Value sets – OAS Obstetric surgery

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Obstetric surgery

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Concept IDDescription
236989008Abdominal delivery for shoulder dystocia
359944002Anal sphincteroplasty for current obstetrical laceration
41059002Caesarean hysterectomy
11466000Caesarean section
450483001Caesarean section through inverted T shaped incision of uterus
450484007Caesarean section through J shaped incision of uterus
46681009Cerclage of cervix during pregnancy by abdominal approach
90442009Cerclage of cervix during pregnancy by vaginal approach
265636007Cerclage of uterine cervix
708967005Cervical cerclage of internal os during pregnancy
84195007Classical caesarean section
57411006Colpoperineorrhaphy following delivery
310603006Digital evacuation of retained products of conception
176827002Dilation of cervix uteri and vacuum aspiration of products of conception from uterus
236988000Elective caesarean hysterectomy
177141003Elective caesarean section
177143000Elective lower segment caesarean section
1197219005Elective lower segment caesarean section through inverted T shaped incision of uterus
736026009Elective lower segment caesarean section with bilateral tubal ligation
177142005Elective upper segment caesarean section
736018001Elective upper segment caesarean section with bilateral tubal ligation
236987005Emergency caesarean hysterectomy
274130007Emergency caesarean section
236985002Emergency lower segment caesarean section
736118004Emergency lower segment caesarean section with bilateral tubal ligation
709004006Emergency lower segment caesarean section with inverted T incision
236986001Emergency upper segment caesarean section
736020003Emergency upper segment caesarean section with bilateral tubal ligation
236883005Evacuation of retained product of conception
274943006Examination of female genital tract under anaesthetic
40801000Exploration of pelvis by laparotomy
74770008Exploratory laparotomy
12324002Exploratory laparotomy with biopsy
310602001Expression of retained products of conception
240278000External cephalic version
5048009External cephalic version with tocolysis
57271003Extraperitoneal caesarean section
302383004Forceps delivery
71166009Forceps delivery with rotation of fetal head
89849000High forceps delivery
1359709000Hysteroscopic evacuation of retained product of conception
177219009Immediate repair of obstetric laceration of perineum and sphincter of anus
177200004Instrumental removal of products of conception from delivered uterus
274492009Insertion of pack to control vaginal bleeding
236972000Insertion of balloon catheter into uterine cavity
840831000000107Laparoscopic cerclage of cervix
446942007Laparoscopic incision and drainage of cyst of ovary with conversion to laparotomy
86481000Laparotomy
264969004Laparotomy and removal of foreign body from abdominal cavity
788180009Lower uterine segment caesarean section
18625004Low forceps delivery
28233006Manual removal of retained placenta
236946009McDonald cervical cerclage
854611000000109Medical evacuation of retained products of conception using prostaglandin
62508004Mid forceps delivery
260645006Minilaparotomy
236975003Nonrotational forceps delivery
265641004Packing to control postnatal vaginal bleeding
243414007Pelvic examination under anaesthesia
244645007Pelvic examination under general anaesthesia
13341006Reduction of volvulus by laparotomy
32023008Removal of packing from vagina
237027001Repair of complete perineal tear
359946000Repair of current obstetric laceration of rectum and sphincter ani
301858009Repair of labial tear
14764004Repair of laceration of male perineum
237029003Repair of laceration of vulva
359937006Repair of obstetric laceration of anus
441619002Repair of obstetric laceration of perineum and anal sphincter and mucosa of rectum
112925006Repair of obstetric laceration of vulva
55669006Repair of obstetrical laceration of perineum
237026005Repair of perineal tear
237030008Repair of superficial vulval tear
238255007Second look laparotomy
236947000Shirodkar cervical cerclage
310604000Suction evacuation of retained products of conception
473236004Suture of caesarean wound for dehiscence
360362007Suture of laceration of perineum
448806005Suturing of laceration of anus
69422002Trial forceps delivery
229761000000107Vacuum aspiration of products of conception from uterus using flexible cannula
229801000000102Vacuum aspiration of products of conception from uterus using rigid cannula
89053004Vaginal caesarean section

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”