Background: Patient involvement in healthcare decisions is essential, with informed-consent (IC) being a legal requirement before any admissions, surgeries, or high-risk treatments, to protect the rights of patients and practitioners. The Saudi MOH mandates that IC be available in English and Arabic language, supporting its 2030 vision.

Aim: This project aims to implement a bilingual electronic informed-consent (e-IC) in our EHR (Epic), to ensure compliance with Saudi accreditation and MOH requirements, and to enhance patient and staff satisfaction over two-years period following implementation.

Methods: This project is a quality improvement initiative that began in 2022, with a timeline dedicated to optimization (in 2023) and sustainability (in 2024).  All paper-based English IC forms were translated into Arabic and integrated into Epic in both languages, featuring an electronic signature (e-Sign). Patient-satisfaction surveys distributed manually across clinical-units, while staff-surveys shared via email using Microsoft-Forms. Data analysis performed using paired t-Tests and Mann-Whitney U tests in JASP, with statistical significance set at 0.05. 

Results: The outcome measures demonstrated significant improvements over two-years after implementation. The number of manually scanned IC dropped to 4.7% (p < 0.001), while e-signed IC consents rose to 95.2% (p < 0.001). Furthermore, deficiencies in IC reduced to 0.8% (p < 0.001), while patient and staff satisfaction were at 92.5% and 75.5% respectively.  

Conclusion: Our quality-initiative has demonstrated that integrating electronic bilingual ICs with e-signature functionality has streamlined the IC process, reduced deficiencies related to consent elements and maintained high patient and staff-satisfaction paving the way for efficient person-centered healthcare.

Keywords:  Bilingual Informed Consent, e- Informed Consent, e-Signature, Epic, EHR