Improving consenting practice in trauma and orthopaedics: A single centre original mixed methods study.

Area of Science:

• Medical Ethics
• Health Informatics
• Surgical Practice

Background:

• Informed consent is vital for ethical and legal surgical care.
• Current handwritten consent processes face challenges in consistency and completeness.
• Busy clinical settings exacerbate difficulties in achieving comprehensive consent.

Purpose of the Study:

• To evaluate existing handwritten consent practices in Trauma and Orthopaedics.
• To assess the implementation of electronic consent (e-consent) forms.
• To identify improvements for surgical consent procedures.

Main Methods:

• A two-phase study at a National Health Service (NHS) trust.
• Retrospective audit of 102 handwritten consent forms against national guidelines.
• Structured survey of clinicians regarding current and electronic consent processes.

Main Results:

• Significant deficiencies found in handwritten consent: poor timing (21% in advance), inadequate information (fewer than 50%), and incomplete risk/alternative documentation (17%).
• Over 60% of forms were illegible, with most lacking complete risk/benefit details.
• Clinicians expressed dissatisfaction and a preference for e-consent for improved legibility and patient engagement.

Conclusions:

• Handwritten consent practices demonstrate substantial deficiencies.
• Standardized e-consent systems are recommended to enhance patient communication and comprehension.
• Adopting e-consent can improve medico-legal protection and patient care standards.