59 / 66
57
10. Audit limitations and data management
As an audit the data is collected to provide feedback to surgeons, rather than for academic research. However, in
audit terms the data are of high quality because every case was subject to external peer review.
The data is self-reported and a certain level of bias may be present, but independent assessors make their own
assessments on the facts presented.
Data quality is an essential component of all audits. Inaccurate and incomplete clinical information will impair the audit
process and prevent identification of trends.
(15)
The volume of data unavailable continues to be most prevalent. The breakdown of sections with sizeable missing data
is the ‘fluid balance management’ 2.9% (154), ‘operative section’ 5.7% (294), and ‘critical care utilisation’ 8.1% (422)
in the 6,179 audited cases. These sections will require further improvements as appropriate and detailed responses in
these areas are important if the audit is to identify and address adverse trends.
Where data integrity issues are identified, it is important for the audit team to review the format of the questions on the
case record forms that will generate the data. The ANZASM felt it appropriate to revise the SCF in 2016.
The current VASM enhanced electronic Fellows’ Interface for data submission should ease the process of the data
submissions and lead to improved data integrity in the future.
Conclusion
10.1.
The VASM audit continues to identify, assess and review factors associated with surgical mortality and will continue to
develop action plans, educational programs and recommendations for further patient care improvements in Victoria.
(35)