Wouter Leclercq

Chapter 11 186 CONCLUSIONS 1. Adequate implementation of the elements of the SIC process will contribute to optimal patient care. Training both patient and surgeon supported by e-health tools may improve the SIC process in daily practice. 2. Overall knowledge of Dutch general, orthopaedic and plastic surgeons regarding SIC is far from optimal. Education, dedication and the use of innovative tools are needed to improve SIC in daily practice in the Netherlands. 3. The SIC process in young adults undergoing bariatric surgery requires improvement. Educational material on possible scenarios after bariatric surgery including risks and lifetime consequences should be developed. 4. Shared decision making (SDM) and SIC share certain aspects but SDM-Q-9 and SDM- Q-Doc questionnaires are inadequate for SIC related research. 5. A substantial portion of malpractice claims and MDB decisions are related to missing items of an overall deficient SIC process. Optimizing SIC may improve patient satisfaction and expectations and may subsequently result in a lower risk on malpractice claims and MDB complaints. 6. Currently used SIC forms in general surgery have insufficient quality. A format for a best-practice SIC form for both surgeon and patient is proposed. 7. Personalised e-health interventions after abdominal surgery accelerate ‘return to normal activities’ compared to usual care. Implementation of an e-health programme is recommended for certain surgical procedures.