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 them here. This will drive further improvements in our hospitals 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 different components of care that need to be assessed when it comes to 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 that good quality care is given consistently, as well as to highlight areas for improvement within hospitals.
WHERE DO THE RESULTS COME FROM?
The data that is used to measure clinical performance in Mediclinic comes from a number of sources. These include 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 Centers 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, it is not possible to assume that the results are then directly comparable.
Mediclinic strives to support the identification and reporting of hospital events accurately and some of the indicators included on 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.
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 hospital.
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 when they occur”. (Angood et al, 2009)
Instilling a patient safety culture is imperative in order to achieve this. Establishing a patient safety culture starts with the collaboration of caregivers 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. If these aren’t measured, further conversation, investigation and ultimately quality improvement would not be possible.
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 hospital’s care provision and processes.
- Optimising accountability in care delivery and driving further hospital-based improvement.
It is important to bear in mind that an elevated result should not be looked at in isolation. Clinical performance results will often act as a ‘smoke alarm’ for when further analysis is needed and therefore forms part of a bigger picture of performance assessment and improvement.