The Australian Council on Healthcare Standards (ACHS) has been involved in the development of clinical indicators in conjunction with medical colleges, associations and societies since 1989. In this time, the clinical indicator program has seen the development of hospital-wide and discipline specific sets of clinical indicators. Clinical indicators are increasingly being used to assess and improve the quality of health care.  It is increasingly acknowledged on an international level that the development and use of clinical indicators can positively influence clinical practice.

The ACHS has gathered considerable information on over 300 clinical indicators, with more than 800 health care organisations participating in the Comparative Report Service. Information from the indicators is the largest source of data gathered on the quality of health care in Australia and New Zealand. The ACHS coordinates the development, collection, collation, analysis, and reporting of the clinical indicators.

What is a clinical indicator?

A clinical indicator is defined as a measure of the clinical management and / or outcome of care.

A well-designed indicator should ‘screen’, ‘flag’ or ‘draw attention’ to a specific clinical issue. Usually rate based, indicators identify the rate of occurrence of an event. Indicators do not provide definitive answers; rather they are designed to indicate potential problems that might need addressing, usually demonstrated by statistical outliers or variations within data results. They are used to assess, compare and determine the potential to improve care. 

Indicators can therefore be used as a tool to assist in assessing whether or not a standard in patient care is being met.  The indicators provide evidence of performance and can be linked to the appropriate ACHSInternational Quality Program standards.

What is the Comparative Report Service for ACHSI members?

The Comparative Report Service (CRS) is a data repository, analysis and reporting service provided by ACHSI to its member organisations. Participating organisations submit indicator data for inclusion in an extensive indicator database. Data are aggregated and analysed twice yearly and results are provided in the form of Comparative Reports which compare results across all contributing organisations as well as providing a comparison with 'peer’ organisations based on a number of variables. Technical support is provided via telephone and e-mail. Participation is voluntary.

What are the benefits?

·       Accessing regular and current information on processes and outcomes of health care

·       Trending data over time and benchmarking with peers

·       Utilising comparative reports in conjunction with a quality improvement program to provide evidence of how an organisation is monitoring and evaluating patient care

·       Accessing documented evidence of improved management and examples of improved patient outcomes, and

·       Utilising indicators to support change and improvement.

How does an organisation select relevant clinical indicators?

There are 21 clinical indicators sets. There is no requirement that an organisation monitor a specific number of indicators. ACHSI recommends organisations consider indicators, which relate to the health services they provide and are appropriate to the size and type of organisation.

New indicator sets are developed when there is interest from medical colleges and other stakeholder groups and organisational demand. An indicator set is regularly reviewed to ensure:

·       it remains reflective of today’s health care environment,

·       there is consensus on collection and reporting requirements and

that the set has remained useful for quality improvement.

Who can subscribe?

Subscription to the Comparative Report Service for ACHSI is open to all health services and a membership fee applies. Fees are based on a calendar year subscription.

What areas do the current clinical indicator sets cover?

Currently there are 21 clinical indicator sets:

·          Adverse Drug Reactions - Version 2

·          Anaesthetics Indicators - Version 4

·          Day Surgery - Version 4

·          Dermatology Indicators - Version 2

·          Day Surgery – Version 4

·          Emergency Medicine Indicators - Version 3

·          Gastrointestinal Endoscopy Indicators – Version 1

·          Hospital in the Home Indicators - Version 3

·          Hospital-Wide Clinical Indicators - Version 9

·          Infection Control Indicators - Version 3

·          Intensive Care Indicators - Version 2

·          Internal Medicine Indicators - Version 3

·          Mental Health Indicators

·          Obstetrics and Gynaecology Indicators

·          Ophthalmology and Excimer Laser Indicators - Version 3

·          Oral Health- Version 2

·          Paediatric Indicators - Version 3

·          Pathology Indicators - Version 2

·          Radiation Oncology Indicators - Version 2

·          Radiology Indicators - Version 4

·          Rehabilitation Medicine Indicators – Version 3

·          Surgical Indicators – Version 3