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{"sheet":"Introduction","index":0,"n_rows":17,"n_cols":2,"rows_kept":17,"cut":false,"hidden":false,"merged":[]}
[]
[]
[]
[]
[null,"Bariatric Surgery: Too Lean a Service"]
[null,"Audit Toolkit"]
[]
[null,"Thank you for downloading the toolkit for 'Bariatric Surgery: Too Lean a Service?'. We hope you find this useful and if you have any feedback please do contact us at info@ncepod.org.uk (see below for link). Please can you advise your local audit department if you plan to undertake this audit, it is important that they are made aware of it for the benefit of demonstrating Trust activity and also so that they are in a position to support you and endorse the activity for your benefit."]
[]
[null,"info@ncepod.org.uk"]
[]
[null,"Please complete as many questions which are applicable to the care of the patient"]
[]
[null,"For information on the recommendation to which each question assesses please click on the         button"]
[]
[null,"This toolkit can be used in conjunction with the Self Assessment Checklist. This can be found by clicking on the report image or at:"]
[null,"http://www.ncepod.org.uk/2012bs.htm"]

{"sheet":"Instructions","index":1,"n_rows":36,"n_cols":1,"rows_kept":36,"cut":false,"hidden":false,"merged":[]}
["Instructions for completion"]
[]
["Before you begin, in order to fill this tool in properly you MAY need to enable macros. To do this please click on the options button above this spreadsheet in the top left of the workbook. In the dialogue box which opens click on enable macros, ok. The spreadsheet should now be functional. "]
[]
["This data collection tool is made up of questions which can be used to assess how well your Trust is meeting recommendations made in \"Bariatric Surgery: Too Lean a Service?\""]
[]
["Amending the tool to include more or less patients"]
["This tool has been set up to be completed on 10 patients."]
["If the audit is undertaken on less than 10 patients, please delete out the extra rows."]
["If the audit is undertaken on more than 10 patients, please add in additional rows by copying row 9 (before populated with patient data), and inserting the copied cells above row 10."]
["Following these steps will ensure the formulas work correctly."]
[]
["For information on the recommendation to which each question assesses please click on the         button. This will take you to the recommendations page. Please click on the Audit tool tab to return to the questionnaire."]
[]
["For date fields please insert using the dd/mm/yyyy format; please insert times using the 24 hour clock (hh:mm)"]
[]
["Where a question answer is highlighted in red, this indicates this is an area of care where the recommendation (or the question assessing a recommendation) is not being met. The more answers are highlighted in red, the more likely it is a recommendation is not being met. "]
[]
["Summary data is given at the bottom of the tool (audit tool tab)."]
[]
["As the questionnaire is completed a summary of responses is collated on the summary tab."]
["Each question that relates to a recommendation will become highlighted with the following "]
["Green - Recommendation sub criteria was met in 100% of the sample"]
["Amber - Recommendation sub criteria was met in between 50-90% of the sample"]
["Red - Recommendation sub criteria was met in less than 50% of the sample"]
["Blue - Recommendation sub criteria were not answered/not applicable for any of the sample"]
[]
["The sub criteria can be changed for the tool as a whole where necessary (not for individual questions). Where this is required please amend the % criteria values in the RAG system table on the summary sheet."]
[]
["As the questionnaire is completed the radar chart will be populated based on the answers given in the recommendation sub criteria. The percentage is worked out based on the number of cases completed; therefore if data is completed for only 1 patient and the subcriteria questions are all met then a Trust will be meeting 100% of recommendations. This must be considered when analysing the results. "]
[]
["Each number point on the chart relates to a recommendation; the higher the percentage, the more likely a recommenation is being met. The total percentage for each recommendation is also displayed below the sub criteria questions."]
[]
["In order for the formulas to work, an answer must be given for each recommendation subcategory; therefore please ensure NA's are input where prompted and appropriate"]
[]
["NCEPOD does not ask for any of this data back; it is for each Trust to make a judgement as to whether they are meeting recommendations."]

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["Too Lean a Service?"]
[]
[null,"PATIENT DETAILS",null,null,null,null,null,"REFERRAL",null,null,null,null,null,null,null,"OUTPATIENT CONSULTATION",null,null,null,null,null,null,null,null,null,null,null,null,"COMORBIDITIES",null,null,null,null,null,null,null,null,null,"PRE-ASSESSMENT",null,null,null,null,"CONSENT",null,"ANAESTHETIC INDUCTION",null,null,null,null,"OPERATION",null,null,null,null,null,null,"OPERATION CONTINUED",null,null,null,null,null,null,"POST-OPERATIVE CARE",null,null,null,null,null,null,null,null,"DISCHARGE",null,null,null,null,null,null,null,"FOLLOW-UP",null,null,null,null,null,null,null,null,"OVERALL ASSESSMENT OF CARE"]
["Recommendation"]
["Question number",1,2,"3a","3b","3c",4,"5a","5b","5c","5d","5e",6,7,8,9,"10a","10b","10c","10d","11a","11b","12a ","12b","12c ","13a ","13b","13c ","14a",null,null,null,null,"14b",null,null,null,null,"15a","15b","16a","16b ",17,"18a ","18b ",19,20,21,22,23,24,"25a","25b","26a","26b","26c","26d","27a","27b","27c","28a","28b",29,30,31,32,"33a","33b",34,35,36,37,38,"39a","39b","39c","40a","40b",41,42,43,"44a","44b",45,"46a","46b","46c","47a ","47b","47c",48]
[null,"Age \n(at time of procedure)","Gender","Weight \n(at referral)","Height","BMI\n(at referral)","Patient funding?","Source of referral to surgical team?","If secondary care selected, please specify","Date of referral","Date of admission","Date of surgery","Did the referral letter to the surgical team include the patients height and weight?","Did the referral comply with NICE guidelines?","In your opinion was the referral of this patient appropriate?","In what type of clinic was the patient first assessed?","Was the patient discussed at an MDT meeting prior to surgery?","If NO to 10a, was a reason for this documented?","If YES to 10a, who of the following attended?","Do you think this was adequate and timely for the needs of the patient?","Who assessed the patient prior to surgery?","Do you think this was adequate and timely for the needs of the patient?","Is there documented evidence that the patient received dietetic assessment and education prior to surgery?","If YES to 12a, when was this?","In your opinion was this adequate for the patient?","Is there documented evidence that the patient was offered psychological support prior to surgery?","If YES to 13a, when was this?","In your opinion was the psychological support the patient received adequate?","Did the patient have any of the following comorbidities prior to surgery?",null,null,null,null,"In your opinion, were they managed appropriately?",null,null,null,null,"Was the patient seen in a pre-assessment clinic?","If NO to 15a, do you think they should have been?","Is it documented that the patient saw an anaethetist prior to this admission?","If NO to 16a, do you think they should have done?","How would you rate the pre-assessment for this patient?","Was a deferred two-stage consent form utilised?","In your opinion is the information contained within the consent form appropriate for the procedure the patient was undergoing?","Was a predicted level of difficulty of intubation assessed and recorded pre-operatively?","What ASA class was the patient?","Is there any evidence of problems with the anaesthetic induction?","What was the grade of the anaesthetist?","In your opinion, did the patient have adequate physiological monitoring?","In what type of facility was the patient's operation?","What was the grade of the primary operator?","If the primary operator was not a consultant, what supervision was available?","What type of operation was this?","Performed by: ","What operative approach was used?","What operation did the patient have?","Weight at time of surgery\n(kg)","Height (m)","BMI at time of surgery","Was there any deviation from the planned procedure?","If YES to 28a, was this appropriately documented?","Were there any untoward events/intra-operative complications during surgery?","Did the patient receive an intra or post-operative blood transfusion?","To what level ward was the patient sent post recovery?","Did the patient have a HDU/ITU stay of unexpected duration or an unexpected readmission to HDU/ITU?","Was a track and trigger system used for this patient?","Did the patient at any time exceed the trigger threshold?","Did the patient require an escalation in care at anytime post-operatively?","Did the patient receive any unplanned interventions/ imaging or a re-operation post-operatively?","In your opinion was the patient adequately monitored?","In your opinion did the patient receive an adequate number of reviews of appropriate seniority ?","How would you rate the post-operative care for this patient?","What level ward was the patient nursed prior to discharge?","Date of discharge","What was the patient's discharge location?","Was a discharge summary included with the notes?","If YES to 40a, how would rate the quality of the discharge summary for this patient?","Were the discharge drugs appropriate for this patient?","Was the diabetic regime/management on discharge appropriate for this patient?","Was the diatetic regime/management on discharge appropriate for this patient?","Was the patient seen by the operating surgeon in the first 6 months post discharge?","If NO to 44a, were they seen by another bariatric surgeon in the first 6 months post discharge?","In your opinion was the follow up in the first 6 months adequate for this patient?","Was the patient readmitted during the first 6 months post surgery?","If YES to 46a, what level ward was this?","Why were they readmitted?","Was this patient entered into the National Bariatric Surgery Registry (NBSR)?","If YES to 47a, has follow up data for this patient been entered into the NBSR?","If YES to 47b, which of the following?","Overall assessment of care for this patient "]
[null,null,null,"                      kg                                       m                   For height/weight conversion click here",null,null,null,null,"e.g. Diabetic clinic","dd/mm/yyyy","dd/mm/yyyy","dd/mm/yyyy",null,null,null,null,null,null,"(answers may be multiple) please select all that apply",null,"(answers may be multiple) please select all that apply",null,null,"(answers may be multiple) please select all that apply",null,null,"(answers may be multiple) please select all that apply",null,"Type 2 Diabetes","Sleep Apnoea","Hypertension","Cardiovascular disease (other than hypertension)","Gastro oesophageal reflux","Type 2 Diabetes","Sleep Apnoea","Hypertension","Cardiovascular disease (other than hypertension)","Gastro oesophageal reflux",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(if revision of same procedure/ conversion of previous operation)",null,null,"kg\nFor weight conversion chart click here",null,null,null,null,null,null,"For definitions click here",null,"For definitions click here",null,null,null,null,null,null,null,"dd/mm/yyyy",null,null,null,null,null,null,null,null,null,null,null,"Please enter as free text",null,null,"(answers may be multiple) \nplease select all that apply","(please select one category only)"]
["Patient 1",null,null,null,null,{"$f":"IFERROR(D8/(E8*E8),0)","v":0},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(Q8=\"No\",\"\",IF(Q8=\"Yes\",\"NA\",IF(Q8=\"Insufficient data\",\"NA\")))","v":false},{"$f":"IF(Q8=\"Yes\",\"\",IF(Q8=\"No\",\"NA\",IF(Q8=\"Unknown\",\"NA\")))","v":false},null,null,null,null,{"$f":"IF(W8=\"Yes\",\"\",IF(W8=\"No\",\"NA\"))","v":false},null,null,{"$f":"IF(Z8=\"Yes\",\"\",IF(Z8=\"No\",\"NA\",IF(Z8=\"Insufficient data\",\"NA\")))","v":false},{"$f":"IF(Z8=\"Yes\",\"\",IF(Z8=\"No\",\"NA\",IF(Z8=\"Insufficient data\",\"NA\")))","v":false},null,null,null,null,null,{"$f":"IF(AC8=\"Yes\",\"\",IF(AC8=\"No\",\"NA\"))","v":false},{"$f":"IF(AD8=\"Yes\",\"\",IF(AD8=\"No\",\"NA\"))","v":false},{"$f":"IF(AE8=\"Yes\",\"\",IF(AE8=\"No\",\"NA\"))","v":false},{"$f":"IF(AF8=\"Yes\",\"\",IF(AF8=\"No\",\"NA\"))","v":false},{"$f":"IF(AG8=\"Yes\",\"\",IF(AG8=\"No\",\"NA\"))","v":false},null,{"$f":"IF(AM8=\"Yes\",\"NA\",IF(AM8=\"No\",\"\",IF(AM8=\"Unknown\",\"NA\")))","v":false},null,{"$f":"IF(AO8=\"Yes\",\"NA\",IF(AO8=\"No\",\"\",IF(AO8=\"Insufficient data\",\"NA\")))","v":false},null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AZ8=\"Consultant\",\"NA\",IF(AZ8=\"Staff grade/Associate specialist\",\"\",IF(AZ8=\"Trainee with CCT\",\"\",IF(AZ8=\"Senior specialist trainee\",\"\",IF(AZ8=\"Junior specialist trainee\",\"\",IF(AZ8=\"Basic grade\",\"\",IF(AZ8=\"Other\",\"\")))))))","v":false},null,{"$f":"IF(BB8=\"Primary\",\"NA\",IF(BB8=\"Revision of same procedure\",\"\",IF(BB8=\"Conversion of previous operation\",\"\",IF(BB8=\"Planned second stage\",\"NA\",IF(BB8=\"Complex revision not otherwise specified\",\"NA\")))))","v":false},null,null,null,{"$f":"E8","v":0},{"$f":"IFERROR(BF8/(BG8*BG8),0)","v":0},null,{"$f":"IF(BI8=\"Yes\",\"\",IF(BI8=\"No\",\"NA\",IF(BI8=\"Insufficient data\",\"NA\")))","v":false},null,null,null,null,{"$f":"IF(BM8=\"Level 0\",\"\",IF(BM8=\"Level 1\",\"\",IF(BM8=\"Level 2\",\"NA\",IF(BM8=\"Level 3\",\"NA\"))))","v":false},{"$f":"IF(BO8=\"\",\"\",IF(BO8=\"NA\",\"NA\",IF(BO8=\"Yes\",\"\",IF(BO8=\"No\",\"NA\",IF(BO8=\"Insufficient data\",\"NA\")))))","v":false},null,null,null,null,null,null,null,null,null,{"$f":"IF(BY8=\"Yes\",\"\",IF(BY8=\"No\",\"NA\"))","v":false},null,null,null,null,{"$f":"IF(CD8=\"Yes\",\"NA\",IF(CD8=\"No\",\"\"))","v":false},null,null,{"$f":"IF(CG8=\"Yes\",\"\",IF(CG8=\"No\",\"NA\",IF(CG8=\"Unknown\",\"NA\")))","v":false},null,null,{"$f":"IF(CJ8=\"Yes\",\"\",IF(CJ8=\"No\",\"NA\"))","v":false},{"$f":"IF(CK8=\"Yes\",\"\",IF(CK8=\"No\",\"NA\",IF(CJ8=\"No\",\"NA\")))","v":false}]
["Patient 2",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,{"$f":"IF(AG9=\"Yes\",\"\",IF(AG9=\"No\",\"NA\"))","v":false},null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,{"$f":"E9","v":0},{"$f":"IFERROR(BF9/(BG9*BG9),0)","v":0},null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 3",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,{"$f":"E10","v":0},0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 4",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,0,0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 5",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,0,0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 6",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,0,0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 7",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,0,0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 8",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,0,0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 9",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,0,0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,false,null,null,false,false]
["Patient 10                                                                                           Add new patient (above this row before populating with data)",null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,null,false,false,null,null,null,null,false,null,null,false,false,null,null,null,null,null,false,false,false,false,false,null,false,null,false,null,null,null,null,null,null,null,null,null,null,false,null,false,null,null,null,0,0,null,false,null,null,null,null,false,false,null,null,null,null,null,null,null,null,null,false,null,null,null,null,false,null,null,{"$f":"IF(CG17=\"Yes\",\"\",IF(CG17=\"No\",\"NA\",IF(CG17=\"Unknown\",\"NA\")))","v":false},null,null,false,false]
[]
["Yes n",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(N8:N17,\"Yes\")","v":0},0,null,0,0,null,0,null,0,0,0,0,0,null,0,null,null,null,null,null,null,null,null,null,null,0,null,0,0,null,0,{"$f":"COUNTIF(AS8:AS17,\"Yes \")","v":0},0,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(BZ8:BZ17,\"*Good*\")+COUNTIF(BZ8:BZ17,\"*Adequate*\")","v":0},{"$f":"COUNTIF(CA8:CA17,\"Yes\")","v":0},0,0,null,null,0,null,null,null,0,0]
["Yes %",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(N19/N23),\"%\",N19/N23*100)","v":"%"},"%",null,"%","%",null,"%",null,"%","%","%","%","%",null,"%",null,null,null,null,null,null,null,null,null,null,"%",null,"%","%",null,"%","%","%",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"%",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(BZ19/BZ23),\"%\",BZ19/BZ23*100)","v":"%"},{"$f":"IF(ISERROR(CA19/CA23),\"%\",CA19/CA23*100)","v":"%"},"%","%",null,null,"%",null,null,null,"%","%"]
["No n",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(N8:N17,\"No\")","v":0},0,null,0,0,null,0,null,0,0,0,0,0,null,0,null,null,null,null,null,null,null,null,null,null,0,null,0,0,null,0,0,0,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(BZ8:BZ17,\"*Poor*\")+COUNTIF(BZ8:BZ17,\"*Unacceptable*\")","v":0},{"$f":"COUNTIF(CA8:CA17,\"No\")","v":0},0,0,null,null,0,null,null,null,0,0]
["No %",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(N21/N23),\"%\",N21/N23*100)","v":"%"},"%",null,"%","%",null,"%",null,"%","%","%","%","%",null,"%",null,null,null,null,null,null,null,null,null,null,"%",null,"%","%",null,"%","%","%",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"%",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(BZ21/BZ23),\"%\",BZ21/BZ23*100)","v":"%"},{"$f":"IF(ISERROR(CA21/CA23),\"%\",CA21/CA23*100)","v":"%"},"%","%",null,null,"%",null,null,null,"%","%"]
["Sub total",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(N19+N21)","v":0},0,null,0,0,null,0,null,0,0,0,0,0,null,0,null,null,null,null,null,null,null,null,null,null,0,null,0,0,null,0,0,0,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(BZ19+BZ21)","v":0},{"$f":"SUM(CA19+CA21)","v":0},0,0,null,null,0,null,null,null,0,0]
["No data/Not answered",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"N28+N29","v":10},10,null,10,10,null,10,null,10,10,10,10,10,null,10,null,null,null,null,null,null,null,null,null,null,10,null,10,10,null,10,10,10,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,null,null,null,null,null,null,null,null,null,{"$f":"BZ28+BZ29","v":10},{"$f":"CA28+CA29","v":10},10,10,null,null,10,null,null,null,10,10]
["Not applicable",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(N8:N17,\"NA\")","v":0},0,null,0,0,null,0,null,0,0,0,0,0,null,0,null,null,null,null,null,null,null,null,null,null,0,null,0,0,null,0,0,0,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(BZ8:BZ17,\"NA\")","v":0},{"$f":"COUNTIF(CA8:CA17,\"NA\")","v":0},0,0,null,null,0,null,null,null,0,0]
["Number of cases included in audit",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"N19+N21+N24+N25","v":10},10,null,10,10,null,10,null,10,10,10,10,10,null,10,null,null,null,null,null,null,null,null,null,null,10,null,10,10,null,10,10,10,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,null,null,null,null,null,null,null,null,null,{"$f":"BZ19+BZ21+BZ24+BZ25","v":10},{"$f":"CA19+CA21+CA24+CA25","v":10},10,10,null,null,10,null,null,null,10,10]
[]
[false,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(N8:N17,\"FALSE\")","v":0},0,null,0,10,null,0,null,0,0,10,0,0,null,10,null,null,null,null,null,null,null,null,null,null,0,null,0,10,null,0,0,0,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(BZ8:BZ17,\"FALSE\")","v":10},{"$f":"COUNTIF(CA8:CA17,\"FALSE\")","v":0},0,0,null,null,0,null,null,null,0,10]
["No data",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(N8:N17,\"\")","v":10},10,null,10,0,null,10,null,10,10,0,10,10,null,0,null,null,null,null,null,null,null,null,null,null,10,null,10,0,null,10,10,10,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0,null,null,null,null,null,null,null,null,null,null,{"$f":"COUNTIF(BZ8:BZ17,\"\")","v":0},{"$f":"COUNTIF(CA8:CA17,\"\")","v":10},10,10,null,null,10,null,null,null,10,0]
["Summary data",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(N24=N26,\"No data\",IF(N25=N26,\"NA\",IF(N24+N25=N26,\"NA\",N20)))","v":"No data"},"No data",null,"No data","No data",null,"No data",null,"No data","No data","No data","No data","No data",null,"No data",null,null,null,null,null,null,null,null,null,null,"No data",null,{"$f":"IF(AO24=AO26,\"No data\",IF(AO25=AO26,\"NA\",IF(AO24+AO25=AO26,\"NA\",AO20)))","v":"No data"},{"$f":"IF(AP24=AP26,\"No data\",IF(AP25=AP26,\"NA\",IF(AP24+AP25=AP26,\"NA\",AP22)))","v":"No data"},null,"No data","No data","No data",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No data",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(BZ24=BZ26,\"No data\", IF(BZ25=BZ26,\"NA\",IF(BZ24+BZ25=BZ26,\"NA\",BZ20)))","v":"No data"},{"$f":"IF(CA24=CA26,\"No data\",IF(CA25=CA26,\"NA\",IF(CA24+CA25=CA26,\"NA\",CA20)))","v":"No data"},"No data","No data",null,null,"No data",null,null,null,"No data","No data"]

{"sheet":"Summary","index":3,"n_rows":18,"n_cols":24,"rows_kept":18,"cut":false,"hidden":false,"merged":[[0,0,0,7],[16,9,16,19],[1,22,5,22],[1,23,5,23],[1,9,1,19],[9,9,9,19]]}
["RADAR CHART"]
[null,null,null,null,null,null,null,null,null,"Recommendation - Sub criteria question number (reference only)",null,null,null,null,null,null,null,null,null,null,null,null,"RAG system (NCEPOD recommends these are set at the following limits, however these can be adapted by your Trust where appropriate by amending the thresholds as required)","%"]
[null,null,null,null,null,null,null,null,null,1,2,3,4,5,6,7,8,9,10,11]
[null,null,null,null,null,null,null,null,null,7,"12a","10a","13a",19,"15a","18a","33a","40b","47a",45]
[null,null,null,null,null,null,null,null,null,8,"12c","10b","13c",null,"16a","18b",null,41,"47b"]
[null,null,null,null,null,null,null,null,null,"11b",null,"10d",null,null,"16b",null,null,42]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,43,null,null,null,null,"Green",100]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Amber",50]
[]
[null,null,null,null,null,null,null,null,null,"Recommendation - Sub criteria questions (score)"]
[null,null,null,null,null,null,null,null,null,1,2,3,4,5,6,7,8,9,10,11]
[null,null,null,null,null,null,null,null,null,{"$f":"'Audit Tool'!N30","v":"No data"},{"$f":"'Audit Tool'!W30","v":"No data"},{"$f":"'Audit Tool'!Q30","v":"No data"},{"$f":"'Audit Tool'!Z30","v":"No data"},{"$f":"'Audit Tool'!AT30","v":"No data"},{"$f":"'Audit Tool'!AM30","v":"No data"},{"$f":"'Audit Tool'!AR30","v":"No data"},{"$f":"'Audit Tool'!BO30","v":"No data"},{"$f":"'Audit Tool'!BZ30","v":"No data"},{"$f":"'Audit Tool'!CJ30","v":"No data"},{"$f":"'Audit Tool'!CF30","v":"No data"}]
[null,null,null,null,null,null,null,null,null,{"$f":"'Audit Tool'!O30","v":"No data"},{"$f":"'Audit Tool'!Y30","v":"No data"},{"$f":"'Audit Tool'!R30","v":"No data"},{"$f":"'Audit Tool'!AB30","v":"No data"},null,{"$f":"'Audit Tool'!AO30","v":"No data"},{"$f":"'Audit Tool'!AS30","v":"No data"},null,{"$f":"'Audit Tool'!CA30","v":"No data"},{"$f":"'Audit Tool'!CK30","v":"No data"}]
[null,null,null,null,null,null,null,null,null,{"$f":"'Audit Tool'!V30","v":"No data"},null,{"$f":"'Audit Tool'!T30","v":"No data"},null,null,{"$f":"'Audit Tool'!AP30","v":"No data"},null,null,{"$f":"'Audit Tool'!CB30","v":"No data"}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"'Audit Tool'!CC30","v":"No data"}]
[]
[null,null,null,null,null,null,null,null,null,"Average % of recommendation"]
[null,null,null,null,null,null,null,null,null,{"$f":"IF(J12=\"No data\",\"No data\",IF(J12=\"NA\",\"NA\",IF(J12=\"%\",\"%\",SUM(J12:J14)/COUNT(J12:J14))))","v":"No data"},{"$f":"IF(K12=\"No data\",\"No data\",IF(K12=\"NA\",\"NA\",IF(K12=\"%\",\"%\",SUM(K12:K13)/COUNT(K12:K13))))","v":"No data"},{"$f":"IF(L12=\"No data\",\"No data\",IF(L12=\"NA\",\"NA\",IF(L12=\"%\",\"%\",SUM(L12:L14)/COUNT(L12:L14))))","v":"No data"},{"$f":"IF(M12=\"No data\",\"No data\",IF(M12=\"NA\",\"NA\",IF(M12=\"%\",\"%\",SUM(M12:M13)/COUNT(M12:M13))))","v":"No data"},{"$f":"IF(N12=\"No data\",\"No data\",IF(N12=\"NA\",\"NA\",IF(N12=\"%\",\"%\",SUM(N12)/COUNT(N12))))","v":"No data"},{"$f":"IF(O12=\"No data\",\"No data\",IF(O12=\"NA\",\"NA\",IF(O12=\"%\",\"%\",SUM(O12:O14)/COUNT(O12:O14))))","v":"No data"},{"$f":"IF(P12=\"No data\",\"No data\",IF(P12=\"NA\",\"NA\",IF(P12=\"%\",\"%\",SUM(P12:P13)/COUNT(P12:P13))))","v":"No data"},{"$f":"IF(Q12=\"No data\",\"No data\",IF(Q12=\"NA\",\"NA\",IF(Q12=\"%\",\"%\",SUM(Q12)/COUNT(Q12))))","v":"No data"},{"$f":"IF(R13=\"No data\",\"No data\",IF(R13=\"NA\",\"NA\",IF(R13=\"%\",\"%\",SUM(R13:R15)/COUNT(R13:R15))))","v":"No data"},{"$f":"IF(S12=\"No data\",\"No data\",IF(S12=\"NA\",\"NA\",IF(S12=\"%\",\"%\",SUM(S12:S13)/COUNT(S12:S13))))","v":"No data"},{"$f":"IF(T12=\"No data\",\"No data\",IF(T12=\"NA\",\"NA\",IF(T12=\"%\",\"%\",SUM(T12)/COUNT(T12))))","v":"No data"}]

{"sheet":"Recommendations","index":4,"n_rows":12,"n_cols":2,"rows_kept":12,"cut":false,"hidden":false,"merged":[[0,0,0,1]]}
["RECOMMENDATIONS"]
[1,"All patients must have access to the full range of specialist professionals appropriate for their needs in line with NICE guidelines."]
[2,"All patients considered for weight loss surgery should receive dietary assessment and education preferably prior to referral, but definitely prior to surgery."]
[3,"The outcome of all MDT discussions must be documented in the medical records. Where an MDT discussion has not taken place this must also be documented with reasons."]
[4,"There should be a greater emphasis on psychological assessment and support and this should occur at an earlier stage in the care pathway for obese patients. Psychological screening tools are available and may be of value in identifying those patients requiring formal psychological intervention."]
[5,"All bariatric patients should have an assessment of the predicted difficulty of intubation recorded."]
[6,"All bariatric patients should attend a preassessment clinic, during which they should have access to a fullrange of health professionals appropriate to their needs,including where required pre-admission assessment by an anaesthetist."]
[7,"As for all elective surgery, a deferred two-stage consent process with sufficient time lapse should be utilised, and details of benefits and risks should be clearly described, and supported with written information. The consent process should not be undertaken in one stage on the day of operation for elective bariatric surgery."]
[8,"All patients nursed outside of critical care should be managed with a ‘track and trigger’ system."]
[9,"Given the potential for significant metabolic change (and its dietary dimension) after bariatric surgery, good quality care is supported if patients have clear post-operative dietary guidance and a timely and complete discharge summary, with full clinical detail and post discharge plan to ensure safe and seamless care. This must be provided to the GP as soon as possible following discharge, preferably within 24 hours."]
[10,"Surgery and follow-up data on all patients undergoing bariatric surgery, in the NHS and independent sector, should be entered into the NBSR."]
[11,"A clear, continuous long-term follow-up plan must be made for every patient undergoing bariatric surgery. This must include appropriate levels of informed surgical, dietitian, GP and nursing input. An assessment for the requirement of physician and psychology/psychiatric input must be made and provided should the patient require it."]

{"sheet":"Answer Sheet","index":5,"n_rows":49,"n_cols":17,"rows_kept":49,"cut":false,"hidden":true,"merged":[]}
[2,null,3,null,4,null,6,null,8,null,9,null,null,null,null,1]
["Male",null,"NHS",null,"GP",null,"Yes",null,"Yes",null,"General Medical",null,null,null,null,"Consultant"]
["Female",null,"Private",null,"Secondary care",null,"No",null,"No",null,"General Surgical",null,null,null,null,"Staff grade/Associate specialist"]
[null,null,"Unknown",null,"Self referral",null,"NA (self referral)",null,"Unknown",null,"Endocrine/Diabetes",null,null,null,null,"Trainee with CCT"]
[null,null,null,null,null,null,"Insufficient data",null,null,null,"Specialist Medical Obesity clinic",null,null,null,null,"Senior specialist trainee"]
[null,null,null,null,null,null,null,null,null,null,"Gastroenterology",null,null,null,null,"Junior specialist trainee"]
[null,null,null,null,null,null,null,null,null,null,"Other",null,null,null,null,"Basic grade"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other"]
[30,null,17,null,null,26,null,null,27,null,28,null,29,null,31,null,32]
["Yes",null,"Bariatric Surgeon",null,null,"Bariatric Surgeon",null,null,"Pre-referral",null,"Yes",null,"Good",null,1,null,"NHS Hospital"]
["No",null,"Bariatric Physician",null,null,"Bariatric Physician",null,null,"Post-referral",null,"No",null,"Adequate",null,2,null,"Independent at NHS Hospital"]
[null,null,"Respiratory Physician",null,null,"Respiratory Physician",null,null,"Insufficient data",null,"Insufficient data",null,"Poor",null,3,null,"Fully Independent Hospital"]
[null,null,"Specialist Nurse",null,null,"Specialist Nurse",null,null,null,null,null,null,"Unacceptable",null,4]
[null,null,"Dietitian",null,null,"Dietitian",null,null,null,null,null,null,"Insufficient data",null,5]
[null,null,"Anaesthetist",null,null,"Anaesthetist",null,null,null,100,null,null,null,null,"Insufficient data"]
[null,null,"Administrator",null,null,"Psychologist/iatrist",null,null,null,"Yes"]
[null,null,"Psychologist/iatrist",null,null,"Other",null,null,null,"No"]
[null,null,"Other",null,null,null,null,null,null,"Insufficient data"]
[null,null,null,null,null,null,null,null,null,"NA"]
[33,null,null,null,null,34,null,null,null,null,null,35]
["Supervised scrubbed",null,null,null,null,"Primary",null,null,null,null,null,"Same surgeon"]
["Supervised in theatre",null,null,null,null,"Revision of same procedure",null,null,null,null,null,"Surgeon that performed first operation"]
["Supervised in hospital",null,null,null,null,"Conversion of previous operation",null,null,null,null,null,"Another surgeon/team"]
["Unsupervised (consultant not in hospital)",null,null,null,null,"Planned second stage"]
["NA, primary operator was a consultant",null,null,null,null,"Complex revision not otherwise specified"]
[]
[37,null,null,null,38,null,null,null,39,null,40,null,null,41,null,42]
["Laparoscopic",null,null,null,"Gastric band",null,null,null,"Level 0",null,"Home",null,null,"Yes",null,"6/52"]
["Endoscopic",null,null,null,"Roux-en-Y gastric bypass",null,null,null,"Level 1",null,"Hospital transfer",null,null,"No",null,"6/12"]
["Laparoscopic converted to open",null,null,null,"Sleeve gastrectomy",null,null,null,"Level 2",null,"Patient died",null,null,"Unknown",null,"1 year"]
["Open",null,null,null,"Duodenal switch",null,null,null,"Level 3",null,null,null,null,"NA",null,"Other"]
[null,null,null,null,"Duodenal switch with sleeve"]
[null,null,null,null,"Bilio-pancreatic diversion"]
[null,null,null,null,"Revisional gastric band"]
[null,null,null,null,"Gastric balloon placement/retrieval"]
[null,null,null,null,"Other"]
[]
[43]
["Good practice - a standard of care you would expect from yourself, your trainess and your institution"]
["Room for improvement: aspects of clinical care that could have been better"]
["Room for improvement: aspects of organisational care that could have been better"]
["Room for improvement: aspects of clinical and organisational care that could have been better"]
["Less than satisfactory: several aspects of clinical and/or organisational care that were well below a standard that you would expect from yourself, your trainees and institution"]
["Insufficient data"]
[]
[null,null,null,45,null,null,null,46]
[null,null,null,"Yes",null,null,null,"Yes "]
[null,null,null,"No",null,null,null,"No"]
[null,null,null,"Consent form missing",null,null,null,"NA"]

{"sheet":"Definitions","index":6,"n_rows":8,"n_cols":2,"rows_kept":8,"cut":false,"hidden":false,"merged":[[0,0,0,1],[6,0,6,1]]}
["LEVEL OF CARE"]
["Level 0","Patients whose needs can be met through normal ward care in an acute hospital."]
["Level 1","Patients at risk of their condition deteriorating, or those recently relocated from higher levels of care whose needs can be met on an acute ward with additional advice and support from the critical care team."]
["Level 2","(e.g. HDU) Patients requiring more detailed observation or intervention including support for a single failing organ system or post operative care, and those stepping down from higher levels of care. (NB: When Basic Respiratory and Basic Cardiovascular support are provided at the same time during the same critical care spell and no other organ support is required, the care is considered to be Level 2 care)."]
["Level 3","(e.g. ICU) Patients requiring advanced respiratory support alone or basic respiratory support together with support of at least two organs. This level includes all complex patients requiring support for multi-organ failure. (NB: Basic Respiratory and Basic Cardiovascular do not count as 2 organs if they occur simultaneously (see above under Level 2 care), but will count as Level 3 if another organ is supported at the same time)."]
[]
["TRACK & TRIGGER"]
[null,"The periodic observation of selected basic physiological signs (‘tracking’) with predetermined calling or response criteria (‘trigger’) for requesting the attendance of staff who have specific competencies in the management of acute illness and/or critical care. (National Institute for Health and Clinical Excellence, 2007)"]

{"sheet":"Height weight conversion chart","index":7,"n_rows":90,"n_cols":38,"rows_kept":90,"cut":false,"hidden":false,"merged":[[0,0,0,3],[0,7,0,11]]}
["UNITS OF LENGTH",null,null,null,null,null,null,"UNITS OF WEIGHT"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"25 - 48 stones >"]
["1 inch = 2.54 cm",null,null,null,null,null,"1 pound = 453.6 g"]
["1 foot = 12 inches = 30.48 cm",null,null,null,null,null,"1 stone = 14 pounds = 6.35kg"]
[]
["feet","inches","m","cm","stones","pounds","kg","lb",null,"stones","pounds","kg","lb",null,"stones","pounds","kg","lb",null,"stones","pounds","kg","lb",null,"stones","pounds","kg","lb",null,"stones","pounds","kg","lb",null,"stones","pounds","kg","lb"]
[4,0,1.22,122,7,0,44.5,98,null,13,0,82.5,182,null,19,0,120.6,266,null,25,0,158.69999999999999,350,null,31,0,196.8,144,null,37,0,234.9,228,null,43,0,273,312]
[4,1,1.24,124,7,1,44.9,99,null,13,1,83,183,null,19,1,121.1,267,null,25,1,159.19999999999999,351,null,31,1,197.3,145,null,37,1,235.4,229,null,43,1,273.5,313]
[4,2,1.27,127,7,2,45.4,100,null,13,2,83.9,184,null,19,2,121.5,268,null,25,2,159.6,352,null,31,2,197.7,146,null,37,2,235.8,230,null,43,2,273.89999999999998,314]
[4,3,1.3,130,7,3,45.8,101,null,13,3,84.4,185,null,19,3,122,269,null,25,3,160.1,353,null,31,3,198.2,147,null,37,3,236.3,231,null,43,3,274.39999999999998,315]
[4,4,1.32,132,7,4,46.3,102,null,13,4,84.8,186,null,19,4,122.4,270,null,25,4,160.5,354,null,31,4,198.6,148,null,37,4,236.7,232,null,43,4,274.8,316]
[4,5,1.35,135,7,5,46.7,103,null,13,5,85.8,187,null,19,5,122.9,271,null,25,5,161,355,null,31,5,199.1,149,null,37,5,237.2,233,null,43,5,275.3,317]
[4,6,1.37,137,7,6,47.2,104,null,13,6,85.3,188,null,19,6,123.3,272,null,25,6,161.4,356,null,31,6,199.5,150,null,37,6,237.6,234,null,43,6,275.7,318]
[4,7,1.4,140,7,7,47.6,105,null,13,7,85.7,189,null,19,7,123.8,273,null,25,7,161.9,357,null,31,7,200,151,null,37,7,238.1,235,null,43,7,276.2,319]
[4,8,1.42,142,7,8,48.1,106,null,13,8,86.2,190,null,19,8,124.2,274,null,25,8,162.30000000000001,358,null,31,8,200.4,152,null,37,8,238.5,236,null,43,8,276.60000000000002,320]
[4,9,1.45,145,7,9,48.5,107,null,13,9,86.6,191,null,19,9,124.7,275,null,25,9,162.80000000000001,359,null,31,9,200.9,153,null,37,9,239,237,null,43,9,277.10000000000002,321]
[4,10,1.47,147,7,10,49,108,null,13,10,87.1,192,null,19,10,125.1,276,null,25,10,163.19999999999999,360,null,31,10,201.3,154,null,37,10,239.4,238,null,43,10,277.5,322]
[4,11,1.5,150,7,11,49.4,109,null,13,11,87.5,193,null,19,11,125.6,277,null,25,11,163.69999999999999,361,null,31,11,201.8,155,null,37,11,239.9,239,null,43,11,278,323]
[5,0,1.52,152,7,12,49.9,110,null,13,12,88,194,null,19,12,126,278,null,25,12,164.2,362,null,31,12,202.3,156,null,37,12,240.4,240,null,43,12,278.5,324]
[5,1,1.55,155,7,13,50.3,111,null,13,13,88.5,195,null,19,13,126.5,279,null,25,13,164.6,363,null,31,13,202.7,157,null,37,13,240.8,241,null,43,13,278.89999999999998,325]
[5,2,1.57,157,8,0,50.8,112,null,14,0,88.9,196,null,20,0,127,280,null,26,0,165.1,364,null,32,0,203.2,158,null,38,0,241.3,242,null,44,0,279.39999999999998,326]
[5,3,1.6,160,8,1,51.3,113,null,14,1,89.4,197,null,20,1,127.4,281,null,26,1,165.5,365,null,32,1,203.6,159,null,38,1,241.7,243,null,44,1,279.8,327]
[5,4,1.63,163,8,2,51.7,114,null,14,2,89.8,198,null,20,2,127.9,282,null,26,2,166,366,null,32,2,204.1,160,null,38,2,242.2,244,null,44,2,280.3,328]
[5,5,1.65,165,8,3,52.2,115,null,14,3,90.3,199,null,20,3,128.30000000000001,283,null,26,3,166.4,367,null,32,3,204.5,161,null,38,3,242.6,245,null,44,3,280.7,329]
[5,6,1.68,168,8,4,52.6,116,null,14,4,90.7,200,null,20,4,128.80000000000001,284,null,26,4,166.9,368,null,32,4,205,162,null,38,4,243.1,246,null,44,4,281.2,330]
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