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Biomedical subjects

R Gruer

Publications and source records attributed to R Gruer.

8 recordsLinked to original sources
PubMed1986

Audit of surgical audit.

A clinical audit, run by surgeons with modest clerical assistance, has been incorporated into the routine clinical practice of all hospitals in a large health authority. Data on operations and deaths are integrated into routine clinical recording, and feedback is by annual report containing statistical analyses and critical commentaries and by discussions with colleagues. The results of the first five years show statistically significant falls in the number of reoperations for intra-abdominal complications, retained gallstones, arterial grafts, and amputations and in operative mortality following surgery for benign biliary and pancreatic disease, resection of large bowel for benign disease, operations on aortic aneurysms, and arterial grafts except for aneurysms. Although the audit was designed originally for monitoring and improving quality of care, other uses include monitoring of increasing specialisation and changes in clinical practice, planning surgical services and postgraduate training, and showing the effects of changes in the availability of resources.

Clinical Competence↗
PubMed1977

Medical audit in practice.

A stage by stage approach was adopted to solve some of the problems of diagnosing and managing acute abdominal pain. Audit started in hopsital and was extended, with the help of a community physician, to cover the practice of a group of general practitioners. Referrals to the accident and emergency department for acute abdominal pain were analysed, and the diagnostic accurancy of general practitioners, accident department staff, and ward staff was assessed. The accuracy of hopsital staff was improved by issuing guidelines and checklists to help in diagnosis. The general practitioners' problems were defined and discussed with the surgeons. The audit continues with the aim of improving the general practitioners' diagnostic accuracy.

Abdomen, Acute↗