Digital transformation of hospital quality and safety: real-time data for real-time action
Amy Barnett A B , Michelle Winning A B , Stephen Canaris C , Michael Cleary A C D E F , Andrew Staib A B and Clair Sullivan B G HA Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, Qld 4102, Australia. Email: amy.barnett@health.qld.gov.au; michelle.winning@health.qld.gov.au; micheal.cleary@health.qld.gov.au; andrew.staib@health.qld.gov.au
B Clinical Excellence Queensland, Herston Road, Herston, Qld 4006, Australia.
C Metro South Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Qld 4102, Australia. Email: stephen.canaris@health.qld.gov.au
D QEII Jubilee Hospital Network, Kessels Road, Mt Gravatt, Qld 4108, Australia.
E Faculty of Health and Behavioural Sciences, Medicine and Biomedical Sciences, University of Queensland, Qld 4072, Australia.
F School of Public Health. Queensland University of Technology, Ipswich Road, Woolloongabba, Brisbane, Qld 4102, Australia.
G Metro North Hospital and Health Service, Herston Road, Herston, Qld 4006, Australia.
H Corresponding author. Email: clair.sullivan@health.qld.gov.au
Australian Health Review 43(6) 656-661 https://doi.org/10.1071/AH18125
Submitted: 16 June 2018 Accepted: 29 August 2018 Published: 2 November 2018
Journal Compilation © AHHA 2019 Open Access CC BY-NC-ND
Abstract
The Australian Commission for Safety and Quality in Health Care has created the National Safety and Quality Health Service standards that all hospitals must address in order to remain accredited. This case study details the first known digitisation of the 10 national quality and safety standards mandated in a quaternary integrated digital hospital. A team of clinical informaticians, information technology experts and clinicians was assembled. Data were chosen and the data were then extracted and validated and presented (often in near real time) in an easily consumable dashboard format with appropriate governance to allow clinicians and executives to monitor the quality and safety standards across the hospital. All 10 standards were defined and extracted contemporaneously from the digital hospital for every patient, every time. This is in stark contrast with traditional retrospective point prevalence surveys. This case study details the first known fully digital accreditation in a sophisticated integrated digital hospital. Digitisation of hospital quality and safety to produce real-time data is the future of clinical redesign to improve patient care.
What is known about the topic? Healthcare delivery is complex and the ability of healthcare providers to maintain consistent standards of quality and safety is variable. Traditionally, these standards have been assessed by intermittent retrospective point-prevalence survey activity. Sophisticated digital hospitals provide the opportunity to develop data and analytics that monitor quality and safety standards across every patient, every time in near real time.
What does this paper add? This paper describes a digital hospital which has created streaming analytics to monitor live performance of quality and safety standards. The necessary skills, leadership and governance for this process are outlined and the products described.
What are the implications for practitioners? Shifting from retrospective paper-based point prevalence surveys to a digital platform has several implications. Firstly, it is an imperative to drive digital transformation of Australian hospitals. Secondly, it provides data for intervention to the hospital staff, so that issues can be addressed and improved in real-time, rather than waiting for survey results. Lastly, this new model of maintaining quality and safety also requires the development of new skills in the hospital setting including data literacy, digital clinical governance and clinical informatics.
References
[1] Australian Institute of Health and Welfare (AIHW). Australia’s health 2016: safety and quality of Australian hospitals. Australia’s health series 2016; no. 15. Canberra: AIHW; 2016. Available at: https://www.aihw.gov.au/getmedia/3876a585-9a48-4553-8939-59711f1aa573/ah16-6-14- safety-quality-australian-hospitals.pdf.aspx [verified 26 May 2018].[2] Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ 2016; 353 i2139
| Medical error-the third leading cause of death in the US.Crossref | GoogleScholarGoogle Scholar |
[3] Braithwaite J. Changing how we think about healthcare improvement. BMJ 2018; 361 k2014
| Changing how we think about healthcare improvement.Crossref | GoogleScholarGoogle Scholar |
[4] Australian Commission on Safety and Quality in Health Care (ACSQHC). National safety and quality health service standards, September 2012. Sydney: ACSQHC; 2012. Available at: https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-2012.pdf [verified 6 September 2018].
[5] Australian Commission on Safety and Quality in Health Care (ACSQHC). Resources to implement the NSQHS Standards (first edition). Sydney: ACSQHC. 2012 Available at: https://www.safetyandquality.gov.au/our-work/assessment-to-the-nsqhs-standards/resources-to-implement-the-nsqhs-standards/#Monitoring-tools [verified 20 September 2018].
[6] Sullivan C, Staib A, Ayre S, Daly M, Collins R, Draheim M, Ashby R. Pioneering digital disruption: Australia’s first integrated digital tertiary hospital. Med J Aust 2016; 205 386–9.
| Pioneering digital disruption: Australia’s first integrated digital tertiary hospital.Crossref | GoogleScholarGoogle Scholar |
[7] Sittig DF, Singh H. Electronic health records and national patient-safety goals. N Engl J Med 2012; 367 1854–60.
| Electronic health records and national patient-safety goals.Crossref | GoogleScholarGoogle Scholar |
[8] HiMMS Analytics Asia Pacific. Stage 6 hospitals. Singapore: HiMMS Analytics Asia Pacific; 2018. Available at: http://www.himssanalyticsasia.org/emram/stage6hospitals.asp [verified 6 September 2018].
[9] Duckett S, Jorm C. Strengthening safety statistics: how to make hospital safety data more useful. Melbourne: Grattan Institute; 2017. Available at: https://grattan.edu.au/wp-content/uploads/2017/11/893-strengthening-safety-statistics.pdf [verified 6 September 2018].
[10] Stadler JG, Donlon K, Siewert JD, Franken T, Lewis NE. Improving the efficiency and ease of healthcare analysis through use of data visualization dashboards. Big Data 2016; 4 129–35.
| Improving the efficiency and ease of healthcare analysis through use of data visualization dashboards.Crossref | GoogleScholarGoogle Scholar |
[11] Raghupathi W, Raghupathi V. Big data analytics in healthcare: promise and potential. Health Inf Sci Syst 2014; 2 1–10.
[12] The Australian Council on Healthcare Standards. ACHS EQuIpNational organisation wide survey: Princess Alexandra Hospital. Brisbane: ACHS; 2017.
[13] Dalrymple PW. Data, information, knowledge: the emerging field of health informatics. Bull Am Soc Inf Sci Technol 2011; 37 41–4.
| Data, information, knowledge: the emerging field of health informatics.Crossref | GoogleScholarGoogle Scholar |