The safety of Australian healthcare: 10 years after QAHCS

Wilson, Ross McL; Van Der Weyden, Martin B

doi:10.5694/j.1326-5377.2005.tb06694.x

Topics

We need a patient safety initiative that captures the imagination of politicians, professionals and the public

Nearly 10 years have elapsed since the Journal published the ground-breaking Quality in Australian Health Care Study (QAHCS)1. With its disturbing findings, the study seared “patient safety” into the public’s psyche. The QAHCS methodology focused on the safety aspects of healthcare quality, without providing systematic data on other domains, such as access, efficiency and acceptability, and provided only some insight into effectiveness and appropriateness of care. The role of QAHCS was to estimate the size and nature of the problem of unsafe healthcare.

1 Northern Centre for Healthcare Improvement, Royal North Shore Hospital, St Leonards, NSW.
2 The Medical Journal of Australia, Strawberry Hills, NSW.

Correspondence: rwilson@doh.health.nsw.gov.au

1. Wilson RM, Runciman WB, Gibberd RW, et al. The Quality in Australian Health Care Study. Med J Aust 1995; 163: 458-471. <eMJA pdf>
2. Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ 2001; 322: 517-519 [erratum in: BMJ 2001; 322: 1395].
3. Baker GR, Norton PG, Flintoft V, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ 2004; 170: 1678-1686.
4. Schioler T, Lipczak H, Pedersen BL, et al. [Incidence of adverse events in hospitals. A retrospective review of medical records]. Ugeskr Laeger 2001 163: 5370-5378 (in Danish).
5. Michel P, Quenon JL, de Sarasqueta AM, Scemama O. Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals. BMJ 2004; 328: 199.
6. World Health Organization. The launch of the World Alliance for Patient Safety. “Please do me no harm.” Available at: www.who.int/patientsafety/launch/en/ (accessed Feb 2005).
7. Australian Council for Safety and Quality in Health Care. Maximising national effectiveness to reduce harm and improve care. Fifth report to the Australian Health Ministers’ Conference, 29 July 2004. Available at: www.safetyandquality.org/annualreptjul04.pdf (accessed Feb 2005).
8. Royal Australasian College of Physicians. Maintenance of professional standards. Available at: www.racp.edu.au/public/mops_whatis.htm (accessed Feb 2005).
9. Faunce TA, Bolsin SN. Three Australian whistleblowing sagas: lessons for internal and external regulations. Med J Aust 2004; 181: 44-47.
10. NSW Health. Patient Safety and Clinical Quality Program. First report on incident management in the NSW public health system 2003–2004. Available at: www.health.nsw.gov.au/pubs/2005/pdf/incident_mgmt.pdf (accessed Feb 2005).
11. Department of Human Services, Victoria. Sentinel Event Program. Annual Report 2002–03. Available at: www.health.vic.gov.au/clinrisk/sentinelevents0203.pdf (accessed Feb 2005).
12. Australian Government Productivity Commission. Report on government services 2005. Chapter 9. Public hospitals. Available at: http://www.pc.gov.au/gsp/reports/rogs/2005/chapter09.pdf (accessed Feb 2005).
13. Australian Government Department of Health and Ageing. Australian Health Ministers Conference. Review of Future Governance Arrangements for Safety and Quality in Health Care. Details available at: www.health.gov.au/internet/wcms/publishing.nsf/Content/health-sqreview.htm (accessed Feb 2005).
14. Institute for Health Improvement. 100 000 lives campaign. Details available at: www.ihi.org/IHI/Programs/Campaign/ (accessed Feb 2005).
15. Marshall MN, Shekelle PG, Davies HTO, et al. Public reporting on quality in the United States and the United Kingdom. Health Aff (Millwood) 2003; 22: 134-148.
16. Institute for Health Improvement. The breakthrough series: IHI’s collaborative model for achieving breakthrough improvement [white paper]. Available at: http://www.ihi.org/NR/rdonlyres/3F1925B7-6C47-48ED-AA83-C85DBABB664D/0/TheBreakthroughSeriespaper.pdf (accessed Feb 2005).
17. Chassin MR, Galvin R, and the Institute of Medicine National Roundtable on Health Care Quality. The urgent need to improve health care quality. JAMA 1998; 280: 1000-1005.
18. AMA submission to the review of future governance arrangements for safety and quality in health care. Canberra: Australian Medical Association, November 2004.
19. Crossing the quality chasm: a new health system for the 21st century. Institute of Medicine Health Care Quality Initiative. Washington, DC: IOM, 2001.

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