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Advancement in the Quality of Operative Documentation: A Meta-Analysis and Systematic Review of Synoptic Versus Narrative Operative Reporting

Shannon Stogryn, MBBS, Jennifer Metcalfe, MD, FRCSC, Krista Hardy, MD, FRCSC, FACS, Ahmed Abou-Setta, MD, PhD, Ashley Vergis, MD, FRCSC, FACS. University of Manitoba

Background: The operative report is a vital document for the surgical patient and central to quality assessment processes for surgical care. Despite this, data suggests that traditional narrative operative reports are often of poor quality. Synoptic reporting has emerged as a means to improve this document and has shown promise across multiple investigations.

Methods: A comprehensive systematic review of the literature was performed including comparative studies evaluating synoptic versus narrative operative reports. The primary outcome of interest was completion of predetermined critical items for an operative report. Secondary outcomes considered were reliability, efficiency, quality, and cost measures. Meta-analysis was performed where sufficient data was available. A quality analysis was performed on all included source articles using the Newcastle-Ottawa scale (NOS).

Results: Of the 1471 citations identified in the literature search, 16 studies met final inclusion criteria. The mean NOS was 7.09 out of 9 (+/- SD 1.73). On meta-analysis, synoptic reporting was significantly more complete than narrative reporting (SMD 1.70, 95% CI 1.13 to 2.26; I2 98%; 14 studies; 2874 reports) suggesting that this format outperforms narrative reporting in terms of completeness. Systematic review suggested the time to complete the operative report was significantly shorter with synoptic reporting (mean difference -0.86, 95% CI -1.17 to -0.55; 6 studies; 891 reports). All other secondary outcomes evaluated favoured the synoptic reporting format.

Conclusion(s): This meta-analysis and systematic review of the literature suggests that synoptic reporting platforms outperform traditional narrative reporting in terms of completeness of critical items and time required to complete it. This reporting format should be incorporated into surgical practice.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86133

Program Number: S114

Presentation Session: Residents/Fellows Session

Presentation Type: ResFel

16

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