Using Improvement Science Methods to Increase Accuracy of Surgical Consents

Abstract

The surgical consent serves as a key link in preventing breakdowns in communication that could lead to wrong-patient, wrong-site, or wrong-procedure events. We conducted a quality improvement initiative at a large, urban pediatric academic medical center to reliably increase the percentage of informed consents for surgical and medical procedures with accurate safety data information at the first point of perioperative contact. Improvement activities focused on awareness, education, standardization, real-time feedback and failure identification, and transparency. A total of 54,082 consent forms from 13 surgical divisions were reviewed between May 18, 2011, and November 30, 2012. Between May 2011 and June 2012, the percentage of consents without safety errors increased from a median of 95.4% to 99.7%. Since July 2012, the median has decreased slightly but has remained stable at 99.4%. Our results suggest that effective safety checks allow discovery and prevention of errors.

The relationship between knowledge and perception of patients regarding informed consent in surgical procedures in Rwanda

“…5,9 Moreover, many patients do not fully understand their health diagnosis, treatment and possible risks because of limited knowledge, personal stress and cultural beliefs. 10 A study conducted on the role of education in the informed consent process revealed that as the patient's level of education increases the requirement of disclosing everything on the surgical process decreases representing 64.7% of patients with no formal education and 56% of patients with university level.…”

Effective Leadership Promotes Perioperative Success

“…In the second article, Wesolowski et al 12 describe their development and implementation of a program to improve patient outcomes through use of a clinical nurse leader. Finally, Mercurio et al 13 present a patient safety initiative that increased surgical consent accuracy through enhanced communication.…”

Perioperative Safety: Engage, Integrate, Empower, Sustain to Eliminate Patient Safety Events

“…1,2 Over this time, much has been done to improve the safety of every patient in our perioperative environment. [3][4][5][6][7][8][9] Although this foundational work has improved patient and employee safety, we recently had a concerning cluster of significant perioperative patient safety events (associated with the time-out process, intraoperative communication, and retained foreign bodies), moving from 133 days between events to only 33 days between events, demanding us to improve further. Improving patient safety in a meaningful and sustained manner requires continuous work.…”