Surgical Outcomes Information Initiative
After three years of planning and negotiation, the VSCC released the first reports of the Surgical Outcome Information Initiative (SOII) in 2007. This development represents a major expansion of VSCC activities by establishing a direct engagement with individual public hospitals throughout the state.
SOII reports (figure 1) are derived from interrogation of the Victorian Admitted Episode dataset. After careful review and statistical analysis, the reports are released to individual hospitals. The reports deal with mortality and significant morbidities of procedures performed in Victorian public hospitals. They allow individual hospitals to benchmark their outcome results with all other hospitals performing the procedure and with the state average outcome. The data are de-identified apart from each hospital knowing who they are. Already, reports have been issued on a diverse range of procedures including aortic aneurysm repair, colectomy, oesophagectomy, hip replacement and prostatectomy. Hospitals receive three reports quarterly and it is planned to continue this rate of information dissemination. Although reports can be issued on a variable time period, they have concentrated on the last two years of activity. They clearly show an exceptional standard across all surgical specialties in Victorian public hospitals and results consistently exceed accepted international standards.
The VSCC?s major purpose in establishing the SOII was to promote internal analysis and review by individual hospitals of their activities, and to disseminate beneficial lessons learnt as a result. It was realised that the SOII data were potentially flawed as they were subject to coding errors and not appropriately risk adjusted. Indeed, there are innumerable difficulties using administrative data to appropriately reflect clinical performance and outcomes. However, the data have the ability to raise questions, and individual hospitals are required to answer these through internal review, and potentially with VSCC assistance. The VSCC?s assessment of the responses has become a major activity.
The SOII represents an innovative and exciting development that has the potential to continue to grow and expand. The VSCC will determine the direction of this growth in consultation with hospitals and other interested stakeholders. In future, it is hoped that this work will also include private hospital data.
The contributions of Peter McNair, Senior Health Funding Policy Officer, DHS, Andrew Clarke, SOII Senior Project Officer, DHS, and Jennie Shepherd, Senior Health Information Manager Advisor, DHS, in making this process successful should be acknowledged.
Figure 1 Sample of SOII report format sent to hospitals
From 2007-2009, the SOII have released real State data rates for twenty-one procedures. The relevant State mortality and morbidity rates are shown below.
Figure 2 state mortality/morbidity rates (non risk adjusted) for elective surgical procedures
