Surgical Case Notes Quality by CRABEL Score in Dow University Hospital

Main Article Content

Masood Jawaid
Abdul Khalique
Foad Ali Moosa
Nighat Bakhtiar

Abstract

Objective: To find out the quality of medical records in the department of surgery at Dow UniversityHospital, a tertiary care teaching hospital.

Methodology: Medical records of all patients admitted in surgery department of surgery at Dow UniversityHospital from February 2012 to April 2012 were reviewed. By analyzing two sets of medical notes, anumerical score out of total 100 was calculated which is used as a representative value of quality; 100being most accurate. For each omission of any of the criteria of CRABEL score, one point was deductedand the total scores was presented as percentage.

Results: The overall CRABEL score was 72.1 in all surgical case notes. Most frequents points werededucted in subsequent entry section with total deduction of 30.3% while least deduction was seen indischarge section with total deduction of 4.4%.

Conclusion: Quality of Record keeping in surgical department of surgery is 71% in relation to CRABELscore. Subsequent entry section is the major factor in decrease in the quality of notes.

Article Details

How to Cite
1.
Jawaid M, Khalique A, Moosa FA, Bakhtiar N. Surgical Case Notes Quality by CRABEL Score in Dow University Hospital. J Postgrad Med Inst [Internet]. 2012 Sep. 24 [cited 2022 May 23];26(4). Available from: https://www.jpmi.org.pk/index.php/jpmi/article/view/1274
Section
Original Article
Author Biographies

Masood Jawaid, Dow International Medical College and Dow University Hospital

Assistant Professor Surgery

Department of Surgery

Abdul Khalique, Dow International Medical College and Dow University Hospital

Senior Registrar,

Department of Surgery

Foad Ali Moosa, Dow International Medical College and Dow University Hospital

Professor of Surgery

Department of Surgery

Nighat Bakhtiar, Dow University Hospital

Resident Surgery,

Department of Surgery

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