title: Development of consensus-derived quality indicators for laparoscopic Roux-en-Y gastric bypass surgery.
abstract: BACKGROUND
  Synoptic operative reporting is a solution to the poor quality of narrative reports.
  
  
  OBJECTIVE
  To develop operative report quality indicators (QI) for laparoscopic Roux-en-Y gastric bypass (LRYGB) to generate validated parameters by which these reports can be evaluated and improved.
  
  
  METHODS
  University hospital in Canada.
  
  
  METHODS
  A Delphi protocol was used to determine QIs for LRYGB reporting. Bariatric surgeons across Canada were recruited along with key physician stakeholders to participate via a secure web-based platform. Participants initially submitted potential QIs. These were grouped by theme. Items were rated on 9-point Likert scales in subsequent rounds. Scores of 70% or greater were used for inclusion consensus, and 30% or less denoted exclusion. Elements scoring 30% to 70% were recirculated by runoff in subsequent rounds to generate the final list of QIs.
  
  
  RESULTS
  Four community and 4 academic bariatric surgeons were invited, representing all provinces performing LRYGB. The 4 multidisciplinary invitees included 1 minimally invasive/acute care surgeon, 1 tertiary abdominal radiologist, 1 gastroenterologist performing advanced endoscopy, and 1 general surgeon with expertise in synoptic reporting. Round 1 achieved an 83.3% (10/12) response and identified 91 potential items for consideration. Round 2 had a 100% response, and 69 items reached inclusion consensus. The third round achieved a 100% response and resulted in 75 QIs reaching final inclusion consensus.
  
  
  CONCLUSIONS
  This study established consensus-derived multidisciplinary QIs for LRYGB operative reports. This will allow further assessment of the quality of narrative reports and afford the development of a synoptic operative report that may ameliorate identified deficiencies.
authors.affiliation: Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, Canada.
authors.forename: Shannon
authors.initials: S
authors.lastname: Stogryn
authors.affiliation: Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, Canada.
authors.forename: Krista
authors.initials: K
authors.lastname: Hardy
authors.affiliation: Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, Canada. Electronic address: avergis@sbgh.mb.ca.
authors.forename: Ashley
authors.initials: A
authors.lastname: Vergis
mesh_terms: D032921:Consensus; D015390:Gastric Bypass / Q000592:standards*; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D008499:Medical Records / Q000592:standards; D058996:Quality Improvement; D019984:Quality Indicators, Health Care
keywords: Bariatric surgery; Operative reporting; Quality indicators