The Collaborating Hospitals’ Audit of Surgical Mortality (CHASM) reviews deaths to help improve surgical care in NSW.
CHASM reviews patients who die within 30 days of surgery, or while under a surgeon’s care during a hospital stay, even if they did not have surgery. It uses peer review to identify where care could improve.
CHASM is an education program led by surgeons for surgeons. It provides confidential feedback to support learning and better clinical practice. Both the treating surgeon and the peer reviewer benefit from reflecting on care.
The program does not assess performance. It aims to support learning, prompt discussion and improve future care.
A committee oversees CHASM. The Secretary, NSW Health appoints members under delegation from the Minister for Health. The committee operates under section 20 of the Health Administration Act 1982, with confidentiality protections under section 23.
Program history
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1994
The Minister for Health initiated a Special Committee Investigating Deaths Associated With Surgery (SCIDAWS). Its purpose was to collate surgical mortality data for the purpose of educating surgeons and health care providers.
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2004
The following recommendations from the Morey Report, SCIDAWS was transferred to the then Institute of Clinical Excellence (ICE) to improve the reporting and investigation of surgical deaths.
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2006
The functions of SCIDAWS were expanded to enable a more systematic and comprehensive audit and included cases where no operation was performed.
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2007
The Minister for Health approved a name change – with SCIDAWS becoming CHASM – to promote the collaborative nature of the audit.
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2007
The Minister confirmed in Government Gazette No. 169 that special privilege provided for SCIDAWS under the Health Administration Act 1982 would apply for CHASM.
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2025
CHASM discontinued its current method of mortality review with plans to develop a new model which includes morbidity.
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2026
The CHASM Redesign Project commenced and will align with key principles of clinical transformation (value, impact and alignment of effort) to ensure that the new model supports the delivery of Future Health.
More on the redesign project:
Committee members
- Conjoint Associate Professor Brett Courtenay OAM, Chair, MBBS FRACS, Orthopaedic Surgeon
- Dr (Upeksha) Pecky De Silva, Deputy Co-Chair, BSc(Med) MBBS FRACS, Vascular Surgeon
- Dr Michelle Atkinson, BMed FRACS (A.Orth.A.), Orthopaedic Surgeon
- Associate Professor Julie Howle, MBBS (Hons I) MS FRACS FACS, Surgical Oncologist
- Dr John Fox, MBBS FRACS(Orth) FAOrthA, Orthopaedic Surgeon
- Dr (Saissan) Sai Rajendran, MBBS GDAAD MS (Vasc) FRACS DDU, Vascular Surgeon
- Professor Zsolt Balogh, MD PhD FRACS FACS FAOrthA, Orthopaedic Trauma Surgeon
- Dr (Katherine) Kate Gibson, MBBS FRACS BSc (Hons) Microbiology MSc (Microbiology), General Surgeon (Colorectal)
- Dr Christina Norris, BMedSci MBBS FRACP, Perioperative Geriatrician
- Dr Sally Butchers, BMed FRACS, General Surgeon (Rural)
- Dr Emily Granger, BMed FRACS, Cardiothoracic Surgeon
- Associate Professor Mark Davies OAM, MBBS (Hons) LLM (Med Law and Ethics) FRACS, Neurosurgeon
- Dr Matthew Stanowski, MBBS BMedSci FRACS, Urologist
Resources
- Terms of Reference (PDF 504.7 KB)
- Trend report: Safe surgery for the elderly (PDF 3.9 MB)
- Joint forum: CHASM and SCIDUA (PDF 3.7 MB)
Annual reports
- CHASM Annual Report 2022 (PDF 1.9 MB)
- CHASM Annual Report 2021 (PDF 2.2 MB)
- CHASM Annual Report 2020 (PDF 4.1 MB)
- CHASM Annual Report 2019 available upon request
Casebook library
- CHASM Casebook 2018 (PDF 13.5 MB)
- CHASM Casebook 2017 (PDF 610.5 KB)
- CHASM Casebook 2016 (PDF 4.8 MB)
- CHASM Casebook 2015 (PDF 931.9 KB)