National Safety and Quality

Indicator Collection for Private

Hospitals

George Neale

APHA National Congress October 2010

APHA Initiative

Commenced in March 2009

Pilot group of 30 hospitals

Data collected quarterly

Data commencement date Q1 2008

Indicators

1. Procedures involving wrong patient, site or procedure

2. Unplanned hospital readmissions within 28 days

3. Positive Staph Aureus >48 hours after admission or within 48 hours of discharge

4. Medication incidents

5. Attempted or actual suicide during an admission

Indicators continued

6. Significant self harm during an admission

7. Patient falls during admission which require

intervention

8. Number of patients who develop one or more

stage 3 or 4 pressure ulcers

9. Unplanned returns to OR

10. Unplanned re admissions to ICU

11. Accreditation status of hospital

Sentinel Events

1. Procedures involving wrong patient, site or

procedure resulting in death or major

permanent loss of function

2. Suicide of a patient in an inpatient unit

3. Retained instruments or other material

requiring reoperation

4. Intravascular gas embolism resulting in death

or neurological damage

Sentinel Events continued

5. Haemolytic blood transfusion reaction

resulting from ABO incompatibility

6. Medication error leading to the death of a

patient

7. Maternal death or serious morbidity associated

with labour or delivery

8. Infant discharged to wrong family

The Pilot Phase

30 hospitals across 6 groups

< 75 beds

75 – 150 beds

150 – 250 beds

>250 beds

Mental Health

Rehabilitation

Issues Identified in the Pilot

Clarification of definitions

Difficulty with measuring risk adjusted mortality

Data collection meaning of zero, blanks and Not

Applicable

Identification of conflicting timing with other

data collections

Reporting

Facility Indicator Summary

Summarises an individual hospital’s data for each of

the indicators. Used to assist in data validation by

hospitals.

Reporting

Indicator Rate Summary

Compares a particular hospital’s incidence by

indicator against all other hospitals

Expansion of the Collection

Commencing Q1 2010 all private hospitals were

invited to participate in the indicator collection

Participation in the collection is free to APHA

members

Currently there are 116 hospitals in the

collection

Data Collection

At present data collection is via an Excel

spreadsheet completed by hospitals each quarter

Moving to a web based input system to simplify

data input and access to reporting

Indicator APHA ACHS

2008*

units

Medication error 0.016 0.055 100 obd

Return to OR 0.33 0.36 100 pts

Pressure Ulcers 0.006 0.071 100 obd

Falls requiring intervention 0.01 0.07 100 obd

Mental Health readmissions

within 28 days

2.44 4.78 100 seps

*Australian Clinical Indicator Report: 2001-2008, Determining the potential to improve quality of care, 10th edition,

ACHS 2008

Learning from Success

Participating Hospitals are encouraged to

identify processes and procedures which have

resulted in successfully minimising their rate for

particular indicators.

We plan to be able to publish case studies for

the information of all participants and to assist

in improving outcomes for patients