Abstract
Introduction: Registration of complications in a Department of Orthopaedic Surgery or Traumatology has always been the concern of surgeons as a simple feedback to improve the quality of care they provide to their patients. However, it has not been made through a systematic approach in Switzerland to date. The literature shows only one study which proposes to set up a database and software for general surgery complications.
The purpose of this study was to show the feasibility of setting up a computerized register of complications for a whole Department of Orthopaedic Surgery and Traumatology, based on a simple, user-friendly and upto-date scientific approach.
Methods: After a systematic literature review, the definitions, types and classification of complications were determined. A protocol for data registration was defined as well as the tasks for the people involved. A client-server software was chosen and further developped, in close collaboration with the Information Technology Department to benefit from an automatic download of patients’ administrative data.
Results: The classification of complications by de Waal Maletfijt was adapted and the coefficient of severity proposed by Clavien was used. A definition of each complication was communicated to all staff involved. A self-developed Microsoft Access application with a local database as back-end was developed. A new strategy to capture the complications efficiently was developed and used after staff approval. Data collection was done before surgery (prehospitalisation), on the day of surgery and after the operation until the end of the stay in hospital.
Conclusions: This systematic approach to record complications was found feasible, efficient and a useful tool for the assessment of quality of care.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
