Towards a Statewide Cardiac Surgery Database: the Victorian initiative

The establishment of the Australasian Society of Cardiac and Thoracic Surgeons (ASCTS) at the beginning of the 1990s gave rise to an early proposal for the development of a cardiac surgical database. The Victorian Government gave its in-principle backing to a statewide database project from late 1997. Release of a promised dollar 200,000 grant for development was contingent on the ASCTS being able to fulfil several initial requirements. These were: (i) the provision of an indicative annual report outlining performance against a series of clinical indicators; (ii) an indicative peer-review process; and (iii) the addressing of issues surrounding intellectual property and ownership of any database that was developed. In outlining a strategy to be used in developing and implementing the project plan, it was determined by the project development team that all Victorian cardiac surgical units were, in fact, collecting similar data, but were using different software and analytical tools. The Cardiovascular Disease Prevention Unit at the Baker Medical Research Institute in Melbourne has developed a model of mortality and risk-adjusted complications out of the pooled Victorian data. This, it is hoped, will be a forerunner of a major achievement in the monitoring of cardiac surgery procedures nationally, and the attainment of national and international best practice.