Wouter Leclercq

Summarizing discussion and conclusions 185 11 in expectations between surgical patients, their consultants and consent recordings was present. However, discriminative characteristics of the tested SDM questionnaires were suboptimal indicating that the use of these SDM questionnaires is not advised in future studies in the SIC domain. Once a patient is (or feels) injured, ill-treated, disappointed or dissatisfied, medical disciplinary complaints and legal claims may be filed. Aim of the study that is reported in chapter 8 was to analyse characteristics of a decade of malpractice claims and medical disciplinary board (MDB) decisions regarding SIC in the Netherlands. It was concluded that a substantial portion of malpractice claims and MDB decisions were related to missing items in an overall deficient SIC process. Conversely, focusing on crucial SIC elements may improve patient satisfaction and expectations and may subsequently result in a lower risk of malpractice claims and MDB complaints. In Chapter 9, an analysis of all SIC forms that are currently used in the Netherlands revealed substantial deficits in most. A practical best-practice guide for documenting SIC is proposed that may help doctors to optimally guide their patients and themselves through the SIC process and may help to provide an EPD with adequate SIC records. These SIC records can be made available to patients as a preoperative SIC leaflet. The efficacy of modern tools using e-health options as a surrogate caregiver aiding patients during their recovery phase were analysed in chapter 10 . Results of this study demonstrated that personalised e-health intervention after abdominal surgery accelerated the return to normal activities compared with usual care. Implementation of this e-health programme was recommended in patients undergoing intermediate-grade abdominal, gynaecological, or general surgical procedures.