How accurate is a computerized surgical audit when resident medical staff collect the data?
Since July 1988 all eight general surgeons at Fremantle Hospital have used a computer-based surgical audit and discharge system. At the time of writing (September 1991) 10,919 computer-generated discharge letters have been produced by the system. This paper describes the system and reports a series of quality control assessments carried out between 1 July 1988 and 30 June 1990 during which 30 pre-registration surgical residents completed 5,716 data collection forms. It was found that: (1) data collection for 23 of 24 monthly surgical audits was at least 95% complete; (2) outstanding surgical discharge summaries were reduced by 89%; (3) the residents recorded 17/19 wound infections and identified 15 (79%) of these as a surgical complication; and (4) the residents tended to under-record complications in patients who had more than one complication during their hospital stay. It was concluded that the system was robust, and that resident staff collected data in such a way that good quality computer-generated discharge letters were produced in a timely manner. Closer attention to aspects of data collection will be required before the optimum surgical audits of the QX system can be generated.
Castleden
W M
WM
University Department of Surgery, Fremantle Hospital, Western Australia.
Norman
P E
PE
Stacey
M C
MC
McGechie
D
D
Brooks
J G
JG
Fisher
J
J
Lawrence-Brown
M M
MM
D000043:Abstracting and Indexing / Q000592:standards; D003625:Data Collection / Q000379:methods / Q000592:standards*; D016208:Databases, Factual / Q000592:standards*; D005069:Evaluation Studies as Topic; D006801:Humans; D008485:Medical Audit / Q000592:standards*; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D011785:Quality Assurance, Health Care / Q000592:standards; D013514:Surgical Procedures, Operative / Q000592:standards*; D014904:Western Australia