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Clinical audit is a regular, documented, critical analysis of the outcomes of surgical care. It is accepted as an essential component of the evidence base that underpins the practice of surgery.
This audit process is designed to gather information on factors involved in the death of patients undergoing surgical treatment. Gathering information from multiple sources over time, will allow detection of system issues and emerging trends.
The aim is to develop strategies to redress these through feedback to individual surgeons, and through aggregate data disseminated to all surgeons, hospitals and departments of health.
Each state and territory audit is funded and managed independently, coming together in the Australian and New Zealand Audit of Surgical Mortality (ANZASM) Steering Committee, 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 both consistency and high standards.
It is a RACS Continuing Professional Development (CPD) requirement to participate in the ANZASM if a surgeon is in operative based practice and experiences 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.
Each regional audit is covered by qualified privilege at a Commonwealth level. The Qualified Privilege (QP) declaration (PDF 983.01KB) 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. The data 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.
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.
ANZASM now offers an electronic submissions platform called Fellows Interface. The new interface allows Fellows to self-report, complete and transmit surgical case and first-line assessment forms securely online.
Interface users will be sent access details by their regional audit office. See list of user guides below:
Fellows Interface user guide (PDF 1.77MB)
Self-generated Notification of Death user guide (PDF 257.88KB)
Third party delegates user guide (PDF 190.11KB)
Third party delegation - Fellows user guide (PDF 553.46KB)
When submitting additional information to the audit office, ensure that the study ID and patient UR number are clearly labelled on all the supporting documentation. Please contact your local audit office for further details on submitting surgical case forms online.
Reports and publications
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.
National Case Note Review booklets
The Australian and New Zealand Audit of Surgical Mortality (ANZASM) 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.
National Case Note Review booklet RANZCOG
The Royal Australian and New Zealand College Of Obstetricians and Gynaecologists (RANZCOG) National Case Note Review (CNR) booklet is in collaboration with the ANZASM.
Case Note Review Booklet RANZCOG
National Case Note Review booklet 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.
National Case Note Review booklet app
National Data Request for Publications
ANZASM data is now available for use in research for scientific publications. ANZASM will consider requests for data and data extracts for special reports.
National and regional scientific publications
The ANZASM audit collaborates with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).
The Collaborating Hospitals’ Audit of Surgical Mortality (CHASM) audits the deaths of patients who were under the care of a surgeon at some time during their hospital stay in NSW, regardless of whether an operation was performed.
CHASM is an education program led by surgeons for surgeons. It uses a systematic peer review methodology and provides feedback on the review findings to the treating surgeons for their consideration and learning.
The Collaborative Hospitals Audit of Surgical Mortality (CHASM) of NSW maintains membership within ANZASM, but is managed by the Clinical Excellence Commission.
All general enquiries can be directed to:
ANZASM Manager - Royal Australasian College of Surgeons
Research, Audit and Academic Surgery Division
24 King William Street
Kent Town SA 5067, Australia
Telephone: +61 8 8219 0937
Fax: +61 8 8219 0999