Annex A > Chapter 18 - Medical and Clinical Audit > The audit and review of the paediatric cardiac surgical services in Bristol > Cardiac surgical audit meetings
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Cardiac surgical audit meetings
`Cardiac Surgical Audit was formally instituted in 1990/91 in response to the White Paper. However, it evolved from pre-existing activities which had been labelled educational but which did involve a significant element of audit. All the cardiac surgical staff, junior and senior, attended this meeting which occurred once a month in term time. ... To begin with there was no minute of the meeting; a record of the meeting was made by the Sub-Directorate Audit Convenor which was submitted to the Trust Audit Committee.' [498]
417 Mr Dhasmana explained that:
`During the eighties and early nineties the records and data were collected by the Registrar/Senior Registrar working with the respective surgeons and presented to the meeting under the supervision of the senior registrar ... Things changed with the establishment of UBHT and organisation of an Audit structure in 91/92. Mr Jonathan Hutter was our first audit co-ordinator, who started collection and storage of these data.' [499]
`The most common method of presentation of data [at the meeting]was for each consultant's registrar to present the work of the previous month and to draw particular attention to any patients where there had been death or serious complications. This led to a discussion of those events which sought to establish whether any modification of clinical practice would be beneficial. Specific topics were also audited such as wound infection. The annual statistics were usually presented to this meeting for discussion.' [500]
419 Mr Wisheart pointed out that the meetings focused on the review of individual cases, although series of patients were reviewed when `topics' were audited, or annual statistics presented. [501]
420 Mr Dhasmana stated that prior to 1992 the meetings were attended by members of the Department of Cardiac Surgery although: `After 1993/94, when the audit was better organised, the attendance increased to include nurses, anaesthetists and adult cardiologists.' [502]
421 Mr Alan Bryan, consultant cardiac surgeon since July 1993, stated that he produced minutes of the meetings which were held at the end of 1993 and in early 1994. He went on:
`In 1994 my role in relation to audit was formalised in that I was asked to be audit convenor for cardiac services. This formalisation of my role in 1994 was part of a Trust-wide move to formalise audit procedures. Prior to this my involvement had been on my own initiative ... It is worthy of note that there would have been no need to do this immediately upon my appointment [in July 1993] if a regular organised programme of audit was in operation.' [503]
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Footnotes
[498] WIT 0120 0392 - 0393 Mr Wisheart
[499] WIT 0084 0017 Mr Dhasmana
[500] WIT 0120 0393 Mr Wisheart
[501] WIT 0120 0393 Mr Wisheart
[502] WIT 0084 0017 Mr Dhasmana
[503] WIT 0081 0021 Mr Bryan