480 RCS Good Surgical Practice Consent Guidelines: An Audit of Compliance After the Introduction of Digital Consent

Abstract Background Informed consent is an ethical and legal obligation of modern-day clinicians. It protects patients from harm and doctors from litigation. Digital consent may enhance patients’ satisfaction and understanding, whilst also facilitating shared decision making. At our institution, digital consent (Concentric®) was introduced to the General Surgery department in May 2022. Aim To evaluate whether electronic consent forms on Concentric® followed RCS Good Surgical Practice Guidelines. Method A retrospective review was conducted on all patients consented using Concentric® by the General Surgery team for the calendar month of August 2023. Endoscopic procedures, blood transfusions and duplicate consent forms were excluded. Data was collected based on current RCS Good Surgical Practice Guidelines. Additional information was extracted from the theatre management software (ORMIS), correlating the time of consent with the date of the procedure. Results Over the month, 398 consent episodes were evaluated. Compliance with RCS standards was as follows: benefits and risks of procedures (100%), clinicians involved (100%), indication for procedure (87%), alternative treatment (62%), and patient information leaflet with follow-up information (37%). Among elective procedures (186 episodes), only 32% of patients were consented prior to the day of surgery. Where there was a significant interval (24 hours) between the original consent signing and the operation, only 52% had consent reconfirmed. Conclusions This audit identified areas of good practice and areas for improvement in relation to digital consent in general surgery. Making fields on the form mandatory would likely improve compliance with current RCS standards.