TPT 6.11 From Paper to Digital Consent in Emergency General Surgery: Pilot Implementation Using Laparoscopic Cholecystectomy as a Tracer

Abstract Aims We describe the implementation of digital consent for adult laparoscopic cholecystectomy (LC), used as a tracer procedure to inform wider roll-out, and in doing so evaluate uptake, consent timing and documentation completeness. Methods In a high-volume UK EGS unit (>700 cholecystectomies/year), we reviewed 50 paper LC consent forms against GMC, RCSEng, GIRFT and NICE standards. Thereafter a procedure-specific digital consent template was implemented (Concentric Health Ltd). Project delivery was supported by a clinical-champion, communications/reminders, one-to-one peer-support and visual awareness materials. Following implementation we prospectively reviewed 50 digital consent forms, quantified adoption, and compared paper versus digital cycles using χ²/Fisher’s exact tests. Results There was a statistically significant increase in core consent documentation, with procedure explanation, indication and intended benefits reaching 100% and alternatives increasing to 74%. There was a statistically significant increase in consent quality measures, with written information provision increasing to 68%, two-stage consent to 76% and legibility to 100%. Procedure-specific risk documentation also showed statistically significant increases for perioperative risk, damage to surrounding structures, pain/discomfort, ongoing symptoms, post-cholecystectomy syndrome, wound infection, hernia, retained gallstones, return to theatre, abscess/collection, and symptom recurrence. Two risk items were 0% post-implementation (de novo CBD stones and death), consistent with template configuration rather than clinical omission. Conclusions Digital consent has significantly improved metrics across measured domains. Some challenges remain relating to specific risk item omission and operational barriers to two-stage consent; Improvements continue with template optimisation and process changes supporting earlier consent completion and review.