The importance of patients having the information they need, and the time to understand it, is recognised in GMC guidance on consent. Now a new tool – Explain my Procedure – shows how technology and animation can help.
Its creator, David Wald, professor of cardiology at St Bart’s in London, tells us how it improves understanding and facilitates better shared decision-making conversations between doctors and their patients, in line with GMC guidance.
The GMC’s Decision making and consent guidance stresses the importance of ensuring patients are given the information they need – and the time to understand it – so they can make informed decisions about their care. Using a shared decision-making approach to gaining consent is fundamental to good medical practice.
In a capacity-stretched health service, technology has a part to play in meeting these challenges. There are various digital ‘solutions’ to securing patients’ informed consent, but many are little more than online forms, sometimes with embedded information leaflets.
Explain my Procedure is different. It uses simple and easy-to-understand digital animations to educate and explain what to expect from medical and surgical procedures.
Images speak louder than words. They are a simple and effective way of communicating complex concepts such as risk, benefit and the trade-off between the two. Our tool does that by taking patients through the intended benefits, possible risks and alternative options.
It is now being used in more than 30 NHS Trusts, having been integrated into existing consent pathways to provide a systematic and standardised approach.
And it works. Use of Explain my Procedure has been shown to increase the proportion of patients reporting a complete understanding, before consent, from about 30% to more than 90%.
Its use has also reduced complaints and serious incidents due to a ‘failure to inform’ by 70%, and led to a substantial reduction in the number of patients who failed to attend for their procedures.
The animations have been translated into multiple languages, helping reduce health inequalities and, in some cases, enabling patients’ family members to access them.
Traditional approaches like information leaflets still have a place but, increasingly, videos are now the expected and inclusive medium for communication. And, with hand-held devices, they have the added benefit of being viewable anywhere at any time.
While the animations help facilitate effective shared decision-making conversations, they are not a replacement for them. Doctors must still have a meaningful dialogue with patients, to support their decision making before seeking consent to treatment.
But using the animations early in the care pathway can mean a patient is partly informed even before the consultation begins, freeing up time to focus on what matters to the individual patient and supporting them to decide on their best option. Ultimately, that is what personalised care is all about.
One of the growing list of key organisations to recognise the role of Explain my Procedure in shared decision making is the Personalised Care Institute, which was established with support from NHS England in 2020 and offers free quality-assured e-learning, including a short refresher module on shared decision making. Its courses teach the importance of valid consent and provide structure and frameworks for personalised care.
Explain my Procedure has been endorsed by national societies, winning the HSJ Digitising Patient Services Award in 2019 and the BMJ Digital Team of the Year Award in 2020. To find out more, including how to subscribe to the service, visit the website.
- With data showing that more patients than ever want to be involved in decisions about their care, the Personalised Care Institute is encouraging clinicians to refresh their shared decision making knowledge with a free peer-reviewed e-learning module, which takes just 30 minutes and is available on its website.