Patient mortality rates, post-operative complications and readmissions in Queensland’s hospitals could be made public in the wake of an audit of surgical patient deaths in the state that found 375 patients died between July 2007 to June 2016 as a result of serious clinical incidents.
Queensland’s Health Minister has called on his department to prepare a discussion paper on improved safety reporting, and flagged the introduction of legislation that would compel private hospitals to report patient data for the first time.
Hospitals in the United States are required to disclose mortality rates, failure to resuscitate, post-operative complications and readmissions online, while in Australia privacy legislation protects private hospitals from disclosure of clinical events such as surgery conducted on wrong body parts.
Inviting contributions from patients, the public and healthcare professionals, Health Minister Cameron Dick said the discussion paper, to be released within two months, will look at aligning patient safety reporting standards across the health system.
“International evidence is clear – the safest hospitals have a strong and open safety culture amongst staff,” Dick said.
“I think it’s important that we have consistent reporting around Australia, and that is consistent across the public and private health systems.”
According to the Queensland Audit of Surgical Mortality carried out by the Royal Australasian College of Surgeons for Queensland Health, while there has been an overall downward trend in preventable serious clinical incidents in the state over the nine-year period, death was caused in 375 patients who would otherwise have been expected to live. In the cases of 2438 patients, clinical incidents may have contributed to death.
The audit found that in 2318 cases – 30.5 per cent – the serious clinical incidents were definitely or probably preventable.
Queensland Nurses and Midwives’ Union Assistant Secretary Sandra Eales said increased public reporting of mortality rates and care outcomes in private and public hospitals would contribute to accountability and patient safety.
“We absolutely want improved transparency around outcomes in both public and private hospitals,’’ Eales said.
“We believe that open, public reporting is essential to ensure accountability and to support a safety culture within all hospitals.’’
The report recommended surgeons improve the “completeness” of data collected on surgical case forms. It also advised that cardiothoracic patients have echocardiograms immediately before surgery to check for additional deterioration. Improved imaging quality was also recommended in operating theatres through the availability of high-grade screens.
The audit also found that infection rates are steadily increasing. Almost 35 per cent of patients died with a clinically significant infection, with 57.2 per cent of infections acquired during hospital stays.
“The proportion of patients who had infections, and acquired them as inpatients, is trending upwards. This trend predicts increases in costs for hospital systems for the future,” according to the report’s authors.