Volume 195 - Issue 1
Development of clinical-quality registries in Australia: the way forward
Author: Brian T Collopy, AM
Med J Aust 2011; 195 (1): 55-56.
Published online: 4 July 2011
Published online: 4 July 2011
To the Editor: I was extremely surprised to note that there was no mention of the Australian Council on Healthcare Standards’ (ACHS) extensive national clinical database (http://www.achs.org.au/ClinicalIndicators) in the recent article by Evans and colleagues on clinical-quality registries.1 Since 1993, commencing with a small set of generic indicators that were of limited value, the ACHS has been collecting clinical data through its clinical indicator (CI) program as part of its accreditation process.
Now, with over 300 CIs in use and around 670 health care organisations (HCOs), including some from New Zealand, contributing data, the scope of the ACHS national clinical database is unique in the world. Its longevity makes it one of very few national programs that can display longer term trends in processes and outcomes — both desirable and undesirable — of medical care.
The clinical indicators, which form the basis of the database, were all developed in conjunction with providers of medical care, namely, the medical colleges. The validity, reliability and effectiveness of the indicators were established (and published) subsequent to introduction of the more specific indicators into the accreditation process.2
In addition to providing aggregate and peer-comparative data to the contributing HCOs, the ACHS publishes aggregate data with detailed analyses on an annual basis.3
As with similar databases, problems have arisen regarding maintenance of currency and relevance, timelines for reporting, and other issues. However, it seems extraordinary that this valuable aid to determining the quality of health care standards — envied by many countries — could be ignored by Evans et al, as it was similarly ignored by the authors of a recent special MJA supplement that reported on gathering patient-centred health care data aimed at improving care.4
References
- Evans SM, Scott IA, Johnson NP, et al. Development of clinical-quality registries in Australia: the way forward. Med J Aust 2011; 194: 360-363. 0_CBBHCFFC
- Collopy BT. Clinical indicators in accreditation: an effective stimulus to improve patient care. Int J Qual Health Care 2000; 12: 211-216. 0_i1095841
- Australian Council on Healthcare Standards. Australasian Clinical Indicator Report: 2001–2009. Determining the potential to improve quality of care. 11th ed. Sydney: ACHS, 2010. 0_i1095843
- Johnson NP, Board N (coordinating editors). Using what we gather — information for improved care. Med J Aust 2010; 193: S89-S120. 0_i1095845