34. Mapping the Consent Process for Transgender Youth: A Content Analysis of Consent Forms for Gender-Related Care

This poster presents a pilot study that analyzed a small corpus of informed consent forms used in research with children, adolescents, and adult early readers using Coh-Metrix, a readability measurement tool. Recommendations for increasing readability of consent forms in order to improve the informed consent process are also provided. Cette affiche présente une étude pilote qui a analysé un corpus restreint de formulaires de consentement éclairé utilisés dans la recherche avec les enfants, les adolescents et les lecteurs précoces adultes, utilisant Coh-Metrix, un outil de mesure de la lisibilité. Nous fournissons également des recommandations pour augmenter la lisibilité des formulaires de consentement afin d'améliorer le processus de consentement éclairé.

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Role of the consent form in UK veterinary practice

Veterinary Record ◽

10.1136/vr.105762 ◽

2020 ◽

Vol 187 (8) ◽

pp. 318-318

Author(s):

Carol Gray

Keyword(s):

Informed Consent ◽

Thematic Analysis ◽

Potential Role ◽

Consent Form ◽

Consent Process ◽

Consent Forms ◽

The Status ◽

The Uk ◽

Sufficient Space

BackgroundInformed consent from the client is required before veterinary professionals may administer treatment or perform surgery on an animal patient, except in an emergency. This study investigates the potential role(s) of the consent form in the consent process in the UK.MethodsThematic analysis was carried out on the text contained in 39 blank consent forms sourced from veterinary practices in the UK. Analysis was conducted at the levels of topical survey and thematic summary.ResultsConsent forms were used to authorise procedures, to define proposed treatment, to offer or recommend additional procedures, to convey the risks of treatment and to document the client’s financial obligations. None of the forms analysed provided sufficient space to document the accompanying conversation. Notable omissions from the submitted forms included options for treatment and benefits of treatment.ConclusionsThe consent form acts as a record of the procedure to be performed, the associated costs and the status of the person giving consent. However, from this analysis, it often fails to record the detail of the consent discussion, an essential part of the consent process. A proposal for an improved version of a veterinary consent form is provided.

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1316 An Evaluation of The Consent Process in One of The Largest Spinal Surgery Units in Europe

British Journal of Surgery ◽

10.1093/bjs/znab259.143 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

E Daitey ◽

J Afolayan ◽

N Shah ◽

T Stringfellow ◽

R Shafafy ◽

...

Keyword(s):

Spinal Surgery ◽

Significant Variation ◽

Consent Process ◽

Supplementary Information ◽

High Morbidity ◽

Consent Forms ◽

Patient Information Leaflets ◽

Information Leaflets ◽

Tertiary Centre ◽

The One

Abstract Complex spinal surgery has high morbidity and mortality making the process of consent central to patient care [1]. Our aim was to qualitatively assess our consent process with three set metrics; how far in advance patients were consented prior to the date of surgery, the inclusion of all relevant risks on the consent form and the provision of supplementary patient information leaflets or equivalent. We retrospectively reviewed 100 consecutive patients undergoing elective spinal surgery at our tertiary centre which is the one of the largest spinal units in Europe between December 2019 and March 2020. All patients had valid consent forms. 16% of patients were consented on the day of surgery, 22% were consented the day before. Of the remaining 62%, 22 patients (35%) were consented within 2 weeks of surgery, and 40 (65%) over 2 weeks prior to surgery. 94% were consented for all relevant risks as determined by the senior authors. 81% had no documentation of receiving supplementary information and 11% had documentation of consent discussion in clinic. In conclusion, this audit revealed a significant variation in the consent process within our unit. This may highlight a deficit in the consenting process which we aim to explore further.

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893 Consenting for Appendicectomy

British Journal of Surgery ◽

10.1093/bjs/znab259.110 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

N Mohamed ◽

K Sinclair

Keyword(s):

Hernia Repair ◽

Diagnostic Laparoscopy ◽

Consent Process ◽

Patient Relationship ◽

Normal Appendix ◽

College Hospital ◽

Consent Forms ◽

King's College ◽

Audit Cycle ◽

The Uk

Abstract Appendicitis denotes to the inflammation of the appendix with over 50,000 cases in the UK per year. The treatment of choice is appendicectomy and this is one of the most common operations in the UK. There are nil NICE or King’s College Hospital (KCH) guidance available on consenting for appendicectomy. Thus, guidance from Guy’s and St Thomas’ and Whittingham Health was used as reference and the consent forms at KCH were analysed for all appendicectomies over 2 months. A retrospective observational audit (Cycle 1) was conducted between Dec 2018 – Jan 2019 consisting of 34 patients. It assessed whether common complications were documented clearly and any possible complications. This audit identified that consenting for diagnostic laparoscopy/appendicectomy did not cover many serious complications and was overall inadequate. One of the most common and serious complications was ileus/SBO (occurred in 9%) and was not consented for in 88% of patients. 12% of patients had a normal appendix and this was not consented in 100% of these patients. Later, posters and teaching sessions were created to optimise the consent process for appendicectomy. This was re-audited (Cycle 2) again between June 2019 – July 2019 with 49 patients to identify whether a positive change was identified. It identified that an 12% increase in consenting for ileus/SBO, 10% increase in conversion to open and 47% of individuals started consenting for hernia repair. This work is vital as inadequate consenting can destroy doctor-patient relationship and result in litigation and we encourage clear consenting guideline for appendicectomies across trusts.

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Improving the orthodontic consent process: Amending hospital policy and implementing change

Journal of Orthodontics ◽

10.1177/1465312518815547 ◽

2019 ◽

Vol 46 (1) ◽

pp. 34-38

Author(s):

Naomi Prado ◽

David Waring

Keyword(s):

Orthodontic Treatment ◽

Consent Process ◽

Treatment Results ◽

Hospital Policy ◽

Consent Forms ◽

Governing Body ◽

Implementing Change ◽

Patient Consent ◽

The Common ◽

Treatment Risks

Patient consent is a principal issue in healthcare. The well-publicised case between Montgomery versus Lanarkshire has highlighted the importance of consent to include a discussion of all relevant treatment risks. Within orthodontics, there are published guidelines from the profession’s governing body as to the common risks associated with treatment. Within hospitals and practices, the consent process is usually determined by set policies, which may be devised by non-clinical teams. Clinicians are well positioned to critique these processes and their input into such policies may be beneficial. A two-cycle, multi-centre audit was completed to assess the consistency of consent forms in two orthodontic departments. The results from the first cycle initiated the implementation of changes to hospital policy, in order to produce a new procedure-specific consent form for orthodontic treatment. Results from the second cycle of the audit, together with clinician feedback, showed that the new forms allowed for a more streamlined approach to the consent process and ensures patients are fully informed of all aspects of their personal treatment.

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Effectiveness of consenting in Otorhinolaryngology

Open Medicine ◽

10.2478/s11536-011-0131-0 ◽

2012 ◽

Vol 7 (2) ◽

pp. 198-202

Author(s):

Nnaemeka Okpala ◽

Amala Okpala ◽

Gareth John ◽

Hugh Cox

Keyword(s):

Informed Consent ◽

Therapeutic Alliance ◽

Medical Practice ◽

Consent Form ◽

Consent Process ◽

Pharyngeal Pouch ◽

Consent Forms ◽

Ethical Component ◽

At Home

AbstractInformed consent in today’s medical practice has become a cornerstone and a routine ethical component playing a major role in forming a therapeutic alliance with the patient. The present study sought to analyse the effectiveness of the consent forms and the consenting process in Otorhinolaryngology. This three month questionnaire-based study covered varying operations which ranged from tonsillectomies, grommet insertions to pharyngeal pouch stapling. Twenty-nine percent of consent forms were signed on the day of the operation. Of the patients who received leaflets (51%) during the process of informed consent, a majority (88%) found it useful. The respondents were satisfied with the explanation of the procedure, benefits and complications (70–74%). Majority kept their consent forms at home (60%) and did not bother engaging in further search with regards to the information in the consent form (81%). Majority of the patients agreed that they had enough time to make an informed consent. Patients were satisfied with the consent process but more can be done to improve the consenting process.

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The consent process in radiotherapy

Journal of Radiotherapy in Practice ◽

10.1017/s1460396907006176 ◽

2007 ◽

Vol 6 (4) ◽

pp. 211-216

Author(s):

Keisha S. Robinson

Keyword(s):

Health Service ◽

Patient Autonomy ◽

Case Law ◽

Medical Professional ◽

Consent Process ◽

Consent Forms ◽

Legal Principles ◽

The Past ◽

Department Of Health ◽

Radiotherapy Department

AbstractOver the past two decades The Department of Health has made the consent process one of its main focus and has issued numerous guidelines on how the process must be conducted in order to make it valid. This mandate has been in accordance with the new patient-centred health service, which has patient autonomy as its fundamental standard. This paper will critically appraise the consent process in a radiotherapy department against the Department of Health’s recommendations. The ethical and legal principles governing the process will also be discussed using guidance from medical professional bodies and reference to English case law. Additionally, the function of written consent and consent forms will be assessed in order to establish whether implied or oral consent has any role in radiotherapy. The paper found that to a large extent the Department of Health’s recommendations are followed in the radiotherapy department evaluated. One key outcome arising from this paper is that written consent is the most appropriate form of consent in radiotherapy; however the record of consent should not be solely confined to a consent form. Rather it is critical that adequate notes of all areas of the dialogue that took place during the consent process with the patient should be written in the patient’s medical notes.

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160 Informed Consent for Surgery at Resumption of Elective Activity After the First Wave of COVID-19

British Journal of Surgery ◽

10.1093/bjs/znab259.442 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

N Darwish ◽

M Iqbal ◽

Adeel A Dhahri ◽

N Jacob ◽

J Jebamani ◽

...

Keyword(s):

Informed Consent ◽

Royal College ◽

General Surgery ◽

Primary Outcome ◽

Informed Consent Process ◽

Consent Process ◽

Princess Alexandra Hospital ◽

International Guidelines ◽

Consent Forms ◽

American Society

Abstract Aim The Royal College of Surgeons of England published guidance on consent during COVID-19. Through this study, we aimed to assess our local consent adherence to these guidelines on the resumption of elective activity after the first wave of COVID-19. Method This prospective review of consecutive elective surgical consent forms was conducted from 20 July 2020 to 16 August 2020 at the Princess Alexandra Hospital NHS Trust, England. The primary outcome was evidence of COVID-19 risk documentation on the consent forms. Results A total of 116 patients’ consent forms were reviewed. Most patients were American Society of Anaesthesiologists (ASA) grade 2 (n = 70; 60.34%). Only 25 consent forms (21.55%) had COVID -19 and its associated risks documented, with registrars being the most compliant (19/46; 41.3%) followed by consultants (6/51; 11.7%). With regards to the surgical sub-specialities, general surgery, orthopaedics and ENT had the highest compliance with the guidance. Conclusions As the elective activity resumes, peri-operative risks of COVID-19 should be weighted in during the informed consent process, as mentioned in the latest international guidelines on consent to avoid litigation and negligence claims.

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SP7.2.3 Documentation of risk discussions prior to elective inguinal hernia surgery, is it standardised for all?

British Journal of Surgery ◽

10.1093/bjs/znab361.152 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Morag McLellan ◽

Brian Stewart

Keyword(s):

Inguinal Hernia ◽

Consent Process ◽

Considerable Variability ◽

Hernia Surgery ◽

Consent Forms ◽

Inguinal Hernia Surgery ◽

Legal Implications ◽

Significant Difference ◽

Basic Statistical Analysis ◽

Surgical Unit

Abstract Aims Obtaining consent is fundamental to surgical practice. Rising levels of litigation have led to increased scrutiny of the process. The Royal College of Surgeons (RCS) recommends a structured consent process enabling patients to make better informed decisions, increasing the legal robustness of the process. Our aim is to audit the documentation of risk discussions prior to elective inguinal hernia repair (EIHR). Methods Data was collected retrospectively for all patients who had undergone EIHR in a single surgical unit between January 2019 and 2020. Outpatient clinic letters and consent forms were reviewed. The grade of surgeon and documentation of consent discussions were recorded. The results were then analysed using basic statistical analysis. Results 146 patients (137 male and 9 female) were included in the audit, with an average age of 63 years (range 20-89 years). 77% of clinic letters recorded a consent discussion. Of these, chronic pain was the risk most commonly documented (62%), followed by recurrence (56%). 19.8% of clinic letters included the level of risk quoted. 86% of consent forms were legible. Documentation of risk was significantly more detailed on consent forms compared to clinic letters (p < 0.05). On these, infection was the most commonly documented (97%), followed by bleeding (91%). Overall, there was no significant difference in documentation relative to surgical grade. Conclusions This study has demonstrated considerable variability in consent process prior to EIHR. This can have both legal implications and impact upon patient experience. Adopting a strategy to ensure a consistent approach is essential.

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Consent Process for Elective Total Hip and Knee Arthroplasty

Journal of Orthopaedic Surgery ◽

10.1177/230949901101900302 ◽

2011 ◽

Vol 19 (3) ◽

pp. 274-278 ◽

Cited By ~ 11

Author(s):

Nicolas Beresford-Cleary ◽

Jane Halliday ◽

Leela Biant ◽

Steffen Breusch

Keyword(s):

Hip Replacement ◽

Consent Form ◽

Consent Process ◽

Medical Complications ◽

Consent Forms ◽

Total Hip ◽

Hip And Knee Arthroplasty ◽

Total Knee ◽

Clinically Significant ◽

British Orthopaedic Association

Purpose. To assess the consent process for elective primary total hip replacement (THR) and total knee replacement (TKR) in our hospital. Methods. Consent processes of 47 THR and 53 TKR patients performed by 11 surgeons were reviewed. Complications that were documented were recorded, as was the grade of surgeon (consultant or specialist trainee) performing consent, and the location at which this took place. Comparisons were made between rates of documented, clinically significant complications discussed during consent, and those listed in the British Orthopaedic Association (BOA), in the literature, and other joint registries. Results. The consent processes of 37, 57, and 6 patients were conducted by consultants, specialist trainees, and both, respectively. 13% and 21% of THR patients had ‘revision’ and ‘heterotropic ossification’, respectively, documented as complications, neither of which were listed on the BOA consent form. Similarly 4% and 11% of TKR patients had ‘revision’ and ‘dissatisfaction’, respectively, documented as complications, neither of which were listed on the BOA consent form. In 23% of THR and 32% of TKR patients, none of the BOA-listed complications was documented. In 13% of THR and 15% of TKR patients, no complications were documented. In 13% of THR and 17% of TKR patients, only non-specific descriptions of complications (e.g. morbidity, mortality and medical complications) were used in their consent forms. Conclusion. Documentation of complications for THR and TKR patients was often incomplete and variable. The use of structured, procedure-specific consent forms is recommended.

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