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?
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
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
A thoughtful decision about which area(s) of surgical practice to review.
A clear description of what is good practice in this area against which the results of the audit will be compared.
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 -