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Medical audit data: counting is not enough.

C Lyons¹, R Gumpert

¹Brighton Health Authority, Brighton General Hospital, Brighton.

BMJ (Clinical Research Ed.)

|June 16, 1990

Summary

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This audit of surgical inpatient data revealed significant data collection challenges and limitations in outcome measures. Accurate data collection is crucial for meaningful surgical audits and effective patient care management.

Area of Science:

Healthcare Management
Surgical Audit
Medical Informatics

Background:

Surgical audits are essential for evaluating and improving patient care.
The meaningfulness and utility of audit data are often questioned.
Accurate data collection is a prerequisite for reliable audit findings.

Purpose of the Study:

To assess the value of one year of general surgeon inpatient audit data.
To critically evaluate the usefulness of specific outcome measures in surgical audits.
To identify challenges in data collection and reporting for surgical audits.

Main Methods:

Analysis of inpatient records from a consultant general surgeon's audit computer data (Dunnfile) over one year.
Comparison of audit data with ward records and the patient administration system for accuracy verification.

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Analysis of procedures by complexity (BUPA code), surgeon grade, complications, and returns to theatre.

Main Results:

Audit data provided insights into surgical activity, such as registrar vs. senior registrar operation numbers and complication rates.
Simple complication rates lacked context regarding avoidability, and returns to theatre required further qualification.
Significant data collection deficits (30% initially, 17% by end of audit) were identified compared to ward and patient administration systems.

Conclusions:

Ensuring adequate data collection for surgical audits is challenging and requires interdisciplinary effort.
Integrating audit systems with patient administration systems could improve data accuracy and completeness.
While crude analyses of workload and complications have limitations, audit data aids in measuring activity and managing surgical services, necessitating careful data interpretation.