Improving the Consent Process with The Use of Bespoke Patient Literature

Nicholas Howard, Simon Platt, Christopher Cowan, Michael Hennessy , Gillian Jackson

Background: Previous studies have shown poor patient comprehension during the consenting process. Improving the readability of consent form documents and patient information leaflets have been recommended. Readability of these documents were compared with novel patient specific letters introduced to the consent process to observe the effect on information recall and satisfaction for patients undergoing elective surgery.

Methods: The bespoke letter system was compared to the two existing methods of consent process; signing for consent at their outpatient encounter at which they were listed for surgery and a separate consent clinic without bespoke literature.

Results: Standardised consent forms had the poorest readability with patients requiring a higher level of education for comprehension. Readability of information leaflets is better with an average reading age of 15-16 years of age and patient specific letters 14-15 years. 111 patients (87 female: 24 male) undergoing elective surgery were assessed on the day of surgery for recall of the procedure, risks, post-operative course and satisfaction with the process. Patients receiving a bespoke letter recalled more than those who attended a routine pre-operative consent clinic and significantly more than those who were consented at their last clinic visit. Patient satisfaction with consent process was also higher in this group

Conclusions: The readability of generic consent forms is poor and should therefore be supplemented by both information leaflets and can be further improved by patient specific letters.

Patients receiving a bespoke letter recalled more than those who attended a routine pre-operative consent clinic and significantly more than those who were consented at their last clinic visit. Patient satisfaction with consent process was also higher in this group.

Our study suggests that consent process is improved by the use of routine pre-operative consent clinics; most notably by the addition of patient specific literature to improve recall and patient satisfaction.