Beiles C Barry
Melbourne Vascular Surgical Association, Melbourne, Victoria, Australia.
ANZ J Surg. 2003 Jan-Feb;73(1-2):69-76. doi: 10.1046/j.1445-2197.2003.02615.x.
The formation of the Melbourne Vascular Surgical Association has led to the establishment of a vascular surgical audit programme that commenced in January 1999. This has allowed establishment of a benchmark for quality assurance in vascular surgery in Australia.
A consultative process allowed widespread adoption of the audit across all public hospital vascular units in Melbourne and the two largest regional centres in Victoria. Data were collected at two points during admission: at operation and at discharge. Risk stratification, using logistic regression and risk-adjusted ratios for adverse events was assessed for comparison of outcomes between units for the first 3 years of data collection. There is regular contact with all participants for data feedback and quality control.
The standard of vascular surgery across Victoria is consistent, and there has been excellent compliance by all academic vascular units. Private practice data are less complete, and only half of the vascular surgeons have participated.
A statewide audit process is feasible and viable. Coordination by the Melbourne Vascular Surgical Association is crucial for its continued success.
墨尔本血管外科学会的成立促成了一项血管外科审计计划的建立，该计划于1999年1月开始实施。这为澳大利亚血管外科的质量保证确立了一个基准。
通过协商过程，墨尔本所有公立医院的血管外科单位以及维多利亚州的两个最大区域中心广泛采用了该审计。在入院期间的两个时间点收集数据：手术时和出院时。在数据收集的前3年，使用逻辑回归和不良事件风险调整比率进行风险分层，以评估各单位之间的结果差异。定期与所有参与者联系以进行数据反馈和质量控制。
维多利亚州的血管外科标准是一致的，所有学术性血管外科单位的依从性都非常好。私人执业的数据不太完整，只有一半的血管外科医生参与其中。
全州范围的审计过程是可行的。墨尔本血管外科学会的协调对于其持续成功至关重要。
