Early experience with clinical indicators in surgery

Collopy, B.T., Rodgers, L., Woodruff, P. and Williams, J. 2000, Early experience with clinical indicators in surgery, ANZ journal of surgery, vol. 70, no. 6, pp. 448-451, doi: 10.1046/j.1440-1622.2000.01863.x.

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Title Early experience with clinical indicators in surgery
Author(s) Collopy, B.T.
Rodgers, L.
Woodruff, P.
Williams, J.ORCID iD for Williams, J. orcid.org/0000-0002-5633-1592
Journal name ANZ journal of surgery
Volume number 70
Issue number 6
Start page 448
End page 451
Total pages 4
Publisher Wiley-Blackwell
Place of publication Chichester, Eng.
Publication date 2000-06
ISSN 0004-8682
Keyword(s) biomarkers
postoperative complications
clinical indicators
surgical outcome data
surgical standards
Summary BACKGROUND: In 1997 a set of 53 clinical indicators developed by the Royal Australasian College of Surgeons (RACS) and the Australian Council on Healthcare Standards (ACHS) Care Evaluation Programme (CEP), was introduced into the ACHS Evaluation and Quality Improvement Programme (EQuIP). The clinical indicators covered 20 different conditions or procedures for eight specialty groups and were designed to act as flags to possible problems in surgical care. METHODS: The development process took several years and included a literature review, field testing, and revision of the indicators prior to approval by the College council. In their first year 155 health-care organizations (HCO) addressed the indicators and this rose to 210 in 1998. Data were received from all states and both public and private facilities. RESULTS: The collected data for 1997 and 1998 for some of the indicators revealed rates which were comparable with those reported in the international literature. For example, the rates of bile duct injury in laparoscopic cholecystectomy were 0.7 and 0.53%, respectively; the mortality rates for coronary artery graft surgery were 2.5 and 2.1%, respectively; the mortality rates after elective abdominal aortic aneurysm repair were 2.5 and 3.7%, respectively; and the post-tonsillectomy reactionary haemorrhage rates were 0.9 and 1.3%, respectively. Results for some indicators differed appreciably from other reports, flagging the need for further investigation; for example, the negative histology rates for appendectomy in children were 18.6 and 21.2%, respectively, and the rates for completeness of excision of malignant skin tumours were 90.7 and 90%, respectively. The significance of these figures, however, depends upon validation of the data and their reliability and reproducibility. Because reliability can be finally determined only at the hospital level they are of limited value for broader comparison. CONCLUSION: The process of review established for the indicator set has led to refinement of some indicators through improvement of definitions, and to a considerable reduction in the number of indicators to 29 (covering 18 procedures), for the second version of the indicators (which was introduced for use from January 1999). The clinical indicator programme, as it has with other disciplines, hopefully will provide a stimulus to the modification and improvement of surgical practice. Clinician ownership should enhance the collection of reliable data and hence their usefulness.
Language eng
DOI 10.1046/j.1440-1622.2000.01863.x
Field of Research 1103 Clinical Sciences
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©[2000, Wiley-Blackwell]
Persistent URL http://hdl.handle.net/10536/DRO/DU:30077683

Document type: Journal Article
Collections: Faculty of Health
School of Health and Social Development
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