Effects of patient education on the outcomes of surgical procedures

Studies have proven that patients with a comprehensive educational process before an operation are more likely to have positive (long-term) outcomes

· Patient Centred Care

The number of studies dealing with patient education is limited. Not many physicians and scientists have dealt with this topic sufficiently. Actually interesting, because the studies that exist on the subject, prove that overall satisfaction, as well as a comprehensive education of patients about their medical intervention, make a great contribution to the outcome of an operation.

Patients with a comprehensive educational process before an operation are more likely to have positive (long-term) outcomes.

Informed consent is a process by which the doctor educates the patient about their upcoming procedure to get his official signed consent. To do so the patient is given a written document that explains in medical terms what is going to happen to them and which side effects and risks are involved in this procedure. On top, it is mandatory for doctors to orally explain and educate the patient shortly before the operation personally and to discuss open questions. For patients, this real-time conversation is considered a valuable interaction. For doctors, on the other hand, the process of informed consent is often regarded as an important obligation that has to be fulfilled regardless of whether the patient has been provided with adequate information about the medical intervention or not.

Why has nothing changed in the process of informed consent procedures?

Especially when it comes to preoperative education it’s known to be difficult to develop formal patient education programs. Usually, patient education consists of analog pamphlets that are given to the patient before the medical procedure as well as verbal instructions from the physician on the day of surgery. The information material is usually 1–2 pages long and is filled with medical terminologies that are unclear to the majority of patients. Not precisely knowing what’s going to happen to them patients feel unsure and submissive to the superiority of their doctor. Especially when it comes to more complex procedures, the involvement of family members is particularly important for patients to cope with the amount of incomprehensible medical information.

So far, there are no standardized procedures to ensure that patients are properly informed and those family members are involved in the process.

Preoperative education is evidently leading to improved surgical outcomes — time to make comprehensive patient education a standard.

Studies such as “Benefits of Preoperative Education for Adult Elective Surgery Patients” from Kruzik N. or “The Benefits of Pre-Surgery Education” from Gallup have proven that comprehensive patient education leads to an increase in patient satisfaction, a reduction of follow up incidents based on insufficient explanations and an overall improvement of quality of life.

Preoperative education is evidently leading to improved surgical outcomes — time to make comprehensive patient education a standard.

But not only patients benefit from enhanced education procedures. Healthcare providers such as hospitals e.g. could benefit from cost savings. Better informed patients reduce the number of problems after operations. Not rarely patients sue hospitals because they were allegedly not or only insufficiently informed about the possible risks of their operation. Such accusations are usually followed by revision surgeries, malpractice lawsuits as well as lengthy legal proceedings which cost hospitals a lot of money.

But it is not only costs that can be reduced by better information procedures. Happy patients recommend hospitals to others and thus create a positive external perception. By using modern digital methods for patient education, hospitals can also position themselves as innovative pioneers who offer their patients the best possible care and support.

So what can be done to improve informed consent procedures for patients and doctors alike?

A study from Italy has conducted an epidemiological cross-sectional study to assess the quality of the informed consent processes at general hospitals. Here are the top findings:

  • Written informed consent is essential to ensure patients have the needed information to make an aware choice and giving real consent to the procedure.
  • Patients understand written information best when they can read it multiple times and share and discuss it with family members
  • Information passed on during the real-time conversation with the doctor shortly before the operation is usually not easily processed by patients. Due to the elevated stress level before surgery patients tend to panic more often.

Overall the study concludes that doctors need to enhance their communication skills and should undergo specific additional training to achieve these skills. By doing so “self-determination” of patients should be guaranteed.

Of course, further communication training for physicians can help to level patient expectations ad inform them better about their procedure. But we also need to find solutions that secure long-term assistance for doctors. They are already pressured to continuously improve their medical skills and to manage a 15 hours working day. There needs to be a more desirable solution than just to “improve their communication skills”.

It is about time that we develop digital solutions that offer significant benefits for medical staff and relieve them from trivial tasks that can easily be standardized.

Informing patients about upcoming operations no longer has to be done analogously in the form of paper and with too many medical terminologies. Most of it is not comprehensible for patients anyway.

We believe that patients would experience a much greater added value if they were informed in the form of customized educational videos. We know this process all too well from our everyday lives. If we don’t understand or want to learn something, we google or watch a YouTube tutorial. Why don’t we give doctors the necessary technological means to efficiently and digitally prepare their patients for the respective operation? Standardized procedures make it possible to save valuable time and invest this saved time in face-to-face meetings with patients. Patients on the other hand then have the possibility to do exactly what the Italian study has already proven. They can watch their personalized video as often as possible and share it with relatives.

This would be a truly positive contribution to patient education and a significant improvement. As explained earlier, it is not only patients who would benefit from enhanced informed consent procedures. The stressful everyday life of doctors can be reduced by trivial tasks and thus also personnel costs in hospitals can be saved. Better informed patients, in turn, reduce the number of legal proceedings against hospitals.

Let’s start now.

Sources:

Turillazzi E, Neri M. Informed consent and Italian physicians: change course or abandon ship-from formal authorization to a culture of sharing. Med Health Care Philos. 2015;18:449–53.

Ghulam AT, Kessler M, Bachmann LM, Haller U, Kessler TM. Patients’ satisfaction with the preoperative informed consent procedure: a multicenter questionnaire survey in Switzerland. Mayo Clin Proc. 2006;81:307–12.

Turillazzi E, Neri M. Informed consent and Italian physicians: change course or abandon ship-from formal authorization to a culture of sharing. Med Health Care Philos. 2015;18:449–53.

https://medium.com/medudoc/effects-of-patient-education-on-the-outcomes-of-surgical-procedures-a7893d152044

https://news.gallup.com/businessjournal/183317/benefits-pre-surgery-education.aspx

https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-018-0340-z