Shannon E Stogryn, MBBS, Krista Hardy, MSc, MD, FRCSC, FACS, Ashley Vergis, MMEd, MD, FRCSC, FACS. University of Manitoba
Our objective was to evaluate the perceptions of Canadian bariatric surgeons regarding the quality of operative reporting in bariatric surgery and if there is a potential need for improvement. Additionally, we aimed to assess opinions on the quality and prospective utility of synoptic operative reporting for bariatric surgical procedures.
Methods & Procedures
A survey was distributed via a secure web based platform to identified active bariatric surgeons across Canada. Our aim was to have representation from every Canadian province/territory currently performing laparoscopic bariatric surgical procedures. Demographic information was gathered including training and practice patterns of current bariatric surgeons. A modification of the validated Structured Assessment Format for Evaluating Operative Reports (SAFE-OR) was used to evaluate the impression of the quality of narrative dictations for bariatric surgery on anchored 5-point Likert scales. This was additionally used to assess the quality of synoptic operative reports and gauge their potential to improve surgical documentation. Free text fields were provided to allow participant elaboration of opinions and feedback. Comments were collated and reported as themes.
34 Canadian bariatric surgeons were invited to participate in the web-based survey. Seventy one percent (24/34) completed the survey. We achieved representation of academic, community, and tertiary care surgeons across Canada. The most commonly performed procedures were roux en Y gastric bypass (RYGB) and sleeve gastrectomy (SG) (95.8% and 100.0% respectively). 70.8% currently perform a traditional narrative operative report and 20.8% perform a narrative operative report from a template. The weighted average SAFE-OR assessment scores of narrative dictations for bariatric procedures by surgeons and trainees were neutral (28.0/40 and 27.5/45 respectively). The lowest scoring items were the “description of indications” for surgeons (2.9/5) and “succinctness” and “readability” for trainees (2.8 and 2.5 respectively). 12.0% of respondents acknowledged having experienced a situation where inaccurate operative reporting had led to poor patient care. Opinions consistently reflected the need for an immediately generated, standardized, template-based report to improve the quality and accessibility of operative documentation. The group agreed that synoptic reports would be beneficial to improving operative reporting for bariatric surgery (weighted average 3.3/5). Finally, feedback suggested the reproducible nature of bariatric procedures lends an inherent suitability to a synoptic format.
Our evaluation of bariatric surgeons demonstrated a perception of mediocre quality of narrative dictations that could potentially lead to poor patient care. There is desire to create a high quality, validated, synoptic operative report to address these shortcomings.