# Printed vs. Digital Patient Information Leaflets—Improving Patient Information Delivery for Enhanced Engagement in Trauma and Orthopaedic Surgery: A Quality Improvement Project

## TL;DR

This study shows that using digital patient information leaflets with QR codes improves patient engagement and reduces costs and environmental impact in trauma and orthopaedic surgery.

## Contribution

The study introduces QR codes as a sustainable alternative to printed patient information leaflets in a clinical setting.

## Key findings

- Most patients aged 15-65 preferred digital information over printed leaflets.
- QR codes improved accessibility and ease of saving information for future use.
- The project saved £1600 annually and reduced CO2 emissions by ~252 kg.

## Abstract

Introduction

The Green Surgery Report, endorsed by the Royal College of Surgeons of England, states that improving the quality of patient care goes hand in hand with sustainability. Patients arriving at the fracture clinic are regularly provided with printed patient information leaflets (PILs) as part of their ongoing care. Current digital technology enables the use of sustainable forms of patient information, such as quick response (QR) codes and digital records. This quality improvement project explored the sustainability potential of improving patient accessibility to information through the use of digital technology.

Methods

Two prospective Plan-Do-Study-Act cycles were carried out from July to October 2024. All patients arriving at the fracture clinic of the Leicester Royal Infirmary were included. Novel questionnaires were used to assess patient experience in receiving PILs in both digital and print forms. Change was introduced by creating QR codes for relevant PILs. Patient preference, cost analysis, and impact on carbon footprint were evaluated.

Results

In the first cycle with 50 patients, only 31 (62%) reported reading the paper or printed information leaflets, and 38 (76%) preferred receiving information in a digital form or via a QR code. All patients aged ≥80 years preferred printed information, while patients in the age range of 15-65 years predominantly preferred digital information. Following the implementation of QR codes in the second cycle, which included 20 patients, 16 (80%) found it easier to access and save digital PILs for future reference. A cost-effectiveness analysis revealed an estimated annual cost saving of £1600 and a reduction in CO2 emissions of ~252 kg.

Conclusion

This project demonstrated measurable benefits towards healthcare information delivery and greener surgery through using QR codes for PILs while simultaneously improving patient engagement.