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Related Experiment Videos

Surgical audit under scrutiny--a prospective study.

M G Davies1, M F Shine, F Lennon

  • 1Department of Surgery, International Missionary Training Hospital, Drogheda, Ireland.

Irish Journal of Medical Science
|October 1, 1991
PubMed
Summary
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A 12-month prospective surgical audit of a district general unit shows low mortality (0.6%) and acceptable morbidity (9.0%). This demonstrates high-quality surgical care is achievable in non-specialist settings with a broad case mix.

Area of Science:

  • Surgical Audit and Quality Improvement
  • General Surgery Outcomes Analysis
  • Healthcare Management in District Hospitals

Background:

  • Surgical audit is crucial for improving clinical practice and patient outcomes.
  • Retrospective studies are often incomplete and unreliable for surgical audit.
  • Prospective review is necessary to accurately assess surgical unit performance.

Purpose of the Study:

  • To prospectively review the activity, morbidity, and mortality of a district general surgical unit.
  • To evaluate the standard of care and practice in a non-specialist setting.
  • To determine if low mortality and acceptable morbidity rates are achievable.

Main Methods:

  • A 12-month prospective review (July 1990-June 1991) of patient admissions and surgical procedures.

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  • Analysis of patient demographics, procedure types (BUPA classification), and outcomes.
  • Recording and categorization of perioperative and non-operative deaths and complications.

    • Main Results:

    • 3,927 patients admitted (1,649 elective, 2,278 emergency); 48 transferred, 41% did not require surgery.
    • 2,335 in-patient and 765 out-patient operations performed; perioperative mortality rate 0.6%.
    • Operative morbidity rate 9.0%, procedure-related morbidity 4.7%, wound infection rate 2%; most deaths in high-risk patients.

    Conclusions:

    • A non-specialist general surgical unit can provide a high standard of care.
    • Low mortality and acceptable morbidity rates are achievable with a broad case mix.
    • Prospective surgical audit is feasible and valuable in district general hospitals.