title: Victorian Audit of Surgical Mortality is associated with improved clinical outcomes.
abstract: BACKGROUND
  Improved outcomes are desirable results of clinical audit. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM) and the Victorian Admitted Episodes Dataset (VAED) to highlight specific areas of clinical improvement and reduction in mortality over the duration of the audit process.
  
  
  METHODS
  This study used retrospective, observational data from VASM and VAED. VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Aggregated VAED data were supplied by the Victorian Department of Health. Assessment of outcomes was performed using chi-squared trend analysis over successive annual audit periods. Because initial collection of data was incomplete in the recruitment phase, statistical analysis was confined to the last 3-year period, 2010-2013.
  
  
  RESULTS
  A 20% reduction in surgical mortality over the past 5 years has been identified from the VAED data. Progressive increase in both surgeon and hospital participation, significant reduction in both errors in management as perceived by assessors and increased direct consultant involvement in cases returned to theatre have been documented.
  
  
  CONCLUSIONS
  The benefits of VASM are reflected in the association with a reduction of mortality and adverse clinical outcomes, which have clinical and financial benefits. It is a purely educational exercise and continued participation in this audit will ensure the highest standards of surgical care in Australia. This also highlights the valuable collaboration between the Victorian Department of Health and the RACS.
authors.affiliation: Victorian Audit of Surgical Mortality, Royal Australasian College of Surgeons, East Melbourne, Victoria, Australia.
authors.forename: C Barry
authors.initials: CB
authors.lastname: Beiles
authors.affiliation: Victorian Audit of Surgical Mortality, Royal Australasian College of Surgeons, East Melbourne, Victoria, Australia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Retegan
authors.affiliation: Australian and New Zealand Audit of Surgical Mortality, Royal Australasian College of Surgeons, East Melbourne, Victoria, Australia.|Department of Surgery, The University of Adelaide and The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Maddern
mesh_terms: D006801:Humans; D008485:Medical Audit; D058996:Quality Improvement / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000401:mortality*; D014739:Victoria
keywords: Victoria; dataset; disease management; medical audit; mortality