How is safety and quality of care in hospitals measured?
The safety and quality of care provided to patients in hospitals can be measured in several ways. Measures reported on these pages are:
- healthcare-associated infections (Staphylococcus aureus bloodstream infections)
- hand hygiene compliance
- unplanned readmissions to hospital
- hospital-acquired complications
- conditions that arose during a hospital stay
- potentially preventable hospitalisations
- patients’ experiences of hospital care.
Below is a summary of the latest results for each of these safety and quality measures. Detailed information and further results, including trends over time, are presented at Admitted patient safety and quality.
Healthcare-associated infections: Staphylococcus aureus bloodstream infections (SABSI)
Healthcare-associated infections are one of the most common complications affecting patients in hospital and can prolong a patient’s hospital stay or result in death. Infections, such as Staphylococcus aureus (also known as ‘golden staph’), can be acquired as a direct or indirect result of care received in hospital. The current agreed benchmark for SABSI is no more than 1 case per 10,000 days of patient care.
- there were 1,535 cases of SABSI occurring during 20.7 million days of patient care in public hospitals – this was a rate of 0.74 SABSI cases per 10,000 patient days
- all public hospitals in each state and territory had rates below the national benchmark of 1 case per 10,000 patient days
- for private hospitals that volunteered to report SABSI surveillance data to the national collection (around 20% of hospitals), there were 229 SABSI cases occurring during just over 5.8 million days of patient care – a rate of 0.40 cases per 10,000 patient days.
Hand hygiene compliance
Good hand hygiene is a key first-line defence to prevent or reduce the transmission of microorganisms, including healthcare-associated infections.
Hand hygiene in hospitals refers to the washing of hands or use of alcohol-based rubs by healthcare workers at specific times (or ’moments’), before and after patient interactions and procedures. The current national benchmark requires that hand hygiene compliance occurs in at least 80% of hand hygiene moments. Compliance is assessed via national hand hygiene audits.
In audit period 2 (1st April to 30th June 2020):
- the national hand hygiene compliance rate was 88%
- compliance rates for each of the 5 moments varied between 83% and 93%
- the lowest compliance rates were among ambulance workers (74.5% and doctors (79.5%).
Unplanned readmissions to hospital
Unplanned readmissions are hospitalisations for which an unplanned readmission to the same public hospital occurred within 28 days following surgery (for selected surgical procedures) for an adverse event.
- rates of unplanned readmissions were highest for tonsillectomy (47.9 per 1,000 hospitalisations) and prostatectomy (30.7 per 1,000 hospitalisations)
- rates of unplanned readmissions were lowest for cataract extraction (2.9 per 1,000 hospitalisations).
The Australian Commission on Safety and Quality in Health Care (ACSQHC) lists 16 hospital-acquired complications (HACs) for which clinical risk mitigation strategies may reduce the risk of occurrence.
- 112,000 hospitalisations in public hospitals (2.0 in every 100 hospitalisations) recorded one or more HAC
- 36,100 hospitalisations in private hospitals (0.9 in every 100 hospitalisations) recorded one or more HAC.
The most commonly recorded type of complication was Healthcare associated infection, which was recorded in 53% of all separations in which a HAC was recorded.
Conditions that arose during a hospital stay
Conditions that arise during a hospital stay include conditions which may or may not have been preventable. These conditions are flagged on patient records when they occur.
In 2020–21, 935,000 hospitalisations (7.9% of hospitalisations) recorded a condition noted as arising during the episode of hospital care. Hospitalisations involving Childbirth were most likely to record a condition that arose during the hospital stay (43% of same-day hospitalisations involving childbirth, and 63% of overnight hospitalisations).
Patients’ experience of hospital care
Patient experience captures information on patients’ views of their interactions with the healthcare system and communication with staff delivering healthcare services.
In 2021–22, among people aged 15 and over who used hospital services as an admitted patient, most reported that:
- hospital doctors and specialists spent enough time with them (73%), listened carefully (76%) and always showed respect (79%)
- hospital nurses spent enough time with them (74%), listened carefully (78%) and always showed respect (80%).
Potentially preventable hospitalisations
Potentially preventable hospitalisations are an indicator of the effectiveness of non-hospital care. These hospitalisations could have potentially been prevented through the provision of appropriate health interventions and early disease management in primary care and community-based care settings (including by general practitioners, medical specialists, dentists, nurses and allied health professionals).
In 2020–21, there were 672,000 potentially preventable hospitalisations in public hospitals and 156,000 in private hospitals. These included:
- 320,000 hospitalisations for chronic conditions (excluding diabetes)
- 56,100 hospitalisations for diabetes complications
- 28,300 hospitalisations for vaccine-preventable conditions.