Aim:
Complete population audits are rare in literature world-wide. We sought to develop a multipronged approach utilising administrative data, supplemented by clinical variables and expert peer review by specialist surgeons to facilitate the nation’s first comprehensive population wide report, Colorectal Cancer Audit 2012 and 2014 for Queensland.
Methods:
Existing data in the Queensland Oncology Repository (QOR) combined with supplementary data collection in QOOL™ provides an audit of CRC surgery for the year 2012, capturing complete demographic data, pathological descriptors and staging. The audit highlights the variation in diagnosis, management and outcomes of patients diagnosed with CRC within Queensland public and private hospitals.
For the 2012 audit 2,788 cases were identified and details on 2,774 were compiled for patient characteristics, staging, surgery, length of stay, in-hospital, 30 day and 90 day mortality and one and two year survival.
The current Colorectal Cancer Audit 2014 is being analysed and will be presented with a focus on complications, return to theatre and ICU transfers.
Results:
Key findings for the 2012 audit include: 75% of colon cancer patients received a major resection within 30 days of diagnosis, although there is a wide variation in the time-span between the public and private sector. Postoperative mortality rates following major resection are among the best in the world and over 80% of CRC patients are living two years following major resection.
Conclusions:
These results have been published in the Queensland Colorectal Cancer Audit 2016 and provided to every hospital in the state, with peer comparators. To assess the impact of the audit each facility is encouraged to provide feedback. This population based approach is an alternative to voluntary self-reporting and clinicians and administrators are ready to respond to excellent information in their quest for improvement – which is after all, the purpose of any good quality audit.