eP305 - Assessing Institutional Compliance to Synoptic Operative Reporting for Rectal Cancer Surgery

Purpose/Background: Synoptic operative reporting has been demonstrated to improve completeness and consistency in surgical documentation. As such, the National Accreditation Program for Rectal Cancer (NAPRC) advocates for synoptic operative reporting with inclusions of key elements such as cancer staging, treatment, tumor location, completeness and extent of resection, and other surgical details. In order to improve compliance with these recommendations, our institution instituted a synoptic operative report extension in our electronic medical record to be used in rectal surgery dictations. We conducted a quality improvement study to assess the adoption of this synoptic operative report template, and identify differences in rates of inclusion of select data points between traditional narrative and synoptic operative dictations.Methods/Interventions: A retrospective review of operative reports describing low anterior resection (LAR) and abdominoperineal resection (APR) performed for rectal adenocarcinoma between January 1 2022 and October 31 2022 was conducted. All operations were performed by five fellowship trained colorectal surgeons. Operative reports were assessed for use of synoptic operative reporting and inclusion of tumor location, ligation of major vessels, and performance of TME. Rates of inclusion of these data points were compared pre- and post-initiation of synoptic operative reporting using a Chi-Square test.Results/Outcomes: Operative reports of 31 patients were reviewed. Sixteen occurred prior to institutional initiation of synoptic operative reporting and fifteen occurred after. Compliance with use of the synoptic operative reporting template was poor, with use in only 33% of cases after introduction. In both narrative and synoptic operative reports, there was adequate documentation of tumor location (96.8%), vascular ligation (100%), and TME (90.3%). There was no statistically significant difference in rates of inclusion of these data points pre- and post-initiation of synoptic operative reporting with p-values of p = 0.345, p = 1.00, and p = 0.583 respectively.Conclusion/

Discussion: This quality improvement project demonstrates poor institutional compliance with use of synoptic operative reporting. However, rates of inclusion of essential data points were adequate in both narrative and synoptic operative reports. Further refinement of our synoptic reporting template and surgeon education may be necessary to help improve quality of documentation for rectal cancer surgery.