Guidelines for Surgical Audit in Australia and New Zealand

Abstract

Surgical audit is an important part of the process to measure performance, reduce clinical risk and improve quality of care. Recognizing this, the Royal Australasian College of Surgeons established a Surgical Audit Taskforce as a subcommittee of the Board of Continuing Professional Standards. This study aims to review the recommendations of the Taskforce for data collection and peer review. The minimum data for whole-practice, continuing audit have been defined. The method of data collection, devices and databases are personal choices for the individual surgeon. However, there are many benefits of developing an electronic surgical audit, and these include facilitating comparison and sharing of audit data between units. Surgical audits should not only report on work carried out but also ensure that outcomes include key performance indicators such as major complications, readmissions, reoperations, transfers, incident reports, complaints and mortalities. Effective clinical governance demands that issues raised by audit need to be documented and reported together with recommendations for improvement. Surgeons should be proactive in helping to find and implement solutions to the issues arising from surgical audit.

Postoperative infection rates in foot and ankle surgery: a clinical audit of Australian podiatric surgeons, January to December 2007

“…22 Specifically, clinical audit is an important part of the process used to measure performance, reduce clinical risk and improve quality of care. 23 French described the audit cycle as having four parts: setting standards, testing practice against these standards, correcting practice where it fails and re-auditing to confirm that standards have been met. 24 Clinical audit may be considered as a process consisting of an initial survey and an intervention of some kind, followed by a review (A. Schox, pers.…”

Assessment and maintenance of competence in urology

“…Formal tools for assessing knowledge in trainees and specialists include certification examinations (written and viva), surgical audit, colleague review 48 and cumu lative sum (cusum) analysis of performance. 53 other assessment tools include casebased discussion and Cme modules.…”

“…47 several multisource feedback tools are used to assess teamwork and communication, such as the sheffield Peer review assessment tool (sPrat) and mini Peer assessment tool, which have been validated by various groups. 48,49 Designed in accordance with GmP guidelines, the sPrat is used in a number of settings to assess workplacebased performance. although the feasi bility and validity of multisource feedback and patient rating instruments has been reported in various studies, these tools have only been tested on careergrade practi tioners and not specialists; 26,49 no multisource feedback tool has yet been approved for use in specialist recertifica tion.…”

Improving surgical outcomes for patients with cancer: An Australian perspective

“…Like most other Surgical Colleges, the Royal Australasian College of Surgeons (RACS) requires all Fellows to participate in continuing professional development which involves activity in a number of mandatory areas such as surgical audit, conference attendance and involvement in clinical governance to name a few [9]. Surgical audit is probably the most important quality activity that surgeons perform [10].…”