A department of surgery looks at outcomes

Quality screens for care of surgical patients were selected and implemented in 1993 by a department in a moderate-sized community hospital. The screens were selected so that assessment might be made of all surgical care and that each surgeon annually might know results compared to peers. There were 127 quality screen failures (2.3%) in 5,615 surgical patients. The incidence of wound infection was 0.1%. Twenty-seven of the screen failures (21.3%) were confirmed by peer review. Issues of quality of care in the confirmed screen failures were resolved by letter or morbidity/mortality conference. The approach merits replication.