357 Improving Surgical Consent – A Quality Improvement Project to Enhance the Consenting Process
Author(s) -
Manu Shrivastava,
Julie Brown,
Luhang Sun,
Rajini Rajagopal
Publication year - 2021
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1093/bjs/znab134.412
Subject(s) - medicine , audit , informed consent , tonsillectomy , septoplasty , quality assurance , quality management , family medicine , medical emergency , surgery , general surgery , alternative medicine , operations management , management system , management , external quality assessment , pathology , economics , nose
RCS guidelines on consent, recently updated, encourage a dialogue where all risks material to that patient are discussed and are clear. An audit was performed to assess whether practice at Oxford Hospitals is compliant with these guidelines – that all patients for elective surgery are consented prior to admission. Method Thirty-two undergoing elective Functional Endoscopic Sinus Surgery (FESS), Tonsillectomy and Septoplasty were interviewed in May-June 2019. Baseline data were presented at a local educational meeting, along with education on the recent changes to the RCS guidelines. Repeat audit took place in August-September 2020. Results All 32 patients were consented as per RCS guidelines and understood the reason for their surgery, but only 31% could explain the risks, and 56% could explain alternative options. Twenty (63%) consent forms were easily legible on randomised heuristic assessment. After education and change in department practice, understanding of the operation was much improved (80-100%). One outcome was to create pre-filled consent forms for common ENT operations. Conclusions Whilst RCS policy on completing consent prior to admission is being achieved, patient interviews suggest a lack of understanding of the operation. Standardised consent forms have the potential to enhance this understanding, as well as saving time.
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