NTASM CLINICAL DIRECTOR’S REPORT

I am pleased to announce the Northern Territory Audit of Surgical Mortality (NTASM) is progressing well. Some examples include the ongoing collaboration with the Northern Territory Department of Health, which extended NTASM funding until June 2024. The NT Department of Health also provided NTASM with baseline data of all patients admitted for surgery and discharged home in 2021. This baseline data is included in NT annual reports and is compared with NTASM patients admitted during the same period.

Obstetrics and Gynaecology (O&G) Fellows started participating in NTASM in 2012, and anaesthetists in June 2016. Two O&G cases and 75 anaesthetic cases have been reported to NTASM. In this reporting period (July 2017 to June 2022), NTASM was notified of 431 surgical deaths, and 8.8% were excluded due to terminal care.

Some issues have been identified in NTASM data collection. The NT has the lowest number of surgeons per population compared with the rest of Australia. NT surgeons rely on locum surgeons and Specialist International Medical Graduate surgeons. Darwin-based vascular and urology surgeons also act as locum surgeons in Alice Springs. To prevent delays in data collection, locum surgeons are advised about NTASM during their orientation training and encouraged to selfreport any patient deaths that occur during their roster.

Previously, NTASM recommended a full-time resident neurosurgeon in Darwin and an appointment resulted. During 2021, the Neurosurgery department reverted to only having locum surgeons, possibly due to COVID-19. Once again, NTASM highly recommends additional surgeons in the NT for the departments of Neurosurgery and Vascular Surgery.

Communication was highlighted as an issue in the 2020 NTASM Annual Report. In 2021, NTASM sponsored a Safer Surgical Teamwork (SST) workshop at Royal Darwin Hospital, focusing on communication, teamwork, leadership and task management, with 24 attendees. On request, another SST workshop was held on 29 and 30 September 2022 at Alice Springs Hospital. This was open to all surgeons, anaesthetists, intensivists and scrub nurses from NT hospitals. The workshop was a success with 52 attendees.

My sincere thanks to all NT surgeons, the NT Department of Health and NTASM support staff for their continued participation and support of the NTASM project.

Dr John North NTASM Clinical Director