title: Evaluating the value and impact of the Victorian Audit of Surgical Mortality.
abstract: BACKGROUND
  Since the Victorian Audit of Surgical Mortality (VASM) commenced in 2007, 95% of Victorian Fellows have agreed to participate and have provided data on the deaths of patients receiving surgical care. All public, and the majority of private, hospitals involved in the delivery of surgical services in Victoria have been submitting data on deaths associated with surgery. De-identified reports on this data are distributed in regular annual reports and case note review booklets. Although informal feedback on the perceived value of the audit was encouraging, a formal review of all aspects of the audit was felt necessary.
  
  
  METHODS
  An independent formal review of VASM governance, documentation, datasets and data analysis was performed, in addition to a survey of 257 individuals (surgeons and other stakeholders) on the perceived impact of VASM.
  
  
  RESULTS
  The review confirmed increasing participation and acceptance by surgeons since the inception of the project. Governance mechanisms were found to be effective and acknowledged by stakeholders and collaborators. Robust participation rates have been achieved, and stakeholders were generally satisfied with the quality of feedback. Suggestions for improvement were provided by some surgeons and hospitals.
  
  
  CONCLUSIONS
  External review of VASM processes and procedures confirmed that the audit was operating effectively, with robust quality control and achieving the trust of stakeholders. The educational value of the audit to the surgical community was acknowledged and areas for future improvement have been identified.
authors.affiliation: Victorian Audit of Surgical Mortality, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Retegan
authors.forename: Colin
authors.initials: C
authors.lastname: Russell
authors.forename: Darren
authors.initials: D
authors.lastname: Harris
authors.forename: Nick
authors.initials: N
authors.lastname: Andrianopoulos
authors.forename: C Barry
authors.initials: CB
authors.lastname: Beiles
mesh_terms: D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006801:Humans; D008485:Medical Audit / Q000379:methods / Q000458:organization & administration; D015397:Program Evaluation; D013514:Surgical Procedures, Operative / Q000401:mortality* / Q000592:standards; D014739:Victoria
keywords: audit; clinical audit; evaluation methodology; health care quality assurance; hospital mortality; operative surgical procedure; surgery