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Brief Report | Resident's Forum

Missing Consent Forms in the Preoperative Area:  A Single-Center Assessment of the Scope of the Problem and Its Downstream Effects

Jacqueline M. Garonzik-Wang, MD, PhD1; Gabriel Brat, MD, MPH, MSc1; Jose H. Salazar, MD1; Andrew Dhanasopon, MD1; Anthony Lin, MD1; Adesola Akinkuotu, MD1; Andres O’Daly, MD1; Benjamin Elder, MD1; Kelly Olino, MD1; William Burns, MD1; Melissa Camp, MD, MPH1; Pamela A. Lipsett, MD1; Julie A. Freischlag, MD1; Elliott R. Haut, MD, FACS1
[+] Author Affiliations
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Surg. 2013;148(9):886-889. doi:10.1001/jamasurg.2013.354.
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Missing consent forms at surgery can lead to delays in patient care, provider frustration, and patient anxiety. We sought to assess the scope and magnitude of this problem at our institution. We surveyed key informants to determine the frequency and effect of missing consent forms. We found that 66% of patients were missing signed consent forms at surgery and that this caused a delay for 14% of operative cases. In many instances, the missing consent forms interfered with team rounds and resident educational activities. In addition, residents spent less time obtaining consent and were often uncomfortable obtaining consent for major procedures. Finally, 40% of faculty felt dissatisfied with resident consent forms, and more than two-thirds felt patients were uncomfortable with being asked for consent by residents. At our center, missing consent forms led to delayed cases, burdensome and inadequate consent by residents, and extra work for nursing staff.

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Figure.
Conceptual Framework of Key Determinants in Consent Forms Arriving in the Preoperative Area Prior to Surgery

Each box represents a different key stakeholder who can play a role in the consent form not making its way to the patient’s medical chart. Listed under each box are the specific components within each system that may limit consent form availability. ED indicates emergency department; IT, Hopkins Information Technology and Computing Systems.

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