Safety scandals in Australian hospitals are depressingly frequent. They stimulate special reports and an immediate flurry of action. The tragedy is that these safety incidents occur despite reporting, governance and oversight mechanisms that – if they were working properly – might have helped to detect the aberrant clinical care.
Lots of information is collected about hospital safety in Australia, but not all of it is shared with the right people.
Hospital boards are often blissfully ignorant of the safety of care being provided in their hospital. More than 70 per cent of board members in one Victorian survey reported implausibly that quality of care in their hospital was above average; none thought they were below average, and only 3 per cent admitted that they did not really know how their health service compared. But there is a lot of data already collected that could help board members to make an accurate assessment of how safe is the hospital for which they are ultimately responsible.
Australia’s hospitals will be safer if we make data about hospital safety as usable and useful as possible. Hospital boards and management teams – the people responsible for the quality of care in the hospital – need to know what is going on, using all the available data.
This report looks at data on patient outcomes: routine data, clinical quality registry data, death audit data, incident reporting and investigation data, patient-reported experience measures, and patient-reported outcome measures.
A first step in improving hospital safety in Australia is to better use the information that is already collected, and to put it in the hands of people who can apply it. This report reviews different sources of information about safety of hospital care. It provides background to a series of Grattan Institute reports which will examine hospital safety in more depth.
Our examination reveals many instances where the data could and should be more accurate, relevant, accessible and understandable. Data registries need to share information more widely, they need to capture a greater proportion of the care given, and they need to get data back to clinicians more quickly. States and private hospitals need to give more information to clinicians, including routine data and patient-experience data. The data needs to be clear and detailed, so clinical teams can see how they are performing compared with their peers, and how they can improve.
Sometimes the information is locked away so only the people who contributed the data can see it – and often then only after a long lag. Some data sets don’t contain enough information. For instance, the narrow remit of the anaesthetic death audit hampers efforts to improve peri-operative care. Some data is not made available quickly enough – old results are of little use to doctors and hospital managers.
This report makes specific recommendations for each data set, and two overarching recommendations: that the links between data sets should be stronger, and that data should be presented more clearly.
The data we have is an extremely valuable resource. Better use needs to be made of it by governments making it more accurate, relevant, accessible, and understandable.