How can we make Australia's hospitals safer?

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Health Report 28 min 2 speakers 8 chapters transcribed 16 hours ago
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What does the Grattan Institute report say about the cost of unsafe hospitals in Australia?

Jenny Hutton 0:02
This is an ABC Podcast.
Dr. Norman Swan 0:06
Hello and welcome to the Health Report with me, Norman Swan. Today, where three into one does go, at least when it comes to treating high blood pressure more effectively. If you can Google in an emergency, is it an emergency? And how to make our hospitals safer? The Gradon Institute today claimed in a report that if all hospitals were as safe as the top ten percent, then one point five billion dollars and two hundred and fifty thousand complications would be saved and three hundred Thousand more patients cared for, but argued the way we monitor safety at the moment is inefficient and not working. They're talking about the set of national standards laid down by the Australian Commission on Safety and Quality and Healthcare, which are assessed by independent assessors to allow the hospital to be accredited.
Dr. Norman Swan 0:46
That's the nice sign that's on the usually on the doorway when you walk into the FOIA. The implication is that the standards and accreditation screen should be junked. Interestingly, at the same time, the The Commission has released its own review of the accreditation scheme announcing six strategies to improve it. This might sound esoteric, but it's actually all about the safety of the care that you get when you enter our hospital system. In our Melbourne studio is Professor Stephen Duckett, who heads the Grattans Health Program, and in our Sydney studio, Professor Ann Duggan, who's the acting chief medical officer of the Australian Commission on Safety and Quality in Healthcare. Welcome to you both.
Ann Duggan 1:19
Thank you.
Dr. Norman Swan 1:20
Thanks, no one. So Steven, why are you so down on the accreditation screen as it exists?
Stephen Duckett 1:26
Well, uh I think uh it's it's done a fair it it does a fair amount. It uh it provides these surveyors and so on. But what we see is that the rates of uh complications are still pretty high. Uh about one in every four people who go into hospital for an overnight stay have some sort of complication. About one in nine or so for people who are in any any admission. And uh Many of the hospitals that we've that have had serious, serious uh complication scandals have been accredited uh for the years previous. And so this causes one to stand back and say, Well, can we do better? And the the Commission is uh trying to do better, but we're saying we need to go even further than that. So and do you
Dr. Norman Swan 2:12
dispute any of that? I mean you've you've come out with a review. Obviously you think there's something wrong with the accreditation system to come up with six strategies to improve it.
Ann Duggan 2:19
Norman a as you know, I'm a a clinician and I've been a clinician for over twenty years. I won't tell your business just how long I've been a clinician. And I think I've seen the change 'cause I've seen the uh the national standards which became mandatory in two thousand eleven come in. And And to
Dr. Norman Swan 2:33
and to explain to the listener who hasn't got a clue what we're talking about here, the national standards are are are things that are that hospitals have got to meet, like wound infection, like not allowing elderly patients to go into delirium and things like that.
Ann Duggan 2:47
That's right. So they've been focused on the As you know, in medicine we say common things happen commonly. And the common areas of complications are infection, falls, pressure injuries, failure to recognize deterioration early, medication areas. The standards are focused around those key areas. And what we've seen since the states and territories in the Commonwealth manned uh and commissioned put them in place, we've seen a marked improvement. So Not in all And all.
Dr. Norman Swan 3:15
of them.
Ann Duggan 3:16
No, you've got to start somewhere. You're a bit better
Dr. Norman Swan 3:18
at an antibiotic prescribing, a bit better in wound infection.
Ann Duggan 3:21
Absolutely. But if you take But the
Dr. Norman Swan 3:23
list runs out, doesn't it?
Ann Duggan 3:24
No, if you take New South Wales, for example, where we had the bet have the Between the Flags program, which is a trigger system for recognising patients who deteriorate, their review showed a fifty percent decrease. decline in in house in hospital cardiac arrests.

Why do Stephen Duckett and Ann Duggan criticize the current hospital accreditation system?

Ann Duggan 3:40
That's a huge personal impact.

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