John B. North

Analysis of the causes and effects of delay before diagnosis using surgical mortality data

The aim of the study was to assess the causes and effects of delay in diagnosis in surgical patients who died in 20 public hospitals participating in the Queensland Audit of Surgical Mortality (QASM) in Australia.

Surgical mortality audit data validity.

Surgical audits provide constructive feedback to individual surgeons, hospitals and other healthcare sector professionals. Audits identify deficiencies in treatment processes, evaluate practice trends and detect practice gaps. The credibility and validity of the Queensland Audit of Surgical Mortality (QASM) relies on the accuracy of its data.

Teleconference fracture clinics: a trial for rural hospitals.

Most experience in telemedicine in orthopaedics has been in teleradiology, where a specialist provides advice based only on the radiograph of a patient’s injury. There have been few trials of full teleconsultations, involving history, examination and imaging analysis of the patient by a specialist in another centre communicating with a doctor and patient in a remote location, via video link in real time. However, such studies have shown that teleconsultations reduced unnecessary patient transfers by 69 to 75%, and are a reliable alternative to live consultations. For 5 months in 2011, 12 trial teleconsultation fracture clinics were conducted between the large city centre, the Princess Alexandra Hospital (PAH), and the rurally located Mt Isa Hospital (MIH). Fracture clinics at MIH are ordinarily conducted twice weekly by an unaccredited orthopaedic registrar. To obtain a specialist opinion or further management, the patient needs to be transferred to the nearest referral centre (Townsville Hospital, located 883 km away). The trial teleconsultation fracture clinic replaced the usual Friday fracture clinic at MIH. The satellite link between the clinics allowed the orthopaedic surgeon to conduct a teleconsultation with the registrar and patient (Fig. 1). The total cost of holding each teleconsultation fracture clinic was

Outcomes from the Northern Territory Audit of Surgical Mortality: Aboriginal deaths

1285. This comprised of

Analysis of deficiencies in care following cholecystectomy

1060 in staff wages for a total of 17 extra work hours each week, and

Surgical care for the aged: a retrospective cross-sectional study of a national surgical mortality audit

225 for the production of patient charts at the PAH for clinical records. The cost of transferring a patient from MIH for assessment at Townsville Hospital totals approximately

Snapshot of trauma laparotomy deaths in Queensland: Trauma laparotomy mortality

1269 per adult patient and

How participation in surgical mortality audit impacts surgical practice

2134 per child patient, as a child patient requires an accompanying adult. This includes

Increasing number of comorbidities is related to delay to surgical management of a perforated peptic ulcer in patients who died.

550 for the airfare (paid by the health system), accommodation, transport and food, and an average loss of

Mortality from acute appendicitis is associated with complex disease and co-morbidity: Acute appendicitis mortality

404 income for 2 days per adult. Five patient transfers were saved in 6 months, comprising three adults and one child with one accompanying adult. This is a total cost saved of