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Elective surgery resulting in adverse events in Australian hospitals

Ashley Kable (PhD student), Associate Professor Robert Gibberd

This study sought to monitor the prevalence of adverse events associated with five common elective surgical procedures in local hospitals. An intervention in the form of prophylactic protocols was developed. The protocols were designed to prevent the occurrence of specific frequent and clinically important post surgical complications. The protocols were trialed for six months and compliance and variance were monitored during this period.

The monitoring was conducted using a two stage screening and review process of medical records of patients who had elective total joint replacement, hysterectomy, transurethral resection of prostate, cholecystectomy and herniorrhaphy. The screening and review data collection forms were based on those used in the "Quality in Australian Health Care Study" (1995), with additional data items generated from the analysis of descriptive data in the QAHC Study. Variance reporting forms were designed for use in this study. A post discharge patient survey was conducted to collect information about complications which develop after discharge, in view of the current approach to early discharge programs. Monitoring was conducted on 2 groups of admissions, each of 6 months duration, (1) before and (1) after the implementation of prophylactic protocols, which allowed a comparison of the prevalence of adverse events between these groups of admissions.

The expected outcomes of this study are:

Standardisation of prophylactic measures for routine elective surgical procedures
Improved compliance with recommended therapeutic guidelines
Reduced cost of provision of prophylactic agents due to use of less costly alternatives
Reduced occurrence of surgical site infections, DVT/PE, and haemorrhage related to surgery