{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:05:31Z","timestamp":1787889931670,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2025,12,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the frequency of non\u2010technical errors in cases of surgical care\u2010related deaths in Australia, by surgical specialty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Retrospective cohort study; analysis of Australian and New Zealand Audit of Surgical Mortality (ANZASM) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting, participants<\/jats:title>\n                    <jats:p>All surgical care\u2010related deaths in Australia (except New South Wales), 1 January 2012 \u2013 31 December 2019, that were flagged in ANZASM as associated with adverse events or areas of concern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Proportions of surgical care\u2010related deaths associated with non\u2010technical errors, overall and by domain (communication\/teamwork, decision making, situational awareness, leadership); paired comparisons of likelihood of errors by specialty; change in error proportions during 2012\u20132019; influence of patient and admission factors on likelihood of non\u2010technical errors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 30\u2009971 surgical care\u2010related deaths reported to ANZASM during 2012\u20132019, 3695 were flagged with adverse events or areas of concern, including 3422 cases (92.6%) in five surgical specialties: general surgery (1570 deaths), cardiothoracic surgery (626), orthopaedic surgery (510), vascular surgery (385), and neurosurgery (331). The proportions of surgical care\u2010related deaths associated with non\u2010technical errors differed by specialty (range, 52.2% to 68.5%), as did those errors in the domains decision making (range, 52.6% to 66.3%) and situational awareness errors (range, 44.4% to 62.5%). The probability of any non\u2010technical error was greater for cardiothoracic than orthopaedic surgery (adjusted odds ratio [aOR], 1.76; 95% confidence interval [CI], 1.37\u20132.28), and for general than orthopaedic surgery (aOR, 1.97, 95% CI, 1.59\u20132.44) or neurosurgery (aOR, 1.47; 95% CI, 1.14\u20131.90); the probability was lower for orthopaedic than vascular surgery (aOR, 0.54; 95% CI, 0.41\u20130.72). The proportion of deaths associated with non\u2010technical errors declined over time for general surgery, but not the other four specialties. Differences by patient and admission characteristics in the proportions of cases including non\u2010technical errors were not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At least 50% of surgical care\u2010related deaths in five surgical specialties were associated with non\u2010technical errors, and the proportions did not substantially change during 2012\u20132019. Differences between specialties in the frequency of fatal non\u2010technical error suggest that targeted improvement strategies are needed, but the persistently high frequency for all specialties indicates that systemwide improvement is crucial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70055","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T07:38:37Z","timestamp":1758613117000},"page":"617-625","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Non\u2010technical errors associated with deaths in surgical care, Australia, 2012\u20132019, by surgical specialty (Australian and New Zealand Audit of Surgical Mortality): a retrospective cohort study"],"prefix":"10.5694","volume":"223","author":[{"given":"Jesse","family":"Ey","sequence":"first","affiliation":[{"name":"The Queen Elizabeth Hospital  Adelaide SA"},{"name":"The University of Adelaide  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Kollias","sequence":"additional","affiliation":[{"name":"The University of Adelaide  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavia","family":"Lee","sequence":"additional","affiliation":[{"name":"The University of Adelaide  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Hou","sequence":"additional","affiliation":[{"name":"The University of Adelaide  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheesha","family":"Herath","sequence":"additional","affiliation":[{"name":"The Queen Elizabeth Hospital  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B","family":"North","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellie","family":"Treloar","sequence":"additional","affiliation":[{"name":"The Queen Elizabeth Hospital  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Edwards","sequence":"additional","affiliation":[{"name":"The University of Adelaide  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bruening","sequence":"additional","affiliation":[{"name":"The Queen Elizabeth Hospital  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J","family":"Wells","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy J","family":"Maddern","sequence":"additional","affiliation":[{"name":"The University of Adelaide  Adelaide SA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae253"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2929.2006.02610.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2012.11.009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2006.01.008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2003.169"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znad042"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15765"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.13542"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaf083"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000581"},{"key":"e_1_2_10_12_1","unstructured":"Royal Australasian College of Surgeons.Australian and New Zealand Audit of Surgical Mortality national report. 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