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Could sequential individual peer reviewed mortality audit data be used in appraisal?
A M Thompson1, W Ritchie, P A Stonebridge
1Department of Surgery and Molecular Oncology, University of Dundee, Scotland, UK. a.m.thompson@dundee.ac.uk
Summary
Peer review of surgical mortality data aids surgeon appraisal. Anonymised data comparison showed adverse events were infrequent, often process-related, not individual errors, supporting its use in revalidation.
Area of Science:
- Medical Auditing
- Surgical Quality Improvement
- Healthcare Performance Measurement
Background:
- Surgeons traditionally monitor patient mortality.
- The study evaluated the utility of peer-reviewed surgical mortality data for professional appraisal.
- The Scottish Audit of Surgical Mortality (SASM) has analyzed surgical deaths since 1994.
Purpose of the Study:
- To assess the value of peer-reviewed surgical mortality data in surgeon appraisal.
- To determine if anonymised mortality data can inform professional revalidation.
- To identify potential improvements in the process of surgical care.
Main Methods:
- Anonymised peer-reviewed mortality records from 16 surgeons over three years (2000-2002) were analyzed.
- Data from a single National Health Service Trust was reviewed.
- Critical event analysis was performed on deaths under surgical care.
Main Results:
- Voluntary audit compliance was high at 97%.
- Adverse events were infrequent and typically linked to care processes, not individual surgeon error.
- The number of requested case note reviews increased significantly (p<0.01), indicating greater scrutiny.
Conclusions:
- Anonymised, peer-reviewed mortality data is valuable for surgeon appraisal and revalidation.
- This data can assure adherence to "good clinical practice" standards.
- It effectively highlights systemic issues within the process of care.