Intraoperative consultation as an instrument of quality management.

BACKGROUND

This study was designed to investigate the effectiveness of intraoperative consultation (IOC) with regard to its feasibility for improving quality management. IOC comprises an assessment of major steps in the operative procedure by another surgeon requested by the operating surgeon to be present in the operating room in a consultative capacity during the operation.

METHODS

Between January and June 2008, IOC was implemented in 1217 operations. Data on the frequency of the feasibility of IOC and on whether IOC led to decisions influencing the course of the procedure were measured.

RESULTS

A total of 872 IOCs were performed: regular IOC in 708 cases (81%), and tactical IOC in 164 cases (19%). In 70 cases (8%), consultation resulted in minor changes, and in 59 cases (7%) major clinically relevant revision of the operative strategy was deemed necessary.

CONCLUSIONS

It was found that IOC can be performed in the majority of cases. In the case of tactical IOC in particular, a large number of treatment-relevant decisions are taken. This means that in the area of operative disciplines, IOC represents a potential preventive strategy within the framework of quality management.