Surgical audit and the evaluation of surgery

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Audit is a process used by clinicians to improve patient care. This process involves the investigation of clinical practice and institutional systems and comparing against given or accepted standards.

There are a number of types of audit that take place within an institution, including morbidity and mortality meetings, local/regional audit, and national or international comparative audit. The structure, process and outcomes of health care can be subject to audit.

Audit is a fundamental part of modern surgical practice in the UK. From consultant to trainee, involvement in audit is desirable and is increasingly becoming compulsory. Experience of audit is an essential criterion in most (if not all) specialist registrar shortlisting procedures, and the Royal College of Surgeons and the Royal College of Physicians in the UK recommend sufficient time is dedicated on a weekly basis for the purpose of audit.

An approach to modern surgical audit was described in a previous review. In this contribution, we discuss the problems in applying this traditional model in local surgical audit and describe ways in which local audit can be improved by applying the high standards adopted by national comparative audit projects. This review should be read with (and be considered a replacement for) the previous contribution.

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