Trainees - Why do my SAC Report Totals Not add up ?
In the Operation group report or Standard report there are 2 types of line (3 in some specialties) in a SAC indicative report. Those in large font indicated by the thick arrows in the screen shot below are called master groups. The lines in the smaller font indicated by the fine arrows below are called groupings. Each line in is a consolidation of numbers for a range of different operations.
e.g. The T&O SAC grouping Trauma - ORIF forearm part of the Master Group Other Groups shows the combined total of the following two operations:
The decision that these, and only these, operations should count to the total for Trauma - ORIF forearm is one taken by the SAC / specialty lead.
Some might feel that other operations should contribute to the group total for Trauma - ORIF forearm (such as the ones highlighted in yellow in the screenshot below of the operation database) and might include them in their own version of the total when looking at the standard or operation group reports.
In addition, the Standard and Operation Group reports will include obsolete operations that might not contribute to the total for a grouping.
The SAC indicator report is designed to give an overall indication/impression of an individual’s experience, rather than representing the totality of the individuals experience.
Trainers and assessors, who will review many these reports, will over time get a “feel” for what an average experience should look like. Changing the operations that make up a group will change the numbers and therefore alter that “feel”. Changes to the groupings are therefore made infrequently and only after senior discussion at the SAC.
There is a specific issue with the T&O SAC report in relation to the top 2 master groups: Overall Experience and Trauma Elective balance, where the latter two totals do not add up to the first. This is because the software (which is written to be common for all 10 surgical subspecialties) makes it easy to count All operations whereas the groupings All trauma and all elective each contain several hundred operations that have been selected manually. This is obviously associated with a high risk of omitting procedures. Because of the complex structure of the operation database, these omissions are tediously slow to fix, a process that currently cannot be automated. Hopefully over time these omissions will be tracked down and corrected
Master Group totals: The totals for each Master Group are a sum of the totals for each grouping within that master group. They may therefore differ in a number of ways from what might be perceived as the correct total based on the Standard or Operation Group reports.
The total will be higher than one might believe to be correct if a procedure is in more than one grouping or could be lower because the groupings do not contain all the procedures some might consider appropriate (see above)
e.g. In this screenshot of the T&O SAC report, the Master Group Other Groups double counts just about everything as the groupings All trauma and All elective will obviously include operations that are in the groupings below.
However, if All trauma and All elective were excluded, the total would be less than 2239 (the total for all trauma and all elective) because the groups below them do not include all operations – they are (see above) only indicators of the experience in that area.