The audit, in Australia, is protected by Commonwealth qualified legal privilege as a quality assurance activity (NZ has its own national legal privilege). Any divulgement of a participant’s identity is punishable by a substantial fine and a custodial sentence.
The audit has been granted official RACS endorsement under its CPD programme.
The audit is indemnified under the umbrella of the RACS insurance policy.
The audit complies with current privacy legislation regarding the collection of health data in situations where it is not practicable to obtain patient consent and when the data is potentially de-identifiable. On the directive of the Privacy Commissioner this required RACS ethics approval which has been subsequently obtained.
Participation in the audit is a necessary requirement for ordinary members to maintain membership of the ANZSVS.
Membership of the ANZSVS is not related to performance.
Scope of the audit; the audit will capture all vascular surgery performed in private and public practice but analysis of outcomes will be restricted to:
Aortic Surgery (Aneurysmal and occlusive disease):
- Survival rate during the same hospital admission:
- for open elective surgery
- for open surgery in patients thought to be actively bleeding or actively thrombosing at the time of intervention ( emergency intervention)
- for elective non-fenestrated EVAR
- for urgent non-fenestrated EVAR
- for fenestrated EVAR
Carotid Intervention (Endarterectomy and CAS):
- Major stroke free and death free rates during the same hospital admission post carotid endarterectomy
- Major stroke free and death free rates during the same hospital admission post carotid stent procedures
Lower Limb Bypass Surgery:
- Patency rate during same admission
- Ipsilateral limb salvage rate during same hospital admission
Dialysis Access Surgery:
- Primary Patency
Endovascular intervention for Peripheral Vascular disease (lower limb):
- Death or any complication after aorto-iliac or distal stent or PTA for occlusive PAD
All members have been allocated a random number which also serves as the member’s username when opening the web-based audit. Given that trainees will know the consultant’s number they would be bound by legal privilege legislation to not divulge that number to any one else. The code would have to be broken in the case of outlying results requiring further evaluation and that would be only to the audit monitoring committee.
- For verification purposes, there will be a random audit process of a certain percentage of the membership. Those who are randomly audited will be expected to submit independent hospital collaboration of their previously submitted figures