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This quality improvement project evaluated digital consent implementation in Trauma and Orthopaedics at Sandwell and West Birmingham NHS Trust by comparing paper-based consent with a digital system. Retrospective baseline data (July-August 2024) were compared with prospective data (August-October 2024) using documentation-quality metrics and survey feedback from professionals (n=24) and patients (n=619) within an iterative Plan-Do-Study-Act cycle.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/implementation-of-digital-consent-at-sandwell-and-west-birmingham-nhs-trust-a-quality-improvement-project/434921/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/implementation-of-digital-consent-at-sandwell-and-west-birmingham-nhs-trust-a-quality-improvement-project/434921.png","ImageObject",300,407,{"name":92,"@type":93},"McQueen","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does the digital consent system address in Trauma and Orthopaedics?","Question",{"text":112,"@type":113},"Traditional paper consent can be illegible and inconsistently record key information, risking medicolegal issues and undermining trust in shared decision-making. The project targets improved documentation quality, accuracy, and patient understanding.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the quality improvement study conducted?",{"text":117,"@type":113},"Baseline data were collected retrospectively from July to August 2024 and compared with prospective data after implementation from August to October 2024. The evaluation used quantitative documentation-quality measures and qualitative feedback from healthcare professionals (n=24) and patients (n=619), guided by an iterative Plan-Do-Study-Act cycle.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main outcomes after implementing digital consent?",{"text":121,"@type":113},"Legibility increased from 42–48% to 100% for digital consents. Documentation of alternative treatment options rose substantially (from 5% to 95% for trauma cases, and from 0% to 98% for elective cases), and risks/benefits were documented in 100% of digital consents.",{"name":123,"@type":110,"acceptedAnswer":124},"What challenges and costs were identified alongside the benefits?",{"text":125,"@type":113},"Barriers included accessibility issues for less digitally literate patients and technical challenges such as digital signing on smaller devices. The transition also produced cumulative cost savings of £2552.90 over the first 7 months.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},434921,1791304088,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":46,"preview_page_count":4},5909890329169,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Open access  \nTo cite: Elhariry M, Dejsupa C, Adlan A, et al. Implementation of Digital Consent at Sandwell and West Birmingham NHS Trust: A Quality Improvement Project. BMJ Open Quality 2025;14:e003606 . doi:10 . 1136/ bmjoq-2025-003606  \nME and CD contributed equally.  \nME and CD are joint first authors.  \nReceived 6 June 2025 Accepted 3 December 2025  \n© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \nTrauma and Orthopaedics, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK  \nCorrespondence to  \nMiss Chaninda Dejsupa; [cdejsupa@gmail.com](cdejsupa@gmail.com)  \nQuality improvement report  \nImplementation of Digital Consent at Sandwell and West Birmingham NHS Trust: A Quality Improvement Project  \nMaiar Elhariry  , Chaninda Dejsupa  , Amirul Adlan, Joanna Richards, Martin Li  , Gary Weekes, Tahir Khaleeq, Kanthan Theivendran   \nABSTRACT  \nDigital consent systems provide a modern alternative to traditional paper-based methods, improving legibility, documentation accuracy, compliance with National Health Service (NHS) medicolegal standards and patient understanding. This quality improvement project evaluated the implementation of a digital consent system in the Trauma and Orthopaedics department at Sandwell and West Birmingham NHS Trust, comparing paper-based consent with the digital system. Baseline data were collected retrospectively from July to August 2024 and compared with prospective data following implementation from August to October 2024, using quantitative measures of documentation quality and qualitative feedback from healthcare professionals (n=24) and patient (n=619) surveys. An iterative Plan-Do-Study-Act cycle approach was used to refine the process.  \nFollowing implementation, legibility improved from 42–48% to 100% across all digital consents, and documentation of alternative treatment options increased substantially from 5% to 95% in trauma cases and from 0% to 98% in elective cases. Risks and benefits were documented in 100% of digital consents. Patient and clinician surveys demonstrated high satisfaction, with a mean System Usability Score of 77 .5, comparable to high-performing consumer technology platforms. Identified barriers included accessibility issues for less digitally literate patients and technical challenges such as digital signing on smaller devices. The transition to digital consent resulted in a cumulative cost saving of £2552.90 over the first 7 months.  \nThe introduction of digital consent significantly improved documentation quality, patient and clinician satisfaction and generated measurable cost savings. Ongoing challenges relating to accessibility and technical usability require targeted interventions. This project demonstrates the potential for digital consent systems to support efficient, sustainable and patient-centred care, with opportunities for broader adoption across NHS specialties.  \nBACKGROUND  \nInformed consent is a fundamental ethical and legal requirement in medical practice, ensuring patients understand the risks, benefits and alternatives before giving consent toa procedure. The General Medical Council outlines that consent must be voluntary, informed and documented appropriately  \nWHAT IS ALREADY KNOWN ON THIS TOPIC  \n\n| ⇒ Paper-based consent is often illegible and inconsistently records key information, exposing patients and clinicians to risk and undermining trust in shared decision-making.\u003Cbr>WHAT THIS STUDY ADDS |\n| --- |\n| ⇒ Introducing digital consent in Trauma and Orthopaedics achieved 100% legibility, raised documentation of alternative treatment options from 5% to over 95%, improved patient and clinician experience and saved £2552.90 within 7 months.\u003Cbr>HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY |\n\n⇒ These findings provide strong evidence for scaling digital consent across the National Health Service to deliver safer, more consistent an","cbCaimzahkKpMra4","https://ap.wps.com/l/cbCaimzahkKpMra4","pdf",565339,"English","# Abstract\n# Background\n# What is already known on this topic\n## What this study adds\n## How this study might affect research, practice or policy","[{\"question\":\"What problem does the digital consent system address in Trauma and Orthopaedics?\",\"answer\":\"Traditional paper consent can be illegible and inconsistently record key information, risking medicolegal issues and undermining trust in shared decision-making. The project targets improved documentation quality, accuracy, and patient understanding.\"},{\"question\":\"How was the quality improvement study conducted?\",\"answer\":\"Baseline data were collected retrospectively from July to August 2024 and compared with prospective data after implementation from August to October 2024. The evaluation used quantitative documentation-quality measures and qualitative feedback from healthcare professionals (n=24) and patients (n=619), guided by an iterative Plan-Do-Study-Act cycle.\"},{\"question\":\"What were the main outcomes after implementing digital consent?\",\"answer\":\"Legibility increased from 42–48% to 100% for digital consents. Documentation of alternative treatment options rose substantially (from 5% to 95% for trauma cases, and from 0% to 98% for elective cases), and risks/benefits were documented in 100% of digital consents.\"},{\"question\":\"What challenges and costs were identified alongside the benefits?\",\"answer\":\"Barriers included accessibility issues for less digitally literate patients and technical challenges such as digital signing on smaller devices. The transition also produced cumulative cost savings of £2552.90 over the first 7 months.\"}]","Implementation of Digital Consent at Sandwell and West Birmingham NHS Trust - A Quality Improvement Project | PDF",1790671115]