Audits of Surgical Mortality

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Background
Qualified Privilege
Regional audits
National report
National case note review
National publications
National workshops and seminars
Electronic platform - Fellows interface
Submission for Data Request
Collaborations
Committee Meeting Dates
Contact

Background

The Royal Australasian College of Surgeons' Council is committed to a national surgical mortality audit program that has been modelled on the successful Western Australian Audit of Surgical Mortality (WAASM).

The RACS fully encourages the audit program as it is fully owned by the surgeons with the understanding for the need to have partnerships with governments and other bodies.

According to the Royal Australasian College of Surgeons' Continuing Professional Development (CPD) Manual, it is a "requirement to participate in the Australian and New Zealand Audit of Surgical Mortality if a surgeon is in operative based practice, has a surgical death and an audit of surgical mortality is available in the surgeon's hospital."

Participation as a first or second line assessor remains voluntary and is encouraged.

The Australian and New Zealand Audit of Surgical Mortality (ANZASM) Steering Committee is the amalgamation of the Australian state-based and New Zealand audits of surgical mortality.

The ANZASM formed to engage and progress the audit implementation in all regions. It provides a forum to support and guide the development of the audit in all states and New Zealand to ensure that both consistency and high standards are met.

Qualified Privilege

The Qualified Privilege (QP) declaration (PDF 2.1MB) encourages surgeon participation within the mortality audits by strictly protecting the confidentiality of information gained in the audit.

Via a blend of state and commonwealth legislation, the declaration prevents third parties from using data that becomes available as a result of the prescribed activity cannot be disclosed (in reports or publications) outside of the activity in a manner that identifies a surgeon. The confidentiality of the information received is protected accordingly and high-level data security procedures are maintained.

The QP declaration allows non-identifiable data to be used in reviewing and analysing surgical procedures, while information that may identify an individual requires the expressed approval of the individual being recognised.

With state and commonwealth authority, the declaration effectively allows surgeons to confidently participate in the mortality audits, knowing information they liberally divulge will be utilised exclusively for its designed professional development purpose and nothing else.

Regional audits

ANZASM is comprised of the following regional audits:

Australian Capital Territory Audit of Surgical Mortality (ACTASM) - Katie McDonnell (Project Manager)
Northern Territory Audit of Surgical Mortality (NTASM) - Therese Rey-Conde (Project Manager)
Queensland Audit of Surgical Mortality (QASM) - Therese Rey-Conde (Project Manager)
South Australian Audit of Surgical Mortality (SAASM) - Sasha Stewart (Project Manager)
Tasmanian Audit of Surgical Mortality (TASM)
- Lisa Lynch (Project Manager)
Victorian Audit of Surgical Mortality (VASM) - Claudia Retegan (Project Manager)
Western Australian Audit of Surgical Mortality (WAASM) - Franca Itotoh (Project Manager)

The Collaborative Hospitals Audit of Surgical Mortality (CHASM) of NSW maintains membership within ANZASM, but is managed by the Clinical Excellence Commission.

National report

This report is based on the activities and outcomes since 2009. Aggregating information from multiple regions over time will allow identification of emerging trends in surgical care. The aim is to identify any system or process errors and develop strategies to redress these.

A limited number of printed copies of this report will be available by requesting a copy from your local audit office.

ANZASM 2015 National Report (eBook)
ANZASM 2015 National Report (PDF 3.3MB) 
ANZASM 2015 National Report Media Release (PDF 124KB)
ANZASM 2014 National Report (PDF 3.9MB)
ANZASM 2014 National Media Release (PDF 30KB)
ANZASM 2013 National Report (PDF 10.3MB)
ANZASM 2013 National Report (eBook)
ANZASM 2012 National Report (PDF 2.3MB)
ANZASM 2012 National Report (eBook)
ANZASM 2011 National Report
(PDF 1.9MB)

An erratum has been issued for the ANZASM 2011 Report 2009-2011 since its release in January 2013. Figure 34, page 39: The percentage of consultant involvement by region performing surgery in region 8 was incorrect. The figures for this region has been correctly revised and should be replaced in the report by the following pdf. ANZASM 2011 Annual Report page 39 (PDF 387 KB).

ANZASM 2010 National Report (PDF 1.8MB)
ANZASM 2010 National Report (eBook)
ANZASM 2009 National Report (PDF 743KB)

National case note review booklet and app

The national case note review (CNR) booklet is based on the case note reviews and its outcomes. The aim is to identify any system or process errors and develop strategies to redress these.  For printed copies of this booklet please contact your local audit office.

ANZASM CNR 2017 - Volume 11 (eBook)
ANZASM CNR 2017 - Volume 11 (PDF 1.2MB)
ANZASM CNR 2016 - Volume 10 (eBook)
ANZASM CNR 2016 - Volume 10 (PDF 1.6MB)
ANZASM CNR 2016 - Volume 9 (eBook)
ANZASM CNR 2016 - Volume 9 (PDF 1.6MB)
ANZASM CNR 2015 - Volume 8 (eBook)
ANZASM CNR 2015 - Volume 8 (PDF 1.7MB)
ANZASM CNR 2015 - Volume 7 (eBook)
ANZASM CNR 2015 - Volume 7 (PDF 710KB)
ANZASM CNR 2014 - Volume 6
 (eBook)
ANZASM CNR 2014 - Volume 6 (PDF 821KB)
ANZASM CNR 2014 - Volume 5 (PDF 2.8MB)
ANZASM CNR 2013 - Volume 4  (eBook)
ANZASM CNR 2013 - Volume 4  (PDF 2.5MB)
ANZASM CNR 2012 - Volume 3  (eBook)
ANZASM CNR 2012 - Volume 3  (PDF 15.3MB)
ANZASM CNR 2012 - Volume 2  (PDF 2.5MB)
ANZASM CNR 2011 - Volume 1 (PDF 2.8MB)

National case note review App

ANZASM is in a good position to utilise the extensive information learned to promote safer health care practices. This App incorporates the second-line case note reviews containing a more in-depth investigation of key surgical issues and lessons. It will increase the quantity and quality of information available on issues that relate to clinical governance and patient care across the country. The second-line reviews will continue to be displayed in a de-identified manner.

   2015-04-09_IMG_ANZASM_CNR_App_Images 

The main features of the ANZASM National Case Note Review App will allow you to:

  • Search for cases - by specialty, key word searches and National Safety and Quality Health Service (NSQHS) Standards.
  • View Latest cases - view the latest monthly new case note review cases that were recently uploaded when you receive a notification.
  • Provide Feedback - have the opportunity to feedback your comments about the App.
  • View notices of upcoming events - view notices about up and coming ASM events around the country, as well as the release of ASM reports.

With its easy accessibility 24x7, it can be accessed while in a hospital or clinical environment without needing to carry a hardcopy of the booklet.

Compatible with Android and iPhone tablets and phones, download the App for free from Apple App store or Google Play and search for "RACS National Case Note Reviews".

National publications 

The Australian and New Zealand Audit of Surgical Mortality-birth, deaths, and carriage Ann Surg. Feb 2015.
No weak days -impact of day in the week on surgical mortality, ANZ J Surg. Jan 2016. 
Perioperative Mortality Rates in Australian Public Hospitals: The Influence of Age, Gender and Urgency, World J Surg Jun 2016.

National workshops and seminars

Future events

Will be posted here.

Previous events in 2016

  • ACTASM Workshop, August 2015, "Closing the Audit Loop".
  • ANZASM Workshop , 11 May 2011, held at the Annual Scientific Congress (ASC) in Adelaide based on some of the activities and findings stemming from the audits.   Download presentation notes (PDF 206KB).
  • QASM and NTASM Seminar , 18 November 2016, "The elderly surgical patient - evidence based practice". Brisbane, RBWH Education Centre-Edwin Tooth Auditorium. 
  • SAASM Seminar, 25 October 2016, "End of life matters". Download   program (PDF 714KB).
  • TASM VASM Workshop , on 11 August 2016, "Would you have changed the management of this patient's course to death?" 03.00pm to 5.00pm, Launceston General Hospital, Tasmania . Download  program (PDF 243KB).
  • VASM Workshop, 21 October 2016, "Lessons learned from the VASM cases" 11.45am to 5.00pm, Ballroom, The Langham Hotel, 1 Southgate Ave, Southbank VIC 3006. Download   program (PDF 158KB). 

Electronic platform - Fellows interface

ANZASM now offers an electronic submissions platform called Fellows Interface. The paper-based submission format is still current and available. The new interface allows Fellows to self-report, complete and transmit surgical case and first-line assessment forms securely online.

The Fellows Interface is an "either or option"; you can only use the online or paper system. If you wish to change from one to the other we will have to be notified to make the necessary changes. Please contact your local audit office for further details on submitting surgical case forms online.

The electronic option will not suit everybody yet. Those who wish to take up the online option will be sent access details, and user instructions see list of user guides below:

Fellows Interface User Guide (PDF 3.1 MB)
Self-generated Notification of Death User Guide (PDF 258 KB)
Third Party Delegates User Guide (PDF 190 KB)
Third Party Delegation - Fellows User Guide (PDF 554 KB)

Submission for Data Request

The Australia and New Zealand Audits of Surgical Mortality (ANZASM) will consider requests for data and data extracts for special reports. ANZASM is a declared Quality Assurance Activity and is required to work within specific requirements of the declaration. ANZASM must protect the confidentiality of the information it receives, to respect the privacy and sensitivity of those to whom it relates and maintain high-level data security procedures. Only de-identified data can be released.

  • Requests for data should accompanied by a reason why the analyses are required.
  • Requests should have a clear & realistic plan.
  • Requests require approval by the audit data-request subcommittee and final endorsement by the ANZASM Steering Committee.
  • Once approved, requests will be prioritised and work will proceed according to the priority list.
  • It is expected that abstracts be progressed into manuscripts within one year.
  • All publications prepared from this RACS data need to be approved by the Director of RAAS, Chair RAAS and Chair ANZASM.  All publications from RAAS are reported to the RACS Council.

Please email the completed data request form (PDF 195KB) to the RAAS Director, Wendy.Babidge@surgeons.org for national data extraction. Alternatively contact the regional audit of mortality manager for regional data extracts.

Collaborations

RANZCOG

Exciting developments in the surgical mortality audits comprise the inclusion of our Gynaecological colleagues into ANZASM with a steadily increasing number of participants. The ANZASM audit is notified of all deaths occurring after a gynaecological surgical procedure. Participation by Royal Australian and New Zealand College of Obstetrics and Gynaecology (RANZCOG) Fellows is currently considered voluntary under RANZCOG CPD requirements.

2015 RANZCOG Progress Report (PDF 1.8 MB)

Contact

All general enquiries can be directed to:
ANZASM Manager - Royal Australasian College of Surgeons
Research, Audit and Academic Surgery Division
199 Ward Street
North Adelaide SA 5006

Telephone: +61 8 8219 0900
Fax: +61 8 8219 0999
Email: Gordon.Guy@surgeons.org

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