Huda Al Sayed Ahmed*¹, Osama Omari², Ameerah Talib³, Anolynne Eastman⁴and Basmah AlDossary⁵

¹Department of Quality and Patient Safety/ Enterprise Quality Compliance Unit, Johns Hopkins Aramco Healthcare Dhahran, Saudi Arabia
²Surgery Department/General Surgery Division, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia, OSAMA.OMARI@JHAH.com
³Clinical Applications Support Department, EHR Ancillary Applications, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia, ameerah.talib@JHAH.com
⁴Department of Quality and Patient Safety, Process Improvement, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia, ANOLYNNE.EASTMAN@JHAH.com
⁵Department of Quality and Patient Safety, Enterprise Quality Compliance Unit, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia, basmah.aldossary@JHAH.com

*Corresponding Author: Huda Al Sayed Ahmed, PhD, CPHQ, CHAP, CHTOT, H(ASCP), SCYM(ASCP), Department of Quality and Patient Safety/ Enterprise Quality Compliance Unit, Johns Hopkins Aramco Healthcare Dhahran, Saudi Arabia. huda.alsayedahmed@jhah.com

Received: November 03, 2025; Published: November 30, 2025

Abstract

Background: Patient involvement in healthcare decisions is essential, with informed consent (IC) being a legal requirement before any admission, surgery, or high-risk treatment. In Saudi Arabia, the local Saudi central board for accreditation of healthcare institutions (CBAHI) and the MOH mandate the use of IC forms in both English and Arabic to support the 2030 Vision.

Objective: To implement a bilingual electronic informed consent (e-IC) with e-signature functionality in the EHR, Epic, aiming to comply with accreditation and MOH requirements and achieve patient satisfaction ≥90% and staff satisfaction ≥75% within two years post-implementation.

Methods: This quality improvement initiative employed an implementation-focused design. All manual, paper-based IC forms were translated into Arabic, and bilingual ICs were integrated into the EHR. Retrospective data were collected to assess baseline practices, while prospective data were collected to measure improvements using several metrics, including patient satisfaction and staff satisfaction, after implementation. Data analysis was performed using SPSS v.30, with a statistical significance level set at p ≤ 0.05.

Results: Between January 2023 and December 2024, manual IC forms significantly decreased to 4.7% (p < 0.001), while e-IC usage rose to 95.2% (p < 0.001). Documentation deficiencies revealed a statistically significant 98.5% reduction (p < 0.001). Additionally, assessed patient satisfaction reached 92.5% while staff satisfaction reached 75.5%, exceeding the set targets.

Conclusions: Implementation of an e-bilingual IC with e-signatures streamlined the consent process, minimized documentation deficiencies, and enhanced patient and staff satisfaction. Healthcare institutions can adopt a standardized approach that supports accreditation compliance, promotes efficient, patient-centered care, and provides a sustainable model for healthcare institutions seeking prompt, measurable improvements in quality and safety.

 Keywords: Bilingual Informed Consent; e-Informed Consent; e-Signature; Electronic Health Record (EHR)

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Citation

Citation: Huda Al Sayed Ahmed., et al. “Implementing e-Bilingual Informed-Consent with e-Signature in EHR at Johns-Hopkins Aramco-Healthcare, Saudi Arabia: Quality-Improvement Initiative”.Acta Scientific Medical Sciences 9.12 (2025): 72-81.

Copyright

Copyright: © 2025 Huda Al Sayed Ahmed., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.