Auditing the audit: can we do better?

Roberts, Jay, Westcott, Adrian, and Pretorius, Frans (2014) Auditing the audit: can we do better? In: ANZ Journal of Surgery (84) p. 168. From: RACS Annual Scientific Congress and ANZCA Annual Scientific Meeting, 5-9 May 2014, Singapore.

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Purpose: Surgical audit and peer review are important strategies in maintaining standards of care in surgery and are a requirement for continuing professional development for all Fellows of The Royal Australasian College of Surgeons. We aim to determine if the current process of determining and reporting complications within our unit was accurate.

Methodology: A systematic review of the medical records for all admissions from 1/1/13 to 31/3/2013 was performed. Results were then compared with those which had been presented at monthly audit meetings. Complications were graded according to the College guidelines.

Results: During the three month period there was a total of 973 admissions, comprising 399 operations performed, 367 endoscopic procedures, and 207 non-operative admissions. Reported complications totalled 17 with 2 grade one, 3 grade two, 7 grade three, and 5 grade four (mortality). Of the 5 mortalities 3 had died of traumatic injuries soon after presentation without operative intervention. Actual complications totalled 70 with 21 grade one, 24 grade two, 20 grade three, and 5 grade four. Also identified were two complications of surgery performed at another facility then transferred for step down care.

Conclusion: In our audit of the audit we found that only 24% of complications were reported using our current process. Within our unit a clinical pathway has been introduced to each patients’ medical record with a check box system for recording complications. Further review will be required to assess the effectiveness of this intervention. This study highlights how auditing processes need ongoing review and hope it can act as a prompt for other units to ensure accuracy in their auditing process.

Item ID: 34708
Item Type: Conference Item (Abstract / Summary)
ISSN: 1445-2197
Keywords: surgical audit; peer review
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Special Issue: Abstracts of the RACS Annual Scientific Congress and ANZCA Annual Scientific Meeting, Singapore, 5–9 May 2014. Volume 84, Issue Supplement S1, pages 166–169, May 2014.

Date Deposited: 26 Feb 2015 03:11
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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