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Surgical audit: variations in wound infection rates of individual surgeons
S F Mishriki1, D J Law, M G Johnson
1Department of Surgery, Dorset County Hospital, Dorchester, UK.
Abstract:
A prospective survey of 1086 general surgical in-patients was carried out in West Dorset district to determine the incidence of postoperative infections for individual surgeons. A total of 79 cases were diagnosed as having become infected, resulting in an overall infection rate of 7.3%. For all cases the infection rate for individual surgeons varied from 3.9 to 14.6% (P less than 0.005; chi 2 test). For the clean operative category only, the infection rate varied from 2.9 to 20.0% (P less than 0.0005; chi 2 test). The results demonstrate the value of routine surgical audit in elaborating the variation in clinical outcomes for individual surgeons. Clinical audit can identify the need for extra supervision and training of junior staff and peer review for senior clinicians.
Insights
A survey of 1086 surgical patients found significant variation in postoperative infection rates among surgeons, highlighting the importance of surgical audit for improving patient outcomes and guiding training needs.
Area of Science:
- Surgical Outcomes
- Infection Control
- Healthcare Quality Improvement
Background:
- Postoperative infections are a significant concern in general surgery.
- Variability in surgical outcomes can impact patient safety and healthcare costs.
- Assessing individual surgeon performance is crucial for quality assurance.
Purpose of the Study:
- To determine the incidence of postoperative infections for individual surgeons.
- To analyze the variation in infection rates across different surgeons.
- To demonstrate the value of routine surgical audit in identifying performance disparities.
Main Methods:
- A prospective survey of 1086 general surgical inpatients was conducted.
- Data on postoperative infections were collected and analyzed.
- Statistical tests (chi-squared) were used to assess the significance of infection rate variations.
Main Results:
- An overall postoperative infection rate of 7.3% was observed.
- Individual surgeon infection rates varied significantly, ranging from 3.9% to 14.6% (P < 0.005).
- In the clean operative category, infection rates varied from 2.9% to 20.0% (P < 0.0005).
Conclusions:
- Routine surgical audit is valuable for identifying variations in clinical outcomes among surgeons.
- Audit findings can guide the need for additional supervision and training for junior staff.
- Peer review for senior clinicians can be informed by audit data to enhance surgical quality.