Volume 195 - Issue 5
Development of clinical-quality registries in Australia: the way forward
Authors: Guy J Maddern, Julian A Smith, Wendy Babidge and Gordon S Guy
Med J Aust 2011; 195 (5): 266. || doi: 10.5694/mja11.10779
Published online: 5 September 2011
Published online: 5 September 2011
To the Editor: Since publishing its first national report on mortality data from 2009,1 the Australian and New Zealand Audit of Surgical Mortality (ANZASM) has provided coverage of surgical mortality in participating hospitals across Australia.
In their recent article promoting the role of clinical-quality registries in improving the quality of health care in Australia, Evans and colleagues2 describe the importance of national registries, particularly in high-cost areas of medicine.
Evans et al present the proposed national quality indicators from a 2009 Australian Institute of Health and Welfare report3 and categorise them as current national indicators, indicators requiring data development and those for which a suitable data source has not been identified or substantial development is required to operationalise the indicator. Indicator 36, “Independent peer review of surgical deaths”, is categorised as the third type. The rationale for this indicator stated that the template of the Scottish Audit of Surgical Mortality had been adapted for use in Australia by some states and territories. The report recommended that data from these sources be reported nationally, ensuring that methods of collecting the data would become standardised across the participating states and territories. We wish to highlight that this is now the case.
The ANZASM is an independent, peer review audit process overseen by the Royal Australasian College of Surgeons (RACS) and funded by state and territory health departments. The audit is designed to identify and monitor improvements in the quality of surgical care through the collection and analysis of patient mortality data. It aims to improve the the delivery of safe, efficient and effective surgical care by identifying, improving and preventing system and process errors. The database is standardised across all sites.
In January 2010, to ensure complete participation by RACS Fellows in this activity in all states and territories across Australia, participation was deemed a mandatory continuing professional development activity (Category 1, surgical audit and peer review). Feedback is provided to individual surgeons on their cases, and overall results are summarised in a de-identified manner as case-note reviews and annual reports that discuss system issues arising on a state and national basis. These issues are analysed further, and recommendations for quality improvement in surgery are disseminated by the ANZASM to the broader surgical community and the respective regional departments of health through its annual reports, case-note-review booklets and, more recently, through workshops and seminars.
Competing interests
No relevant disclosures.
References
- Royal Australasian College of Surgeons. Australian and New Zealand Audit of Surgical Mortality: national report 2009. Adelaide: RACGP, 2010. http://www.racs.edu.au/media/365955/anzasm_2009_annual_report.pdf (accessed Jan 2010).
- Evans SM, Scott IA, Johnson NP. Development of clinical-quality registries in Australia: the way forward Med J Aust 2011; 194: 360-363. 0_i1140151
- Australian Institute of Health and Welfare. Towards national indicators on safety and quality in health care. Canberra: AIHW, 2009. (AIHW Cat. No. HSE 75.) 0_i1140153