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DEVELOPMENT OF CONSENSUS-DERIVED QUALITY INDICATORS FOR LAPAROSCOPIC SLEEVE GASTRECTOMY

Shannon Stogryn, MSc, MBBS, FRCSC, Alistair Sharples, MBChB, MSc, FRCS, Krista Hardy, MSc, MD, FRCSC, FACS, Ashley Vergis, MMEd, MD, FRCSC, FACS. University of Manitoba

Introduction: Synoptic operative reporting has gained popularity due to the poor overall quality of dictated narrative reports. Bariatric surgery is a rapidly expanding field and sleeve gastrectomy is the most common bariatric procedure. The objective was to systematically develop a list of operative report quality indicators for a laparoscopic sleeve gastrectomy (LSG) to generate validated items to include in a synoptic operative report for LSG.

Methods: A Delphi protocol was used to determine quality indicators for a LSG report. Bariatric surgeons across Canada were recruited with physician key stakeholders to participate via a secure web-based platform. We aimed for one representative bariatric surgeon from all Royal College of Physicians and Surgeons Regions in Canada. Participants initially submitted quality indicators for a LSG. Suggested quality indicators were assessed and grouped by theme. Items were then rated on a 5-point Likert scale in subsequent rounds. For consensus, a score of 70% (mean 3.5/5) or greater indicated inclusion of an item and 30% (mean 1.5/5) or less denoted exclusion. Elements scoring 30 – 70% consensus were re-circulated in subsequent rounds to generate the final list of quality indicators. 

Results: Seven bariatric surgeons were invited. We one representative from all regions in Canada. The 3 multidisciplinary invitees were comprised of: 1 academic minimally invasive/acute care surgeon, 1 tertiary abdominal radiologist, and  gastroenterologist with expertise in endoscopic management of bariatric complications. The overall survey response rate was 90.0% (9/10) and identified 61 potential quality indicators for consideration. In the second-round survey 53 items reached inclusion consensus (see Table 1).

TABLE 1 – QUALITY INDICATORS FOR LSG
Headings # items Example
Team demographics 11 Surgeon 
Patient demographics 5 BMI
Pre-operative events 1 Weight lost on pre-op diet
Intra-op details 14 Leak test
Sleeve formation 11 # stapler firings 
Closure details 10 Port closure 
Post-op details 1 Post-operative condition 

Conclusion: This study established consensus-derived multidisciplinary quality indicators for LSG operative reports. This will allow further assessment of the quality of existing documentation and will afford the development of a synoptic report that may improve this documentation.


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

Abstract ID: 94782

Program Number: P093

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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