Operative reporting is the foundation of surgical communication. The quality indicators (QIs) contained in these reports can be used to document the performance of processes that affect patient care and may afford quality assurance with improvement in health care. We assessed the degree to which the electronic synoptic report (SR) documents the operative QIs compared with narrative reports (NR) for Roux-en-Y gastric bypass (RYGB). 
Forty prospectively collected RYGB SRs and 40 case-matched historical NRs were compared against checklist QIs that were established by a national Delphi process by both overall completion and completion by QI subsection (e.g., “Entero-enterostomy Details”). These checklist QIs are validated and have high inter-rater agreement at our institution. 
SRs had a mean completion of 99.7% (SD 1.3%) compared with 64.0% (SD 6.3%) for NRs (t = 36.0, p < 0.0001). All subsections of SRs were more than 99% complete and significantly higher than NRs (range 36.6%– 99.3%, p < 0.001). 
The RYGB synoptic report is superior to the narrative report for inclusion of accepted QIs. Important elements, including process of care, demographics and anatomic-related data were frequently missing from the NR. Thus, the SR is an encouraging method for improving documentation and may serve as a measure of quality care in RYGB.

Documentation of quality of care data for Roux-en-Y gas- tric bypass: comparison of synoptic and narrative operative reports.