COVID-19’s impact on informed patient consent

Dr Ajay Kumar discusses informed patient consent

COVID-19 has disrupted and altered work practices in Australian hospitals. And the new “contactless” processes are having unintended consequences for the communication process between anaesthetists and their patients pre-admission. While some aspects of the informed consent process have traditionally been done just prior to surgery – social distancing, the use of personal protective equipment and clothing, and complex COVID-19-focused admission processes are limiting the time, access and quality of the communication anaesthetists have with their patients.

This has the potential to compromise the patient consent experience and place anaesthetists at increased legal and ethical risk. To counter these changes, some anaesthetists are adopting new ways of interacting with their patients prior to their procedure. Videoconferencing, FaceTime, email and phone call are now becoming the new normal for many. This has replaced the traditional pre-admission consultation for medical patients.

Some anaesthetists are establishing new telehealth practices to connect with their patients in their homes, and gain informed consent well before their admission to the hospital. From adopting technologies for patient consent, to extended personal telehealth calls, read how one Sydney anaesthetists has adapted to these changes.

A new era for informed consent processes

Sydney anaesthetist, Dr Ajay Kumar, works in three major private hospitals in Sydney’s north west – all of which have adopted similar COVID-19 health procedures and processes. He dons personal protective equipment for certain medical procedures before he speaks with at-risk patients. He has found that hygiene protocols and social distancing are making communication with his clients more challenging.

Asking for informed patient consent pre-COVID-19 was substantially different to how it is performed now, which sees his patients move through a largely contactless pre-admission process. Dr Kumar now contacts his patients via the phone, FaceTime or videoconference before their admission to hospital, and uses an online consent tool to manage the formal aspects of informed patient and financial consent.

Many of his patients are elderly or do not speak english as a first language. He sets up telehealth consults and invites them to print off the patient consent forms he has provided electronically. He has found that the consenting process is taking – in some cases – up to half an hour longer, but patients are accepting of the new online tool. Starting the consenting process earlier and using technology to help manage it with pre-operation patients in the home has been key to his success. Dr Kumar says it has been a difficult time for everyone – patients as well as doctor – however forward planning and technology are helping to smooth the way.

Advice and actions for gaining patient consent

Explaining the risks of anaesthetic procedures to patients can be challenging, and none more so than in this changing COVID-19 environment. The pandemic is interfering with the normal patient consenting process, making it more difficult for anaesthetists to ensure that they have properly comprehended and understood the risks of their procedure.

The courts have made it clear that the obligation to ensure patients have properly heard and considering the risks and information rests solely with the clinician. And that responsibility will not be diminished by environmental factors, such as COVID-19.

Whilst COVID-19 restrictions have resulted in greater acceptance by patients of electronic communication instead of face-to-face consultations, the problem for doctors who use online tools poorly is that they can undermine the clinical relationship with their patients.

An integrated online consenting tool – like MedConsent – can assist in ensuring not only that the informed patient consent process is streamlined, but that the anaesthetist/patient relationship is safeguarded and the proper information is conveyed.

When adopting any new tool, it is critical that it is user-friendly, secure and provides content which is peer-reviewed and health literacy-compliant.

Want to make informed patient consent easy?

MedConsent is an interactive online consent tool that enables clinicians to use a consistent informed consent process for each procedure that ‘s aligned with best practice. It’s easy to use and accessible, making it the ideal consent solution.

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