Animation-supported consent for urgent angiography and angioplasty: a service improvement initiative

Abstract

ObjectivePatient understanding of angiography and angioplasty is often incomplete at the time of consent. Language barriers and time constraints are significant obstacles, particularly in the urgent setting. We introduced digital animations to support consent and assessed the effect on patient understanding.MethodsMulti-language animations explaining angiography and angioplasty (www.explainmyprocedure.com/heart) were introduced at nine district hospitals for patients with acute coronary syndrome before urgent transfer to a cardiac centre for their procedure. Reported understanding of the reason for transfer, the procedure, its benefits and risks in 100 consecutive patients were recorded before introduction of the animations into practice (no animation group) and in 100 consecutive patients after their introduction (animation group). Patient understanding in the two groups was compared.ResultsFollowing introduction, 83/100 patients reported they had watched the animation before inter-hospital transfer (3 declined and 14 were overlooked). The proportions of patients who understood the reason for transfer, the procedure, its benefits and risks in the no animation group were 58%, 38%, 25% and 7% and in the animation group, 85%, 81%, 73% and 61%, respectively. The relative improvement (ratio of proportions) was 1.5 (95% CI 1.2 to 1.8), 2.1 (1.6 to 2.8), 2.9 (2.0 to 4.2) and 8.7 (4.2 to 18.1), respectively (p<0.001 for all comparisons).ConclusionUse of animations explaining angiography and angioplasty is feasible before urgent inter-hospital transfer and was associated with substantial improvement in reported understanding of the procedure, its risks and its benefits. The approach is not limited to cardiology and has the potential to be applied to all specialties in medicine.

Animation Supported Consent Before Elective Laparoscopic Cholecystectomy

“…Previous work has shown that use of Explain my Procedure multi-language animations improved patient and relative-reported understanding in other disciplines, including interventional cardiology [ 7 , 8 ], radiology [ 11 ], electrophysiology [ 12 ] and intensive care medicine [ 13 ]. The present work extends the benefits of this approach into a general surgical setting for one of the most commonly performed surgical procedures.…”

“…Multimedia resources such as animation-supported consent have been effectively implemented to improve patients’ understanding before consent and free up time to focus on material concerns. In angiography and angioplasty, digital animations have been introduced into the elective and urgent patient pathways [ 7 , 8 ]. The animations describe the procedure, its intended benefits, possible risks, and alternatives to the procedure in multiple languages that patients can choose; and approach consistent with GMC guidance [ 2 ].…”

“…The animations describe the procedure, its intended benefits, possible risks, and alternatives to the procedure in multiple languages that patients can choose; and approach consistent with GMC guidance [2]. Implementation of this approach resulted in a threefold increase in reported understanding before consent and a 70% reduction in complaints and serious incidents due to failure to inform [7][8][9]. Here we describe the use of animation-supported video books to support consent for patients being admitted for elective day case laparoscopic cholecystectomy and report the results of a consecutive patient survey of reported understanding before and after the introduction of the initiative.…”

Animation supported communication on intensive care; a service improvement initiative

“…[10][11][12][13][14][15] Introduction of digital animations in a network of 9 hospitals lead to a 3-fold increase in understanding of urgent angiography and a 10-fold increase in appreciation of risks before consent. 7 The present work, using multi-language animations, extends this approach to supporting families of patients on intensive care, rather than patients themselves. The striking differences in reported understanding between the animation and no animation groups, particularly in understanding what mechanical ventilation involves (94% v 15%) and appreciation of risk (84% v 0%) quantifies the benefit but also highlights the sizeable gap in understanding that exists and that has, no doubt, been worsened by the COVID-19 pandemic restrictions on visiting and communication.…”

“…5 Multi-language animations describing the benefits, risks and alternatives of commonly performed medical and surgical procedures have been shown to substantially improve patient understanding before consent, both in the elective and urgent patient pathway. 6,7 Animations describing ICU and the treatments offered were developed and translated into 5 different languages (Explain my Procedure Ltd) as part of a UK Government Scheme to support the COVID-19 response and were endorsed by the Intensive Care Society.…”