Canadian general surgeons' opinions about clinical practice audit

The objective of this study was to explore the opinions of Canadian surgeons about their knowledge regarding clinical practice audit (CPA), existing audit tools, experience with CPA, barriers to implementation, and concerns about consequences of CPA implementation.

A 20-question survey was distributed to members of the Canadian Association of General Surgeons.

Of the surveys distributed, 108 were completed, a response rate of 13.5%. The mean age of the participants was 44 years (SD, 12). Familiarity with common audit tools ranged from 4% to 28%, with 41% familiar with none and 44% having previously performed CPA. Most respondents believed that CPA should be mandatory (48%); that CPA is best done by self (34%); and that the Ministry of Health ought to pay for CPA (35%). Using a Likert scale, we found that a majority of respondents felt that CPA is effective in changing both clinical practice (73%) and patient outcomes (57%) and that barriers included time constraints (91%), cost (62%), resources (91%), and inadequate documentation (57%). A majority of respondents would participate in CPA if the data were reviewed by themselves (93%), their department (82%), the Royal College (51%), or provincial organizations (48%) as long as the data were not made available to the public (42%), the ministry of health (48%), or hospital administration (47%).

Canadian surgeons perceive usefulness in clinical audit but have limited knowledge about available audit tools and resources. The creation of a national auditing system combined with strategies for effective implementation of this system is the stepping-stone in this process.