© 2019 RNS Data Analysis & Surgical Outcomes Unit

SURGICAL AUDIT

What is Surgical Audit?

The Royal Australasian College of Surgeons (RACS) has defined “audit” clearly in their Surgical Audit and Peer Review Guide 2014 (https://www.surgeons.org/media/20671311/surgical_audit_and_peer_review_guide_2014.pdf) as follows:

 

“… a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognised standards, and then used to further inform and improve surgical practice with the ultimate goal of improving the quality of care for patients. The purpose of audit is to examine whether what you think is happening really is, and whether current performance meets existing standards.”

 

A surgical audit involves:

• Collection and measurement of clinical activities and outcomes

• Analysis and comparison using standards, performance indicators an outcome parameters and

• A peer review process with a feedback mechanism to redress problems.

 

The aims of audit are:

• To identify ways of improving and maintaining the quality of care for patients;

• To assist in the continuing education of surgeons;

• To help make the most of resources available for the provision of surgical services.

Why Undertake Surgical Audit?

Reasons:

  • To facilitate clinical incident reporting

  • To comply with state and national audit initiatives (RACS, NSW Health etc.)

  • To inform patients about surgical performance outcomes at a department and division level

  • To drive continuous quality improvement in surgical care

  • To assess surgical performance

  • For health care regulation

  • To facilitate surgical outcome research

Benefits:

Potential benefits of surgical audit include:

  • Sustained reduction in postoperative mortality and complication rates

  • Decreased costs of care for hospitals

  • Performance information that guides surgical care and identifies areas for improvement and research

  • Reduced variations in clinical practice

  • Enhanced community reputation through improved patient outcomes

  • More reliable application of evidence based medicine i.e. reduced inappropriate variation

  • Shorter hospital stays

  • Greater patient satisfaction

Surgical Audit Cycle

Determine scope:

A thoughtful decision about which area(s) of surgical practice to review.

Select standards:

A clear description of what is good practice in this area against which the results of the audit will be compared.

Collect data:

The collection of relevant data.

Present and interpret results including peer review:

Comparison of results to standards and/or those of peers, discussion with peers, decision about what changes may lead to improvement.

Make changes and monitor progress:

Alteration or confirmation of practice in accord with the results of analysis and consultation with peers, then checking that improvement has occurred

Surgical audit activities are based on a five step cycle -