Victoria Tasmania Annual Surgical Meeting Coping with Change VASM TASM Collaborative Workshop 2015 Would you have changed the management of this patient s course to death? 16 October 2015 12.30pm-5.00pm The Grand Chancellor Hotel 1 Davey St, Hobart TAS 7000
Workshop Overview The Audit of Surgical Mortality (ASM) audit process is designed to highlight system and process errors in the management of surgical patients. The review process is a peer assessment of events that led to the death of a patient. All reviews should be carried out in a spirit of empathic enquiry. This peer review is intended as an educational rather than a punitive exercise. This workshop is suitable for Fellows, IMGs, Medical students, Anaesthetists, Gynaecologists and clinicians. Program 12.30pm 12.50pm Welcome Chair 1.00pm 1.15pm 1.15pm 1.30pm 1.30pm 1.50pm 1.50pm 2.20pm Arrival - Light Lunch Opening Session Dr Ashutosh A. Hardikar, MCh, FRACS, Clinical Director, Surgical Services, Royal Hobart Hospital, Department of Cardiothoracic Surgery Mr Barry Beiles, MB.BCh, FRACS(Vasc), Clinical Director, Victorian Audit of Surgical Mortality (VASM) Value of surgical peer review assessments Mr Barry Beiles, MB.BCh, FRACS(Vasc), Clinical Director, Victorian Audit of Surgical Mortality (VASM) Value of anaesthetic peer review assessments Dr Margaret Walker, B Med Sc(Hons), MBBS(Hons), FANZCA, Cert DHM (ANZCA), MAICD, The Hobart Anaesthetic Group Legal implications of the ASM peer review process Felicity England, BA LLB GDLP, Contracts Manager and ANZASM legal advisor, Royal Australasian College of Surgeons (RACS) Understanding the basic risk management practices Sarah O Leary, BA, LLB, GradDipLegPrac, Claims Executive, VMIA Marianna Kelly, Senior Medico-legal Risk Manager/Adviser, Avant Law, Queensland Workshop Welcome / Chair 2:20pm 2:50pm 2.50pm 3.00pm 3.00pm 3.30pm 3.30pm 4.00pm 4.00pm 4.30pm 4.30pm 4.40pm Peer-review Assessment Workshop Emeritus Professor Peter Stanton, BMedSci(Hons), MBBS(Hons), PhD(Glas) RCPSG, FRACS General Surgeon, Hobart, Tasmania Vascular & Gynaecology: Laparoscopic surgery can we do better? Mr Barry Beiles, MB.BCh, FRACS(Vasc), Clinical Director, Victorian Audit of Surgical Mortality (VASM) Afternoon Tea Colorectal Surgery: Surgical delays, can they be eliminated? Mr Emilio Mignanelli, MBBS, FRACS, CSSANZ, Hobart, Tasmania General Surgery: Diagnosis delays, can they be eliminated? Dr Amanda Young, MBBS, FRACS, Launceston, Tasmania Neurosurgery: Transfer for surgery, can we do better? Mr Nova Thani, MBBS, M Med Sci, FRACS, Tasmanian Spine Service, Hobart, Tasmania Summary and conclusion Page 2
Mr Ashutosh Avadhoot Hardikar MCh, FRACS Welcome Opening Session Dr Ashutosh Avadhoot Hardikar, MCh, FRACS, Clinical Director, Surgical Services, Royal Hobart Hospital, Department of Cardiothoracic Surgery Dr Hardikar is an Australian-based health professional. He is the Clinical Director, Surgical Services at Royal Hobart Hospital. He is trained as a Cardiothoracic Surgeon and has a practice located in Hobart. Page 3
Mr Barry Beiles MB.BCh, FRACS(Vasc) 1.00pm 1.15pm Value of surgical peer review assessments Mr Barry Beiles, MB.BCh, FRACS(Vasc), Clinical Director, Victorian Audit of Surgical Mortality (VASM) Mr Beiles is a Vascular Surgeon and Clinical Director of the Victorian Audit of Surgical Mortality (VASM). He has a long-time interest in audit and administers the Australasian Vascular Audit (AVA) since its inception in 2010. Prior to this he developed and administered the Melbourne Vascular Association audit for 10 years. He is a devotee of acoustic finger style guitar. Page 4
Dr Margaret Walker B Med Sc(Hons), MBBS(Hons), FANZCA, Cert DHM (ANZCA), MAICD 1.15pm 1.30pm Value of anaesthetic peer review assessments Dr Margaret Walker, B Med Sc(Hons), MBBS(Hons), FANZCA, Cert DHM (ANZCA), MAICD, The Hobart Anaesthetic Group Dr Walker has been a Specialist Anaesthetist since 1993. She is currently a Visiting Specialist in Anaesthesia at the Royal Hobart Hospital, and a Clinical Senior Lecturer at the University of Tasmania, School of Medicine, and maintains a busy private practice. She is the Tasmanian Coordinator of the Australian and New Zealand College of Anaesthetists (ANZCA) Quality and Safety Audit, which is monitoring the safety of anaesthesia in Australia, and represents Tasmania on the ANZCA Quality and Safety Committee and the ANZCA Mortality Committee. She was the Medical Co-Director of the Diving and Hyperbaric Medicine Unit at the Royal Hobart Hospital from 1997 2012. Page 5
Felicity England BA, BA LLB GDLP 1.30pm 1.50pm Legal implications of the Audit of Surgical Mortality (ASM) peer review process Felicity England, BA LLB GDLP, Contracts Manager and ANZASM legal advisor, Royal Australasian College of Surgeons (RACS) Felicity is the Contracts ManAger for the College s Research, Audit and Academic Surgery Division and works closely with the ANZASM program, its managers and clinical directors, advising in relation to obligations under qualified privilege and audit governance. A legal practitioner with over 14 years of experience in contractual advice, contractual disputes, and defendant (personal injury) litigation. She is committed to providing focused, strategic and pragmatic advice. Page 6
Sarah O Leary BA, LLB, GradDipLegPrac 1.50pm 2.20pm Understanding the basic risk management practices Sarah O Leary, BA, LLB, GradDipLegPrac, Claims Executive, Victorian Managed Insurance Authority (VMIA) Sarah is a Claims Executive within the Health team at the VMIA. She manages medical indemnity claims arising from all areas of clinical practice across the public healthcare system in Victoria. She graduated from the University of Tasmania. She has previously practiced as a lawyer both in Australia and the United Kingdom, specialising in health law. She represented patients in medical negligence cases whilst living in Bristol and later acted for healthcare practitioners in London before returning to Melbourne in 2009. Sarah and the team at VMIA work closely with the health services to manage claims from notification to trial. At the conclusion of each claim the VMIA reflect on its circumstances to identify clinical risks which may be reduced or prevented in the future. Page 7
Marianna Kelly Senior Medico-legal Risk Manager/Adviser, Mast Risk Mgt, R.N. Grad Dip Disp Mgt, Dip Prac Mgt, Accredited Mediator 1.50pm 2.20pm Understanding the basic risk management practices Marianna Kelly, Senior Medico-legal Risk Manager/Adviser, Mast Risk Mgt, R.N. Grad Dip Disp Mgt, Dip Prac Mgt, Accredited Mediator Marianna is a Senior Risk Advisor and manager for Avant. Marianna assists members of Avant through the provision of medico-legal advice, risk assessments and the development and implementation of risk management strategies. She has a Masters in Risk Management so she is able to support the theory of risk management with the practical experience of developing strategies to manage the medico-legal road blocks. Page 8
Emeritus Professor Peter Stanton BMedSci(Hons), MBBS(Hons), PhD(Glas) RCPSG, FRACS Welcome / Chair Peer-review Assessment Workshop Emeritus Professor Peter Stanton, BMedSci(Hons), MBBS(Hons), PhD(Glas) RCPSG, FRACS - General Surgeon Emeritus Professor Peter Stanton is a semi-retired breast endocrine surgeon in private practice in Hobart. He undertook undergraduate studies at the University of Tasmania, and then a PhD at the University of Glasgow. He was employed by the University of Glasgow as Research Fellow, Lecturer, and Senior Lecturer, with appointment to Glasgow Royal Infirmary as Consultant Surgeon, and spent 6 months as Visiting Lecturer at the Chinese University of Hong Kong. He returned to Tasmania as Professor of Surgery for a decade, before winding back to his current position. A contributor to the Scottish Audit of Surgical Mortality when he worked in Glasgow, he has been involved with TASM since its inception in 2004. He is a keen walker, skier and traveller. He is not, and will never be, found on Facebook or LinkedIn. Page 9
Mr Barry Beiles MB.BCh, FRACS(Vasc) 2.20pm 2.50pm Vascular & Gynaecology: Laparoscopic surgery can we do better? Mr Barry Beiles, MB.BCh, FRACS(Vasc), Clinical Director, Victorian Audit of Surgical Mortality (VASM) Mr Beiles is a Vascular Surgeon and Clinical Director of the Victorian Audit of Surgical Mortality (VASM). He has a long-time interest in audit and administers the Australasian Vascular Audit (AVA) since its inception in 2010. Prior to this he developed and administered the Melbourne Vascular Association audit for 10 years. He is a devotee of acoustic finger style guitar. Page 10
Mr Emilio Mignanelli MBBS, FRACS, CSSANZ 3.00pm 3.30pm Colorectal Surgery: Surgical delays, can they be eliminated? Mr Emilio Mignanelli, FRACS, CSSANZ Mr Mignanelli is a consultant General Surgeon with subspecialty qualifications in Colorectal Surgery. He is a Fellow of the Royal Australasian College of Surgeons and a member of the Colorectal Surgical Society of Australia and New Zealand (CSSANZ). He completed his medical degree at the University of Tasmania and underwent surgical training through the Alfred Hospital in Melbourne as well as Taunton Hospital in the United Kingdom. He completed his training as a Clinical Fellow in Colorectal Surgery at the Cleveland Clinic in the USA. His main interest is in laparoscopic surgery for colon and rectal cancer as well as inflammatory bowel disease (IBD). He commenced consultant practice in Hobart in 2009 and is based at the Royal Hobart Hospital and Calvary Hospital. Page 11
Dr Amanda Young MBBS, FRACS 3.30pm 4.00pm General Surgery: Diagnosis delays, can they be eliminated? Dr Amanda Young, MBBS, FRACS Dr Young graduated from University of Sydney and currently has a private practice at Launceston. She is a Consultant Surgeon at the Launceston General Hospital, General Surgeon at Calvary, St Vincent s and St Luke s Private Hospitals, Launceston. Her primary specialty interests are in Breast and Endocrine, Melanoma, Head & Neck and Hand Surgery. Dr Young previously worked as a Resident and Junior Registrar at The Royal Prince Alfred Hospital, the Royal Camperdown and the Royal Alexandra Hospital for Children. In 2013, she has been involved in the training foreign doctors examination course. She published in several medical journals and attended international conferences and events as a guest speaker. In 2000, she was the Chairman of Tasmania Cooperative Oncology Group. Page 12
Mr Nova Thani MBBS, M Med Sci, FRACS 4.00pm 4.30pm Neurosurgery: Transfer for surgery, can we do better? Mr Nova Thani, MBBS, M Med Sci, FRACS, Tasmanian Spine Service, Hobart, Tasmania Mr Nova Thani is an adult and paediatric neurosurgeon at Royal Hobart Hospital and an associate at Tasmanian Spine Service and Neurosurgery Tasmania. He is an Adjunct Senior Lecturer within the School of Medicine at University of Tasmania. He has particular interest in complex spinal surgery and has undergone extensive post-fellowship training at St Michael s Hospital in Canada through the University of Toronto. His other areas of expertise include skull base surgery, neuro-endoscopy and cerebrovascular surgery. He has diverse experience in neurosurgery by working in multiple hospitals within Australia (Melbourne, Perth, Hobart) and internationally (Toronto, Canada). Page 13
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Acknowledgements : The Royal Australasian College of Surgeons (RACS) The Victorian Regional Office (VRO) The Tasmanian Regional Office (TRO) The Tasmanian and Victorian Presenters The Victorian Audit of Surgical Mortality (VASM) The Tasmanian Audit of Surgical Mortality (TASM) The Faculty of Health Science, School of Medicine, University of Tasmania The Victorian Department of Health and Human Services (VIC DHHS) The Tasmanian Department of Health and Human Services (TAS DHHS) The Victorian Managed Insurance Authority (VMIA) Avant Risk IQ _ Page 15
Victorian Audit of Surgical Mortality (VASM) GPO Box 2821 Melbourne VIC 3001 Australia Telephone: +61 3 9249 1153 Fax: +61 3 9249 1130 Email: vasm@surgeons.org Web: www.surgeons.org/vasm Tasmanian Audit of Surgical Mortality (TASM) 147 Davey Street Hobart TAS 7000 Australia Telephone: +61 3 6223 8848 Fax: +61 3 6223 5019 Email: tasm@surgeons.org Web: www.surgeons.org/tasm