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Published on: August 1, 2019
The Dutch surgical colorectal audit
N J Van Leersum1, H S Snijders, D Henneman
1Leiden University Medical Center, Leiden, Department of Surgery, The Netherlands.
Summary
The Dutch Surgical Colorectal Audit (DSCA) improved colorectal cancer care by increasing guideline compliance and reducing complications and mortality. Its success stems from surgical collaboration and national quality standards.
Area of Science:
- Healthcare Quality Improvement
- Surgical Auditing
- Colorectal Cancer Management
Background:
- The Dutch Surgical Colorectal Audit (DSCA) was established in 2009 by the Association of Surgeons of the Netherlands (ASN) to enhance colorectal cancer care.
- The DSCA serves as a model for other national clinical audits, coordinated by the Dutch Institute for Clinical Auditing (DICA).
Purpose of the Study:
- To illustrate the key elements of the DSCA.
- To present the outcomes of three years of auditing colorectal cancer care in the Netherlands.
Main Methods:
- Web-based registration by medical specialists.
- Weekly online feedback to participants.
- Annual external data verification against sources like the Netherlands Cancer Registry (NCR).
- Implementation of improvement projects based on audit findings.
Main Results:
- Achieved 100% hospital participation within two years.
- High case-ascertainment rates (92% in 2010, 95% in 2011).
- Demonstrated significant improvements in guideline compliance and reductions in complication, re-intervention, and mortality rates within three years.
Conclusions:
- Effective surgical collaboration, led by the ASN, was crucial for the DSCA's success and full participation.
- The audit facilitated the establishment of national quality standards for colorectal cancer care.
- Future efforts should focus on reducing administrative burden, expanding to multidisciplinary registration, and incorporating financial data and patient-reported outcomes.
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