One in every nine patients who go into hospital in Australia suffers a complication – about 900,000 patients each year. If they stay in overnight, the figure rises to one in four – about 725,000 patients each year. A patient’s risk of developing a complication varies dramatically depending on which hospital they go to: in some cases, the additional risk of a complication at the worst-performing hospitals can be four times higher than at the best performers. If all hospitals lifted their safety performance to the level of the best 10 per cent of Australian hospitals, the complication rate across the nation would fall by more than a quarter.
This report exposes the flaws in Australian hospitals’ safety and quality monitoring regime, and recommends reforms that could result in an extra 250,000 patients leaving hospital each year free of complications.
At the moment, a veil of secrecy hangs over which hospitals and clinicians have higher rates of complications and which are safety leaders. Hospital safety statistics are collected, but they are kept secret, not just from patients but from doctors and hospitals. This has to change. Patients have a right to know the data on complication rates in different hospitals and for different procedures, so they – and their GPs – can make better-informed decisions about how and where they are treated. Doctors and hospitals need to know how they are performing compared to their peers, so that they can learn from the best-performing hospitals and clinicians.
At the moment, hospital safety policies focus on only a small subset of complications classified by government as being ‘preventable’. Instead policy should be directed towards reducing all complications to the best rate achievable. This requires building up a comprehensive picture of patient outcomes, and understanding how some hospitals and clinical teams reduce all complications and achieve excellent outcomes.
Private health insurers should release the information they gather on private hospitals: reducing complication rates would mean quicker recoveries and lower premiums for their members. State and territory governments should release detailed data on the performance of both public and private hospitals. This data needs to show the whole gamut of hospital performance, from catastrophic but rare errors to less harmful but prevalent complications. It should highlight the areas where there is a big gap between the best and worst performers. Governments need to set ambitious goals for every hospital – public and private – to improve their safety and quality of care. And they need to ensure the data is published widely so that patients and taxpayers can see which hospitals are improving and which are not.