We were pleased to welcome health service CEOs and board members, clinicians, consumers and colleagues from across government to VAHI’s Annual Forum on 19 September 2019.
VAHI CEO, Dr Lance Emerson, opened the event and shared some of our highlights from the past year, including the release of the first private hospital quality and safety report and deploying the new Victorian Health Incident Management System (VHIMS) Central Solution for incident reporting.
He explained how VAHI had listened to feedback and identified priority areas of focus to meet health service and clinician needs over the coming years, including improving the timeliness of reporting and making information more actionable for health services. These priorities are reflected in VAHI’s new Strategic plan 2019–22, which was launched at the forum. ‘Trusted information, which has got to be timely, relevant and actionable. That’s what we’re focusing on over the next three years,’ he said.
Looking to the future, Lance talked about the development of the VAHI portal, the Analytical Strategy and ultimately broadening reporting into human services and community services.
Lance finished by thanking partners, saying that ‘We will continue to strengthen the partnerships that make all of our strategic projects possible.’
Jen Morris, healthcare consumer advocate and member of the Victorian Clinical Council (VCC), then gave a consumer perspective on the role of data in healthcare quality and safety improvement. She shared her own experience involving diagnostic error and showed how the data recording the event tells a very different story to what she went through as the patient. Speaking about these two stories, she said they are both accurate but, ‘The one etched in data is unremarkable. The other, which sits invisible behind the data, raises multiple safety issues.’
Jen suggested that there is ‘an enormous opportunity for health services and organisations like VAHI … to design data collection systems that allow us to better understand patterns of diagnostic error.’
Kira Leeb, VAHI’s Executive Director, Health and System Performance, then presented on what the data tells us about quality and safety in Victoria. VAHI has looked at statewide results across time for key performance measures such as mortality, infections, unplanned readmissions and patient safety culture.
Looking through the measures, Kira explained how some, such as mortality results for acute myocardial infarction and stroke, have remained stable. For other safety measures, such as the rate of Central Line-Associated Bloodstream Infection (CLABSI) for Victorian Adult Intensive Care Units and the percentage of staff immunised for influenza, we can see a statewide improvement.
Meanwhile, readmissions for paediatric tonsillectomy and adenoidectomy have increased over the past 10 years, indicating a statewide decline in performance for this measure.
After Kira’s tour of the data, Jen Morris moderated a panel discussion that asked the question, ‘Quality and safety in Victoria – is it improving?’
Professor Christine Kilpatrick, CEO of Melbourne Health, answered this question first saying, ‘I think definitely yes, quality and safety has improved. But, given all the resources, investment, the effort that has gone into it, is it as good as it could be and should be? I think possibly not.’
She suggested that, until recently, there hasn’t been a systematic, industry-wide approach to quality and safety improvement, which is needed to have a real impact.
Associate Professor Jill Sewell, consultant paediatrician and Chair of the VCC, spoke about the challenge of performance data being timely. She looked forward to the release of VAHI’s interactive data portal later this year to allow clinicians to search for indicators and compare with historical data.
Professor Sewell said that while clinical quality registries need considerable resources to develop and maintain, they ‘certainly make a difference to driving significant improvements and less variation in care.’
She spoke about the VCC’s work with VAHI earlier this year on prioritising measures for development and stated the importance of clinical engagement and co-design with clinicians and consumers at all stages. ‘Clinicians want data to drive change and we want relevant VAHI data to help us and complement our many other sources of data,’ she said.
In answer to the question of whether quality and safety is improving, Safer Care Victoria CEO, Professor Euan Wallace, said ‘Maybe’. He suggested that the quality of healthcare has improved considerably but the signals are that safety is not improving.
To address this, firstly, he said we need better data going into the right hands. Secondly, we need improved workforce culture with greater consumer involvement. Lastly, we need increased capability to sustain improvement across the health system.
Mary Draper AM, a member of the board at Austin Health, also suggested a shift in culture is needed to realise healthcare improvement. She spoke about the importance of ‘team responsibility’ for quality and safety, from the CEO and right across the hospital.
Questions from the audience prompted a lively discussion about what needs to be done to improve quality and safety. The panel noted an imperative to increase data literacy, particularly for health service boards, as well as increasing health literacy consumers. They also discussed public reporting and debated the right amount of data to present to public, while agreeing on its importance for transparency and developing an improvement culture within health services.
Thank you to everyone who came along to the forum, and particular thanks to our panel for taking part. We hope to see you next year!
If you were unable to attend this year’s forum, click here to watch a recap of the event and hear about key learnings and highlights from our VAHI speakers.