Sub-specialist Trauma Surgeon Graduates with PhD
Sub-specialist trauma surgeon, Dr Grant Laing, graduated from UKZN with a PhD on the basis of his thesis which originated as part of a multifaceted quality improvement programme (QIP) within the Pietermaritzburg Metropolitan Surgical Service.
The study was titled: “The Construction, Implementation and Evaluation of Surgical Electronic Medical Record Systems within the Pietermaritzburg Metropolitan Hospital Complex. A Means of Implementing Clinical Governance to Audit and Improve the Quality of Local Services”.
Laing said the intention of the collection of projects in the study was to implement standardised information systems to capture data and thereafter benchmark local service outcomes.
‘This process has created the opportunity to improve the quality of trauma care for acute surgical patients within the metropolitan surgical service,’ he said.
The thesis integrated several separate but related projects, such as the design and implementation of a standardised surgical admission document, the digitisation of this document and creation of an Electronic Surgical Registry (ESR), and finally the design, construction and implementation of a more sophisticated Hybrid Electronic Medical Record (HEMR) system, designed with the dual function of a registry and electronic medical record system.
Supervised by Dr Damian Clarke and Dr Colleen Aldous, the study was launched and implemented at two South African state hospitals, Edendale and Greys.
‘These information systems provide a robust platform to perform comprehensive quality improvement audits,’ said Laing
‘These audits included publications evaluating the burden of trauma-related pathology placed upon the resources within the Pietermaritzburg hospital services, quantifying the burden of district-level pathologies managed within the tertiary hospital services and mapping referral patterns, ratifying the practice of selective non-operative management (SNOM) of penetrating abdominal trauma and finally a study auditing and evaluating the incidence and types of adverse events within a tertiary surgical department.’
Laing’s study involved the design, development and implementation of cost-effective, user-friendly information systems to be integrated at the two state hospitals
He said there had been several attempts and pilot projects at other African hospitals within various medical disciplines to develop and implement cost-effective, simple information systems, ‘These projects have had varying levels of success. My thesis was limited to developing information systems for surgical departments - my base area of clinical expertise.’
Several of the chapters which constitute the thesis were published in the international journals, Injury and the World Journal of Surgery.
According to Laing his study highlights the importance of prioritising the value of accurate data for performing regular, reliable audits, ‘This is an essential component for quality improvement in any institution. There is currently no comparable standardised information system within the South African Healthcare System. My hope is that my study will show other healthcare workers who share an interest in clinical governance that it is possible to design, develop and implement a cost-effective and simple information system such as my own.’
Laing completed his Fellowship in Trauma Surgery and Critical Care, and has completed training in the Intensive Care Medicine fellowship. He practices full time in critical care medicine and continues to support Dr Clarke in the postgraduate research within the Pietermaritzburg Metropolitan Trauma Service and Pietermaritzburg Metropolitan Department of Surgery.
He is married to a medical doctor, Dr Julia Ann Laing. They are the proud parents of John-Marc who was born earlier this year.
‘My wife has been very supportive throughout the years I worked on my thesis. She too shares an interest in clinical governance, which made the research all the more interesting,’ he said.
Laing was born in the Cape and completed his undergraduate degree at the University of Cape Town.