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Lessons from two decades of surgical audit

John Holdsworth (Cumberland Infirmary, Carlisle, UK)

Clinical Governance: An International Journal

ISSN: 1477-7274

Article publication date: 25 April 2008




The purpose of this paper is to report on the use of a computer database used by medical secretaries to routinely and continuously store information on the work of a hospital consultant in order to monitor clinical activity and patient outcomes.


The methodology uses database software developed to deal with discharge summaries, outpatient attendances, operation notes and in‐hospital ward referrals.


From October 1984 to June 2006 there were 18,743 discharge summaries and from 1991 15,827 outpatient and 6,199 operation notes. The paper demonstrates changing clinical practice over more than 20 years and reduction in the number of postoperative complications and patients having second operations during the same admission. There is also evidence of conformity to expected outcomes for patients having carotid thromboendarterectomy and grafting of aortic aneurysm.


The paper shows that computer software of this type can operate seamlessly to document clinical activity and should be in use by all consultants working in the National Health Service.



Holdsworth, J. (2008), "Lessons from two decades of surgical audit", Clinical Governance: An International Journal, Vol. 13 No. 2, pp. 115-127.



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Copyright © 2008, Emerald Group Publishing Limited

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