B. T. Collopy FRACS, FRACMA; J. M. Bichel-Findlay HScD, MPH; P. W. H. Woodruff ChM, FRACS; R. W. Gibberd BSc (Hons), PhD.
GENERAL, UPPER GI & HEPATOBILIARY
Clinical indicators in surgery: a critical review of the Australian experience
Article first published online: 9 NOV 2012
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons
ANZ Journal of Surgery
Volume 84, Issue 1-2, pages 42–46, January-February 2014
How to Cite
Collopy, B. T., Bichel-Findlay, J. M., Woodruff, P. W. H. and Gibberd, R. W. (2014), Clinical indicators in surgery: a critical review of the Australian experience. ANZ Journal of Surgery, 84: 42–46. doi: 10.1111/ans.12004
- Issue published online: 22 JAN 2014
- Article first published online: 9 NOV 2012
- Manuscript Accepted: 24 SEP 2012
- clinical indicator;
- surgical practice
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.
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.
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.
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.