Jenna Hagan,
Human-centred
Visual & Service Designer




Agreement to Treatment Consent Form redesign through user trial



Redesigning the Agreement to Treatment Consent Form for clarity, safety, and national consistency

Following a recent HDC report and an audit against the Ngā Paerewa Health and Disability Standards, Health New Zealand identified a need to improve and standardise how informed consent is documented nationally. 

Ara Manawa was engaged to redesign the Agreement to Treatment Consent Form to ensure it better reflected clinical, legal, and patient needs—while supporting clarity, usability, and equity.

My Role

I led the project end-to-end, from scoping through to delivery. My work included shadowing clinicians to observe consent conversations, facilitating a co-design workshop with clinicians and a consumer representative, and synthesising insights into design iterations. I developed the prototype, led engagement with legal and clinical governance groups, and managed a 10-week in-situ trial across operating rooms and procedural settings. I also implemented feedback and refined the form for national alignment.

The Opportunity

Our aim for this work was to ensure that the new form provides more space to document risks, includes the option to consent for the presence of students and has a more streamlined layout. 

Key Challenges

  • Complex requirements: Balancing legal, clinical, and consumer expectations in a single form
  • Limited real estate: Adding fields for documentation without making the form overwhelming
  • Cultural safety: Ensuring the language and structure aligned with equity principles
  • Variation in use: Accommodating different workflows across surgical and procedural settings
  • Stakeholder alignment: Managing feedback from multiple disciplines and governance groups

The Approach

I began by shadowing clinicians—both surgeons and anaesthetists—to observe the consent process in real-time with patients. This gave us valuable insight into how the form was used during clinical conversations and where friction points occurred.

We also held a co-design workshop with clinicians and a member of the Consumer Engagement Council, whose lived experience added critical perspective to our understanding of what good informed consent looks like for patients and whānau.

Key Activities Included:

  • Observation: Shadowed surgeons and anaesthetists during real consent conversations to identify workflow needs
  • Co-Design: Facilitated a workshop with clinicians and a Consumer Engagement Council member to shape design priorities
  • Prototyping: Developed early versions of the form based on insights and stakeholder feedback
  • Expert Review: Engaged legal and clinical experts to ensure compliance and best practice
  • In-Situ Trial: Ran a 10-week usability trial across operating rooms and procedural settings, gathering feedback from surgeons, anaesthetists, and proceduralists
  • Iteration: Incorporated critical feedback by week eight to deliver a near-final version for broader engagement

    Sponsor, Dr Michael Puttick discusses the form in a workshop as clinicians sticky note their ideas for improving the form.

    Key Outcomes

    • Improved usability: The new form is easier to navigate and supports informed consent conversations effectively
    • More space for critical details: Risks, benefits, and alternatives documented clearly
    • Patient-centred features: Option for consent to the presence of students included
    • Streamlined structure: Reduced cognitive load for clinicians and patients
    • Readiness for national alignment: Form now meets Ngā Paerewa standards and supports future standardisation across Health NZ

    Our Learnings

    • Forms guide conversations: The consent form is not just a legal document—it shapes how clinicians discuss care with patients and whānau
    • Collaboration builds better tools: Bringing surgeons and anaesthetists together during co-design fostered shared ownership
    • Design sprint + real-world testing works: Combining rapid prototyping with a 10-week usability trial ensured we delivered a solution that worked in practice
    • Partnership with governance matters: Early engagement with Clinical Forms and Māori Health leadership helped mitigate risks and ensure cultural alignment

    Conclusion

    The new Agreement to Treatment Consent Form is more user-friendly, fit for purpose, and ready to support a nationally consistent approach to consent. Beyond this specific form, the process and learnings offer a pathway to improve other consent documentation through human-centred design.

    There’s also an opportunity to develop a clinician-facing guide to designing and trialling clinical forms—helping scale best practice across the health system. Further exploration is needed to assess how specialty-specific consent forms might be consolidated or redesigned to meet a broader range of user needs.

    Project Lead:
    Jenna Hagan

    Project Support:
    Deepa Swami

    Sponsors:
    Dr Michael Puttick, Department of General Surgery
    Dr Justine Wright, Department of Anaesthesia and Perioperative Medcine

    Māori Health Lead: 
    Dawson Ward, RN

    Other Collaborators: 
    Liza Labuschange, Clinical Forms
    Fiona Downs, Fujifilm Account Manager