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).
| 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