Collaborating Hospitals’ Audit of Surgical Mortality (CHASM)
To improve the quality and safety of surgical care in NSW hospitals. To reduce the number of preventable surgical deaths in NSW hospitals.
All surgeons who are in operative practice are required to report the clinical management of their patients who die while under their care to CHASM for peer review. CHASM provides feedback on the peer review findings to surgeons to facilitate reflective learning and improvement in surgical care.
CHASM reviews deaths of patients who were under the care of a surgeon, or where a surgeon had major input to care, irrespective of whether or not an operation was performed. Each patient death is reviewed by an anonymous peer surgeon. If there are questions or concerns, a second and more detailed case notes review will be undertaken. The peer review aims to identify any system and process errors in the management of the patient. CHASM provides feedback on the peer review findings to surgeons to facilitate reflective learning and improvement in surgical care.
CHASM reviews deaths of patients who were under the care of a surgeon, or where a surgeon had major input to care, irrespective of whether or not an operation was performed.
Each patient death is reviewed by an anonymous peer surgeon. If there are questions or concerns, a second and more detailed case notes review will be undertaken.
Participation in CHASM is a requirement of the Continuing Professional Development Program (CPD) of the Royal Australasian College of Surgeons (RACS). Surgeons who had a death under their care in NSW, are required to participate by completing details of the death in the surgical form for review by CHASM.
All information collected by CHASM have special privilege under section 23 of the Health Administration Act 1982 to enable robust discussion on the clinical management of the patient.
Participation as a surgical assessor is voluntary and is encouraged by RACS through CPD points.
CHASM provides feedback on the audit findings to surgeons to facilitate reflective learning and improvement in surgical care.
CHASM also produces various publications including:
- an annual report on program participation and audit findings
- a casebook that features the surgical learnings of selected cases
- an annual individualised report to participating surgeons
- an annual individualised local health district report on its performance against 13 program indicators.
CHASM is funded by NSW Health, administered by the Clinical Excellence Commission (CEC), and co-managed with the NSW State Committee of the Royal Australasian College of Surgeons (RACS).
CHASM is also a partner of the Australian and New Zealand Audit of Surgical Mortality, which is the bi-national framework of regionally based audits of surgical mortality administered by the RACS.
The following LHDs and private hospitals are participating in CHASM by providing regular notifications and medical records for case review to CHASM:
- Central Coast
- Far West
- Hunter New England
- Illawarra Shoalhaven
- Mid North Coast
- Nepean Blue Mountains
- Northern NSW
- Northern Sydney
- South Eastern Sydney
- South Western Sydney
- Southern NSW
- St Vincent's Health
- Western NSW
- Western Sydney
- Sydney Children's Hospitals Network
- North Shore Private Hospital
- Strathfield Private Hospital
- Sydney Private Hospital
- St George Private Hospital
- Sydney Adventist Hospital
- St Luke’s Hospital, Darlinghurst
- St Vincent's Private Hospital
- St Vincent's Private Hospital, Lismore
- Macquarie University Hospital
- The Mater Private Hospital
CHASM produces its annual publications between September and December. Copies of these publications are distributed to all surgical fellows and trainees in NSW and the local health districts participating in CHASM.
CHASM commenced data collection at the former Western Sydney Area Health Service and Hunter New England Area Health Services in January 2008. Now rolled out across the state.
|Hunter New England Local Health District||Hunter New England Local Health DistrictCommenced data collection|
|Western Sydney Local Health District||Western Sydney Local Health DistrictCommenced data collection|
CHASM has been implemented in all NSW public hospitals since 2009. It is being promoted to private hospitals in NSW.
|Central Coast Local Health District||Central Coast Local Health District|
|Far West Local Health District||Far West Local Health District|
|Hunter New England Local Health District||Hunter New England Local Health District|
|Illawarra Shoalhaven Local Health District||Illawarra Shoalhaven Local Health District|
|Mid North Coast Local Health District||Mid North Coast Local Health District|
|Murrumbidgee Local Health District||Murrumbidgee Local Health District|
|Nepean Blue Mountains Local Health District||Nepean Blue Mountains Local Health District|
|Northern NSW Local Health District||Northern NSW Local Health District|
|Northern Sydney Local Health District||Northern Sydney Local Health District|
|South Eastern Sydney Local Health District||South Eastern Sydney Local Health District|
|South Western Sydney Local Health District||South Western Sydney Local Health District|
|Southern NSW Local Health District||Southern NSW Local Health District|
|St Vincent's Health Network||St Vincent's Health Network|
|Sydney Children's Hospital Network||Sydney Children's Hospitals Specialty Network|
|Sydney Local Health District||Sydney Local Health District|
|Western NSW Local Health District||Western NSW Local Health District|
|Western Sydney Local Health District||Western Sydney Local Health District|
Key Date (location) Pilot Site Implementation Site
A survey was conducted in 2010 to assess surgeons’ participation experience and identify areas for improvement. The survey findings were published in the newsletter of the NSW Chairman of RACS.
LHD participation data are reported monthly to the senior executives.
An individualized program report was published for each participating local health district in July 2013. The report presents the local health district’s participation data and its performance against 13 clinical indicators between 2008 and 2012.
CHASM shares its confidential information with the Special Committee Investigating Deaths Under Anaesthesia.
For more information about CHASM, including its peer review methodology, program governance and publications, please visit CHASM - Collaborating Hospitals' Audit of Surgical Mortality on the CEC website.
Manager, Special Committees
(02) 9269 5543
Prof Peter Zelas OAM
Page Top | Added: 30 October 2013 | Last modified: 30 May 2014