Could Patients Be Better Prepared Before Surgery?

At Touch Surgery, our mission has always been to provide patients with the care they deserve and from the very beginning our goal has always remained the same; to improve patient safety.

The app is designed to improve patient safety, giving surgeons more confidence and providing a means of safe training and assessment before a blade ever reaches a body. But could patients also be better prepared before undergoing a surgery?

We often get feedbacks from patients and recently we received one of the messages for neurosurgery from a user preparing for a brain surgery, explaining how Touch Surgery eased his anxiousness and gave him peace of mind by showing him the steps of the procedure.

“As a patient approaching brain surgery, this is a very nice tool to be able to calm your nerves by walking through the procedure yourself!”

Besides being a tool intended for medical professionals, Touch Surgery is also used by non-medics and patients who like to understand exactly what to expect during an operation.

Could such simulation-based tools be used before signing the patient’s “informed” consent?

Having the patient’s consent is now being obtained well in advance. This is to ensure that the patient have plenty of time to examine any information about the procedure and ask questions.

Defining consent:

 

The relevant and comprehensive information about surgical procedures is important for every patient. Recently it has become an important part of medical practice and often a legal necessity for surgical procedures.

The concept of patient consent evolved from a judgement in the US supreme court during 1914 and it became a part of international law following World War II with the basic concept that patient consent is mandatory prior to performing any invasive procedure.

For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. These terms are explained below:

  • Voluntary – the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family.
  • Informed – the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if treatment does not go ahead.
  • Capacity – the person must be capable of giving consent, which means they understand the information given to them, and they can use it to make an informed decision.

How well can a patient give their consent for something as novel to them as surgery at a time of high stress such as going in for a brain surgery?

Seeking consent for surgical intervention goes beyond merely be the signing of a form.

It is the process of providing the information that enables the patient to make a decision to undergo a specific treatment. Consent is about informed decision making by the person taking the risk of surgery. This process requires time, patience and clarity of explanation.

Besides, the process whereby patients are provided with all the necessary information about healthcare and subsequent treatment plans, has many benefits including patient cooperation, impacting on surgical complications.

A study by Sanjay Marsini et al.¹ examined Informed consent in patients undergoing eye surgery by assessing their attitude, knowledge and anxiety level. The study concluded that the information helps patients to cope with the treatment and helps to achieve better surgical outcome.

Another study by Hussain al saffar et al.² investigated whether giving patients procedure-specific handouts pre-operatively as part of the established informed consent process significantly improves overall risk-recall following surgery. This study proved that a pamphlet or handout alone might not be sufficient to enhance patient test scores and optimally educate the patient on their expected care pathway in their surgery.

The authors concluded that supplementation with alternative means of patient education perhaps using emerging technologies needs to be further investigated.

Could having a tool that helps to visualize and simulate every step of the operation help surgeons explain the details so the patient can come up with a well-informed decision?

What about patients? Would they be interested in this level of details?

And finally what is the right balance between too much Vs. too little information? Can this be generalized or is it case-based?

 


¹ Sanjay Marasini et al. (July–September 2013). Informed consent in patients undergoing eye surgery: A qualitative study assessing their attitude, knowledge and anxiety level in a community based hospital of Nepal. Journal of Optometry. 6 (3), Pages 147–153.
² Hussain Alsaffar et al. (2016) 45:14. Informed consent: do information pamphlets improve post-operative risk-recall in patients undergoing total thyroidectomy: prospective randomized control study. Journal of Otolaryngology – Head & Neck Surgery