Royal College of Surgeons comparative ENT audit 1990

TLDR

The Royal College of Surgeons Comparative Audit Service was established in 1990 to enable surgeons to pool audit data and benchmark against national standards. In December 1991, 405 consultant ENT surgeons were invited to submit 1990 audit data on resources, workload, case‑mix, complications, and outcomes for myringoplasty and laryngeal carcinoma. The audit, completed by 65 consultants, reported 52,208 admissions and 31,240 procedures in 1990, with an average surgeon managing 829 patients, performing 744 operations, and experiencing a 1.39 % complication rate; myringoplasty success averaged 65 % with 53 % hearing improvement, while laryngeal carcinoma cases were treated 69 % with radiotherapy alone versus 14 % with surgery alone, and the data enabled individual surgeons to benchmark against the pooled national profile.

Abstract

The Royal College of Surgeons Comparative Audit Service was set up in 1990 so that surgeons could pool their audit data, to provide 'standards' with which to compare their own figures. A total of 405 consultant otolaryngologists were circularized in December 1991 inviting them to return data about their resources, workload, case-mix and complications, and about two specific audit topics-Myringoplasty and Carcinoma of the Larynx--for the calendar year 1990. A total of 65 consultants returned proformas with data on 52208 admissions and 31240 surgical procedures. The 'average' respondent admitted 829 patients in the year (19% of these day cases and 14% emergencies) and performed 744 surgical procedures with a mean complication rate of 1.39% using three theatre sessions per week. Cancelled theatre sessions per annum per consultant ranged from 0 to 71. The mean known success rate after myringoplasty was 65%, with hearing improvement in 53%. The 'average' ENT surgeon saw 3.5 new cases of invasive carcinoma of the larynx and treated 69% of these with radiotherapy alone, compared with 14% surgery alone. As well as allowing a profile to be drawn up of the 'average' respondent, this audit allowed individual consultants returning data to compare their own figures in detail with the pooled data, which were presented graphically at a meeting in April 1992.