The team was delighted and honoured to win this award for their ‘Digital pathways for pre-operative consent’ approach, placing patients at the centre of the pathway and maximising every opportunity to inform and improve understanding throughout their journey.
Project lead Dr Jonathan Behar, consultant cardiologist and electrophysiologist, writes on behalf of the Cardiology Pre-assessment Improvement team.
As clinicians, it’s our duty to ensure our patients understand a proposed treatment and its benefits and risks. This is always a challenge, but the onset of the COVID-19 pandemic and subsequent infection control measures required us to minimise in-person attendance at our hospitals, making this even more difficult to achieve.
Patient feedback had told us that our previous single-episode consultation required improvement, to guarantee our patients were informed.
In response, we designed and delivered a novel, pragmatic, digital and holistic pathway for pre-operative shared decision-making and consent for cardiac catheter lab procedures.
Following our intervention, 92% of patients reported outcomes demonstrated a significant improvement in understanding their procedure (compared with 54% before our intervention).
The pathway incorporated animated videos to explain the relevant procedure clearly, an electronic consent form and video consultations for pre-assessment. Viewing the videos before their pre-assessment appointment enabled patients to hone their questions, and in turn improve the effectiveness of their consultation.
Furthermore, a simple digitisation method enabled the team to upload a signed electronic consent form to the patient’s record ahead of their operative date, with consent confirmation on the day of the procedure. This not only improved patient understanding, by giving them enough time to go through all elements of the procedure in advance, rather than on the day, but also improved the efficiency of our cardiac catheter lab flow.
Following our intervention, patient reported outcomes demonstrated a significant improvement in understanding:
- 92% said they understood their procedure (compared with 54% before our intervention)
- 90% said they understood the possible benefits (up from 58%)
- 90% said they understood the possible risks (up from 50%)
- 76% said they understood the alternatives (up from 38%).
Our pathway has empowered patients to be more effective decision-makers in relation to their own care. It has also improved patient experience of the service, reduced hospital contacts and infection risk, reduced the use of paper, postage and unnecessary travel, and has supported our clinical and administration teams to work remotely.
Since implementation, we have begun rolling out this pathway across other care groups at the trust. The EPCA 2021 digital award has also increased our visibility, enabling discussions with other departments and hospitals wishing to employ similar practices, with ultimate improved patient benefit.