When Paper Informed Consents Bring Surgeons to a Hard Stop

    

Help your stellar surgical team deliver on their reputation

Becoming a board certified surgeon is no small feat. It’s a journey that requires dedication, sacrifice, support of loved ones, singular focus, and financial investment. From overachieving as an undergrad to gaining entry into a renowned medical school to a further sleep-deprived residency and fellowship, surgeons go “all in” for their professional aspirations.

So imagine finally securing your place as part of a talented surgical team—the opportunity to positively impact patient lives daily, with the latest medical technology at your fingertips. Yet for all the positives, one downside becomes increasingly frustrating. Several times a month you're scrubbed in the OR and all set to begin, only to learn there’s a needless delay due to an antiquated paper-based process.

If your hospital still uses paper-based Informed Consents for Surgical Services, you know exactly what I’m talking about. 

An avoidable roadblock

All too often (14 percent of the time, according to a JAMA Surgery study by JM Garonzik-Wang et al. titled “Missing Consent Forms in the Preoperative Area”)[i] the reason for the delay is the most mundane and avoidable reason imaginable—someone lost your patient’s Informed Consent form. The same form you carefully explained a few days before, and both you and your patient signed and dated has gone missing. So now, you wait … for a resident to run and re-consent the patient—a proposition that holds big implications from the patient’s perspective as well. (See more on that in our previous post in this series, Enhancing the Patient Experience with a Better Informed Consent Process.)

It’s an inconvenient and risky situation, placing you in the firing line of a potential malpractice lawsuit, but it is also an avoidable roadblock to you and your Surgical Services team delivering the quality of care you’ve built a reputation on. This paper-based setback simply doesn’t represent the modern image your hospital wants to portray. And given that Surgical Services can account for up to 60% of overall hospital revenue, it can be a direct hit to the bottom line.

Undue stress on residents and clinical staff

Due to the rush of activity and, most likely, their unfamiliarity with each patient’s specific case history, 78.9% of residents called to the OR to re-consent spent just five minutes talking with the patient, according to the JAMA study. Almost 66% of residents had to halt their rounds once a week to deal with re-consenting, and 13% were interrupted daily.

And the delays caused by re-consenting don’t exist in isolation. A study by John Girotto, Peter Koltz and George Drugas titled Optimizing your Operating Room: Or, Why Large, Traditional Hospitals Don’t Work published in the International Journal of Surgery[ii] found that first-start delays (i.e. holdups to the first surgery of the morning) have a domino effect for every subsequent procedure that day. This not only causes hassle for staff but also requires them to work longer hours, resulting in budget-busting overtime costs that can amount to hundreds of thousands or even millions of dollars over the course of a year.

While surgeons may be the most obvious ones impacted by missing or incomplete Informed Consents, so too are nurses, anesthesiologists and other team members. Just like the surgeon, these are well-trained and highly skilled professionals who want to benefit patient health and wellbeing. So when operative cases are delayed or cancelled due to a lost document, it’s easy to see how frustration and impact becomes widespread. Simply put, lost Informed Consents are morale killers!

Electronic consents close the gap

Now for the good news. Costly delays and frustrations associated with paper-based process in the Surgical Suite are a foregone conclusion. Forward-thinking hospitals have made the move to further modernize the Surgical Services process and close paper gaps by implementing electronic forms and electronic signatures technology. This ensures Informed Consents are captured the first time, every time and all required information is securely available in the patient chart during the pre-surgery document review.

While other factors can delay procedures, with eForms and eSignatures, the 66% of instances where the consent is missing can be reduced to zero. Replacing paper consents with digital versions that are instantly integrated with patients’ electronic charts allows surgeons and the entire OR team to focus on patients, residents to concentrate on their rounds, and admin staff to get on with more rewarding projects. Sometimes the best fixes to complex problems are the simplest.

Learn more about Access eForms and eSignatures solutions here.

 

Resources:

[i] Garonzik-Wang, Jacqueline M., Gabriel Brat, Jose H. Salazar, Andrew Dhanasopon, Anthony Lin, Adesola Akinkuotu, Andres O’Daly, et al. 2013. “Missing Consent Forms in the Preoperative Area,”JAMA Surgery 148 (9): 886.

[ii] Girotto, John A., Peter F. Koltz, and George Drugas. 2010. “Optimizing Your Operating Room: Or, Why Large, Traditional Hospitals Don’t Work.” International Journal of Surgery  8 (5): 359–67.

 

About The Author - Cody Strate

For more than 10 years, Cody has helped healthcare organizations worldwide eliminate the costs and risks of paper through e-forms and e-signature solutions. In addition to helping others achieve their paperless goals, Cody finds time to put his biochemistry degree to work in the kitchen testing out new recipes on his unsuspecting family.

Feel free to email me here.