ACHS Clinical Indicator Program Myu Nathan Manager, Performance and Outcomes Service
Overview The role of the Performance and Outcomes Service is to coordinate the: Development Collection Collation Analysis & Reporting of ACHS clinical indicators
Timeline 1989 Care Evaluation Program commenced 1991 First set of Hospital-Wide CIs developed 1993 Introduction of CIs into the ACHS accreditation program 2009 CI data entry commenced through PIRT online 2015 Data repository with more than 20 years of data
What are Clinical Indicators? Measures of elements of clinical care May provide a method of assessing quality and safety of care at a system level
ACHS Clinical Indicator sets Set Icon Set Icon Anaesthesia and Perioperative Care Maternity Day Patient Emergency Medicine Gastrointestinal Endoscopy Gynaecology Hospital in the Home Hospital-Wide Infection Control Intensive Care Internal Medicine Medication Safety Mental Health Ophthalmology Oral Health Paediatrics Pathology Radiation Oncology Radiology Rehabilitation Medicine
ACHS Clinical Indicator Program Voluntary program data submitted on a 6 monthly basis Results from more than 300 rate-based CIs across 20 clinical areas 806 HCOs submitted data in 2014 Public / Private sector HCOs (57% / 43% split) Participation - ACHS members (no additional cost) and non-achs members (subscription) Members of the program: Australia & New Zealand Asia Indonesia & Hong Kong Middle East Saudi Arabia
Why do healthcare organisations participate? To improve standards of care To benchmark their performance against a national clinical data set To build evidence of performance monitoring and evaluation for accreditation To submit specific mandatory data to private health funds and the Department of Veterans Affairs
Participation in 2014 Set HCOs Set HCOs Anaesthesia and Perioperative Care 261 Maternity 175 Day Patient 318 Medication Safety 269 Emergency Medicine 150 Mental Health 104 Gastrointestinal Endoscopy 78 Ophthalmology 75 Gynaecology 52 Oral Health 84 Hospital in the Home 34 Paediatrics 11 Hospital-Wide 468 Pathology 44 Infection Control 424 Radiation Oncology 14 Intensive Care 107 Radiology 41 Internal Medicine 46 Rehabilitation Medicine 105
Revision of Clinical Indicator sets Formal process of collaboration with: Specialist medical & nursing colleges / associations / societies Consumer representative Australian Private Hospitals Association (APHA) Health Services Research Group (Uni. of Newcastle) ACHS staff Other experts as required Through the convening of specialist working groups, consultation, development, testing & refinement
Examples of collaborating Colleges/Societies/Associations Australian and New Zealand College of Anaesthetists (ANZCA) Internal Medicine Society of Australia and New Zealand (IMSANZ) Australian Day Surgery Council (ADSC) Australasian College for Emergency Medicine (ACEM) Hospital in the Home Society Australasia (HITHSA) Royal Australasian College of Medical Administrators (RACMA) Australasian College for Infection Prevention and Control (ACIPC) Australian and New Zealand Intensive Care Society (ANZICS) New South Wales Therapeutic Advisory Group (NSW TAG) Royal Australian and New Zealand College of Psychiatrists (RANZCP) Royal Australian and New Zealand College of Ophthalmologists (RANZCO) Royal Australasian College of Dental Surgeons (RACDS) Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Royal College of Pathologists of Australasia (RCPA) Royal Australian and New Zealand College of Radiologists (RANZCR)
Performance Indicator Reporting Tool
Data analysis ACHS collaborates with the Health Services Research Group (HSRG), at the University of Newcastle, which provides data analysis and statistical expertise Data are aggregated and analysed twice yearly and results are provided in the form of comparison reports These reports compare results across all contributing organisations as well as providing a comparison with 'peer organisations based on a number of stratification variables
General Comparison Report
Peer Comparison Report
HCO Trend Report HOSW CI 1.1 Unplanned and unexpected readmission within 28 days (L)
HCO Trend Report INFC CI 1.3 Superficial incisional SSI in knee prosthesis procedures (L)
HCO Trend Report EMED CI 1.1 ATS Category 1 patients attended to immediately (H)
Australasian Clinical Indicator Report Summary data Expert commentary Retrospective data in full Statistical methods
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