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 setsSet Icon Set Icon

Anaesthesia and

Perioperative CareMaternity

Day Patient Medication Safety

Emergency Medicine Mental Health

Gastrointestinal

EndoscopyOphthalmology

Gynaecology Oral Health

Hospital in the Home Paediatrics

Hospital-Wide Pathology

Infection Control Radiation Oncology

Intensive Care Radiology

Internal Medicine 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 2014Set HCOs Set HCOs

Anaesthesia and

Perioperative Care261 Maternity 175

Day Patient 318 Medication Safety 269

Emergency Medicine 150 Mental Health 104

Gastrointestinal

Endoscopy78 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)

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)

Internal Medicine Society of Australia and

New Zealand (IMSANZ)

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

Any questions???