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Mary Ann

Mary Ann Benitez

Cardiac unit audit shows treatment to be world-class

The Prince of Wales Hospital's cardiac unit is set to release a report that will show that heart surgery carried out in the city is on a par with international standards.

Part of the city's first clinical audit, the report will show how the cardiac unit measures up to international standards in terms of morbidity and mortality rates for  300 heart patients seen at the hospital since November 2005.

Clinical audits of Prince of Wales, Queen Elizabeth and Grantham Hospitals will be released in an annual report this year.

Since last December, the three cardiac surgery units have placed complete details of  every patient undergoing surgery on a surgical audit database.

This allows tracking of patients' morbidity and mortality outcomes and shows overall trends measured against international standards for cardiac surgery.

For individual patients, their surgeons also would be able to evaluate a procedure's particular risks, based on statistical evidence.

The hospitals also are  planning to audit chest, oesophagus, liver and colo-rectal operations.

Malcolm Underwood, chief of service in cardiothoracic surgery at Prince of Wales, said preliminary analysis showed that 'we are actually performing better than you would expect in terms of the risk to patients that we are operating on. I think it is fair to say that most units now who were using this scoring system are performing better than expected'.

When the Prince of Wales Hospital's mortality rate was risk-adjusted using a European evaluation method,  there was likely to be 12 to 13 deaths, said visiting professor from The Heart Hospital in London, Sir Bruce Keogh.

'But, in fact, it is only four deaths. Actually Professor Underwood's team is performing very well. They are having a third of the predicted number of deaths. That is  a very good performance,' he said.

Professor Keogh, who has seen the clinical audit report, said that by reputation Hong Kong's cardiac surgery was 'very high'.

'This endeavour provides an opportunity to demonstrate that fact in statistical terms and to reassure the public, health authorities and heart surgeons in Hong Kong that it is as good as anywhere else in the world,' he said.

Andrew Van Hasselt, chairman of the department of surgery at Prince of Wales  said the HK$2 million clinical audit system 'is so powerful and so real-time that very quickly once a hospital is falling below accepted standards, then the professional group gets together and are made aware of it'.

This would then allow the specialist group to look at the systems in that hospital 'very quickly before the patients get compromised'.

Professor Keogh said it was 'good practice to report the results of surgery at a hospital level out into the public domain'. But whether to publicise results of individual surgeons  is a 'slightly more contentious issue'.



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