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Key Results of 2019
IMPROVEMENTS
In 2019, there were 114 CIs which showed statistically significant trends in the desired direction. Of these, 59 CIs remained significant after allowing for changes in the composition of HCOs contributing over the period. There were 8 CI sets that had an improvement in at least two-thirds of all significantly trended CIs. They were Anaesthesia and Perioperative Care, Day Patient, Emergency Medicine, Gynaecology, Hospital in the Home, Hospital-Wide, Infection Control and Intensive Care. For the CIs denoted below (L) means low desirable rate while (H) means high desirable rate. There were noteworthy improvements in the following sets:
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Day Patient
4.1 Patients who experience an adverse event during care delivery (L)
This well reported indicator shows that the rate of adverse events reported during care delivered for day procedure centres approximately halved. The fitted rate has dropped from 0.12 in 2013 to 0.068 in 2019. There was a decrease in system wide variation as measured by the difference between the 80th and 20th centiles, showing a significant improvement in the previous poorer performers.
Hospital-Wide
The rate of inpatients who develop 1 or more pressure injuries has decreased significantly since 2015.The fitted rate decreased by approximately one third from 0.078 to 0.053 per 100 bed days. The rate of both the 20th and 80th centiles continues to improve. In 2019, 366 HCOs reported 4,868 pressure injuries in 11,259,237 bed days (0.0432 per 100 bed days).
Hospital-Wide
6.1 Significant adverse blood transfusion events (L)
The rate of significant adverse events from blood transfusion in healthcare organisations has decreased significantly since 2012, with a decrease from 0.19 to 0.11 per 100 transfusions. The decrease was accompanied by improvements in both the 20th and 80th centiles over the review period.
Mental Health
The rate of monitoring of metabolic side effects for consumers taking regular antipsychotic medications has improved over the short period the indicator has been in use. The four-year period shows an improvement in the fitted rate from 29.3 to 70.7 percent. There was a significant improvement in the 20th and 80th centiles, showing industry-wide improvement.
Trend plot of rates and centiles by year
KEY RESULTS OF 2019
DETERIORATIONS
In 2019, there were 47 CIs which showed statistically significant trends in the undesirable direction. Of these, 15 remained significant after allowing for changes in the composition of HCOs contributing over the period. It is recommended that HCOs give consideration to determining and to addressing the reasons for the deterioration. There were noteworthy deteriorations in the following sets:
Infection Control
3.1 Haemodialysis – Arteriovenous-fistula access-associated blood-stream infection (L)
The rate of patients on haemodialysis with an arteriovenous fistula access-associated blood-stream infection grew from a low fitted rate in 2012 of 0.023 to 0.071 per 100 patient-months in 2019. There has also been a corresponding increase in variability in the data with divergent 20th and 80th centiles.
Maternity
1.2 Selected primipara - induction of labour (L)
The rate of induction of labour for the selected set of primipara mothers has increased since 2012 with a deterioration from 30 to 45.6 percent of births. There has been a steady increase in both the 20th and 80th centile rates during the period and the trend does not appear to be flattening, which indicates this is an ongoing trend.
Mental Health
5.4 Physical restraint - 1 or more episodes (L)
There is an ongoing increase in the rate of physical restraint. The fitted rate increased from 1.9 to 5.7 per 100 episodes of care between 2012 and 2019. In 2019, there were 35 records from 22 HCOs. The annual rate was 4.8 per 100 episodes of care. Both the poorest 80th centile rate and the best 20th centile rate deteriorated over the period.
Oral Health
1.1 Restorative treatment - teeth retreated within 6 months (L)
The rate of teeth needing repeated restorative treatment within 6 months of the primary treatment has deteriorated with a fitted increase from 6.2 to 6.9 per 100 teeth restored. The best 20th centile rate has remained steady.
Trend plot of rates and centiles by year
