# Intraoperative Consultation-Related Documentation: A Three-Year Quality Improvement Audit

## TL;DR

This study examines how well education and reminders improved documentation quality during surgical consultations in Manitoba hospitals over three years.

## Contribution

The study evaluates the impact of targeted interventions on intraoperative consultation documentation compliance over time.

## Key findings

- Documentation completeness improved in 2022 but not in 2023.
- QA review entries improved in 2022 but not consistently in later audits.
- Checklist stickers were ineffective, suggesting workflow optimization is needed.

## Abstract

This study evaluates the effectiveness of interventions aimed at improving compliance with intraoperative consultation (IOC) documentation standards within the health system in Manitoba, Canada.

A quality improvement study assessed IOC documentation quality within Shared Health Manitoba system. Audits of 60 consecutive IOC cases (specimens) annually (2021-2023) evaluated frozen section (FS) requisitions, final pathology reports, and quality assurance (QA) review entries. Interventions included education sessions, email reminders, posters, and a trial of checklist stickers, though the latter was unsuccessful. Statistical analyses assessed documentation trends.

Interventions led to some significant but inconsistent improvements. Overall documentation completeness improved in IOC requisitions from 2021 to 2022 (p = 0.0245, 95% CI = 3.69, 38.16) but not in 2023. QA review entries also showed significant improvement in the second audit in 2022, but not in the third audit in 2023 (2021 vs 2022: 0.0327, although the 95% CI lower bound was slightly negative (−2.55, 19.05). No overall significant improvements were observed in final report IOC documentation.

Targeted interventions improved some IOC documentation aspects, but sustained success requires addressing systemic challenges through ongoing education and workflow optimization to enhance IOC-related documentation quality.