Mini-audits facilitate quality assurance in outpatient units

Purpose: It has been shown that large-scale epidemiological studies are an unsatisfactory method of measuring quality of care in anesthesia. We perfor med a mini-audit of the outpatient surgery unit at Vancouver General Hospit al to determine whether such methodology would be helpful in assessing and monitoring quality of care and in identifying areas where improvements coul d be made. Methods: After institutional approval, we conducted a prospective quality a ssurance audit in a cohort of 462 consecutive outpatients. A measurement to ol was developed using information from previous literature. Data recorded included demographics, type of surgery and anesthesia, duration of stay in the postanesthetic care unit (PACU) and any adverse events in the PACU, The effect of ethnicity on the above was also examined. Results: The demographics and practice profiles of our unit were comparable to other units. The mean duration of stay in the PACU was 91 +/- 55.3 min and is twice as long as other units. The incidence of hypotension, hypother mia and excessive pain in the PACU were higher compared to other centres, T he incidence of other adverse events was comparable to that reported by oth er centres. O-2 supplementation was required more frequently in Caucasians (23% vs 9%; P < 0.05) and postoperative bleeding occurred more frequently i n Asiatics (46% vs 27%; P < 0.05). Conclusion: A mini-audit was found to be helpful in assessing and monitorin g quality of care and in identifying areas where improvements could be made .