors in three key process measures: clarity of documentation, failure to record procedure-specific risks and not offering a copy of the consent form to the patient. Pre-printed stickers and targeted teaching were then introduced as quality improvement measures. Their impact was evaluated over subsequent 4-week review of the same patient demographic, with further refinement of these interventions being carried out and re-evaluated for a final cycle.Results: Cycle 1 (n=26) following targeted teaching demonstrated a reduction in abbreviations from 38% to 20%, while doubling the documentation of discussion of procedure-specific risks from 31% to 72%. More patients were offered a copy of their consent form, rising from 12% to 48%. Cycle 2 (n=24) saw the introduction of pre-printed “risk of procedure” stickers. Although clarity measures continued to improve, quality of pre-procedure risk documentation remained static while the number of forms being offered to patients fell to 8%.Conclusions: Our project would suggest that while pre-printed stickers can be useful memory aids, specific teaching on consenting produces the greatest benefit. The usage of such tools should therefore be limited, as adjuncts only to specific training.

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project

Singh

Assaf

Bayley

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Prior data has demonstrated that many consent forms do not contain all of the required elements to facilitate patient understanding and retention [10-11]. Additionally, the development of procedure-specific labels and consent forms will be considered, as they have previously demonstrated improvement in consent form accuracy [12]. Furthermore, the implementation of electronic and interactive versions of these consent forms would improve both the accuracy of documentation and patient understanding/informed decision-making [13].…”

Section: Discussionmentioning

confidence: 99%

Improving Consent Documentation in the Medical Intensive Care Unit

Krvavac

Patel

Kamel

et al. 2019

Cureus

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The contemporary patient-centered medical practice relies upon the acquisition of informed consent, which serves as written proof that the patient has recognized and agreed to the risks and benefits of their treatment. Well-documented informed consent forms are not only reflective of important ethical practices in medicine but can also serve as legal documents to protect healthcare providers from undue liabilities. We conducted a quality improvement project with the intention to improve the accuracy and completeness of consent form documentation in the medical intensive care unit.The evaluation of consent forms before our intervention revealed that only 6.8% were correctly completed, with an average of 10.2 out of 14 (73%) essential items correct. Our intervention involved a multifaceted approach that included targeted education in combination with process improvement. The post-intervention results at one month revealed improvement in consent form accuracy from 6.8% to 60% (p = 0.0001), with an increase in the average number of essential items documented correctly from 10.2 to 13.5 (p = 0.0001). Data were collected three months post-intervention to evaluate for sustained improvement. Results revealed a significant decrease in consent form accuracy to 39% when compared to the one-month post-intervention data but still maintained a statistically significant improvement when compared to initial baseline data; 6.8% to 39% (p = <0.01).Following the intervention, overall consent form accuracy improved significantly at our institution. Furthermore, these positive adjustments persisted when assessed at three months post-intervention despite the decrease as compared to one-month post-intervention. This trend suggests that our multifaceted intervention was able to increase the quality and accuracy of consent form documentation successfully.

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“…The goal of these resources was to provide a uniform approach to documenting risks, and their use has been shown to produce an improvement in quality of consenting [24]. Similar benefits were found when using pre-printed consent labels for consenting patients [7,25].…”

Section: Introductionmentioning

confidence: 89%

“…In order to reduce the variation in the admission and consenting process, several approaches have been evaluated, ranging from enhanced training to the use of procedure-specific proformas [6] and consent stickers with pre-printed risks [7]. Although these have demonstrated benefit, their usage remains limited and best practice is still unknown.…”

Section: Introductionmentioning

confidence: 99%

Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project

et al. 2020

View full text Add to dashboard Cite

Background: Consenting patients for trauma procedures following hip fracture is a key stage in the treatment pathway from admission to the operating theatre. Errors in this process can result in delayed procedures which may negatively impact patient recovery. The aim of this project was to identify and reduce errors in our consenting process for patients with capacity. Methods: Consent forms for all adult patients with capacity admitted for surgical repair of traumatic hip fracture were reviewed over a 4-week period. The baseline measurement (n = 24), identified errors in three key process measures: clarity of documentation, failure to record procedure-specific risks and not offering a copy of the consent form to the patient. Pre-printed stickers and targeted teaching were then introduced as quality improvement measures. Their impact was evaluated over subsequent 4-week review of the same patient demographic, with further refinement of these interventions being carried out and re-evaluated for a final cycle. Results: Cycle 1 (n = 26) following targeted teaching demonstrated a reduction in abbreviations from 38 to 20%, while doubling the documentation of discussion of procedure-specific risks from 31 to 72%. More patients were offered a copy of their consent form, rising from 12 to 48%. Cycle 2 (n = 24) saw the introduction of pre-printed "risk of procedure" stickers. Although clarity measures continued to improve, quality of pre-procedure risk documentation remained static while the number of forms being offered to patients fell to 8%. Conclusions: Our project would suggest that while pre-printed stickers can be useful memory aids, specific teaching on consenting produces the greatest benefit. The usage of such tools should therefore be limited, as adjuncts only to specific training.

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Improving consent form documentation and introduction of procedure-specific labels in a district general hospital

Cited by 15 publications

References 6 publications

Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project

Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project

Improving Consent Documentation in the Medical Intensive Care Unit

Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project

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