title: Synoptic operative reports enhance documentation of best practices for rectal cancer.
abstract: BACKGROUND
  Implementation of best practices surgical checklists improves patient safety and outcomes. However, documenting performance of these practices can be challenging. The American Society of Colon and Rectal Surgeons developed a Best Practices for Rectal Cancer Checklist (RCC) to standardize and improve the quality of rectal cancer surgery. This study compared the degree to which synoptic (SR) and narrative (NR) operative reports document RCC items.
  
  
  METHODS
  Two reviewers independently reviewed a cohort of prospectively collected SR for rectal cancer surgery and a case-matched historical cohort of NR. Reports were reviewed for documentation of performance of operative items on the RCC. Abstraction time and inter-rater agreement were also measured.
  
  
  RESULTS
  SR scored significantly higher than NR on the overall checklist score (mean adjusted score ± standard deviation 12.4 ± 0.9 vs. 5.7 ± 1.9, maximum possible score 18, P < 0.001). Reviewers abstracted data significantly faster from SR. Inter-rater agreement between reviewers was high for both types of reports.
  
  
  CONCLUSIONS
  SR were associated with reliable and more complete and reliable documentation of items on the RCC. Use of an SR system standardizes operative reporting, providing the opportunity to enhance checklist compliance, and enable timely feedback to improve surgical outcomes for rectal cancer patients.
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Reagan L
authors.initials: RL
authors.lastname: Maniar
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Sytnik
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Debrah A
authors.initials: DA
authors.lastname: Wirtzfeld
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hochman
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: McKay
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Benson
authors.initials: B
authors.lastname: Yip
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Pamela C
authors.initials: PC
authors.lastname: Hebbard
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Park
mesh_terms: D057189:Checklist; D003625:Data Collection / Q000379:methods*; D004282:Documentation / Q000592:standards*; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000592:standards*; D012004:Rectal Neoplasms / Q000601:surgery*
keywords: colorectal surgery; operative reports; quality of health care; rectal neoplasms; safety checklists; synoptic reports