Live Quality Assurance: Using a Multimedia Messaging Service Group Chat to Instantly Grade Intraoperative Images
| Autor: | Amy N. Hildreth, Stephen S. McNatt, Myron S. Powell, Carl J. Westcott, Barbara K. Yoza, Adolfo Z. Fernandez, Kathryn B. Sobba, Andrew M. Nunn, Preston R. Miller, Jessica L. Gross |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Time Factors Quality Assurance Health Care Cholecystitis Acute Feedback 03 medical and health sciences Intraoperative Period fluids and secretions 0302 clinical medicine medicine Photography Humans Medical physics Grading (education) Laparoscopic cholecystectomy business.industry equipment and supplies medicine.disease Cholecystectomy Laparoscopic Multimedia 030220 oncology & carcinogenesis Image scoring Cholecystitis Operative time Feasibility Studies 030211 gastroenterology & hepatology Surgery Multimedia Messaging Service Health information business Quality assurance Cell Phone |
| Zdroj: | Journal of the American College of Surgeons. 230(2) |
| ISSN: | 1879-1190 |
| Popis: | Background The technique for attaining photographic evidence of the critical view of safety (CVS) in laparoscopic cholecystectomy (LC) has previously been defined; however, the consistency, accuracy, and feasibility of CVS in practice is unknown. The aim of this study was to use an already established image sharing and grading system to determine the feasibility of timely feedback after sharing intraoperative images of the CVS and to evaluate if and how cholecystitis affects the ability to attain a CVS. Study Design We studied 193 laparoscopic cholecystectomies performed by 14 surgeons between August 2017 and January 2019. Anterior and posterior intraoperative CVS images were shared using a standard multimedia messaging system (MMS). Images were graded remotely by members of the group using an established scoring system, and their times to response and scores were recorded. Response data were analyzed for the ability to attain timely and consistent CVS scores. Results There were 74 urgent laparoscopic cholecystectomies for acute cholecystitis and 119 nonurgent cholecystectomies performed during the study period. Scoring of shared images occurred in less than 5 minutes, and peer review (mean 3 responses) showed agreement that was not significantly different. In patients with acute cholecystitis, a small but significant difference was observed between anterior and posterior image scoring agreement. Conclusions An established image sharing and grading system for CVS can be used for real-time intraoperative feedback without increasing operative time or compromising private health information. The CVS is almost always attainable; however, decreases in CVS quality and grading agreement are observed in patients with acute cholecystitis. |
| Databáze: | OpenAIRE |
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