How our hospitals could reduce the pain and cost of complications
Australia’s hospitals would reduce avoidable suffering of hundreds of thousands of patients and save many millions of dollars every year by introducing more effective quality and safety systems, a Grattan Institute study has found.
“Our hospitals by and large perform and serve patients well, but this report shows that many could do even better by introducing more focused methods of identifying and correcting practices that frequently expose patients to avoidable complications in hospital,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“This study by the Grattan Institute shows that if all hospitals achieved the performance of the 10 per cent top performing hospitals, 250,000 patients would be protected from complications like hospital acquired infections, adverse events and medication errors.
“The study makes seven recommendations to boost hospital safety and quality including more public information about the cost and revenue resulting from complications, a more open and effective accreditation system including surprise inspections of hospitals by accreditors and financial safety and quality incentives tailored to individual hospitals.
“We support public disclosure of hospital data on preventable complications so that hospitals can compare, benchmark and improve their performance.
“These changes should appeal to state governments and hospital managers as a means of improving their bottom line by realising up to $1.5 billion in estimated savings which could finance hospital care for an additional 300,000 patients.
“The report coincides with the imminent introduction of the new National Safety and Quality Health Service Standards on 1 January 2019 and the Australian Commission on Safety and Quality in Health Care’s own review of the Australian Health Service Safety and Quality Accreditation (AHSSQA) Scheme which it coordinates.
“Having found wide variation and lack of consistency in how assessments were being undertaken, the AHSSQA Scheme review recommended measures to revamp the assessment of hospitals against national standards including standardised accreditation cycles, short notice assessments, repeat assessments for those hospitals found to have large number of areas for improvement, and better public reporting of assessment outcomes.
“Many of these accord with the Grattan Institute’s recommendations and are supported by the Consumers Health Forum.
“The Consumers Health Forum has always supported a continuous improvement approach to strengthening hospital performance: standards and accreditation are tools towards that end.
“We would be concerned if version 2 of the national standards created a more compliance than continuous improvement approach. Compliance and culture that fosters improvement and innovation are both important. We believe that the recommended measures to make the accreditation scheme more robust and consistent will help strike that balance.
“We particularly welcome the public reporting of hospital quality and safety issues in a way that does not alarm the community. The report makes the point that with the publication of detailed accreditation reports, citizens would be better equipped to hold elected governments responsible for hospital performance.
“We also welcome the AHSSQA review recommendation that it should be mandatory that assessment teams complete a comprehensive orientation program and that consumers will be routinely invited to participate in the assessment process.
“We would argue however that steps should be taken to further develop and formally recognise and mandate the role of the consumer accreditor system-wide. It should be mandatory for consumers to occupy designated roles in accrediting teams and that they are actively supported with tailored training for this purpose. We are starting to see the emergence of a small consumer accreditor workforce. This should be encouraged and rapidly built in to accreditation processes as a business as usual practice,” Ms Wells said.