Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

Abstract

Background Surgical logbooks are a commonly used tool for quality assurance of surgical training. Electronic logbooks are increasingly applied in low-resource settings, but there is limited research on their quality. The aim of this study is to evaluate the quality of an app-based surgical e-logbook system shortly after its implementation in a low-income country and to identify potential areas of improvement for the system. Methods Entries in the e-logbook system were cross-checked with hospital records and categorized as matched or overreported. Moreover, the hospital records were checked for underreported procedures. Additionally, semi-structured interviews were conducted with users of the e-logbook system. Results A total of 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analyzed. Matches were found in the hospital records for 67.3% of the database entries. Moreover, 32.7% of the database entries were overreported and 50.7% of the procedures in the hospital records were underreported. A previous study of an analog surgical logbook system in the same setting estimated that 73.1% of the entries were matches or close matches. Interviews with 12 e-logbook users found overall satisfaction but also identified potential areas of improvement, including the need for more training in the use of the system, modifications to improve user-friendliness, and better access to the necessary technology. Conclusions A reliable documentation system is necessary to evaluate the quality of health workforce training. The early evaluation of a surgical e-logbook system in a low-income country showed that the collected data should be approached with caution. The quantitative analysis suggests that the e-logbook system needs to be improved in terms of accuracy. In interviews, users reported that digitalization of the logbook system was a much-needed innovation but also identified important areas of improvement. Recognition of these aspects at an early stage facilitates guidance and adjustment of further implementation and might improve the accuracy of the system.

Improving TB Surveillance and Patients' Quality of Care Through Improved Data Collection in Angola: Development of an Electronic Medical Record System in Two Health Facilities of Luanda

“…Nevertheless, once the health emergency situation will decrease, the system will be piloted, evaluated and refined. According to other similar studies, during the piloting stage of the EMR system, particular care needs to be focused on enhancing the accuracy of the data recorded ( 19 , 20 ). The evaluation of the EMR system will target the actual impact of the system on data quality and quality of care.…”

Investigating the advantages and disadvantages of electronic logbooks for education goals promotion in medical sciences students: A systematic review

“…After reviewing previous studies, 11,16 the advantages of e-logbooks were categorized into 52 items and their disadvantages into 22 items.…”

“…-Improving the relationship between supervisor and supervisee 8 -Creating a connection between students and educational items 29 -Increasing interaction with supervisors 32 -Increasing student satisfaction 8,16 7…”

“…In this review, ease of accessing 11,16,24,25,30 and maintaining information 31 were among the e-logbook advantages. Brouwer et al revealed that the ease of recording information online resulted in educational progress and access to information at any time and place.…”

“…Ease of accessing, maintaining, and sharing information -More efficient access to data 16,24,30 -Access to information at any time and place 11,16,25 -Indexing students' experiences 8,29 -The ability to link data 28 -Ease of access to educational materials 8,28 -Ease of maintaining e-logbooks 31 3 Supervising, monitoring, and evaluating students' and educators' performance -Providing the conditions for continuous monitoring and evaluating students' performance 11,25,28 -Curriculum evaluation and development 26 -Monitoring student experiences during a clinical rotation 26,27 -Comparison of student experiences in a multi-department hospital internship unit 26 -Better performance monitoring than paper logbook 8,20 -Better management of trainees' workflow 8,11 -Getting an overview of student education 11,30 -Supervising and monitoring education and educational program 31,32 -Supervising and monitoring trainees and trainers 24 -Identifying educational gaps 32…”