Quality of Surgical Practice

1987 ◽  
Vol 44 (1) ◽  
pp. 1
Author(s):  
C. Rollins Hanlon
Keyword(s):  
Surgical Practice

scholarly journals The Art of Surgery: Balancing Compassionate With Virtual Care (Preprint)

2020 ◽  
Author(s):  
Elisheva Tamar Anne Nemetz ◽  
David Robert Urbach ◽  
Karen Michelle Devon
Keyword(s):  
Health Care ◽  
Physical Examination ◽  
Health Care Team ◽  
Body Language ◽  
Surgical Practice ◽  
Good Communication ◽  
Academic Literature ◽  
Virtual Care ◽  
Patient Groups

UNSTRUCTURED The recent drive to include virtual care in surgical practice has been accelerated due to the COVID-19 pandemic. Many physicians feel that communicating via telehealth is unlike traditional methods of providing health care, and thus guidance on maintaining excellence in communication is necessary, especially as academic literature on virtual care in surgery is nonexistent. Challenges faced in transitioning to virtual care include the inability to utilize body language, barriers to traditional physical examination, exacerbation of existing vulnerabilities and inequities in patient groups, the declining quality of medical education, and the fragmentation of the multidisciplinary health care team. This paper seeks to resolve these challenges by focusing on the pillars of good communication, including preparation, professionalism, empathy, respect, and the virtual physical examination.

scholarly journals A prospective closed loop audit on the quality of the operative notes in a general surgical unit in a quaternary care centre

2020 ◽  
Vol 7 (2) ◽  
pp. 382 ◽  
Author(s):  
Mohamed Javid ◽  
Shanthi Ponnandai Swaminathan ◽  
Arun Victor Jebasingh ◽  
Manivannan Velayutham ◽  
Rajeswari Mani
Keyword(s):  
Clinical Audit ◽  
Improve Patient Safety ◽  
Care Hospital ◽  
Prospective Audit ◽  
Surgical Practice ◽  
Standards Of Practice ◽  
Operative Notes ◽  
Improve Patient ◽  
Surgical Unit

Background: Proper documentation of the surgery done in the form of operative notes is a very important aspect of surgical practice. The aim of this clinical audit was to identify the existing standard of the operative notes written in a general surgical unit in a quaternary care hospital; and to compare it with the recommendations given by Royal College of Surgeons, England (in Good Surgical Practice, 2014) and if needed, to improve the standard of practice.Methods: In the first loop of this prospective audit, 75 consecutive operative notes which were written were compared with the RCS guidelines and the areas which had missing data were identified. These areas were informed to the residents, who are primarily involved in the documentation of the operative notes. The second loop of the audit was conducted after a gap of 4 months involving 75 consecutive operative notes again.Results: The areas which were initially deficient were better documented when analysed in the second loop.Conclusions: Documentation of operative notes does not always comply with the set guidelines as highlighted in the first loop of our audit. But by employing a clinical audit it is possible to identify the existing deficiencies and thereby improving the standards of practice. Also, operative note writing should be taught as part of surgical training. Definitions should be clearly provided, and specific guidelines should be established to improve the quality of the operative notes and their use to improve patient safety.

Quality assurance in surgical practice

1993 ◽  
Vol 101 ◽  
pp. 183-191
Author(s):  
S. J. Nixon
Keyword(s):  
Critical Evaluation ◽  
Poor Performance ◽  
Late Complications ◽  
Surgical Practice ◽  
The Right ◽  
Discharge From Hospital ◽  
The Cost ◽  
First Time ◽  
Additional Therapy

Audit is the critical evaluation of medical practice to effect an improvement in quality of service. Quality has been described as ‘getting it right the first time’ and audit as asking ‘whether you are doing the right thing and you doing it right?’. Surgeons are acutely aware of the penalty paid by the patient when he ‘gets it wrong’. Immediate complications such as wound infection and anastomotic leakage may require additional therapy, delay discharge from hospital, necessitate further surgery or even lead to death. Late complications may result in recurrence of the presenting pathology or complications which cause more distress than the original disease. Surgery and audit seem to be closely linked and naturally associated. Surgical skills have developed immeasurably, no doubt accelerated by the realisation of the penalties of failure. Fortunately the cost of poor performance to the surgeon is no longer to have ones hand cut off as it was in 1750 BC under the rule of King Hammurabi of Babylonia.

Quality of life: An important endpoint both in surgical practice and research

1987 ◽  
Vol 40 (6) ◽  
pp. 523-528 ◽  
Author(s):  
Hans Troidl ◽  
Juergen Kusche ◽  
Karl-Heinz Vestweber ◽  
Ernst Eypasch ◽  
Ludwig Koeppen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Practice

scholarly journals 531 An Admission Proforma to Improve Clerking Documentation in the ENT Department During the Covid-19 Pandemic: A Full Cycle Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Brown ◽  
C Ashton ◽  
A Poulios
Keyword(s):  
Risk Assessment ◽  
Patient Safety ◽  
Venous Thromboembolism ◽  
Adverse Effects ◽  
Referral Source ◽  
Surgical Practice ◽  
Surgical Tool

Abstract Aim Good Surgical Practice states that surgeons must ensure that accurate, comprehensive, legible and contemporaneous records are maintained for all their interactions with patients. It is therefore critical that the clerking document, as the initial record of an admission, meets this standard. During the Covid-19 pandemic, an emergency rota meant that cross-covering of ENT at junior level was increasingly required in our hospital. Understandably, these trainees were less familiar with admitting ENT patients and of departmental standards. Our aim was to evaluate the quality of clerking documentation in our department during this period and investigate whether a standardised admission proforma could improve this. Method Clerking documents for all patients admitted in April 2020 were checked for completion of venous thromboembolism (VTE) risk assessment and inclusion of ten key pieces of information as outlined by the Surgical Tool for Auditing Records score. As was standard at this time, all clerking documentation had been completed on blank hospital continuation paper. A departmental admission proforma was introduced before admissions in June 2020 were then assessed identically. Results Improvement was noted in all measured parameters with no adverse effects. There was particular improvement in documentation of referral source (28% to 97%), consultant in charge (35% to 90%), name/grade/bleep (25% to 94%) and VTE risk assessment (14% to 78%). Trainee response was positive. Conclusions A simple admission proforma can markedly improve the standard of clerking documentation and therefore increase patient safety during a turbulent time. We would encourage other departments to consider developing their own.

EP.FRI.583 Re-Audit of the Quality of Operation Notes

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Orlaith McAuliffe ◽  
Ahmed Aboulela ◽  
Mohamed Mohamed
Keyword(s):  
Blood Loss ◽  
Surgical Patients ◽  
High Quality ◽  
Surgical Practice ◽  
Intraoperative Diagnosis ◽  
Retrospective Audit ◽  
Safe Management ◽  
Audit Data ◽  
Estimated Blood Loss

Abstract Aims High quality operation notes are crucial for the safe management of surgical patients. The Royal College of Surgeons Good Surgical Practice (2014) describes eighteen separate pieces of information that should be included in operation notes. Our aim was to determine whether the quality of operation notes have improved since the introduction in our hospital in 2015 of an electronic proforma to record these notes. Methods We conducted a retrospective audit of operation notes between 28th October and 19th November 2020 based on the RCS guidelines. These results were compared to those of our 2015 audit. Results Of the seventy eight operation notes analysed in this re-audit, twenty eight percent were produced using the electronic proforma compared to forty five percent in 2015. In our re-audit a significantly higher proportion of notes had records of whether operations were elective or emergency (p < 0.01), intraoperative diagnosis (p < 0.01) and estimated blood loss (p < 0.05).Compared to the 2015 audit data there was a significant improvement in recording whether or not the surgery was elective or emergency (p < 0.0001). Conclusion In this audit we noted a disappointing decrease in proportion of operation notes that were produced using the electronic proforma. We also noted that operation notes produced using the electronic proforma were of higher quality compared to those that were not. We need to increase awareness amongst surgeons in our hospital of the benefits of using the electronic proforma to improve the quality of operation notes.

scholarly journals Assessment, Ethics, and the Randomized Controlled Trial

1989 ◽  
Vol 5 (3) ◽  
pp. 305-308 ◽  
Author(s):  
Michael Baum
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Final Analysis ◽  
Complex Interaction ◽  
Weight Of Evidence ◽  
Surgical Practice ◽  
Randomized Controlled

Decision-making in surgical practice is a highly complex interaction between the client (patient) and his or her professional advisor (surgeon). The client approaches the professional advisor full of expectations and fears. The expectations may be realistic or unrealistic, and, in the same way, the fears may be justified or unjustified. Furthermore, the client may have a variety of priorities not immediately apparent to the surgeon and may wish to express different degrees of autonomy. For example, some patients may demand the final say in determining the balance between length and quality of survival, whereas others would be happy to allow complete abrogation of their responsibilities to the surgeon, who is invited to make the difficult decisions concerning the patient's utilities. From the viewpoint of the surgeon, the transaction is equally complex, and his or her decisions may be constrained by resource allocation and time available. However, in the final analysis, assuming a beneficent doctor, the most appropriate decision will be determined by the weight of evidence that can be adduced in favor of any intervention.

Improving the quality of operation notes with electronic proformas

2018 ◽  
Vol 29 (7-8) ◽  
pp. 223-227
Author(s):  
Danielle Whiting ◽  
Mohamed Mohamed
Keyword(s):  
Practice Guidelines ◽  
Improve Quality ◽  
Exact Tests ◽  
Education Session ◽  
Chi Square ◽  
Surgical Practice ◽  
Audit Cycle ◽  
Operative Notes

Introduction Surgeons must ensure operative notes are legible and sufficiently detailed, outlined by 21 criteria in Good Surgical Practice guidelines (2014). Our aim was to introduce an electronic operating proforma to improve quality of operation notes. Methods Two audits were performed six months apart, after an education session and introduction of an electronic operating proforma, assessing adherence to the guidelines. Results were compared and analysed using Chi-square and Fisher’s exact tests. Results In both audits, notes for 187 operations performed over a two-week period were studied. In the first audit, six of the 21 criteria were recorded in ≥95% of operation notes, improving to nine in the second audit. In the second audit cycle, two subgroups were analysed, non-proforma (n = 30) and proforma (n = 157). In the proforma subgroup, 15 criteria were recorded in ≥95% of operation notes. Conclusion Quality of operation notes can be significantly improved by using a combination of education, electronic proformas and avoiding handwritten notes.

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