Clinical indicators in surgery: a critical review of the Australian experience

Background A set of clinical measures (indicators), developed by an Australian Council on Healthcare Standards (ACHS) and Royal Australasian College of Surgeons (RACS) working party, was introduced into the accreditation programme in 1997. Although early qualitative and quantitative reporting by hea...

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Veröffentlicht in:ANZ journal of surgery 2014-01, Vol.84 (1-2), p.42-46
Hauptverfasser: Collopy, Brian T., Bichel-Findlay, Jennifer M., Woodruff, Peter W. H., Gibberd, Robert W.
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container_end_page 46
container_issue 1-2
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container_title ANZ journal of surgery
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creator Collopy, Brian T.
Bichel-Findlay, Jennifer M.
Woodruff, Peter W. H.
Gibberd, Robert W.
description Background A set of clinical measures (indicators), developed by an Australian Council on Healthcare Standards (ACHS) and Royal Australasian College of Surgeons (RACS) working party, was introduced into the accreditation programme in 1997. Although early qualitative and quantitative reporting by health‐care organizations (HCOs) reflected their value in stimulating change, the number of HCOs reporting data on this set of clinical indicators (CIs) has declined, despite an increase in the number of HCOs reporting data on the CIs programme overall. Possible reasons for this decline were sought. Methods A retrospective review of prospectively collected surgical CI data was performed, a national survey of stakeholders in the ACHS programme was conducted and a comparison was made with published international data. Results From a maximum of 247 HCOs reporting data in 2002, the number fell to 168 by 2011. While favourable trends were evident with some CIs, for example, a decline in the rate of negative histology in childhood appendicectomy and in the rate of in‐hospital infection in total hip joint replacement, there was minimal change with many of the CIs, suggesting limited responsiveness as measures of care. In the national survey, stakeholder's response was positive overall, but there was a requirement for regular review of CIs. Although some colleges viewed the CIs as simplistic and not reliable, comparisons with similar measures available in the international literature were favourable. Conclusions Possible reasons for the declining number of HCOs reporting surgical CI data are a lack of a recent revision of the CIs and a lack of engagement of clinicians from the RACS. Revision of the surgical CI set is required.
doi_str_mv 10.1111/ans.12004
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H. ; Gibberd, Robert W.</creator><creatorcontrib>Collopy, Brian T. ; Bichel-Findlay, Jennifer M. ; Woodruff, Peter W. H. ; Gibberd, Robert W.</creatorcontrib><description>Background A set of clinical measures (indicators), developed by an Australian Council on Healthcare Standards (ACHS) and Royal Australasian College of Surgeons (RACS) working party, was introduced into the accreditation programme in 1997. Although early qualitative and quantitative reporting by health‐care organizations (HCOs) reflected their value in stimulating change, the number of HCOs reporting data on this set of clinical indicators (CIs) has declined, despite an increase in the number of HCOs reporting data on the CIs programme overall. Possible reasons for this decline were sought. Methods A retrospective review of prospectively collected surgical CI data was performed, a national survey of stakeholders in the ACHS programme was conducted and a comparison was made with published international data. Results From a maximum of 247 HCOs reporting data in 2002, the number fell to 168 by 2011. While favourable trends were evident with some CIs, for example, a decline in the rate of negative histology in childhood appendicectomy and in the rate of in‐hospital infection in total hip joint replacement, there was minimal change with many of the CIs, suggesting limited responsiveness as measures of care. In the national survey, stakeholder's response was positive overall, but there was a requirement for regular review of CIs. Although some colleges viewed the CIs as simplistic and not reliable, comparisons with similar measures available in the international literature were favourable. Conclusions Possible reasons for the declining number of HCOs reporting surgical CI data are a lack of a recent revision of the CIs and a lack of engagement of clinicians from the RACS. Revision of the surgical CI set is required.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.12004</identifier><identifier>PMID: 23137043</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Accreditation ; Australia ; clinical indicator ; Health Care Surveys ; Humans ; Program Evaluation ; Quality Improvement - standards ; Quality Improvement - statistics &amp; numerical data ; Quality Improvement - trends ; Quality Indicators, Health Care - standards ; Quality Indicators, Health Care - statistics &amp; numerical data ; Quality Indicators, Health Care - trends ; Retrospective Studies ; Surgery ; Surgical outcomes ; surgical practice ; Surgical Procedures, Operative - standards</subject><ispartof>ANZ journal of surgery, 2014-01, Vol.84 (1-2), p.42-46</ispartof><rights>2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons</rights><rights>2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.</rights><rights>Copyright © 2014 Royal Australasian College of Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3574-232cda849cd8359fb0afc37054f3ba56c973cd6b90503fb97c394937995df7a03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.12004$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.12004$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23137043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Collopy, Brian T.</creatorcontrib><creatorcontrib>Bichel-Findlay, Jennifer M.</creatorcontrib><creatorcontrib>Woodruff, Peter W. H.</creatorcontrib><creatorcontrib>Gibberd, Robert W.</creatorcontrib><title>Clinical indicators in surgery: a critical review of the Australian experience</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background A set of clinical measures (indicators), developed by an Australian Council on Healthcare Standards (ACHS) and Royal Australasian College of Surgeons (RACS) working party, was introduced into the accreditation programme in 1997. Although early qualitative and quantitative reporting by health‐care organizations (HCOs) reflected their value in stimulating change, the number of HCOs reporting data on this set of clinical indicators (CIs) has declined, despite an increase in the number of HCOs reporting data on the CIs programme overall. Possible reasons for this decline were sought. Methods A retrospective review of prospectively collected surgical CI data was performed, a national survey of stakeholders in the ACHS programme was conducted and a comparison was made with published international data. Results From a maximum of 247 HCOs reporting data in 2002, the number fell to 168 by 2011. While favourable trends were evident with some CIs, for example, a decline in the rate of negative histology in childhood appendicectomy and in the rate of in‐hospital infection in total hip joint replacement, there was minimal change with many of the CIs, suggesting limited responsiveness as measures of care. In the national survey, stakeholder's response was positive overall, but there was a requirement for regular review of CIs. Although some colleges viewed the CIs as simplistic and not reliable, comparisons with similar measures available in the international literature were favourable. Conclusions Possible reasons for the declining number of HCOs reporting surgical CI data are a lack of a recent revision of the CIs and a lack of engagement of clinicians from the RACS. 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H.</creator><creator>Gibberd, Robert W.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201401</creationdate><title>Clinical indicators in surgery: a critical review of the Australian experience</title><author>Collopy, Brian T. ; Bichel-Findlay, Jennifer M. ; Woodruff, Peter W. H. ; Gibberd, Robert W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3574-232cda849cd8359fb0afc37054f3ba56c973cd6b90503fb97c394937995df7a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Accreditation</topic><topic>Australia</topic><topic>clinical indicator</topic><topic>Health Care Surveys</topic><topic>Humans</topic><topic>Program Evaluation</topic><topic>Quality Improvement - standards</topic><topic>Quality Improvement - statistics &amp; numerical data</topic><topic>Quality Improvement - trends</topic><topic>Quality Indicators, Health Care - standards</topic><topic>Quality Indicators, Health Care - statistics &amp; numerical data</topic><topic>Quality Indicators, Health Care - trends</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>surgical practice</topic><topic>Surgical Procedures, Operative - standards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Collopy, Brian T.</creatorcontrib><creatorcontrib>Bichel-Findlay, Jennifer M.</creatorcontrib><creatorcontrib>Woodruff, Peter W. H.</creatorcontrib><creatorcontrib>Gibberd, Robert W.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Collopy, Brian T.</au><au>Bichel-Findlay, Jennifer M.</au><au>Woodruff, Peter W. H.</au><au>Gibberd, Robert W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical indicators in surgery: a critical review of the Australian experience</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2014-01</date><risdate>2014</risdate><volume>84</volume><issue>1-2</issue><spage>42</spage><epage>46</epage><pages>42-46</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background A set of clinical measures (indicators), developed by an Australian Council on Healthcare Standards (ACHS) and Royal Australasian College of Surgeons (RACS) working party, was introduced into the accreditation programme in 1997. Although early qualitative and quantitative reporting by health‐care organizations (HCOs) reflected their value in stimulating change, the number of HCOs reporting data on this set of clinical indicators (CIs) has declined, despite an increase in the number of HCOs reporting data on the CIs programme overall. Possible reasons for this decline were sought. Methods A retrospective review of prospectively collected surgical CI data was performed, a national survey of stakeholders in the ACHS programme was conducted and a comparison was made with published international data. Results From a maximum of 247 HCOs reporting data in 2002, the number fell to 168 by 2011. While favourable trends were evident with some CIs, for example, a decline in the rate of negative histology in childhood appendicectomy and in the rate of in‐hospital infection in total hip joint replacement, there was minimal change with many of the CIs, suggesting limited responsiveness as measures of care. In the national survey, stakeholder's response was positive overall, but there was a requirement for regular review of CIs. Although some colleges viewed the CIs as simplistic and not reliable, comparisons with similar measures available in the international literature were favourable. Conclusions Possible reasons for the declining number of HCOs reporting surgical CI data are a lack of a recent revision of the CIs and a lack of engagement of clinicians from the RACS. Revision of the surgical CI set is required.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>23137043</pmid><doi>10.1111/ans.12004</doi><tpages>5</tpages></addata></record>
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subjects Accreditation
Australia
clinical indicator
Health Care Surveys
Humans
Program Evaluation
Quality Improvement - standards
Quality Improvement - statistics & numerical data
Quality Improvement - trends
Quality Indicators, Health Care - standards
Quality Indicators, Health Care - statistics & numerical data
Quality Indicators, Health Care - trends
Retrospective Studies
Surgery
Surgical outcomes
surgical practice
Surgical Procedures, Operative - standards
title Clinical indicators in surgery: a critical review of the Australian experience
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