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Implementation of surgical audit in Pakistan
N Noorani1, M Ahmed, S T Esufali
1Department of Surgery, Aga Khan University Hospital, Karachi.
Annals of the Royal College of Surgeons of England
|March 1, 1992
Summary
Surgical audit is feasible in developing countries using basic computers. This study demonstrates its usefulness for improving patient care and resident training in Karachi.
Area of Science:
- Healthcare Management
- Surgical Outcomes
- Developing Country Health Systems
Background:
- Surgical audit is crucial for quality improvement but often considered too costly for developing nations.
- Implementation challenges include high technology requirements and perceived complexity.
- This study explores a low-cost, feasible approach to surgical audit in a resource-limited setting.
Purpose of the Study:
- To demonstrate the feasibility and usefulness of implementing surgical audit in a developing country.
- To utilize personal computers (PCs) with simple, inexpensive software for data analysis.
- To provide a model for other resource-limited healthcare settings.
Main Methods:
- Data analysis of inpatient audit proformas collected over 18 months (January 1989-July 1990).
- Utilized Dbase III Plus software on personal computers for data management and analysis.
- Focused on a single general surgery team at a tertiary care hospital in Karachi.
Main Results:
- Biliary system conditions accounted for 26.1% of admissions.
- Comorbidities like diabetes and hypertension were common (25.3%).
- Overall morbidity was 12.3%, with a mortality rate of 1.5%. Common complications included chest infection, wound infection, and urinary retention.
Conclusions:
- Surgical audit data analysis spurred new research and protocol development for enhanced patient care.
- Audit meetings provided valuable teaching opportunities for surgical residents.
- The study highlights the adaptability of surgical audit in resource-constrained environments.