Clinical Effectiveness

The Clinical Effectiveness Sub-Committee of BAOMS was set up in 1991 to look at the management of patients and the provision of services. Audit co-ordinators were established in each region and report back to the Audit Sub-Committee and are responsible for regional and national audit and clinical effectiveness projects organised by the Association.

To help establish the principle of evidence-based medicine, guidelines for Oral & Maxillofacial Surgery have been drawn up for the 9 main areas of the Speciality:

• Dentoalveolar Surgery
• Trauma
• Temporomandibular Joint Disorders
• Pre-prosthetic Surgery
• Orthognathic Surgery
• Oncology
• Salivary Gland Disorders
• Cleft Lip and Palate
• Craniofacial Surgery

Audit projects carried out include The management of third molars and the management of the fractured mandibular condyle. There has also been a national survey to examine the delay in the management of trauma and the seniority of the operating surgeon. The BAOMS Audit Report is published annually and circulated to all Fellows of the Association.

In the past, Audit projects looked at the management of a condition, analysed the results and then altered practice to take into account adverse findings or emissions. The main thrust was to assess the evidence for the benefit of a treatment so that changes could be made to enhance current practice.

The Department of Health has changed the emphasis to clinical governance rather than effectiveness, which is more an assessment of clinical competence rather than patient management, and has established The National Institute of Clinical Effectiveness (NICE) and the Commission for Health Improvement (CHImp). The purpose of NICE is to examine current practice with regard to variations in outcome as well as clinical and cost-effectiveness and has just produced guidance in the management of third molars. This is similar to the role of traditional audit practice.

CHImp is responsible for the scrutiny of clinical governance and has a programme of reviews to try and identify any serious or persistent clinical problems. How these new developments will affect the practice of oral & maxillofacial surgeons is difficult to predict, but there is no doubt that all clinicians must be involved in this process and the Audit Sub-Committee takes a lead in this matter and is available for guidance to all Fellows and Members of the Association.

The Royal College of Surgeons of England has a Clinical Effectiveness Unit and Committee which has evolved from the previously named Surgical Epidemiology and Audit Unit. The role of this Unit and Committee is to :

• determine which areas of surgery are most in need of evaluation
• devise methods of collecting routine surgical data
• design and conduct multi-centre studies
• develop methods of analysis and interpretation of data on surgical
  performance
• train surgeons in the principles of surgical research methods
• offer help and support to any surgeon seeking to conduct a study looking
  at any aspect of surgery

The role of this Sub-Committee is to help implement these aims and develop clinical governance within the speciality. The Committee is responsible for changes made to Clinical Guidelines or "Agreed Clinical Practice" through continuing communication with the Members and Fellows of the Association.

Clinical Effectiveness Matters 2005 Document Type: Microsoft Word File Size: 224Kb Clinical Effectiveness Matters 2005 Document Type: Adobe PDF File File Size: 179.74Kb CEM 2006 Document Type: Adobe PDF File File Size: 328.16Kb CEM Newsletter March 2007 Document Type: Adobe PDF File File Size: 150.13Kb CEM November 2009 Document Type: Adobe PDF File File Size: 146.43Kb Clinical Effectiveness Committee Newsletter March 2009 Document Type: Microsoft Word File Size: 76Kb