Clinical Indicators

What is a clinical indicator?

A clinical indicator is simply 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 are therefore, tools to assist in assessing whether or not a standard in patient care is being met.

What is the ACHS Clinical Indicator Program?

The ACHS Clinical Indicator Program is a data repository, analysis and reporting service provided by the ACHS to healthcare organisations. It provides comparative information on the processes and outcomes of health care. Participating organisations are able to 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. These reports compare results across all contributing organisations as well as providing a comparison with 'peer’ organisations based on a number of variables.

The Performance and Outcomes Service (POS) team also provides individual support to HCOs, via telephone and e-mail. Consultancies can be arranged through the ACHS Education Service and Calendar Workshops are provided on a range of topics related to performance improvement. The Clinical Indicator Program provides all necessary products, tools and services required for members to participate. These resources are available via a secure website where members can also submit and download the clinical indicator data.

What are the benefits of participating in the ACHS Clinical Indicator Program?

The benefits are outlined below:

· Participation in the ACHS Clinical Indicator Program encourages organisations to collect and report current data on the processes and outcomes of health care

· Health care organisations can trend the data over time and benchmark with peers

· The comparative reports provided to organisations by the ACHS are an invaluable adjunct to a quality improvement program and can provide evidence of how an organisation is monitoring and evaluating patient care and performing in relation to peers

· The reports can provide documented evidence of improved management and examples of improving or worsening patient outcomes

How does an organisation select relevant clinical indicators and performance measures?

There are 23 clinical indicator sets and over 350 indicators to choose from in the ACHS program. There is no requirement that an organisation monitor a specific number of indicators. Organisations are required to consider indicators that relate to the health services they provide and are appropriate to their size and type of organisation.

To identify those clinical indicators which are potentially relevant and appropriate, the following points should be considered:

· Does the indicator measure an important aspect of clinical practice?

· Will the data collected on this indicator assist in improving clinical care?

· Will the information be useful and meaningful to clinicians in demonstrating how the service is performing and ways that it may be improved?

· Will the data be accessible to clinicians to allow for monitoring of the indicator?

· Are existing resources sufficient to allow for ongoing monitoring of the indicator?

How does an organisation collect and report clinical indicator data?

Program members are supplied with comprehensive information on how to collect the indicators which is supplied in the Clinical Indicator Users’ Manual. Further support is provided by POS team members via phone and email. In terms of collecting the indicators, the ACHS is not prescriptive about how organisations collect the data, for example some indicators are collected via manual audit of medical records while others can be generated from internal computer systems, for example, adverse event or risk management systems. Organisations should however ensure they collect the information in strict accordance with the definitions in the Users’ Manual. This ensures that data submitted to ACHS’s National Aggregate Indicator Database (NAID) is consistent.

Organisations are required to submit their data to the ACHS using the Performance Indicator Reporting Tool (PIRT). This tool, known as PIRT Online, is accessible via a secure internet site.

Who can subscribe the ACHS Clinical Indicator Program?

Subscription to the ACHS Clinical Indicator Program is a component of EQuIP membership. All EQuIP members are encouraged to submit indicator data.

Non-EQuIP members may subscribe and a membership fee applies. Fees are based on a calendar year subscription.

For more information on the subscription fee, please download the ACHS Clinical Indicator Program application form 2009.

If you wish to obtain more information on the ACHS Clinical Indicator Program, please download the ACHS Clinical Indicator Program Information 2009.