EVALUATION OF SURGICAL SERVICES IN A LARGE UNIVERSITY-AFFILIATED VA HOSPITAL - USE OF AN IN-HOUSE GENERATED QUALITY ASSURANCE DATA-BASE

In this era of occurrence screening, increased documentation of surgical resident supervision, and overall efforts to alter quality of patient care through increased documentation, an in-house quality assurance data base can greatly facilitate these activities. To establish a data base, 6241 operative procedures over a 15-month interval were logged into a StatView II Database using the patient's name and record number, diagnosis, and operative information available from the standard operation report worksheet. Additional information, including the name of the supervising staff and level of supervision, had also been recorded concurrently on this form. Each month, after this demographic information has been entered into the data base for each surgical service, it is reviewed, ensuring 100% surveillance of all cases. The subsequent morbidity and mortality (M & M) information is then added to the data base. Using the contingency table option of the StatView II Database, quarterly and annual reviews have been done to study individual services, types of cases, staff attending, individual supervision, levels of staff involvement, and incidence of complications. Our Surgical Service has reported an overall morbidity of 306 cases (4.9%) and mortality of 71 (1.14%). Average numerically coded levels of resident supervision have been compiled with regard to individual services and staff surgeons. This data base has proved helpful in the recredentialling process of our surgical staff, resident logs, identification of necessary reviews of certain case types, and formation of a computerized operative log.