The Australasian Clinical Indicator Report helps healthcare organisations (HCOs) reflect on their place in the ongoing improvement of our health system through analysing the raw data contributed to the Australian Council of Healthcare Standards for 2011 by 690 facilities, now evenly balanced between the public and private sectors. Of the six (out of 10) Medication Safety Indicators suited for trend analysis, two improved and two deteriorated.

The reporting of adverse drug reactions from HCOs declined from 0.17 to 0.093 per 100 separations in 2011, continuing a trend that has seen them halve since 2004. This is a concern when our ageing population is more likely to suffer from the effects of polypharmacy, as is reflected by the TGA receiving more reports overall. Medication errors resulting in an adverse event, however, did improve from 0.051 to 0.030 per 100 bed days.

Warfarin management had some interesting variations, with more patients showing abnormal bleeding, while fewer showed high INRs. Only 23 HCOs reported on reviewing dosage after measuring a high INR, and seven reported on compliance to hospital protocol when initiating warfarin.

Three hospitals demonstrated their implementation of antibiotic stewardship through timely monitoring and dosage adjustment in 97.8% of their aminoglycoside antibiotic patients. Error-prone abbreviations were seen in 4.7% of medication orders in the 36 HCOs reporting this indicator.

Medications also feature in other sets of indicators, as seen in the steady improvement in initiating venous thromboembolism prophylaxis for high risk patients, antibiotic prophylaxis in caesarean sections, and a considerable decline in acquired methicillin resistant Staphylococcus aureus (MRSA).

Now that the National Safety and Quality Health Service (NSQHS) Standards have become mandatory for accreditation, these clinical indicator reports will become increasingly useful as hospitals contribute more.

References:

  1. Australian Council on Healthcare Standards (ACHS). Australasian Clinical Indicator Report 2004–2011: 13th edition. Sydney NSW; ACHS; 2012.