Post-Procedure Complications Monitoring Programme 27th Review Meeting Friday, 22 March 2013 4:00-5:30pm, AKC Li Library

Attendance Present Prof. Paul B S Lai (Chairman) Team 1 – Dr. Charing Chong & Dr. Anthony Fong Team 2 – Dr. Simon Wong Team 3 – Dr. Hon Sok Fei Team 4 – Prof. James Lau & Dr. Micah Chan PRAS – Dr. David Wong & Dr. Teresa Tan PSU – Dr. Peter Tam URO – Dr. Peter Chiu CTS – Dr. Randolph Wong Mr. Alfred Chan Ms Eunice Tam

Items discussed Complications report – Jan 2013 AOB Logistics

1. Complications Report – Jan 2013

Complication rate and Magnitude January Summary (case collection progress, Complication rates and Mortality) Case collection Complication rate and Magnitude Mortality

Cumulative data (2010-2013/1 and 2010-2012)

Team 1 – Hepatobiliary & Pancreatic Surgery Potential M & M Case

Team 1 – Hepatobiliary & Pancreatic Surgery (Cont’d 2/5)

Team 1 – Hepatobiliary & Pancreatic Surgery (Cont’d 3/5)

Team 1 – Hepatobiliary & Pancreatic Surgery (Cont’d 4/5)

Team 1 – Hepatobiliary & Pancreatic Surgery (Cont’d 5/5)

Team 2 – Upper Gastro-intestinal Surgery Same patient

Team 2 – Upper Gastro-intestinal Surgery (Cont’d 2/4)

Team 2 – Upper Gastro-intestinal Surgery (Cont’d 3/4)

Team 2 – Upper Gastro-intestinal Surgery (Cont’d 4/4) Highly unusual case

Team 3 – Colorectal Surgery

Team 3 – Colorectal Surgery (Cont’d 2/7) Note : > Ecoli

Team 3 – Colorectal Surgery (Cont’d 3/7) Combined as one entry

Team 3 – Colorectal Surgery (Cont’d 4/7)

Team 3 – Colorectal Surgery (Cont’d 5/7) Remove from complication and count as Mortality

Team 3 – Colorectal Surgery (Cont’d 6/7) Add “post-op dehydration”

Team 3 – Colorectal Surgery (Cont’d 7/7)  Non-discharge

Team 4 – Vascular Surgery Add ‘UTI’ Same patient as the following case

Team 4 – Vascular Surgery (Cont’d 2/3) Add ‘limb loss’ Same patient as the previous case M & M Case Guidewire not strong enough complication led to change in practice

Team 4 – Vascular Surgery (Cont’d 3/3)

Plastic, Reconstructive and Aesthetic Surgery

Plastic, Reconstructive and Aesthetic Surgery (Cont’d 2/2)

Neurosurgery

Neurosurgery (Cont’d 2/2)

Paediatric Surgery and Paediatric Urology PSU Team will grade all complication Very difficult to extubate Grade IIIa Complication

Paediatric Surgery and Paediatric Urology (Cont’d 2/2) 19 Feb 13 Grade IIIb Grade I Quite complicated & unexpected Transanal part difficult Total operative time > 6 hours Sepsis set in a few hours after surgery

Urology Post-op Fever (Gout)

Urology (Cont’d 2/3) Patient admitted under PSU but stone problem treated by Uro.

Urology (Cont’d 3/3)

Cardiothoracic Surgery

Cardiothoracic Surgery (Cont’d 2/4)

Cardiothoracic Surgery (Cont’d 3/4)

Cardiothoracic Surgery (Cont’d 4/4) Randolph to study on the efficacy of lung biopsy request from ICU

2. AOB

Surgical Outcome / SOMIP Sharing (tentative on 27 April 2013) Potential topics - Paediatric Surgery- relook of 2013 complications with grading Potential Speakers to be invited by Prof Paul B S Lai : Dr. W C Yuen & Dr. Amy Cho Complications grading – to implement wef 2013

3. Logistics Period Programme Logistic (Distribution) Method Within 1-2 Week(s) before the week with Meeting 1st Missing case lists   Email, and a hard copy addressed to HST via team Secretary Monday in the Week with meeting 2ndMissing case lists Wednesday in the Week with meeting Report preview (v1.1) 3rd Missing case lists Morning of the day with meeting Meeting Report (v1.2) Email Within 1 week from post-meeting Post-meeting Report (v1.3)

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