Annual report 2010 - Australian and New Zealand College of ...

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Fellowshipaffairscontinuedquality and safetyEleven HCI organisations supportedthe meeting. There was much praisefor the visiting speakers from theTRIAD consulting group who arebased in the US.Anzca Annual Scientific Meeting(Asm)Christchurch, New Zealand – May 1-5The annual scientific meeting (ASM) ofthe College and Faculty took place at theChristchurch Convention and ExhibitionCentre. Associate Professor Ross Kennedyconvened the conference with the theme“How meets why – clinical practiceand the science behind It”. Dr RichardFrench was the Deputy Convenor andDr Mark Waddington organised a verysuccessful scientific program. ProfessorTed Shipton was the Faculty of PainMedicine Convenor and oversaw the FPMprogram. The conference welcomed 756full registrants, 154 Faculty registrants,92 exhibitor registrants and 49 dayregistrants. Conference Innovators was theprofessional conference organiser (PCO).International visitors included ANZCAASM Visitor Professor Talmage Eganfrom the US, FPM ASM Visitor ProfessorJeffrey S Mogil from Canada, AustralasianVisitor and Douglas Joseph Professor,Professor Paul Myles from Australia,Pain Medicine Visitor’s Lecturer ProfessorRichard W Rosenquist, US, andOrganising Committee Visitor ProfessorSteven Shafer, US. Industry supportedspeakers included Professor GerardManecke and Dr Daniel Sessler whoboth were from the US.The ASM was supported by a strong HCIexhibition. Dr Sue Nicoll and Dr DebbieGoodall successfully organised thesocial program, with the highlight beingthe Gala Dinner which was held at theWestpac Arena. Robbie Deans, coach ofthe Australian rugby team delivered theoration at the College Ceremony.The New Fellows Conference wasthemed “Anaesthesia and adventure” andwas held prior to the start of the ASM atHanmer Springs. Dr Karen Ryan was theNew Fellows Convenor. The Faculty ofPain Medicine Refresher Course Day washeld on April 30 and themed “Creativepain management: One goal, multipleapproaches”.Named LecturesEllis Gillespie LectureANZCA ASM Visitor: Professor TalmageEgan (US)“Pharmacodynamic interactions:hypnotics and opioids”.Michael Cousins LectureFPM ASM Visitor: ProfessorJeffrey S Mogil (Canada)“What’s wrong with animal modelsof pain?”Mary Burnell LectureFPM ASM Visitor: Professor Michael(Monty) Mythen (UK)“Why is it easier to get doctors to thetop of Mount Everest than it is to changetheir clinical practice?”Australasian Visitors LectureAustralasian Visitor and Douglas JosephProfessor: Professor Paul Myles (Aus)“Stochasticity in clinical medicine”Pain Medicine Visitor’s LectureProfessor Richard W Rosenquist (US)“Perineural catheter techniquesfor postoperative pain managementat home”The ASM Committee LectureProfessor Steven Shafer (US)“Unsolved mysteries of anaesthesia”Prize Winners – 2010Gilbert Brown Prize:Dr Forbes McGain“Financial and environmentalcosts of drug trays”Formal Project Prize:Dr Peter John Carlin“Midwife management of epiduralanalgesia in 2nd stage labour – a survey”Renton Prize:Dr Alexander Smirk, April 2009Dr Queenie Hoi Ying Tung,September 2009Cecil Gray Prize:Dr James Jarman, May 2009Dr Louise Ellard, October 2009WorkforceAt the end of 2010, there were 4950(active and retired) Fellows of the College.Of that number, 27 per cent are femaleand 73 per cent are male. There were 308new Fellows admitted in 2010.Geographical distribution was as follows:2010 Fellows New FellowsAustralia 3861 243ACT 66 7NSW 1210 65Qld 775 51SA/NT 365 24Tas 104 6Vic 950 57WA 374 33New Zealand 558 43Hong Kong 198 11Malaysia 50 3Singapore 71 2Other 212 6Total 4950 308The number of anaesthetists admitted toFellowship by training and examination in2010 was 231. There were also 76 Fellowsapproved via the international medicalgraduate specialist (IMGS) pathway.There was one new Fellow approvedvia the election to fellowship pathway.The purpose of the Quality and Safety Committee is: “To assist Councilin actively advancing the mission of ANZCA to serve the communityby fostering safety and quality in patient care in anaesthesia, intensivecare and pain medicine”.Highlights:• The committee reviewed andcontributed to 10 governmentsubmissions to various organisationsincluding the Australian Commissionfor Quality and Safety in Healthcare;National Health and Medical ResearchCouncil and Australian Council onHealthcare Standards.• Dr Peter Roessler joined the committeeas the Director of Professional Affairs.• Twenty quality and safety articles werepublished in the ANZCA Bulletin and16 articles in the ANZCA e-Newsletter.• The Special Committee InvestigatingDeaths Under Anaesthesia (SCIDUA)celebrated its 50th anniversary.• The Australian and New ZealandTripartite Anaesthetic Data Committee(ANZTADC) formed an AnalysisSubcommittee.• Each national and state committeeof ANZCA has appointed a Qualityand Safety Officer.Quality and Safety information atthe Annual Scientific Meeting(ASM), ChristchurchTwo sessions were particularly relevantto quality and safety: “Why Bad ThingsHappen to Good People”, and a “Qualityof Recovery” symposium.External submissions, reviewsand projectsThroughout 2010, the committeereviewed and contributed to 10submissions. In addition, volunteerswere found to represent the College ona variety of working groups, projects,reviews of external guidelines and inseveral workshops.Work undertaken by the six Qualityand Safety portfoliosEvidence-based medicine portfolio(Associate Professor David Scott andProfessor Alan Merry)Dr Peter Roessler joined the Quality andSafety Committee in 2010 as the Directorof Professional Affairs.The following documents were approvedby Council in 2010. APD1 ProfessionalDocuments and the accompanyingbackground paper. TG4 Equipmentto Manage a Difficult Airway duringAnaesthesia and the accompanyingbackground paper (presently intheir pilot phase).The following documents are underreview:• PS46 Recommendations for Trainingand Practice of Diagnostic PerioperativeTransoesophageal Echocardiographyin Adults• PS28 Guidelines on Infection Controlin Anaesthesia• PS10 Guidelines on the Handover ofResponsibility During an Anaesthetic• PS20 Recommendations onResponsibilities of the Anaesthetist inthe Post-Anaesthesia PeriodCommunication/liaison portfolio(Dr Patricia Mackay)ANZCA BulletinTwenty articles were published in theQuality and Safety section of the ANZCABulletin and 16 articles were publishedin the ANZCA e-Newsletter, includinga number of alerts, warnings andrecommended reading.The items for the Bulletin are increasingwhich is gratifying. Of note are theregular reports from ANZTADC, andthe current series of reports on airwayaccidents, aimed at promoting awarenessabout the problem of “Can’t IntubateCan’t Oxygenate” scenarios. It has beensuggested by Associate Professor PamMacintyre that a similar exercise could beundertaken for acute pain management,an area where adverse outcomes arestill occurring in the context of failuresto observe essential safeguards in themanagement of patients.24 ANZCA Annual Report 2010ANZCA Annual Report 2010 25
quality and safetycontinuedEmergency Care ResearchInstitute (ECRI) reportsConsideration should be given to theusefulness of the Ecri reports and also,if they are to be continued, all suchreports should be published in boththe Bulletin and the E-Newsletter.The communication/liaison portfolioagreed to a process for the timely reviewand publication of alerts from theAustralian and New Zealand TripartiteAnaesthetic Data Committee’sWebAIRS site.Clinical indicators portfolio(Dr Margie Cowling andProfessor Paul Myles)Dr Cowling and Professor Myles havehad input into the development ofthe Australian Council on HealthcareStandards.Legal Matters portfolio(Mr Michael Gorton, Mr Bruce Corkill,QC, and Professor Alan Merry)Valuable advice and commentary wasprovided to the Quality and SafetyCommittee regarding a range oflegislation and draft documentation.Mortality portfolio(Dr Neville Gibbs)The Mortality Working Group Meetingwas held in Melbourne on April 16. Thismeeting is usually held annually beforeor during the ANZCA Annual ScientificMeeting (ASM). However, this year itwas more convenient for the majorityof members to hold the meeting inMelbourne, prior to the April Quality andSafety meeting, as the ASM was beingheld in Christchurch, NZ. During themeeting updates were received fromall regions:• In NSW, David Pickford replacedProfessor Ross Holland as chairman ofSCIDUA. New legislative requirementsare being introduced in NSW under thePublic Health Act to mandate reportingof all unexpected deaths, includingdeaths during, within 24 hours of, ordue to anaesthesia. This legislationwas necessary as a result of changes tothe Coroner’s Act. SCIDUA is lobbyingto have “or sedation” addedto “anaesthesia”.• In Victoria there is a new Public Healthand Wellbeing Act, which includeslegislation to support mandatorynotification of anaesthesia mortalityand major morbidity to the VictorianConsultative Council on AnaestheticMortality and Morbidity (VCCAMM).VCCAMM is liaising with the CoronialOffice to improve communicationand capture of all anaesthesia-relateddeaths.• In Western Australia, there will be anattempt by the Health Department toidentify all deaths within 48 hours of asurgical procedure. It is hoped that thislist can be used to cross-check againstreceived anaesthetic mortality reports.• Dr Margaret Walker indicated in awritten report that the TasmanianAnaesthetic Mortality Committee hasbeen functioning well in associationwith the Tasmanian Audit of SurgicalMortality, and will be able to providedata for the 2006-2008 Triennial Report.• In South Australia, plans to re-establishan anaesthetic mortality committee arewell advanced. The committee’s draftterms of reference were discussed. It isenvisaged that the new committee willbe functional in 2011 and will cover theNorthern Territory as before.• In New Zealand the formation of aPeri-operative Mortality Committeeas a ministerial advisory committeehas been approved and draft termsof reference have been circulated forcomment. The committee is nowestablished, with Dr Leona Wilsonas its deputy chair.• In the ACT there are plans to establisha Mortality and Morbidity Committee,but the current model would not allowfeedback to anaesthetists or release ofdata. Dr Steve Brazenor is continuing tonegotiate with authorities in the ACT.• There have been no furtherdevelopments in Queensland in relationto its Anaesthetic Mortality Committee,which remains non-functioning.SCIDUA 50th AnniversaryThe NSW Anaesthesia CME meetingon August 14 recognised the 50thAnniversary of the foundation of SCIDUA.PublicationsA paper entitled “Anaesthetic-RelatedMorbidity in Victoria: A report from1990 to 2005” was published by DrLarry McNicol and Dr Pat Mackay onbehalf of VCCAMM in the Septemberissue of Anaesthesia and Intensive Care.This report was notable because itaddressed anaesthetic morbidity aswell as mortality.An editorial in Anaesthesia and IntensiveCare, entitled “Milestones in AnaesthesiaMortality and Morbidity Reportingin Australia”, was published by DrNeville Gibbs which accompanied theAnaesthetic Related Morbidity Report.These editorials were recognised at the50th Anniversary of SCIDUA.2006-2008 Triennial ReportDuring the year the timeline forpreparation of the 2006-2008 triennialreport was set. It was anticipated thatdata would be received from NSW,Victoria, WA and Tasmania. Data areexpected by February 2011, and a draftreport should be available for discussionat the April Mortality Working Groupmeeting. Meanwhile, a request was madeto the Australian Institute of Healthand Welfare for data on the numberof anaesthetics performed in the fourparticipating states over the triennium.Change of Quality and Safety OfficerIt was with considerable regret that theworking group received the news thatMs Pauline Berryman would not becontinuing in the position of Quality andSafety Officer. Pauline Berryman hadmade an outstanding contribution to theactivities of the group and, in particular,to the preparation of the 2003-2005triennial report. The group welcomedMs Giselle Collins, the new Quality andSafety Officer. The group would like tothank both Ms Berryman and Ms Collinsfor their assistance and contributionsduring the year.Dr Neville GibbsMember of Mortality Working GroupAustralia and New Zealand TripartiteAnaesthesia Data Committee(AnztadC) Professor Alan MerryThis committee is a joint initiativeof ANZCA, the Australian Society ofAnaesthetists (ASA) and the NewZealand Society of Anaesthetists(NZSA). It relates to the College throughthe Quality and Safety Committee. Itsmedical director is Adjunct ProfessorMartin Culwick, who has provided thefollowing report:During 2010, the ANZTADC continuedto collect data from the pilot sites untilthe pilot phase was completed at theend of August 2010. At this stage, 252incidents had been collected. Threepublications based on these data werereleased in the bulletins and newslettersof the ANZTADC parent organisations.Presentations or workshops took placeat the following conferences during 2010.- ANZCA/NZSA CSM in ChristchurchMay 2010- Victorian 31st Annual Combined CMEmeeting, July 2010, Melbourne- ASA NSC October 2010, Melbourne.Program development continued withan administration system and ananalysis program.At the May 2010 meeting, alertsand analysis subcommittees wereproposed. It was decided to combinethese committees into a single AnalysisSubcommittee and this subcommitteemet for the first time in October 2010.A data analyst has been appointed andattended the analysis workshops as wellas the ANZTADC meeting in October2010.While I was on vacation in the USA inJune 2010, I arranged to meet with DrRichard Dutton, the Executive Directorof the Anesthesia Quality Institute (AQI).We were able to exchange ideas relatingto quality and safety in anaesthesia andagreed in principle to co-operate in thearea of incident monitoring as well asother areas of patient safety.A proposal to allow electroniccommunication with external softwaresuch as anaesthetic record keepingsystems or patient databases wasproposed at the October 2010 meeting.Such communication was approvedin principle and ANZTADC is in theprocess of developing suitable agreementdocuments.A proposal was made at the Octobermeeting to allow external analysers tojoin the Analysis Subcommittee. Anagreement has been made in principleand suitable agreement documents arebeing developed at present.In October 2010 the web-basedanaesthetic reporting system (WebAIRS)program was released throughoutAustralia and New Zealand. There hasbeen a good response. Twenty-four siteshad completed the registration processby December 2010, 14 in Australia and10 in New Zealand. A further 79 havecommenced the process. The lattersites are being followed up and offeredfurther assistance. The memorandumof agreement for pilot sites is beingrewritten to suit the change from pilot toregistered site status for organisationssubmitting data to ANZTADC.Offers to present at the 2012 ASM andNSC are being made at present.In conclusion, 2010 resulted incontinuing progress for the developmentof WebAIRS by ANZTADC. Release ofpreliminary results has commenced andthe program has been released. Thereare now 24 sites reporting and hopefullymany more will complete the processin 2011. ANZTADC has commencedsetting up communication pathways withlike-minded organisations such as theAQI in the US and the NPSA in the UK.Presentations have been made at themeetings of ANZCA, the ASA and NZSAin 2010 and are planned to continuein 2011.Adjunct Professor Martin CulwickMedical Director ANZTADC26 ANZCA Annual Report 2010ANZCA Annual Report 2010 27
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