Health care safety and quality – Australian Institute of Health and Welfare

The safety and quality of the care provided in Australia’s health system is of utmost importance to all patients, their families and carers. A safe and high-quality health system provides the most appropriate and best-value care, while keeping patients safe from preventable harm.

Definitions

Safety: the avoidance or reduction to acceptable limits of actual or potential harm from health care management or the environment in which health care is delivered (NHIPPC 2017).

Quality: the degree to which health services for individuals and populations increase the likelihood of desired health outcomes, and are consistent with current professional knowledge (ACSQHC 2019).

Improving safety and quality

Australia’s health system is relatively safe and high performing when compared to other countries but with some ongoing challenges. Data collated by the Organisation for Economic Co-operation and Development (OECD) across a number of health care quality and outcome indicator areas found that Australia generally performed better than other OECD countries across most indicators, but with some areas for improvement (AIHW 2022).

Ensuring the safety and quality of health care in Australia involves many agencies, professional groups and regulatory frameworks and is a regular focus of government policies. For example, the Australian Commission on Safety and Quality in Health Care (ACSQHC) provides leadership to improve the safety and quality of health care at the national level, the Australian Health Practitioner Regulation Agency administers the national registration system for health professionals and there are dedicated teams in states and territories and in individual health services that work to ensure the safety and quality of the care being provided across the system.

Performance and safety reporting

It is a key role of the AIHW to report a wide range of information on the many different dimensions of the performance of our health system. Monitoring the performance of the health system in this way helps inform governments, service providers and the public about how effective, efficient and appropriate the system is and whether it is achieving good outcomes for patients and the wider community.

Information, data and resources made available by the AIHW includes:

• Australia’s health – AIHW’s biennial report on the health of Australians
• a national ‘front door’ to information on Australia’s health performance
• maintaining a set of nationally agreed health system indicators based around the Australian Health Performance Framework
• the MyHospitals webpages, which include detailed information on the characteristics and performance of the hospital system at the national, state and local levels.

Some specific measures of hospital performance include:

Data are also available for potentially preventable hospitalisations which can be used as a measure of the accessibility and effectiveness of primary and community healthcare services.

Impact of COVID-19 on the health system

Much of the data that is available to the AIHW is also able to be used to examine the impact that COVID-19 has had on sectors within the health system which is relevant to exploration of the performance of the system as a whole.

• In some cases these are direct effects, such as the role of hospitals in managing the additional caseload of patients diagnosed with COVID-19, or reductions in the delivery of elective surgeries that have been required at various times to manage the resources available within the healthcare system.
• In other cases the impacts are indirect, for example, the reduction in injury presentations to emergency departments associated with public health orders which restricted activities, and the introduction of telehealth arrangements for some medical consultations which enabled continuity of care for many patients.

See ‘Chapter 2 Changes in the health of Australians during the COVID-19 period’ in Australia’s health 2022: data insights or explore the links below for more information

Patient experiences

Other important measures of the performance of the health system come from the patients themselves in the form of feedback on their outcomes and experiences with a range of healthcare providers. It has been an expectation for many years, for example, that under health service accreditation standards set by the ACSQHC that health services routinely survey patients to obtain the patient’s perspectives on the care provided and their experiences as a patient.

The Australian Bureau of Statistics also conducts an annual Patient Experience Survey (PEx) covering various aspects of the health system, including hospitals and dental professionals.

In 2020–21, most people reported positive experiences of health care provided by their health care practitioners. For example:

• Over three-quarters of those who saw a general practitioner (77%) felt that their GPs always listened carefully to them, 83.5% felt their GPs always showed respect, and 78% felt their GPs always spent enough time with them.
• In relation to medical specialists, 81% felt that their specialists always listened carefully to them, 85% felt their specialists always showed respect, and 82% felt their specialists always spent enough time with them.

Following the expansion of the availability of telehealth services as a strategy to prevent the spread of COVID-19 infection, the 2020–21 PEx also included questions about patients’ experiences using telehealth services. For those who had had a telehealth consultation with a GP or medical specialist, 84% reported that their telehealth practitioners always listened carefully, 87% reported that their telehealth practitioners always showed respect, and 83% reported that their telehealth practitioners always spent enough time with them.

The AIHW also reports on patient experiences with mental health services specifically, through the Your Experience of Service (YES) survey. For patient experiences with mental health services, see Mental health services in Australia.

Where do I go for more information?

For more information on safety and quality of health care, see:

Visit Health care quality & performance for more on this topic.

References

ACSQHC (Australian Commission for Safety and Quality in Health Care) (2019) The state of patient safety and quality in Australian hospitals 2019, ACSQHC website, accessed 6 April 2022.

AIHW (Australian Institute of Health and Welfare) (2022) OECD Health Care Quality and Outcomes Indicators, Australia 2021, AIHW website, accessed 21 April 2022.

NHIPPC (National Health Information and Performance Principal Committee) (2017)
The Australian Health Performance Framework, COAG Health Council website, accessed 18 May 2022.