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The Role of public accountability
            mechanisms

    Taming the Queue Conference
          29 March 2012

                   Chris Baggoley
                 Chief Medical Officer
Australian Government Department of Health and Ageing
AUSTRALIAN
 CHARTER
    OF
HEALTHCARE
  RIGHTS
Elective Surgery Performance
 Elective Surgery Plan separations – Final Period Jul to Dec 2010

                          – Target                                     311,860
                          – Achievement 331,992
                          – % over target 6.5%
                          Source: Commonwealth Reform Commission Report - Period 3 independent assessment


 Performance – 2006-07 to 2010-11

                                                     2006-07                             2010-11            Change
Admissions                                           556,770                             620,783             +64,013
Waiting Times
Median wait                                          32 days                             36 days             + 4 days X
90th percentile                                      226 days                            252 days            + 26 days X
% > 365 days                                           3.1%                              2.9%                - 0.2%

Source: Australian Institute of Health and Welfare, Australian Hospital Statistics 2010-11
Demand for Emergency Departments

Australian EDs are facing                                                            National ED presentations vs Population
                                                                                             (% change over 2004-05)
   rising demand, well
   above rates of
                                                            45.00%
   population growth:
                              Percent change over 2004-05
                                                            40.00%
                                                            35.00%
•   In 2004-05, there were                                  30.00%
    4.3 million                                             25.00%
    presentations to EDs.                                   20.00%
    By 2010-11, this had                                    15.00%
    risen to 6 million – an                                 10.00%
    increase of nearly 40%                                  5.00%
    over 5 years.                                           0.00%
•   Over the same period,                                                2005-06            2006-07            2007-08           2008-09            2009-10            2010-11
    population growth was                                                                                                 Year
    10%.
                                                               Growth Total emergency visits (over base year)                      Growth Population (over base year)


                                                              Sources: AIHW Australian Hospital Statistics publications, 2004-05 to 2010-11; and Australian Bureau of Statistics 3101.0
                                                                                                                                    Demographic Statistics Table 2. Population Change
Australian Emergency Departments:
                                                      Triage Category Performance

                             % presentations treated within recommended times,
                                                  Australia                                                                     The goal of the ‘Taking
                  100%

                   95%
                                                                                                                                Pressure Off Public
                   90%                                                                                                          Hospitals’ agreement is to
                                                                                                             Improvement
                   85%
                                                                                                          required to hit 80%   raise the National Average
% presentations




                   80%

                   75%
                                                                                                                                to 80% by 2012-13.
                   70%

                   65%
                                                                                                                                Sources: Australian Hospital Statistics
                   60%                                                                                                          2002-03 to 2009-10, produced by the
                                                                                                                                Australian Institute of Health and
                   55%
                                                                                                                                Welfare.
                   50%
                         3          4          5          6          7          8          9          0          2          3
                     2-0        3-0        4-0        5-0        6-0        7-0        8-0        9-1        1-1        2-1
                  200        200        200        200        200        200        200        200        201        201



                                                       National Average (all Cats)
Four hour length of stay
2006-07 to 2009-10 by Jurisdiction




                           Source: Expert Panel Review of Elective and Emergency Access
                          Targets under the National Partnership Agreement in Improving
  Public Hospital Services: Supplementary Annexure. Report to COAG: August 2011 p.46
Monthly performance against the Four Hour
Rule Program in Western Australia **July
            2008 – April 2011
Data in Queensland


 Use of statistical process control charts
 Using routine data
 Starting point for learning and subsequent action to
  improve quality of care




                                      Duckett, S. et al, MJA, 19 November 2007
Queensland Health Annual Report 2007-08
MyHospitals

•   Myhospitals presents information on hospitals throughout Australia and how they
    compare against national and state and territory data, including:

     – Hospital profile
     – Services offered
     – Number of admissions
     – Waiting times for emergency departments and elective surgery
     – Safety and quality (Staphylococcus aureus bacteraemia; hand hygiene)


     Visit the MyHospitals website at: http://www.myhospitals.gov.au/
Role of Public Accountability Mechanisms

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Role of Public Accountability Mechanisms

  • 1. The Role of public accountability mechanisms Taming the Queue Conference 29 March 2012 Chris Baggoley Chief Medical Officer Australian Government Department of Health and Ageing
  • 2. AUSTRALIAN CHARTER OF HEALTHCARE RIGHTS
  • 3. Elective Surgery Performance  Elective Surgery Plan separations – Final Period Jul to Dec 2010 – Target 311,860 – Achievement 331,992 – % over target 6.5% Source: Commonwealth Reform Commission Report - Period 3 independent assessment  Performance – 2006-07 to 2010-11 2006-07 2010-11 Change Admissions 556,770 620,783 +64,013 Waiting Times Median wait 32 days 36 days + 4 days X 90th percentile 226 days 252 days + 26 days X % > 365 days 3.1% 2.9% - 0.2% Source: Australian Institute of Health and Welfare, Australian Hospital Statistics 2010-11
  • 4. Demand for Emergency Departments Australian EDs are facing National ED presentations vs Population (% change over 2004-05) rising demand, well above rates of 45.00% population growth: Percent change over 2004-05 40.00% 35.00% • In 2004-05, there were 30.00% 4.3 million 25.00% presentations to EDs. 20.00% By 2010-11, this had 15.00% risen to 6 million – an 10.00% increase of nearly 40% 5.00% over 5 years. 0.00% • Over the same period, 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 population growth was Year 10%. Growth Total emergency visits (over base year) Growth Population (over base year) Sources: AIHW Australian Hospital Statistics publications, 2004-05 to 2010-11; and Australian Bureau of Statistics 3101.0 Demographic Statistics Table 2. Population Change
  • 5. Australian Emergency Departments: Triage Category Performance % presentations treated within recommended times, Australia The goal of the ‘Taking 100% 95% Pressure Off Public 90% Hospitals’ agreement is to Improvement 85% required to hit 80% raise the National Average % presentations 80% 75% to 80% by 2012-13. 70% 65% Sources: Australian Hospital Statistics 60% 2002-03 to 2009-10, produced by the Australian Institute of Health and 55% Welfare. 50% 3 4 5 6 7 8 9 0 2 3 2-0 3-0 4-0 5-0 6-0 7-0 8-0 9-1 1-1 2-1 200 200 200 200 200 200 200 200 201 201 National Average (all Cats)
  • 6. Four hour length of stay 2006-07 to 2009-10 by Jurisdiction Source: Expert Panel Review of Elective and Emergency Access Targets under the National Partnership Agreement in Improving Public Hospital Services: Supplementary Annexure. Report to COAG: August 2011 p.46
  • 7. Monthly performance against the Four Hour Rule Program in Western Australia **July 2008 – April 2011
  • 8. Data in Queensland  Use of statistical process control charts  Using routine data  Starting point for learning and subsequent action to improve quality of care Duckett, S. et al, MJA, 19 November 2007
  • 9. Queensland Health Annual Report 2007-08
  • 10. MyHospitals • Myhospitals presents information on hospitals throughout Australia and how they compare against national and state and territory data, including: – Hospital profile – Services offered – Number of admissions – Waiting times for emergency departments and elective surgery – Safety and quality (Staphylococcus aureus bacteraemia; hand hygiene) Visit the MyHospitals website at: http://www.myhospitals.gov.au/