Surgical Unit Audit Or Personal Audit

1. Surgical Unit AuditOr Personal Audit Insert dates here Welcome to the fair dinkum audit

2. Total admissions Total admissions: AAA • Elective admissions: BB • Emergency admissions: CC • Unplanned readmissions: D • Transfers (for more complex treatment): E • Consultation: F

3. Non operative cases • Total admissions: AA Double click on table to edit

4. Operative work Double click on table to edit and insert own data and numbers Double-click on the graph to insert unit data

5. Endoscopy Colonoscopy: XX Gastroscopy:YY Colonoscopy Completion rate Polypectomies Complications Double-click on the graph to insert unit data

6. Operative Workby type Double-click on the chart to insert unit data

7. Colorectal Operative Work Colorectal example only Choose your specialty (ies) Replace with appropriate specialty list

8. Biliary Surgery Gall bladder and biliary surgery Indicators for GB surgery Bile leaks Unplanned postop ERCP Revisional surgery/Transfers Double click on table to edit and insert own data and numbers

9. Upper GI Surgery Upper GI surgeons Double click on table to edit and insert own data and numbers

10. Breast Operations Breast specialty only Breast cancers treated: Double click on table to edit and insert own data and numbers

11. Endocrine Surgery Endocrine Surgery example Double click on table to edit and insert own data and numbers

12. Minor/Moderate Surgery Rural Surgery Examples Double click on table to edit and insert own data and numbers

13. Complications: summary

14. Grade Explanation Examples Grade 1 Those that do not delay discharge and have little impact on the patient’s wellbeing Phlebitis, electrolyte imbalances, acute retention Grade 2 Prolongs stay or causes significant morbidity Wound infection, fall causing fracture, Grade 3 Require significant intervention to manage complication including operative or radiological intervention Requiring reoperation, ICU admission, nutritional support, coronary stenting, radiological drainage of abscess Grade 4 Complication causing or contributing to death of patient Fatal complications such as pulmonary embolus, myocardial infarction, postoperative peritonitis

15. Complications Grade 1 (minor inconvenience – a sign that you record complications comprehensively): AA Examples only – put in your own Click on Graph to enter data and add rows

16. Complications Grade 2 (Increase length of stay or cause major morbidity without needing a major intervention Click on Graph to enter data and add rows Examples only – put in your own

17. Complications Grade 3 (Requiring major intervention): CC Examples only – put in your own Click on Graph to enter data and add rows

18. Complications • Elaborate on type 3 complications • Sex, age, admission problem, diagnosis • development and treatment of complications • Avoidable? • Effect on patient? Use one slide per major complication or event Add an illustrative photo or xray image

19. Indicators 1:Unplanned readmissions • Sex and age • Admission presentation • Procedure • Reason for re-admission • Subsequent adverse events/indicators? • Avoidable? • Outcome

20. Indicators 2:Unplanned return to theatre • Initials, sex and age • Admission presentation • Procedure • Post op complications • Repeat procedure(s) • Subsequent course • Outcome

21. Indicators 3:Unplanned readmission to ICU • Initials, sex and age • Admission presentation • Procedure • Post op complications • ICU admission dates; ?early discharge • ?timing of transfers appropriate • Date of death – expected? • Avoidable?

22. Mortality • Initials, sex and age • Admission presentation/representation • Post op complications • ICU admission dates • Date of death • Autopsy/Coroner • Death Classification (Examples below) • Expected due to nature of disease process • Unexpected death not reasonably preventable • Unexpected, preventable death • Death due to a recognised complication of surgery

23. An Interesting/Challenging Case Age Sex Presentation Insert Photo You heard it first at the PSA Treatment, Progress Outcome

24. Reporting the Issues Click on Graph to enter data and add rows