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Implementation Science
Published in: Implementation Science 1/2008

Open Access 01-12-2008 | Research article

Implementing an innovative consent form: the PREDICT experience

Authors: Carole Decker, Suzanne V Arnold, Olawale Olabiyi, Homaa Ahmad, Elizabeth Gialde, Jamie Luark, Lisa Riggs, Terry DeJaynes, Gabriel E Soto, John A Spertus

Published in: Implementation Science | Issue 1/2008

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Abstract

Background

In the setting of coronary angiography, generic consent forms permit highly variable communication between patients and physicians. Even with the existence of multiple risk models, clinicians have been unable to readily access them and thus provide patients with vague estimations regarding risks of the procedure.

Methods

We created a web-based vehicle, PREDICT, for embedding patient-specific estimates of risk from validated multivariable models into individualized consent documents at the point-of-care. Beginning August 2006, outpatients undergoing coronary angiography at the Mid America Heart Institute received individualized consent documents generated by PREDICT. In February 2007 this approach was expanded to all patients undergoing coronary angiography within the four Kansas City hospitals of the Saint Luke's Health System. Qualitative research methods were used to identify the implementation challenges and successes with incorporating PREDICT-enhanced consent documents into routine clinical care from multiple perspectives: administration, information systems, nurses, physicians, and patients.

Results

Most clinicians found usefulness in the tool (providing clarity and educational value for patients) and satisfaction with the altered processes of care, although a few cardiologists cited delayed patient flow and excessive patient questions. The responses from administration and patients were uniformly positive. The key barrier was related to informatics.

Conclusion

This preliminary experience suggests that successful change in clinical processes and organizational culture can be accomplished through multidisciplinary collaboration. A randomized trial of PREDICT consent, leveraging the accumulated knowledge from this first experience, is needed to further evaluate its impact on medical decision-making, patient compliance, and clinical outcomes.
Appendix
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Metadata
Title
Implementing an innovative consent form: the PREDICT experience
Authors
Carole Decker
Suzanne V Arnold
Olawale Olabiyi
Homaa Ahmad
Elizabeth Gialde
Jamie Luark
Lisa Riggs
Terry DeJaynes
Gabriel E Soto
John A Spertus
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2008
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-3-58

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