Mediclinic is leading the way in publishing clinical and patient experience results. In April 2017, Mediclinic became the first hospital group in South Africa to publish patient experience results and has now published key clinical data as part of our public commitment to greater transparency around the care we are providing. This information is intended to empower consumers and provide them with the necessary insight to make informed decisions.
CLINICAL PERFORMANCE INDICATORS
Mediclinic has developed a strong focus on clinical performance to ensure efficient, effective and safe patient care of the highest standard." - Dr Ronnie van der Merwe, Group CEO.
Mediclinic is committed to improving the quality of life of all our patients. In order to ensure that we continue to provide quality care and identify areas for improvement, we need to measure key aspects of our care delivery. Currently, we measure and report on a number of internationally defined and recognised clinical quality measures for all hospitals and, in the spirit of improvement and transparency, we are publishing a subset of those here.
This will drive further improvements in our healthcare facilities and empower patients in making healthcare decisions.
WHAT ARE CLINICAL PERFORMANCE RESULTS?
Mediclinic clinical performance refers to the quality of our clinical processes and outcomes and is supported by our clinical performance model. The four components of the model are patient safety, effectiveness, cost efficiency and value-based care. Sound clinical governance structures form the foundation of this clinical care delivery.
Different indicators are used to assess each of these areas. Falls, pressure ulcers, medication errors and near misses are reported here under patient safety. The Extended/Prolonged Length of Stay Index is the reported effectiveness indicator.
WHY DO WE MEASURE CLINICAL PERFORMANCE?
Clinical care is complex and there are several components of care that need to be assessed to determine healthcare quality. Within these areas different structures, processes and outcomes are monitored.
Simply put, measurement is the first step towards improvement. Measures in healthcare need to touch on the multiple areas of care delivery in a patient's journey through the healthcare system. Measurement of care is done to assure good quality care is consistently provided, as well as to highlight areas for improvement.
WHERE DO THE RESULTS COME FROM?
The data that are used to measure clinical performance in Mediclinic come from a number of sources, including clinical databases, our patient safety events management system, infection prevention and control surveillance system and administrative systems.
The indicators used in Mediclinic follow methodologies and definitions proposed by institutions that include the Agency for Healthcare Research and Quality (AHRQ) and the Centres for Disease Control and Prevention (CDC) in the USA, the National Health Service (NHS) in the UK, and the World Health Organization (WHO).
How measures are defined is key if comparisons are to be made between facilities or organisations. If what is considered a fall, for example, is classified differently in another organisation, the results cannot be directly comparable.
Mediclinic strives to support the identification and reporting of hospital events accurately and some of the indicators included here are self-reported measures. Proactive and accurate reporting is one of the fundamental tenets in our patient safety culture.
HOW ARE RESULTS REPORTED?
Depending on the specific measurement, quality indicators may be reported as a rate, ratio, index, count or by simply documenting where a structure or service is available or not.
The indicators contained on this site are updated every quarter (three months) and reflect specific elements of the quality of care delivered over the preceding 12-month period. The day hospitals are currently not included on this website, however, will be included in further iterations.
Many of the categories contained here are reported as a ‘rate per 1000 patient days"’ A patient day is a standardised unit of time that counts the number of 24-hour-long stays per patient in a healthcare facility.
Benchmarking allows facilities to compare their performance. Where international and national benchmarks are unavailable, Mediclinic will internally benchmark off the division's own performance.
THE PATIENT SAFETY FOCUS
Providing safe patient care is a Mediclinic priority. Patient safety is defined as the ‘prevention and mitigation of harm caused by errors of omission or commission associated with healthcare, and involves the establishment of systems and processes that minimise the likelihood of errors and maximise the likelihood of intercepting them before they occur’. (Angood et al, 2009)
Instilling a patient safety culture is imperative to quality care. Establishing a patient safety culture starts with the collaboration of care providers and an openness to learn from errors and near misses in a way that drives improvement in care delivery.
Mediclinic is therefore committed to reporting errors in clinical care delivery. Such reporting enables further conversation, investigation and ultimately quality improvement would not be possible.
INFECTION PREVENTION AND CONTROL (IPC) – HOW WE KEEP YOU SAFE
Our IPC Managers are specially trained experts who are involved in multiple aspects across each department in the hospital to reduce the risk of infection. They follow national and international guidelines, track infection trends, investigate potential risks, and lead improvement.
We also use smart electronic systems that alert our teams early to possible infection risks—so we can act quickly to protect patients and staff.
All of this helps ensure you’re cared for in the safest environment possible during your hospital stay.
"Clean Hands, Safe Care"
Hand hygiene may seem simple, but doing it at the right times is critical to preventing infections. During patient care, there are key moments when cleaning hands is essential to stop the spread of micro-organisms (germs) from one patient—or the healthcare environment—to another.
Every time we clean our hands, we help keep you safe.
Trained teams regularly observe and support our staff to maintain the highest standards of hand hygiene—because your safety is our priority.
Trained to Protect
Our staff undergo regular infection prevention training, equipping them with the knowledge to assess risk and manage patients safely. Each unit has an IPC Link Nurse to lead and monitor IPC practices within each department, building a culture of prevention.
Clean Environments, Safe Care
Our dedicated cleaning teams follow strict healthcare cleaning and disinfection procedures, using approved products and regular monitoring to ensure every space meets the highest safety standards.
Precision in Every Procedure
From surgical instruments to everyday equipment, everything we use is carefully selected by specialists or thoroughly decontaminated by trained staff - so it is safe and ready for use when it matters most.
WHAT DO THE RESULTS MEAN FOR ME?
These clinical performance results have been published to assist patients directly and indirectly by:
- Providing insight into the quality of a facility’s care provision and processes.
- Optimising accountability in care delivery and driving further facility-based improvement.
It is important that a result should not be looked at in isolation. Clinical performance results form part of a bigger picture of performance assessment and improvement.
For specific information on the reported measures, click on the “what we measure” tab on each specific indicator.
MEDICATION REPORTING ERROR RATES
* Reported as a rate per 1000 patient days
A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient or consumer. Such events may be related to professional practice, healthcare products, procedures and systems. They include prescribing, order communication, product labelling, packaging, nomenclature, compounding, dispensing, distribution, administration, education, monitoring and use. This category also measures medication that was ordered but not administered.
What we measure?
We encourage the reporting of hospital events when they occur in our hospitals. This forms the main source of the information presented in this indicator.
What it means if the result was 1.0 per 1000 patient days:
If a patient were to stay in hospital for a thousand days there would be one medication error within that 1000-day period.
To get to the number in the result, the total number of medication errors in the hospital is counted. The bed days of a hospital are then calculated by reviewing the hospital bed occupancy (how much time in that month the available beds are full).
The number of near misses is then divided by the number of bed days to give us rate per bed day. This will often be a very small figure. The number is then multiplied by 1000 to give a result per 1000 bed days as reflected.
FALL RATES
* Reported as a rate per 1000 patient days
Falls are defined by AHRQ as “a sudden, unintended, descent of a patient’s body to the ground or other object (e.g. onto a bed, chair, or bedside mat)”. These can occur in patients that are assisted or unassisted in their movement. All falls are included in this indicator, whether they have resulted in injury or not.
The falls result reflected here does not take into account how sick the patient is, or the age or mobility of the patient admitted. In other words, there is no risk adjustment for other risk factors that may contribute to a patient falling.
What it means if the result is 0.8:
If a patient were to stay in hospital for a thousand days there would be 0.8 (or less than 1) fall within that 1000-day period.
To get to the number in the result, the total number of falls in the hospital is counted. The bed days of a hospital are then calculated by reviewing the hospital bed occupancy (how much time in that month the available beds are full).
The number of falls is then divided by the number of bed days to give us rate per bed day. This will often be a very small figure. The number is then multiplied by 1000 to give a result per 1000 bed days as reflected.
PRESSURE ULCER RATES
* Reported as a rate per 1000 patient days
Pressure ulcers are sometimes referred to as bed sores or pressure injuries. A pressure ulcer is defined by AHRQ as “localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device. The injury can present as intact skin or an open ulcer and may be painful”. All grades of pressure ulcer are included in the reported indicator.
What we measure?
Pressure ulcers in Mediclinic are staged using the information provided by the National Pressure Ulcer Advisory Panel.
What it means if the result was 1.0:
If a patient were to stay in hospital for a thousand days there would be one pressure ulcer within that 1000-day period.
To get the number in the result, the total number of pressure ulcers in the hospital is counted. The bed days of a hospital are then calculated by reviewing the hospital bed occupancy (how much time in that month the available beds are full).
The number of pressure ulcers is then divided by the number of bed days to give us rate per bed day. This will often be a very small figure. The number is then multiplied by 1000 to give a result per 1000 bed days as reflected.
NEAR MISS RATES
* Reported as a rate per 1000 patient days
Near misses are events or errors that potentially could have resulted in harm to patients but were prevented prior to their reaching the patient and resulting in harm.
What we measure?
An example of a near miss in a hospital setting is illustrated in the following scenario. A patient may need a blood transfusion and when the blood that has been delivered for a patient is checked the nursing staff pick up that the initials on the blood labels do not match those of the patient. Incorrect transfusion could have resulted in patient harm however the error was picked up prior to harm reaching the patient.
What a result of 1.2 means:
If a patient were to stay in hospital for a thousand days there would be 1.2 near misses within that 1000 day period.
To get to the number in the result, the total number of near misses in the hospital is counted. The bed days of a hospital are then calculated by reviewing the hospital bed occupancy (how much time in that month the available beds are full).
The number of near misses is then divided by the number of bed days to give us rate per bed day. This will often be a very small figure. The number is then multiplied by 1000 to give a result per 1000 bed days as reflected.
ANTIMICROBIAL STEWARDSHIP
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