Every daily on-call report must include:

• Patient ID / Age / Referring site
• Diagnosis
• Procedure performed: technique, laterality, complications
• Immediate postoperative status: GCS, imaging, drains, destination unit

• Reason for admission and working diagnosis
• Neurological exam and baseline status
• Imaging findings
• Clear clinical plan: observation, scheduled surgery, pending decisions

• Precise clinical justification
• Destination service and accepting physician (name, department)

• Relevant acute events (e.g. mydriasis, ICP spikes, coma)
• Action taken: medical/surgical response
• Follow-up plan: re-evaluation, imaging, surgical reconsideration

• The on-call neurosurgeon must endorse all surgical and critical decisions.
• ICU and comatose patients must be formally re-evaluated by neurosurgery daily.
• The on-call coordinator or senior consultant reviews all reports within 48 hours.

• Daily verification of essential devices: valve programmers, external drains, shunts.
• Checklist for surgical readiness: OR availability, drains, emergency CT access.
• Formal inter-hospital communication protocols with nearby centers (e.g. Elche, Orihuela).

• Monthly audit of on-call reports by the head of department.
• Identification of recurring issues: vague reports, unclear plans, protocol breaches.
• Summary report sent to the medical director with key indicators:
  • Number of surgeries
  • Avoidable admissions
  • Incidents or adverse events