Improving the quality of procedure-specific operation reports in orthopaedic surgery

Ann R Coll Surg Engl. 2010 Mar;92(2):159-62. doi: 10.1308/003588410X12518836439245. Epub 2009 Dec 7.

Abstract

Introduction: The objectives of this study were to: (i) assess whether handwritten operation reports for hip hemi-arthroplasties adhere to The Royal College of Surgeons of England (RCSE) guidelines on surgical documentation; (ii) improve adherence to these guidelines with procedure-specific computerised operation reports; and (iii) improve the quality of documentation in surgery.

Patients and methods: Thirty-three parameters based on RCSE guidelines were used to score hip hemi-arthroplasty operation reports. The first audit cycle was performed retrospectively to assess 50 handwritten operation reports, and the second cycle prospectively to assess 30 new computerised procedure-specific operation reports produced for hip hemi-arthroplasties. Eighty patients undergoing hip hemi-arthroplasty in a department of orthopaedic surgery within a UK hospital between September 2007 and August 2008 formed the study cohort.

Results: The main outcome measure was the average scores attained by handwritten versus computerised operation reports. Handwritten reports scored an average of 58.7%, rising significantly (P < 0.01) to 92.8% following the introduction of detailed, computerised proformas for the operation note. Adherence to each RCSE parameter was improved.

Conclusions: Computerised proformas reduce variability between different operation reports for the same procedure and increase their content in line with RCSE recommendations. The proformas also constitute a more robust means of operative documentation.

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • England
  • Guideline Adherence
  • Handwriting
  • Humans
  • Medical Audit
  • Medical Records / standards*
  • Medical Records Systems, Computerized / standards
  • Practice Guidelines as Topic
  • Quality of Health Care*