1186 Audit Driven Standardisation Of Perioperative Risk Profiling in Carotid Endarterectomy
Abstract Introduction It is a fundamental good clinical practice in our medicolegal rights era to obtain standard, adequate, and transparent informed consent before any planned intervention. Currently, there are neither national approved vascular intervention-specific consents nor explicit guidelines for it. We aim to achieve a standardisation of perioperative risk profiling of carotid endarterectomy consents and produce a model one. Method A retrospective analysis of 65 carotid endarterectomy consents (audit/reaudit) between (2016-2019) retrieved to evaluate quality and completeness against GMC 2008 guidance: "Consent: patients and doctors making decisions together". Data included basic consent requirements according to guidelines and specific risks of carotid endarterectomy. It was registered with the Trust Clinical Audit Department. Results (90%) audit vs (87%) reaudit consents documented the intended benefits of surgery. Inclusion into the National Vascular Registry (NVR) was achieved (0%) in audit vs (60%) in reaudit forms. Of the 14 documented postoperative complications, reaudit significant improvement observed in % of documenting 12 items with 6 complications recorded above 50%. The maximum number of audit documented risks was 11 (79%), the median 6 (43%), and the least was 3 (21%) compared to maximum 13 (93%), the median 7 (50%) and the least was 5 (36%) when reaudited, respectively. Conclusions Deficiencies in performing and adequately completing surgical consents still occur. Introducing a national pre-printed vascular intervention-specific consent is vital for accomplishing and maintaining a good clinical practice. It should include all complications with relative % risk to minimise errors, provide good quality consent, and promote clinical practice at a national level.