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MOTIVATIONS AND BARRIERS TOWARD IMPLEMENTATION OF A RECTAL CANCER SYNOPTIC OPERATIVE REPORT: A PROCESS EVALUATION. Diseases of the colon and rectum Bidwell, S., Poles, G., Shelton, A., Staudenmayer, K., Bereknyei Merrell, S., Morris, A. M. 2021

Abstract

BACKGROUND: Use of synoptic reporting has been shown to improve documentation of critical information and provide added value related to data access and extraction, data reliability, relevant detail, and completeness of information. Surgeon acceptance and adoption of synoptic reports has lagged behind other specialties.OBJECTIVE: To evaluate the process of implementing a synoptic operative report.DESIGN: Mixed methods process evaluation including surveys and qualitative interviews.SETTINGS: Colorectal Surgery practices across the United States.PATIENTS: Twenty-eight board-certified colorectal surgeons.INTERVENTIONS: Implementation of the synoptic operative report for rectal cancer.MAIN OUTCOME MEASURES: Acceptability, feasibility, and usability measured by Likert-type survey questions and followed up with individual interviews to elicit experiences with implementation as well as motivations and barriers to use.RESULTS: Among all study participants, 28 surgeons completed the electronic survey (76% response rate) and 21 (57%) completed the telephone interview. Mean usability was 4.14 (range=1-5, standard error (SE)=0.15), mean feasibility was 3.90 (SE=0.15), and acceptability was 3.98 (SE=0.18). Participants indicated substantial administrative and technical support were necessary but not always available for implementation and many were frustrated by the need to change their workflow.LIMITATIONS: Most surgeon participants were male, white, had >12 years in practice, and used Epic electronic medical record systems. Therefore, they may not represent the perspectives of all U.S. colon and rectal surgeons. Additionally, as the synoptic operative report is implemented more broadly across the U.S., it will be important to consider variations in the process by EMR system.CONCLUSIONS: The synoptic operative report for rectal cancer was generally easy to implement and incorporate into workflow but surgeons remained concerned about additional burden without immediate and tangible value. In spite of recognizing benefits, many participants indicated they only implemented the synoptic operative report because it was mandated by the National Accreditation Program for Rectal Cancer. See Video Abstract at http://links.lww.com/DCR/B735.

View details for DOI 10.1097/DCR.0000000000002202

View details for PubMedID 34711713