THE QUALITY OF SURGICAL CARE PROJECT - A MODEL TO EVALUATE SURGICAL OUTCOMES IN WESTERN-AUSTRALIA USING POPULATION-BASED RECORD LINKAGE

Background: The aim of this study is to establish a model to evaluate surgical outcomes and, where indicated, recommend changes to improve t he quality of surgical care in Western Australia (WA). Open resection for aneurysm of the abdominal aorta was the first procedure evaluated and the results are reported in an accompanying paper. Methods: The Qu ality of Surgical Care Project (QSCP) is conducted under the aegis of the Royal Australasian College of Surgeons (RACS) in WA, and brings to gether a multidisciplinary team of surgeons, public health researchers and health service administrators. The Western Australia Health Servi ces Research Linked Database (the WA Linked Database) is used to provi de linked chains of patients records residing in the state health depa rtment from the following sources: hospital morbidity data system, bir th and death records, mental health services data, cancer registration s and midwives' notifications. This links 16 years of population-based patient records from 1980, including all public and private hospital admissions and re-admissions. The Quality of Surgical Care Project was established to use and to correlate the data from the WA Linked Datab ase. Results: The result is a powerful database for a contained popula tion that is available for scientific analysis by a multidisciplinary team of clinical epidemiologists, surgeons and health service managers . Users will have the ability to establish benchmark standards for the outcomes of surgical procedures in WA for use in quality improvement programmes run by the College and will facilitate self-directed perfor mance auditing activities as a commitment to greater community account ability. Conclusions: The Quality of Surgical Care Project provides a potential model of benefits to be realized by both the medical profess ion and the community through multidisciplinary collaboration supporte d by adequate information. Although migration from WA is relatively lo w, future linkage to the state electoral roll will allow correction fo r any population change.