# Implementation of Synoptic Reporting for Endoscopic Localization of Complex Colorectal Neoplasms

## TL;DR

A synoptic reporting template was implemented to improve marking of colorectal neoplasms during colonoscopies, aiming to reduce repeat procedures.

## Contribution

A national consensus-based synoptic reporting template was developed and piloted in a Canadian healthcare system.

## Key findings

- 54% of endoscopists completed the interview, with 50% using the synoptic template.
- Users found the template impactful but not widely adopted due to lack of awareness.
- Endoscopists perceived the template as helpful for communication but uncertain about reducing repeat colonoscopies.

## Abstract

Introduction

Lack of documented tattooing of colorectal neoplasms at index colonoscopy results in high repeat preoperative colonoscopy rates. We developed national consensus recommendations for endoscopic localization and piloted an electronic synoptic reporting template. We report on the implementation and perceptions of using synoptic reporting to enhance colorectal lesion marking in a central Canadian healthcare system.

Methods

We implemented the template within our endoscopy reporting system and ran an infographic education campaign. We then conducted a follow-up email-based interview with all regional endoscopists. Thematic analysis and a mixed-methods triangulation approach were employed to synthesize qualitative and quantitative data.

Results

The interview was completed by 28/52 endoscopists (54%). Most (60.7%; n = 17) completed >100 colonoscopies and 71.4% (n = 20) identified six to 20 neoplasms requiring tattooing since introduction. A total of 50% (n = 14) used the template. Those not using it were unaware of it (42.9%; n = 12), or preferred using narrative text (17.9%; n = 5). Users reported modest mean functionality scores (intuitiveness: 3.56/5; efficiency: 3.7/5) and high impact scores (credible: 4.22/5; informative: 4.21/5). However, the perception of the synoptic template’s ability to reduce the repeat preoperative colonoscopy rate was more circumspect (3.76/5).

Conclusions

Endoscopists believed the synoptic template was a functional, impactful tool that would improve communication and help to decrease the repeat preoperative colonoscopy rate. However, synoptic template uptake was limited by provider awareness, therefore more educational efforts are needed to increase uptake.