Audit meeting
Same job as the Society’s audit system. Each case is marked after discharge. A deliberate skip is left out of the score. The weak element is the number to discuss, not the average. These ten records are teaching cases, not hospital charts.
Cases reviewed
10
Element compliance
89.9%
Mean nights
3.6
30-day readmit
0%
| Case | Compliance | Nights | Complication | Readmit |
|---|---|---|---|---|
| GYN-1046Hysterectomy | 95.7% | 2.4 | No | No |
| ORTHO-2082Total knee arthroplasty | 79.2% | 1.6 | No | No |
| CRS-3318Colectomy | 86.4% | 3.7 | No | No |
| GEN-0035Laparoscopic cholecystectomy | 95% | 0.4 | No | No |
| HPB-4410Major liver resection | 91.3% | 5.3 | No | No |
| UGI-1175Esophagectomy | 95.8% | 8.5 | No | No |
| OB-5521Cesarean delivery | 90.5% | 2.1 | Yes | No |
| SPN-7704Posterior lumbar fusion | 89.5% | 2.6 | No | No |
| ENT-2219Free flap | 80% | 7.6 | No | No |
| BAR-8842Sleeve gastrectomy | 95.2% | 1.4 | No | No |
Which element was missed
| Element | Done | Missed | Skipped on purpose | Compliance |
|---|---|---|---|---|
| Surgical approach | 3 | 2 | 1 | 60% |
| No long-acting sedative premedication | 7 | 2 | 1 | 77.8% |
| NSAID or COX-2 | 7 | 2 | 1 | 77.8% |
| Normothermia | 7 | 2 | 1 | 77.8% |
| Early mobilization | 8 | 2 | 0 | 80% |
| Avoid routine nasogastric tube | 8 | 2 | 0 | 80% |
| Counseling and shared expectations | 7 | 1 | 2 | 87.5% |
| Prehabilitation | 7 | 1 | 2 | 87.5% |
| Glucose control | 7 | 1 | 2 | 87.5% |
| Clear liquids | 8 | 1 | 1 | 88.9% |
| Solid food fasting | 8 | 1 | 1 | 88.9% |
| Dexamethasone | 8 | 1 | 1 | 88.9% |
| PONV prophylaxis | 8 | 1 | 1 | 88.9% |
| VTE prophylaxis | 8 | 1 | 1 | 88.9% |
| Carbohydrate drink | 9 | 1 | 0 | 90% |
| Urinary catheter removal | 9 | 1 | 0 | 90% |
| GLP-1 receptor agonist plan | 2 | 0 | 0 | 100% |
| Bowel preparation | 2 | 0 | 0 | 100% |
| Acetaminophen | 9 | 0 | 1 | 100% |
| Regional or neuraxial block | 10 | 0 | 0 | 100% |
| Goal-directed fluids | 10 | 0 | 0 | 100% |
| Early oral intake | 8 | 0 | 2 | 100% |
| Avoid routine drains | 8 | 0 | 2 | 100% |
| Anemia correction | 5 | 0 | 0 | 100% |
| Tranexamic acid | 2 | 0 | 0 | 100% |
| Gabapentinoid | 2 | 0 | 0 | 100% |
| Delirium prevention bundle | 2 | 0 | 0 | 100% |
| Diabetes medication plan | 1 | 0 | 0 | 100% |
| Low-CVP liver technique | 1 | 0 | 0 | 100% |
| Early enteral feeding | 2 | 0 | 0 | 100% |
| Smoking cessation | 2 | 0 | 0 | 100% |
| Alcohol cessation | 1 | 0 | 0 | 100% |
| Intrathecal morphine | 1 | 0 | 0 | 100% |
| Delayed cord clamping | 1 | 0 | 0 | 100% |
| Anticoagulant or antiplatelet plan | 1 | 0 | 0 | 100% |
| Airway and tracheostomy plan | 1 | 0 | 0 | 100% |
| Flap monitoring | 1 | 0 | 0 | 100% |
| Early tracheostomy care | 1 | 0 | 0 | 100% |
| Liver-shrink diet | 1 | 0 | 0 | 100% |
| Avoid long-acting opioids | 1 | 0 | 0 | 100% |
| OSA precautions | 1 | 0 | 0 | 100% |
Practice year
300 synthetic cases, so a full year has a shape. Nothing here is a real patient. The meeting above is the audit you would actually run.
Cases
300
Element compliance
90.4%
MODIFY rate
19.1%
HOLD rate
3%
Red flags
4
Mean LOS
3.7
PONV
24%
Mean opioid MME
31
30-day readmit
3.7%
Cancellations avoided
2