Peer Review Audit of Caesarean Sections in a Tertiary Hospital

Zheng Yuan Ng, Jarrod K Tan, Eng Loy Tan, Devendra Kanagalingam and Lay-Kok Tan

Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore

^*Correspondance to: Zheng Yuan Ng 

 PDF  Full Text DOI: 10.25107/2474-1647.1628

Abstract

We aimed to evaluate the use of a peer review audit on the indication and decision for Caesarean sections at our hospital to ensure appropriate patient selection and audit clinical quality. Weekly anonymized audits were held for all Caesarean sections performed in the preceding week. Each reviewer gave a score of 1, 2 or 3 for each case based on whether they believed the decision for Caesarean section was appropriate, appropriate with areas for improvement, or inappropriate respectively. Mean scores were used for classification to one of four categories: Category A (score 1.0) implying unanimous agreement with management, B (1.1-1.9) suggesting minor reservations about management, C (2.0-2.4) suggesting significant reservations and D (2.5-3.0) suggesting serious issues with management. All indications for CS in our institution had a low mean score of <1.6. Among singleton pregnancies, there were more category A cases (72.0% versus 54.9%, p <0.001) but also more Category D cases (2.8% versus 0.9%, p <0.05) in the elective CS group than the emergency CS group. We conclude that the majority of reviewed cases had appropriate indications and acceptable management. Peer review audit sessions provide a platform for discussion, education, and identification of specific conditions where management can be improved.

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Cite the article

Ng ZY, Tan JK, Tan EL, Kanagalingam D, Tan L-K. Peer Review Audit of Caesarean Sections in a Tertiary Hospital. Clin Surg. 2017; 2: 1628.