Overview

The use of checklists for complicated processes is widely embraced and leads to reductions in morbidity as well as mortality rates of hospitalized patients.[1] Checklists help avoid omission of crucial steps, especially during uncommonly performed procedures or when information complexity negatively impacts situational awareness.[2]

The Quality Assessment and Safety Committee of the American Society of Colon and Rectal Surgeons (ASCRS) developed a rectal cancer surgery checklist as a guide to enhance safety and quality of care for patients with rectal cancer undergoing surgery, to incorporate best practices in treating these patients, to raise general awareness of the importance of each individual checklist item, and to serve as a potential foundation for building accredited centers in rectal cancer treatment.[3] The Optimizing the Surgical Treatment of Rectal Cancer (OSTRiCh) Standardized Synoptic Operative Report Committee subsequently used the ASCRS rectal cancer checklist as a guide in the development of its standardized synoptic operative report (Table 1). The National Accreditation Program for Rectal Cancer (NAPRC), developed in collaboration with the OSTRiCh Consortium and the American College of Surgeons Commission on Cancer, now includes synoptic operative reporting as a standard for its accreditation.[4]

The use of synoptic operative reporting in rectal cancer has been shown to increase the completeness and reliability of documentation of critical elements when compared to narrative reporting alone.[5][6]

Table 1. Required Elements and Response Options for Rectal Cancer Synoptic Operative Report

APR, abdominoperineal resection; ASA, American Society of Anesthesiologists; IMA, inferior mesenteric artery; IMV, inferior mesenteric vein; LAR, Low anterior resection; SRA, superior rectal artery; TES, transanal endoscopic surgery; TME, total mesorectal excision; TPC, transperitoneal colostomy.

Reprinted with the permission of the OSTRiCh Standardized Synoptic Operative Report Committee.