Rehabilitation Medicine version 6

REHABILITATION MEDICINEREHABILITATION MEDICINE

GENERAL COMMENTS

Tim Geraghty President, Australasian Faculty of Rehabilitation

The Australasian Faculty of Rehabilitation Medicine and the Australasian Rehabilitation Outcomes Centre (AROC) acknowledge and are proud of the continuing high rate of compliance with the ACHS Rehabilitation Medicine CIs.

This should be seen in the context of very high compliance in provision of detailed outcome data (including data items required to calculate the CIs) to AROC, and a strong culture of continuous improvement within the Rehabilitation Medicine community and demonstrates a continuing commitment to provide best-practice, evidence based clinical care to our population of individuals.

Outcome and process measures demonstrated by these clinical indicators show a continued improvement, with few outlier data points. All CIs showed improvement compared to 2017 data except for CI 4.1 (Discharge plan on separation) for which the rate was the same as in 2017.

This improvement is also reflected in shorter lengths of stay and more functional improvement for similar diagnostic groups, demonstrated by AROC benchmarking data.

Where differences in indicator outcomes are evident between sectors (public compared with private facilities) or jurisdictions, they should be interpreted very cautiously, because these data are not casemix adjusted.

SUMMARY OF RESULTS

In 2018 there were 1,131 submissions from 121 HCOs for 6 CIs. Six were analysed for trend, 5 of which improved, and the remaining CI showed no evidence of trend. In 2018, significant stratum variation was observed in 4 CIs. Six CIs showed greater systematic variation, with centile gains in excess of 50% of all events. Outlier gains in excess of 25% of all events were observed in 6 CIs. See Summary of Indicator Results below.

Summary of Indicator Results

Indicator HCOs Aggregate rate %

Best Stratum Outlier HCOS (%*) Outlier Gains (%+) Centile Gains (%+) Events# Trend

Timely assessment of function on admission 1.1 Functional assessment within 72 hours of admission (H) 101 98.7

21 (21%)

Assessment of function prior to episode end 2.1 Functional assessment within 72 hours before end of rehabilitation (H)

96 99.2 Private 19 (20%) Timely establishment of a multidisciplinary team rehabilitation plan 3.1 Multidisciplinary team plan within 7 days (H) 101 98.8 25 (25%)

Multidisciplinary discharge documentation 4.1 Discharge plan on separation (H) 94 97.8 Private 15 (16%) Functional gain achieved by rehabilitation program 5.1 Functional gain following completed rehabilitation program (H) 117 97.9 Private 28 (24%) Discharge destination 6.1 Destination after discharge from a rehabilitation program (H) 93 94.2 Private 29 (31%)

# Number of undesirable or non-compliant events + % of events that contribute to outlier/centile gains * % of outlier HCOs 592 (64%)

245 (47%)

458 (59%)

1,021 (76%)

598 (39%)

1,162 (36%) 878 (95%) 920

471 (90%) 522

739 (95%) 776

1,325 (99%) 1,343

1,163 (76%) 1,535

2,325 (72%) 3,223

PREVIOUS VOLUMES IN THIS SERIES

Hospital Wide Medical Indicator Data: Quantitative and Qualitative Results 1993 Measurement of Care in Australian Hospitals 1994: Hospital-Wide Medical Indicator results and comparisons to 1993 results Measurement of Care in Australian Hospitals 1996: Obstetrics and Gynaecology Indicators and Hospital-Wide Medical Indicators Measurement of Care in Australian Hospitals 1997: Anaesthesia, Day procedures, Emergency Medicine, Hospital-Wide, Internal Medicine, Obstetrics and Gynaecology and Psychiatry Indicators Determining the Potential to Improve the Quality of Care in Australian Health Care Organisations: Results from the ACHS Clinical Indicator Data 1998 and 1999 Determining the Potential to Improve the Quality of Care in Australian Health Care Organisations 2nd Edition: Trends in Quality of Care: Results of the ACHS Clinical Indicators 1998–2000 Determining the Potential to Improve Quality of Care 3rd Edition ACHS Clinical Indicator Results for Australia and New Zealand 1998–2001 Determining the Potential to Improve Quality of Care 4th Edition ACHS Clinical Indicator Results for Australia and New Zealand 1998–2002 Determining the Potential to Improve Quality of Care 5th Edition ACHS Clinical Indicator Results for Australia and New Zealand 1998–2003 Determining the Potential to Improve Quality of Care 6th Edition ACHS Clinical Indicator Results for Australia and New Zealand 1998–2004 ACHS Clinical Indicator Results for Australia and New Zealand 1998–2005 Determining the Potential to Improve Quality of Care 7th Edition Australasian Clinical Indicator Report: 1998–2006 Determining the Potential to Improve Quality of Care: 8th Edition Australasian Clinical Indicator Report: 2001–2007 Determining the Potential to Improve Quality of Care: 9th Edition Australasian Clinical Indicator Report: 2001–2008 Determining the Potential to Improve Quality of Care: 10th Edition Australasian Clinical Indicator Report: 2001–2009 Determining the Potential to Improve Quality of Care: 11th Edition Australasian Clinical Indicator Report: 2003–2010: 12th Edition Australasian Clinical Indicator Report: 2004–2011: 13th Edition Australasian Clinical Indicator Report: 2005–2012: 14th Edition Australasian Clinical Indicator Report: 2006–2013: 15th Edition Australasian Clinical Indicator Report: 2007–2014: 16th Edition Australasian Clinical Indicator Report: 2008–2015: 17th Edition Australasian Clinical Indicator Report: 2009-2016: 18th Edition Australasian Clinical Indicator Report: 2010-2017: 19th Edition

Inquiries regarding the Australasian Clinical Indicator Report 20th Edition 2011-2018 or the ACHS Clinical Indicator Program should be directed to:

ACHS Performance and Outcomes Service (POS) 5 Macarthur Street, Ultimo NSW 2007 T +61 2 9281 9955 F +61 2 9211 9633 E pos@achs.org.au