PROSPECTIVE BASIC CLINICAL AUDIT USING MINIMAL CLINICAL DATA SET

Authors

  • Syed Asad Ali
  • Abdul Ghani Soomro
  • Syed Muhammad Tahir
  • Abdul Sattar Memon

Abstract

Background: Audit is a means of quality control for medical practice by which the profession shouldregulate its activities with intention of improving overall patient care. Objective of this study was toreport 1 year basic clinical audit of a general surgical ward and comparison of results with availabledata. Methods: All patients admitted and managed in Department of Surgery Unit-II, LiaquatUniversity Hospital, Jamshoro/Hyderabad from January to December 2007 were included in the studyfor basic clinical audit. Data of all surgical patients admitted during this period were retrieved from thedepartmental register. Details of surgical procedures and complications were recorded from thepatients’ charts. Results: Total number of patients was 1434, out of which 844 (58.85%) were malesand 590 (41.14%) were females. Majority (70.02%) of the patients were between 16 to 50 years of age.Elective surgeries were performed in 487 (33.74%) and emergency surgeries in 430 (29.79%) cases,whereas rest of the 526 patients (36.28%) were managed conservatively. Consultant was the primarysurgeon in less than 50% of the procedures compare to post graduate trainees and registrars. The mostcommon surgeries performed in elective wing were inguinal hernia repairs (25.66%) andcholecystectomies (22.99%). In emergency wing, most of the surgeries were exploratory laparotomies(38.13%) and appendicectomies (22.79%). Average duration of hospital stay in elective wing was 1–10days and in emergency wing it was 2–21 days. There was an overall complication rate of 6.3% and amortality rate of 2.44% respectively. Conclusion: We conclude that surgical audit has potentialbenefits for patients, clinicians, and provision of services for a continuous education, research andimproved practice habits and should be perform on yearly basis. We also recommend the propercomputerised audit programs and committees for its monitoring and evaluation.Keywords: Clinical Audit, Surgery, Outcome

References

Russel RCG, Williams NS, Bulstrode CJK, Surgical audit.

Baily & Loves short practice of surgery, 23rd addition London:

Arnold; 2000.p.1307–13

Shaw CD. Aspect of Audit 1. The back ground. Br Med J

; 280:1256–8.

Sanazaro PJ, Worth RM. Concurrent quality assurance in

hospital care, report of a study by private initiative in PSRO. N

Eng J Med 1978;298:1171–7.

Codman EA. Surgical audit –Lecture. Available at:

http://www.edu.rcsed.ac.uk/Lectures/L117.htm (accessed:

August 2008).

Isbister WH, Simpson JS. A simple surgical audit. Aust NZ J

Surg 1987;57:771–4.

Dunn C, Fowler S. Comparative audit: An experimental study

of 147, 882 general surgical admissions during 1990. Br J Surg

;79:1073–6.

Williams O. What is clinical audit? Ann R Coll Surg Engl

;15:67–79.

Aitken RJ, Nixon SJ, Ruckley CV. Lothian surgical audit: a 15-

year experience of improvement in surgical practice through

regional computerized audit. Lancet 1997;350:800–4.

Hunter JG, Lyon C, Galloway K, Putterill M, van Rij A.

Complete clinical outcomes audit. Resource requirements and

validation of the instrument. Surg Endosc 1999;13:699–704.

Stonebridge PA, Thompson AM, Nixon SJ. Completion of the

journey of care: Scottish Audit of Surgical Mortality (SASM).

J R Coll Surg Edinb 1999;44:185–6.

Campbell WB, Souter RJ, Collin J, Wood RFM, Kidson IG,

Morris PJ. Auditing the vascular surgical audit. Br J Surg

;74:98–100.

Ruckley CV. Mechanisms of Audit: discussion paper. J R Soc

Med 1984;77:40–4.

Semmens JB, Aitken RJ, Sanfilippo FM, Mukhtar SA, Haynes

NS, Mountain JA. The Western Australian Audit of Surgical

Mortality: advancing surgical accountability Med J Aust

;183:504–8.

Bhatti G, Haider J, Zaheer F, Khan SQ, Pirzada MT, Khan TM.

Surgical Audit of Unit II, Department of Surgery, Abbasi

Shaheed Hospital, Karachi. Ann Abbasi Shaheed Hosp Karachi

Med Dent Coll 2006;11(2):54–8.

Qureshi WI, Durrani KM. Surgical Audit of Acute

Appendicitis. Proceeding Shaikh Zayed Postgrad Med Inst

;14:7–12.

Shively EH, Heine MJ, Schel RH, Sharpe JN, Garrison RN,

Vallance SR. et al. Practicing surgeons lead in quality care,

safety, and cost control. Ann Surg 2004; 239: 752-60.

Tasmanian Audit of Surgical Mortality. 2006 annual report.

Tasmania: Department of Health and Human Services. Available

at: http://www.surgeons.org/Content/NavigationMenu/Research/

Audit/TASM_Annual_Report_Final_130606.pdf. (accessed

August 2008).

Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR,

Lawthers AG, et al. Incidence of adverse events and negligence

in hospitalized patients. N Engl J Med 1991;324:370–6.

Hayat W, Fahim F, Cheema A. Mortality analysis of a surgical

unit. Biomedica 2004;20:96–8.

McGuire HH, Horsley JS, Salter DR, Sobel M. Measuring and

managing quality of surgery: statistical vs. incidental

approaches. Arch Surg 1992; 127: 733–7.

Scottish Audit of Surgical Mortality. 2001 annual report

Glasgow: SASM, Royal College of Physicians and Surgeons of

Glasgow. Available at http://www.sasm.scot.nhs.uk/REports/

Report/SASM2001Report.pdf (accessed August 2008)

Published

2010-03-01

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