Surgical audit: Comparison of the work load and results of two hospitals in the same district.

Surgical audit is being undertaken to monitor and compare (by computer) the type of patient, work load, and results of two similar surgical units. Both units are in the City and Hackney District of London, one at St Bartholomew's Hospital and the other at Hackney Hospital. During 1978, 736 patients were admitted by the unit at St Bartholomew's Hospital and 902 by the unit at Hackney. At St Bartholomew's 70% of admissions were elective compared with 49% at Hackney, where 86% of patients lived within the district compared with only 36% at St Bartholomew's. The wound was the commonest site for complications, infection affecting 9% of those at Hackney and 6% at St Bartholomew's, despite identical antibiotic policies. There were six post-operative deaths at St Bartholomew's and 32 at Hackney. In both hospitals the length of stay was similar, 50% of patients being discharged within one week and 80% within two weeks. As a result of the audit a vigorous venous thrombosis prophylactic regimen has been instituted, and at Hackney the anaesthetic department has been strengthened and a new intensive care unit opened.