Audit of vascular surgical workload: use of data for service development.

The power of surgical audit lies in the ability to clearly record complications and to compare case mix from year to year and between centres in order to compare results. In addition, accurate data about surgical activity is vital for the development of new services. We have analysed 52 weeks of activity in a developing pure vascular surgical service and compared activity against the recommendations previously published for consultant surgical workload. During the 12-month period the mean number of admissions per week was 25.3 (95% CI, 23.43-27.29). Mean elective surgical activity was 18.2 h/week (95% CI, 16.5-19.9) and mean emergency workload 12.7 h (95% CI, 10.7-15.4). Mean intermediate equivalent value (IEV) operations per week was 37 (95% CI, 33.6-40.8) and of these 26.4 IEV (95% CI, 22.96-29.6) were complex major operations. Finally, the mean bed occupancy of vascular patients on the unit was 23.3 (95% CI, 21.15-24.97). The recommendations for surgical activity are 3.5 IEV/list. In our unit this would equate to 21 IEV/week compared with 37.2 in our practice. This data forms the basis of a powerful bid for increased consultant manpower and theatre resources. Surgical audit is time-consuming and should be consultant led, but the benefits are tangible and the data generated can be used to support bids for resource re-allocation.