Preoperative surgical case review program in a community-based, academic medical center: a feasibility study.
OBJECTIVE
To assess the feasibility of applying postoperative objective criteria for preoperative evaluation of scheduled gynecologic cases.


METHODS
A preoperative evaluation program was introduced in which all surgeons were asked to voluntarily submit a 1-page case summary questionnaire for each elective gynecologic surgical procedure. A committee of departmental peers reviewed each submission for appropriateness of indications and completeness of preoperative evaluation. Cases were evaluated against quality assessment criteria sets created by the American College of Obstetricians and Gynecologists. Reviewed summaries were categorized as either meeting criteria, not meeting criteria but appropriate, not meeting criteria or no pertinent criteria available for the procedure planned.


RESULTS
In all, 2,005 elective gynecologic surgical procedures were performed by 70 active surgeons during the 1-year study period; 1,166 procedures (58%) were reported. Of 70 surgeons, 57 reported at least 1 procedure, but only 6 were 100% compliant with their surgical submissions. In total, 1,008 procedures (86% of reported cases) met the criteria or were deemed appropriate by committee review. In 166 instances, additional information was requested from and provided by the surgeon before the case could be adjudicated.


CONCLUSIONS
A voluntary program of preoperative surgical case review for scheduled gynecologic procedures appeared feasible but resulted in only modest initial participation.
Nelson
Kenneth J
KJ
Department of Obstetrics and Gynecology, Evanston Northwestern Healthcare, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA. knelson62@aol.com
Wagner
Arnold L
AL
Gordon
Trent E J
TE
Silver
Richard K
RK
D000046:Academic Medical Centers; D003159:Community-Institutional Relations; D005240:Feasibility Studies; D005260:Female; D017408:Guidelines as Topic; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D018024:Peer Review, Health Care; D011300:Preoperative Care / Q000379:methods*; D011786:Quality Control