P066 Improving the quality of informed consent in dermatological surgery through standardized electronic consent

Abstract

Dermatological surgery now accounts for approximately half of the dermatology workload in the UK. Valid informed consent requires patients to be adequately informed of procedure-specific risks; however, paper consent forms often document only a limited range of risks, raising concerns regarding the quality and legal robustness of consent. We aimed to improve the quality and completeness of documented informed consent for dermatological surgical procedures by introducing a standardized electronic consent (e-consent) form with prepopulated risk templates. A quality improvement project using a plan–do–study–act framework was undertaken. Baseline data were collected via retrospective review of 98 paper consent forms for excisional biopsy and wide local excision, analysing the number and types of risks documented. An electronic consent system with procedure-specific, prepopulated risk templates was introduced and staff trained in its use. Postintervention data were collected from 22 e-consent forms and compared with baseline. Statistical analysis was performed to assess differences in risk documentation. Preintervention, only three risks (scar, postoperative bleeding and infection) were documented in > 90% of paper consent forms, while important risks such as pain (20%), bruising (10%) and recurrence (4%) were infrequently recorded. Following implementation of e-consent, 15 different risks were documented in > 90% of cases, including pain, bruising, recurrence and swelling. Statistically significant improvements (P < 0.05) were demonstrated across multiple domains, including pain, bruising, recurrence, incomplete excision and allergic reactions. Introduction of a standardized e-consent form significantly improved the completeness and consistency of documented surgical risks. This intervention supports higher-quality, more legally robust informed consent and demonstrates the value of digital solutions in dermatology surgical practice.