Introduction to SQSCP

The Safety and Quality of Surgical Care Project

Promoting Best Practice in Surgical and Procedural Care

The Safety and Quality of Surgical Care Project (SQSCP) is a unique quality assurance program in Australia.  It aims to establish best practice in surgical and procedural care, using evidence-based medicine, in terms of patient and economic outcomes in our health care systems.

The Program is made possible because of the population-based record linkage data sets available in this state. 

Assoc Prof James Semmens, was the last Director of The Centre for Health Services Research, and is currently the Manager of the Safety and Quality of Surgical Care Project.

SQSCP:

• Was established in 1996 to evaluate the safety, quality, clinical epidemiology and outcomes of surgical procedures at a state population level.
• Involves collaboration between;
  • The WA Branch of the Royal Australian College of Surgeons (RACS),
  • The University of Western Australia’s School of Population Health (CHSR), and
  • The Western Australian Department of Health, Health Information Centre (DLU). 
• Is overseen by a State Executive Committee.
• Has obtained research funding of more than $6 million to date (1996-2004), from the NHMRC, government health departments and industry.

Aims

• To undertake system-wide studies of indicators of health care quality and adverse events
• To describe the epidemiology of selected diseases requiring surgical care
• To monitor trends in utilisation of surgical procedures
• Compare standards of surgery in WA with national and international standards of best practice
• To establish benchmark standards of surgical care
• To evaluate and compare the outcomes of new and established surgical procedures
• To recommend and evaluate the implementation of appropriate changes in surgical practice
• To provide an independent audit of post-operative surgical mortality (WAASM)
• To disseminate outcomes of the evaluation process to individual surgeons, RACS, health service managers, policy makers, the WA Health Consumers Council and consumers.

The aims of the SQSCP are consistent with the recommendations of the Taskforce of the Quality of Australian Health Care Study, and the recently formed Australian Council for Safety and Quality in Health Care. 

Aspirations

• To gain knowledge concerning the appropriateness and outcomes of important surgical and medical procedures, with Australian results that can be used to promote best practice in procedural care and to inform medical and patient decisions
• Identification of important risks to public safety due to surgical procedures and new technology
• The ability to influence surgical practice by independently reviewing all postoperative surgical deaths
• To develop national and international collaborative relationships with industry and high quality research centres

Achievements

Research to date (2004) has resulted in:

• 83 scientific publications; and
  138 presentations at state, national and international forums
  This data has been instrumental in establishing key standards of care specific for the Australian context and have contributed to changes in clinical practice.
• Successful engagement of senior clinical providers in a rigorous, cutting-edge program of clinical epidemiology and outcomes research, with state, national and international significance.  SQSCP provides a collaborative bridge between clinical epidemiological and outcomes research methodology, and surgical practice. 
• Findings specifically targeted to individual surgeons, specialty groups and the RACS.
• Contributions to clinical knowledge on outcomes of surgical care in WA, through the publication of papers in international journals on population standards, including.
  • Clinical changes for laparoscopic cholecystectomy.
  • Provision of data for establishment of standards for endoluminal repair of aneurysm of the abdominal aorta (AAA) for regulatory bodies in Australia, Europe, the UK and the US.
  • Changes in the use of prophylactic treatment for deep vein thrombosis (DVT) by hospitals, surgeons and health policy makers in WA.
  • Contributing to the removal of elective circumcision from the WA public hospital system following recommendations published in the MJA and the ANZ J Surg.
• The development of clinical information systems (database development), as part of specific studies within the SQSCP program. These include:
  • The Western Australian Audit of Surgical Mortality project database (WAASM) 
  • The WA Gynaecological Cancer registry at King Edward Memorial Hospital
  • WA Tissue Network database system for Sir Charles Gairdner and Royal Perth Hospitals. 

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