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"Uninformed" Consent: Patient Recollection From Surgical Consent in Hand Surgery-A Quality Improvement Initiative.

Monica Yu¹, Herbert P von Schroeder¹

¹University of Toronto, Ontario, Canada.

Hand (New York, N.Y.)

|July 14, 2021

Summary

Patients undergoing elective hand surgery have poor recall of surgical risks and benefits discussed during informed consent. This highlights significant inadequacies in the surgical consent process from the patient

Keywords:

consent diagnosis disability informed consent outcomes pain psychosocial research and health outcomes specialty surgery treatment

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Area of Science:

Surgical Education
Patient Safety
Informed Consent

Background:

Informed surgical consent is a critical component of patient care.
Existing surgical consent processes often exhibit significant inadequacies.
Patient understanding and recall are key indicators of consent effectiveness.

Purpose of the Study:

To investigate patient recollection of the surgical consent process.
To evaluate the adequacy of the informed consent process from the patient's perspective.

Main Methods:

A quality improvement framework was employed.
Two patient surveys were administered in five consecutive hand clinics.
Included patients who had previously undergone elective hand surgery.

Main Results:

Exceptionally low recall of surgical risks and benefits was observed in 103 patients.
Patients under 35 years old demonstrated slightly better recall of surgical risks.
Unexpected postoperative events influenced patient perceptions of the consent process.

Conclusions:

Elective hand surgery patients demonstrate poor recollection of consent information, indicating a deficient process.
Surgeons may overestimate the efficacy of the consent process due to patient's perceived sufficiency.