Providers and consumers support the Western Australian Audit of Surgical Mortality.
BACKGROUND
The Western Australian Audit of Surgical Mortality (WAASM) was established in June 2001 to independently peer-review all surgical deaths in Western Australia. The objectives of this study were (i) to evaluate whether participation in the WAASM has influenced clinical and hospital practice; and (ii) to ascertain the support and relevance of the WAASM to surgeons, hospitals and consumers.


METHODS
Three qualitative questionnaires were designed to evaluate the response of surgeons, hospital administrators and consumers to the WAASM. The outcomes measured included audit participation, value and use of feedback provided, changes to clinical and hospital practice and the future role of the WAASM.


RESULTS
The key findings were that 138 (73%) of 190 surgeons participating in the WAASM had changed their clinical practice in at least one way, 44 (24%) were aware of changes in hospital practice and 21 (11%) were aware of changes in a colleague's practice. Particular areas where changes in surgical practice had occurred included attention to deep vein thrombosis prophylaxis (81, 44%), increased constructive discussion among peers (78, 42%) and quality of documentation in case notes (68, 37%). All groups supported the continuation of the WAASM. Hospital executives and consumers recommended that the WAASM be included in accreditation.


CONCLUSIONS
Surgeons, hospitals and consumers supported the concept of independent peer review of surgical care. They confirmed the ability of audit to influence and change surgical and hospital practice. It strengthens the intention of the Royal Australasian College of Surgeons to extend the WAASM project throughout Australia and New Zealand.
Semmens
James B
JB
Centre for Health Services Research, School of Population Health, The University of Western Australia, Crawley, Australia. james@sph.uwa.edu.au
Mountain
Jenny A
JA
Sanfilippo
Frank M
FM
Barraclough
Jenny Y
JY
McKenzie
Anne
A
Mukhtar
S Aqif
SA
Haynes
Natasha S
NS
Aitken
R James
RJ
D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D006801:Humans; D008485:Medical Audit; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D013503:Surgery Department, Hospital / Q000458:organization & administration; D013514:Surgical Procedures, Operative / Q000401:mortality*; D014904:Western Australia