As well as the existing collections which have been identified in the preceding section, two areas of potential future national collection of data from private hospitals were identified. The first of these related to safety and quality indicators and the second relates to health workforce. Each of these is discussed below.
2.2.1 Safety and Quality Indicators
The ACSQHC was established in 2006 to develop a national framework for safety and quality in health care, together with an associated programme of work. Under the proposed national health reforms the ACSQHC has a larger responsibility to formulate and implement safety and quality standards, as well as to collect and disseminate information relating to safety and quality37.
37 National Health and Hospitals Network Bill 2011. Parliament of Australia.
Even if the reforms were not present, the Commission has a deep interest in the use of private hospital data for data-driven quality improvement. The second of three elements in its Australian Safety and Quality Framework for Health Care38 is Driven by Information. This element enacts the Commission’s view that timely review – at provider level – of a series of measures of safety and other elements of health care quality, within a sound clinical governance system, is an essential element of quality improvement.
38 Australian Safety and Quality Framework for Health Care. Australian Commission for Safety and Quality in Health Care, Canberra. Endorsed by Health Ministers in 2010.
Nonetheless, the ACSQHC currently has no intentions of pursuing new collections of data from hospitals in Australia. Rather, it holds the view that existing data collections, including those from private hospitals, are under-utilised in terms of routine generation and review of indicators of health care quality. Consequently, the ACSQHC aims to populate its safety and quality measures using existing data held in collections such as the APC (see Section 2.1.3).
The ACSQHC has developed 10 standards relating to safety and quality in health care. These standards have been piloted in health services39 and the final standards are expected to be endorsed by the Australian Health Ministers' Conference (AHMC) during 2011. Once endorsed, the standards will form the basis for future accreditation of hospitals in Australia, including private hospitals.Top of page
39 Commission Update, April 2011. Australian Commission on Safety and Quality in Health Care.
Under this new accreditation system, private hospitals will be required to provide data on measures related to the 10 standards to accrediting bodies. There are 13 accrediting bodies that will be empowered to accredit hospitals under the standards. As stated above, the ACSQHC expects the data related to each of the measures to be able to be extracted from existing data collections.
It is probable that the data provided by private hospitals to the accrediting organisations will also be required to be forwarded to the NHPA40.
40 The NHPA is yet to be established, with enabling legislation passed by both houses of the Australian Parliament after the completion of this Review, on 20 September 2011 (National Health Reform Amendment (National Health Performance Authority) Bill 2011). The scope of data collections that the NHPA may initiate and their implications for future burdens on private hospitals are not yet determined. It is not clear whether the NHPA will have the power to initiate new data collections or will rely on other bodies to collect data, becoming a user of secondary data rather than a primary data collector.
The new accreditation system is scheduled to begin from 1 July 2011 and to be implemented fully by 2015. During the implementation phase, hospitals will have a choice of accreditation under the current system or under the new standards’ based system.
In addition to the developmental work relating to the standards and accreditation, the ACSQHC has already developed a set of core, hospital level indicators for routine monitoring and reporting. From a private hospital perspective, these indicators “can be generated by jurisdictions or private hospital ownership groups, which hold the source data, and reported back to provider facilities” 41.Top of page
41 Australian Safety and Quality Framework for Health Care. Australian Commission for Safety and Quality in Health Care, Canberra.
ACSQHC has also established principles for clinical quality registers42, following a process of field testing, which involved six existing national clinical registries. Further work in this area is intended to produce “national arrangements ... for Australian clinical quality registries” and to develop a plan for the necessary technical infrastructure to support such arrangements43.
42 Strategic Principles for a National Approach to Australian Clinical Quality Registries. Endorsed by Health Ministers in November 2010.
43 Australian Safety and Quality Framework for Health Care. Australian Commission for Safety and Quality in Health Care, Canberra.
Health Workforce Australia (HWA) is a Commonwealth statutory authority. It was established under the Health Workforce Australia Act 2009 with wide ranging responsibilities for the improvement of health workforce policy and planning in Australia. HWA reports to the Australian Health Ministers' Conference (AHMC).
Part of HWA's remit is to provide accurate information to support workforce policy development and planning. Since its establishment the HWA has commenced a number of activities involving the collection and collation of information on workforce within the Australian hospital sector. Some of those activities have involved requests to private hospitals to provide (workforce related) data to HWA.
In addition to these ad hoc data requests, HWA is responsible for the development of the National Health Workforce Statistical Resource. This resource is “a statistical database with two major components, the National Health Workforce Dataset (NHWDS) and the National Health Workforce Planning Tool (HWPT)”44.Top of page
44 Health Workforce Australia. Accessed on 9 June 2011.
In light of these facts the HWA were approached to contribute to this Review. In particular, they were asked about the future prospects for ongoing data collection from private hospitals by the HWA. It is the view of the HWA that the NHWDS collection and reporting requirements in the future are likely to be served through data obtained from sources other than ongoing collection from private hospitals. The most recent experience of collecting data on clinical placements directly from private hospitals has proven burdensome and difficult, and HWA is actively pursuing alternative means to obtain this data in the future.
The HWPT is expected to rely on data from existing sources that do not require new or additional collection from private hospitals.
For these reasons, this Review did not consider potential future workforce collections as being relevant to the streamlining objective.