Breast cancer audit: adapting national audit frameworks for local review of clinical practice.

OBJECTIVE: To assess the value of using a nationally devised data set for breast cancer audit at a local level for reviewing clinical practice.
DESIGN: Audit proforma based on the Scottish Cancer Therapy Network (SCTN) minimum data set and database completed prospectively from January 1999.
SETTING: Hairmyres Hospital, a district general hospital within Lanarkshire Acute Services NHS Trust.
SUBJECTS: The inclusion criteria were those developed by SCTN for the core minimum data set for breast cancer (SCTN 1999).
RESULTS: The results indicate that the SCTN minimum data set can be usefully employed to collect prospective data on breast cancer. The data set is sensitive enough to identify any problem areas, which can be reviewed at greater detail when required. This datset is a robust mechanism for collecting meaningful and comparable data both at a local and national level.
CONCLUSIONS: The use of SCTN's minimum data set has been successful for local review of practice. This has led to the identification of "out-liers" from the normal range of process indicators and further internal examination of these at a local level by individual clinicians is under way. This exercise has also proved fruitful in identification of other fields, which can be added to the data set to refine the data collected. The database provided by SCTN is easily manipulated allowing for refinement where required. Breast cancer audit carried out in this way is a useful way of reflecting on clinical practice throughout the multidisciplinary team.