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THE VALUE OF CLINICAL INDICATORS IN SETTING STANDARDS OR IMPROVING CLINICAL OUTCOMES
Author(s) -
Beasley S. W.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04129_21.x
Subject(s) - medicine , pyloromyotomy , atresia , data extraction , specialty , general surgery , surgery , medline , pylorus , family medicine , stomach , political science , law
Purpose The Australasian Association of Paediatric Surgeons (AAPS) has collected Clinical Indicator (CI) data from virtually all the paediatric surgical institutions of Australia and New Zealand for the last five years. These CI’s were modified and expanded from the original ACHS/RACS specialty specific CI’s. This study reviews the CI data to determine the extent to which they have set standards or influenced the management of several paediatric surgical conditions. Methodology Analysis of AAPS CI data for pyloric stenosis, intussusception, appendicectomy and oesophageal atresia collected between 2001–2005 inclusive, and comparison with published outcome data for the same conditions. Results To date, the data have been accessed only rarely. For some of the CI’s, eg duodenal perforation during pyloromyotomy, the numbers have established a reliable benchmark rate (1.55% of 581 pyloromyotomies), and have already proved useful in the reconfiguration of services. For others, eg leak rate after repair of oesophageal atresia, the small numbers and complexity of confounding variables mean that they are unlikely to have any longterm value or application. Conclusion Well constructed CI’s provide data that can been useful to improve clinical outcomes. However, regular review is required to identify those that are unlikely to have useful application so they can be removed.