Western Australian Audit of Surgical Mortality (WAASM)

The audit is centred on evidence based methodology adapted from the Scottish Audit of Surgical Mortality (external site).

WAASM commenced in 2001, and is funded by the WA Department of Health while being managed by the Royal Australasian College of Surgeons (RACS) (external site).

WAASM is designed to provide feedback by surgeons to surgeons. The purpose of this feedback is to inform, educate, facilitate change and improve practice of all clinicians.

The WAASM process

The WAASM methodology flowchart (PDF 18.20KB) gives a diagrammatic representation of the following process:

• deaths where a surgeon was involved in the care of the patient that occur in public hospitals are automatically notified to WAASM through:
  • electronic patient administration systems (TOPAS or WebPAS)
  • directly by the medical records departments of regional and private hospitals.
• the consultant surgeon is sent a proforma for completion, highlighting any areas for consideration or concern or adverse events that may have occurred.
• the completed proforma is anonymised and then given to another consultant surgeon (first-line assessor) for peer review.
• if the case warrants an additional detailed review it may then be referred to a second-line assessor for case note review.
• feedback is disseminated to all surgeons, hospitals and the public via WAASM annual reports and other formats.
• the process is currently protected by:
  • Part VC (quality assurance confidentiality) of the Commonwealth’s Health Insurance Act 1973 (PDF 102KB)

Any preventable deaths identified via the review process are required to be notified as Severity Assessment Code (SAC) 1 clinical incidents and investigated in accordance with the Clinical Incident Management Policy. Participation in the WAASM fulfils mortality review obligations established by the Review of Death Policy.

WAASM annual reports

The WAASM website (external site) contains annual reports that incorporate de-identified trend information of cumulative data gathered through the audit process.

More information

Patient Safety Surveillance Unit
Email: pssu@health.wa.gov.au