title: Documenting informed consent in elective hip replacement surgery: a simple change in practice.
abstract: Adequate documentation of informed consent is an important aspect of many doctors' work and failings in this area may result in patient dissatisfaction or litigation. In 2009 the documentation of risks and complications on the consent forms of patients undergoing primary hip replacement was audited at a specialist centre. Following this audit procedure-specific complication stickers were introduced in an attempt to improve the documentation of the consent process. This article discusses the results of a re-audit and aims to determine if this change in practice had resulted in any significant improvement in documentation. The consent forms of 100 consecutive patients undergoing primary total hip replacement were re-audited using a standardized data collection sheet in order to close the audit loop. The re-audit found that 86 consent forms used the procedure-specific complication sticker to list the potential complications associated with a total hip replacement. Statistically significant improvements in the documentation of fracture, neurovascular damage, leg length discrepancy, failure, premature loosening, death, medical complications, ongoing pain, stiffness, wound healing problems and other were all seen in the 2012 re-audit in comparison to the 2009 audit (P<0.0001). The cheap and simple introduction of procedure-specific complication stickers in order to help surgeons document the process of informed consent has resulted in significant improvements in practice. In the context of patient-focused care and satisfaction in the NHS, it is vital that simple measures such as the introduction of procedure-specific complication stickers are embraced.
authors.affiliation: Department of Surgery, Nuffield Orthopaedic Centre, Oxford, UK. jisherwood@doctors.org.uk
authors.forename: Jennifer
authors.initials: J
authors.lastname: Isherwood
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dean
authors.forename: Hemant
authors.initials: H
authors.lastname: Pandit
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002985:Clinical Protocols; D015331:Cohort Studies; D032962:Consent Forms / Q000458:organization & administration*; D004282:Documentation; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008485:Medical Audit; D006113:United Kingdom