Consent Plus: Improving the Consent Process in Elective Lower Limb Arthroplasty
Lee, A. P. Chandratreya
Orthopsedic Proceedings, 4 April 2019; 101B(3)
Background of study
Following the Montgomery ruling, consent is now a matter of law. The medical professionals have to show proof that risks and implications and material risks are explained to the patient and that they have accepted to go ahead with surgery.
Materials and Methods
We devised a free web based programme (www.consentplus.com) which introduces a documented checkpoint to the consent process in hip and knee replacement surgery. It enables reproducible high-quality bite-sized information delivery to patients and their families in an optimal environment. It utilises the flip classroom principle to facilitate dialogue between doctors and patients. It generates physical documentation to show patients’ knowledge and understanding of the risks; to produce a truly informed consent.
1567 users completed the Consent PLUS process over 28 hospitals across the UK. 98.1% of users were satisfied with Consent PLUS in terms of quality of service and information delivered. Users’ self-rated knowledge increased by 29%, independent of age group, prior knowledge or check-point scores. Supportive documentation for 100% of the users, which facilitated the consent process but did not replace the consultation. 60% of users accessed the system via desktop computers, 23% via tablet and 17% via mobile phone. 55 consultant surgeons and 28 hospitals have been registered into the system by the users. 96.9% of users found Consent PLUS useful and 96.3% would recommend it to their friends. 92.6% would use it again.
Consent PLUS can facilitate information delivery and improve patients’ understanding of the risks of surgery and its implications subjectively and objectively. Consent PLUS is a tool designed to enhance and facilitate the consent process, not to replace the current consent forms.
Editor’s Note: The mission statement of Consent PLUS as taken from the website on 17 April 2019 is as follows: “Consent PLUS has enabled the healthcare team to improve patient experience, save consultant time and standardise information delivery processes. Using Consent PLUS at the hospital in an access-controlled manner has enabled competent clinicians to give individual patients and their carers much more quality information about the procedure, including the material risks and benefit involved for that individual. From the healthcare provider point of view, it saves a considerable amount of time, checklist and videos help standardised the information delivery, rather than the clinician having to repeat them. The form is stored on the server and can be scanned back into the system once signed.”