Frequently asked questions
Electronic platform - Fellows interface
Reports and publications
Submission for Data Request
Committee Meeting Dates
WAASM commenced on 1 June 2001 as a pilot project, under the
management of the University of Western Australia.
In 2005 management of the project was transferred to the
College. The WAASM Management
Committee oversees the project which constitutes an
invaluable foundation to the running and success of the audit
The project is funded by the Western Australian Department of
In November 2006, the WADH issued an operational directive
stating that all deaths that occur in public hospitals and licensed
private health care facilities providing services for public
patients are required to be classified and reviewed under the
Western Australian Review of Mortality (WARM). WARM came into
effect on 1 January 2007. Deaths that are reviewed under the WAASM
process are exempt from the WARM process.
Similar projects are now running in most states including Australian Capital
Northern Territory (NTASM),
Queensland (QASM), South Australia (SAAPM), Tasmania
(TASM), and Victoria (VASM). All audits function under the
umbrella of the
Australian and New Zealand Audits of Surgical Mortality
(ANZASM). ANZASM, as an audit process, fulfils the following
- it is independent
- it is external
- it is peer-reviewed
- it is systematic
- it is routine
- it is objective
- it is confidential (all audits are covered by qualified
privilege at a Commonwealth level).
The Qualified Privilege (QP) declaration (PDF
2.1MB) encourages surgeon participation within the mortality audits
by strictly protecting the confidentiality of information gained in
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
The Royal Australasian College of Surgeons received approval
from the Minister of Health and Ageing to declare the
Australian and New Zealand Audit of Surgical Mortality (ANZASM)
a "quality assurance" activity under the Commonwealth QP
QP declarations encourage participation of surgeons by protecting
the confidentiality of information created as part of this
ANZASM is a bi-national framework of regionally based audits of
surgical mortality. As of July 2007, every state in Australia has
its own audit. Although regionally based, all audits are covered by
an over-arching QP protection that
ANZASM has obtained at the national level. In some regions,
state coverage is also held.
This document explains:
- how the national QP legislation imposes responsibilities for
legal disclosure of audit-related information on both the regional
audits and their related audit staff
- what information the regional audit is permitted to disclose to
hospitals (in relation to the Commonwealth QP scheme)
- what information the regional audit is not permitted to
disclose to hospital (in relation to the Commonwealth QP
The regional surgical mortality audits are permitted to:
- provide annual state and hospital reports that contain
aggregated, de-identified (with respect to surgeon and patient)
data that will report on the following:
- audit participation rates for their surgeons (exception:
hospitals with consultant numbers less than two)
- hospital specific rates of optimal or suboptimal care of
patients as compared to state and national averages
- information about the general quality of surgical care being
undertaken at that hospital, relating to all aspects of care during
a surgical admission.
The regional surgical mortality audits are not permitted to:
- disclose confidential information gained from audit activities
to anyone other than the surgeon involved in the case or the
surgeons specifically assigned to provide a peer review assessment
of the case,
- a person who discloses information stemming from the declared
activity either indirectly or directly to another person or a court
of law faces a possible penalty of up to 2 years imprisonment
(Section 124Y, Health Insurance Act 1973).
Important, to provide audit information to:
- chief executive officers, or
- surgical/medical/clinical directors,
at hospitals where the surgeon is practicing is not permitted by
law. However, the Federal Minister of Health may authorise
disclosure of information that relates to a serious offence against
a law-in-force in any State or Territory. This means:
- identifying information can only be disclosed with the express
approval of the identified individuals.
- the release of any such information would be unusual and should
only occur after the implications of disclosure are properly
Participating surgeons in the audit are permitted to identify
other practitioners involved in the case.
ANZASM in partnership with Russell Kennedy lawyers compiled the
QP guide (PDF 2.1MB). For further information
about the QP scheme contact
WAASM is a peer-review process. Participation by consultant
surgeons is a requirement of the College's Continuing Professional
Development (CPD) Program.
To start, WAASM is notified of all deaths that occur in Western
Australia through The Open Patient Administration System (TOPAS).
In the case of private and smaller regional hospitals that are not
linked into the TOPAS system, WAASM is notified of all deaths
directly by the medical records department.
Next, WAASM sends a Surgical Case Form to the consultant surgeon
linked to the case. The Surgical Case Form is:
- completed by the consultant surgeon or a registrar (under
- returned to WAASM in the envelope provided (as soon as
- de-identified and sent to a first-line assessor (a consultant
surgeon; same speciality, different hospital) for anonymous
If a second-line assessment (case note review) is not requested
by the first-line assessor, the original surgeon will be sent
written feedback to this effect (and the case will be closed).
If a second-line assessment (case note review) is requested by
the first-line assessor (that is, insufficient information has been
provided on the Surgical Case Form or the case needs further
investigation) then these steps are followed:
- a second-line assessor is chosen by WAASM staff based upon a
set of criteria created to minimise any selection bias
- medical records are requested
- the second-line assessor then reviews the Surgical Case Form;
the medical records; and the first-line assessor's comment
(comments from first- line assessor are transcribed onto the
second-line assessors form), before writing a one-page report.
Note: The review is carried out and the report written in a spirit
of sympathetic enquiry, providing sufficient details for a clear
view of events
- the report and relevant feedback is sent to the original
surgeon. The case is then closed.
- at each stage of the process the original surgeon has right of
Frequently asked questions
Do I have to participate in the WAASM?
Your participation in WAASM is a requirement if you are a
surgeon in an operative based practice, have a surgical death and
an audit of surgical mortality is available in your hospital.
If I participate do I have to be a first or second-line
You can choose to be a first-line assessor, and/or a
You can participate in the WAASM without being a first-line
assessor, and/or a second-line assessor.
Are instructions/guidelines provided for first and/or
Guidelines are sent with along with surgical proformas
forms. An example of a second-line assessment report (1-2 page) is
also sent to you.
Is the WAASM process confidential?
All data and forms are de-identified. All data and forms
are securely stored. WAASM reports are covered by qualified
How will WAASM know if a patient has died under my
WAASM is notified of all deaths either through TOPAS or
medical records departments.
What if I need the medical records to fill out the WAASM
Surgical Case Form?
Contact the medical records department of your hospital
to ensure records can be located & delivered to you.
What do I do after completing the WAASM Surgical Case
Please return the Surgical Case Form to WAASM in the
Send us an email if you have any questions or
Who do I contact if I have any queries?
Please contact the WAASM Project
Electronic platform - Fellows
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
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 3.1MB)
Self-generated Notification of Death User
Guide (PDF 258KB)
Third Party Delegates User Guide (PDF
Third Party Delegation - Fellows User Guide
The paper-based submission format is still current and
available. When submitting information to the audit office, ensure
that the study ID and patient UR number are clearly labelled on all
the supporting documentation.
WAASM Annual Report 2016 (PDF 1.3MB)
WAASM Annual Report 2015 (PDF 1.2MB)
WAASM Annual Report 2014 (PDF 1MB)
WAASM Annual Report 2013 (PDF 1.5MB)
WAASM Annual Report 2012 (PDF 1.9MB)
WAASM Annual Report 2011 (PDF 3MB)
WAASM Annual Report 2010 (PDF 6MB)
Report 2009 (PDF 10MB)
Report 2008 (PDF 516KB)
Report 2007 (PDF 1MB)
Report 2006 (PDF 320KB)
Report 2004 (PDF 249KB)
Case Note Review
Read the documents (members only)
Surgical Case Form (PDF 484KB)
Surgical Case Form - Neuro
First Line Assessment Form (PDF 405KB)
Second Line Assessment Form (PDF 401KB)
Data Request Form (PDF 195KB)
User Guide (PDF 3.1MB)
Self-generated Notification of Death User
Guide (PDF 1.1MB)
Read the WAASM newsletter (members only)
WAASM consumer booklet (PDF
Population Health (CHSR)
Department of Health, Western Australia
Clinical Training and Education Centre
Confidential Enquiry into Patient Outcome and Death
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
- 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.
Future events will be posted here.
Tuesday, 15 November 2016, "Futile Care and End of Life Matters".
Download report (PDF 795KB)
Presentations as follows:
Prof James Aitken Introduction - Futile Care and End of Life
Matters (PDF 625KB), watch video.
Hon Jim McGinty AM Parliament's Role in End of Life
Matters (PDF 203KB), watch
Dr Penny Flett The Aged Care Sector's Role In Preparing For The
End Of Life (PDF 356KB)
Dr Matthew Anstey End of Life Care - National Policy
Perspective (PDF 1.2MB),
Dr Tim Paterson Fifty fifty Doc? Proceeding in Borderline
Cases (PDF 815KB), watch video.
Mr Stephen Honeybul
Futile Care or No Treatment (PDF 10.6 MB), watch video.
Dr Zaza Lyons and Mr Albie
Lyons Futility Recovery Personal
Reflection (PDF 1.9MB),
WAASM Symposium, 31 August 2015, "Transferring Surgical
Patients: better organisation is required", Harry Perkins Institute
of Medical Research (QEII), Perth. Download the program (PDF 107KB). For more
information email the WAASM office.
WAASM Symposium, February 2011, "Recognising
the Deteriorating Patient". For a copy of audio/video file email the WAASM office.
All general enquiries can be directed to:
WA Audit of Surgical Mortality (WAASM)
University of Western Australia
M308, 35 Stirling Highway
Crawley WA 6009 Australia
Telephone: +61 8 6389 8650
Fax: +61 8 6389 8655
Clinical Director - Mr James Aitken
Project Manager - Franca Itotoh
Senior Project Officer - Natalie Zorbas-Connell
Project Officer - Sonya Furneyvall
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