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Session: ePoster Monitor 7-Quality and Cost 6

eP632 - Money Talks: Do Financial Incentives Improve Adherence with Synoptic Operative Reporting?

Monday, June 3, 2024
10:30 AM – 10:35 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • ZR

    Zachary J. Roberts, MD

    Colon and Rectal Fellow
    Ochsner Medical Center
    Metairie, LA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Jennifer L. Paruch, MD MS FASCRS (she/her/hers)

    Staff Surgeon
    Ochsner Medical Center
    Ochsner Medical Center
    New Orleans, Louisiana, United States

    Disclosure information not submitted.

  • W. Forrest Johnston, MD

    Ochsner Health
    University of Queensland
    New Orleans, LA, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

  • Brian R. Kann, MD, FACS, FASCRS

    Chairman & Program Director, Deptartment of Colon & Rectal Surgery
    Ochsner Medical Center
    University of Queensland/Ochsner Clinical School
    New Orleans, Louisiana, United States

    Disclosure information not submitted.

  • CW

    Charles Whitlow, M.D., F.A.C.S., F.A.S.C.R.S.

    Associate Medical Director, Surgery
    Ochsner Medical Center
    New Orleans, Louisiana, United States

    Disclosure information not submitted.

  • David Vargas, MD

    Senior Staff Surgeon and Vice Chair
    Ochsner Clinic
    New Orleans, Louisiana, United States

    Disclosure information not submitted.

  • DK

    Danielle Kay, MD

    Staff Surgeon
    Ochsner
    New Orleans, LA, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • William Kethman, MD, FACS, FASCRS

    Staff Surgeon
    Ochsner Health
    New Orleans, Louisiana, United States

    Disclosure information not submitted.

Purpose/Background: Synoptic operative reports are becoming the standard for documentation of oncologic surgeries. They ensure standardized recording of the critical elements of procedures allowing for improved patient care, data acquisition, and education. The Commission on Cancer(CoC) and the National Accreditation Program for Rectal Cancer(NAPRC) have developed minimum standards for synoptic operative reporting for colon, rectal, lung, melanoma and breast oncology, as well as, minimum utilization thresholds that must be met for continued accreditation starting in 2023. Practitioners can be resistant to change and often need an initial stimulus to adjust their practice. The goal of this study was to evaluate if financial incentives improve usage of synoptic operative reports.Methods/Interventions: A retrospective analysis was used to evaluate all patients who underwent surgery for colon, rectal, breast and lung cancer at a quaternary referral center between July 2022- July 2023 and adherence with synoptic operative reporting over that period. Beginning January 1, 2023 the colorectal department tied a 2.5% salary withholding to the value-based metric of synoptic operative report utilization. This withholding is repaid at years end if the threshold of 70% set by the CoC is met. Other departments (lung and breast) did not implement a financial incentive. Statistical analysis using Fischer’s exact test was used to compare synoptic operative reporting usage before and after the implementation of the financial incentive.Results/Outcomes: A total of 281 patients underwent surgery for colon, rectal, lung or breast cancer between July 2022-July 2023. For colon and rectal cancer patients in 2022, 8/51 (15.7%) had a synoptic report compared to 44/65 (67.7%) in 2023 (p < 0.001). For breast and lung cancer patients synoptic reports were utilized for 0/80 (0%) cases in 2022 compared to 44/85 (51%) in 2023 (p < 0.001). When comparing utilization of synoptic reports in 2023 between departments, colon and rectal surgery had a significantly higher utilization rate compared to breast and lung, 67.7% vs 51% respectively (p=0.03).Conclusion/

Discussion: All services saw an increase in utilization of synoptic reports in 2023 compared to 2022, this coincides with the rollout of tracking synoptic operative report compliance set by the CoC. However, the utilization of synoptic reports for the colorectal department was significantly higher than the other services, consistent with financial incentives contributing to their increased usage. With synoptic reports becoming the standard for oncologic procedures and accreditation by the CoC soon being tied to their utilization, it is important for surgeons to quickly adopt synoptic reports into their routine. In coming years, the minimum threshold set by the CoC will continue to increase, making adoption of this practice imperative. Financial incentives are one viable method to improve utilization of synoptic reports.Synoptic operative reporting adherence 2022 vs 2023