Clinical Indicators

What is the ACHS Clinical Indicator Program?

The ACHS Clinical Indicator Program is a data repository, analysis and reporting service provided by the ACHS to healthcare organisations. It provides comparative information on the processes and outcomes of health care. Participating organisations are able to submit indicator data for inclusion in an extensive indicator database. Data are aggregated and analysed twice yearly and results are provided in the form of comparative reports. These reports compare results across all contributing organisations as well as providing a comparison with 'peer’ organisations based on a number of variables.

The Performance and Outcomes Service (POS) team also provides individual support to HCOs, via telephone and e-mail. Consultancies can be arranged through the ACHS Education Service and Calendar Workshops are provided on a range of topics related to performance improvement. The Clinical Indicator Program provides all necessary products, tools and services required for members to participate. These resources are available via a CD ROM titled ACHS PIRT Installation and Clinical Indicators which is distributed annually to members.

For further information on the ACHS Clinical Indicator Program, please download the ACHS Clinical Indicator Program Information 2008.

What is a clinical indicator?

A clinical indicator is simply a measure of the clinical management and / or outcome of care. A well-designed indicator should ‘screen’, ‘flag’ or ‘draw attention’ to a specific clinical issue. Usually rate based, indicators identify the rate of occurrence of an event. Indicators do not provide definitive answers; rather they are designed to indicate potential problems that might need addressing, usually demonstrated by statistical outliers or variations within data results. They are used to assess, compare and determine the potential to improve care. Indicators are therefore, tools to assist in assessing whether or not a standard in patient care is being met.

Data Collection Periods

For the July to December 2007 collection period organisations must submit their data to the ACHS by 29 February 2008 and for the January to June 2008 collection period organisations must submit their data to the ACHS by 31 August 2008.

What areas do the current clinical indicator sets cover?

Currently the ACHS has 23 clinical indicator sets. Below is a listing of the current sets and the areas which they cover.

Adverse Drug Reactions version 2

Reporting mechanisms

Warfarin drug monitoring

Anaesthetics version 4

Pre-anaesthesia period

Intra-operative period

Patient recovery period

Post-operative period

Management of acute pain

Day surgery anaesthesia care

Obstetric anaesthesia care

Day Surgery version 4

Cancellation of booked procedures

Unplanned return to operating room

Unplanned overnight admission

Delayed patient discharge

Dermatology version 2

Dermatological consult

Phototherapy

Skin tumour pathology

Emergency Medicine version 4

Waiting time

Acute myocardial infarction (AMI)

Access block

Gastrointestinal Endoscopy version 1

Colonoscopy

Gastroscopy

Complications of sedation

Gynaecology version 6

Blood transfusion

Injury to a major viscus

Laparoscopic surgery

Laparoscopic management of an ectopic pregnancy

Urogynaecology

Antibiotic prophylaxis

Thromboprophylaxis

Hospital in the Home version 3

Patient safety and selection

Program interruption

Hospital-Wide version 10

Medication errors

Hospital re-admissions

Return to operating room

Pressure ulcers

Patient falls

Patient deaths

Blood transfusion

Day of surgery admission

Thromboprophylaxis

Infection Control version 3

Surgical Site Infection (SSI)

Central line associated Blood Stream Infections (CLAB)

Haemodialysis associated blood stream infection surveillance

Neonatal infections

Healthcare-associated methicillin-resistant staphylococcus aureus (MRSA) morbidity

Occupational exposures to blood and / or body fluids

Intensive Care version 3

Utilisation of patient assessment systems

Access and exit block to the ICU

Intensive care patient management

Intensive care patient treatment

Internal Medicine version 3

Cardiology

Endocrinology

Gastroenterology

Geriatric medicine

Nephrology

Neurology

Oncology

Thoracic medicine

Mental Health Inpatient version 5

Diagnosis and care planning

Physical examination of patients

Prescribing patterns

Electro convulsive therapy

Use of seclusion

Major critical incidents

Re-admissions to hospital

Mortality

Continuity of care

Long term care

Average length of stay

Admission

Mental Health Community Based version 2

Community care

Care planning

Obstetric version 6

Outcome of selected primipara

Vaginal delivery following caesarean section (VBAC)

Major perineal tears & surgical repair of the perineum

General Anaesthesia for caesarean section

Antibiotic prophylaxis & caesarean section

Pharmacological thromboprophylaxis & caesarean section

Postpartum haemorrhage / blood transfusion

Intrauterine growth restriction (IUGR)

Apgar score

Admission of term babies to special care nursery (SCN) or neonatal intensive care nursery (NICN)

Peer review of serious adverse events

Ophthalmology version 4

Cataract surgery

Glaucoma surgery

Retinal detachment surgery

Refractive surgery

Oral Health version 2

Unplanned returns to the dental centre

Endodontic treatment

Patient record audits

Children’s dental care

Radiographs

Paediatric version 4

Paediatric – general

Paediatric – asthma

Utilisation of patient assessment systems

Access and exit block to the ICU

Intensive care patient management

Pathology version 3

Chemical pathology

Haematology

Anatomical pathology

Microbiology

Radiation Oncology version 3

Consultation process

Treatment process

Outcome process

Radiology version 4

Report availability

Morbidity of radiological procedures

Rehabilitation Medicine version 4

Timely assessment of function on admission

Assessment of function prior to episode end

Timely establishment of a multidisciplinary rehabilitation plan

Discharge plan prior to patient separation

Functional gain achieved by rehabilitation program

Discharge destination

Surgical version 3

Paediatric surgery

Urology

TUR for benign prostatomegaly

Orthopaedic surgery

Plastic surgery

Cardiothoracic surgery

Neurosurgery

General surgery

Vascular surgery

Otolaryngology surgery

Who can subscribe?

Subscription to The ACHS Clinical Indicator Program is a component of EQuIP membership. All EQuIP members are encouraged to submit indicator data.

Non-EQuIP members may subscribe and a membership fee applies. Fees are based on a calendar year subscription.

For further information on the subscription fee, please download the ACHS Clinical Indicator Program Application Form 2008.