Description:  

Report of Clinical Practice Committee to the CAGS Board

January 2010

  Name of Committee:  Clinical Practice

Name of Chair:           Dr Chris de Gara

  REPORT

The committee having completed a series of position statements for inclusion on the CAGS web site has moved on in the last couple of years to the topic of Clinical Practice Audit.  Extensive literature review, multiple meetings and teleconferences produced a concept for the development of a Clinical Practice Audit tool for Minimally Invasive Colorectal Surgery.  It was decided that rather than developing software from the ground up or using older PDA technology developed by Dr Schlachta the program that the Canadian Association of Gastroenterologists has successfully implemented, for auditing endoscopy, would be used.  The executive of CAG had kindly agreed to make the template and software engineers available to the Clinical Practice Committee; in return CAG would like to see their endoscopy program adopted by general surgeons.  Preliminary attempts at the University of Alberta to gain acceptance of this program was met with little up-take to date.  The reason for this is likely that the endoscoping community of general surgeons at the University of Alberta were already comfortable using an alternate package for endoscopy recording and reporting.

In order to modify the CAG endoscopy software to allow audit of colorectal minimally invasive surgery necessarily there would need to be modifications to the software by the software company and authors of the original program.  A seed funding request of $20,000 - $30,000 dollars was made to the CAGS executive and at the CAGS executive meeting, at the end of 2009, this request was declined. 

The Chair of the Clinical Practice Committee remains committed to Comparative Audit (vs personal audit) as a method of practice enhancement.  The committee also feels that CAGS members would be significantly advantaged by being provided with practice audit tools as audit will inevitably become part of the Revalidation process that both provincial and national regulatory authorities are rapidly moving towards mandating.