Clinical variation is a difference in healthcare processes or outcomes, compared to peers or to a gold standard such as an evidence-based guideline recommendation.
Variation in itself is not necessarily bad, and it can be good if it reflects health services responding to differences in patient preferences or underlying needs. When a difference in the use of health services does not reflect these factors, it is unwarranted variation and represents an opportunity for the health system to improve.
The Commission has developed the Atlas series and a number of related programs to support policy makers, health services and clinicians to monitor for variation in health care and identify opportunities for improvement.
Australian Atlas of Healthcare Variation series
The Australian Atlas of Healthcare Variation series illuminates variation by using data to map the use of health care according to where people live. Each Atlas identifies specific achievable actions for exploration and quality improvement.
NSQHS Standards: Action 1.28 on clinical variation
The value of monitoring clinical variation is now reflected in the National Safety and Quality Health Service (NSQHS) Standards. Developed by the Commission in collaboration with the Australian Government, states and territories, the private sector, clinical experts, patients and carers, the NSQHS Standards aim to protect the public from harm and to improve the quality of health service provision.
The Clinical Governance Standard: Action 1.28 variation in clinical practice requires health service organisations to have systems in place that use data to monitor variation in care to identify unwarranted variation and to regularly review and improve the appropriateness of clinical care.
User Guide for the Review of Clinical Variation in Health Care
The Commission has developed a NSQHS Standards User Guide for the Review of Clinical Variation in Health Care to support health service organisations implement Action 1.28 of the NSQHS Standards. The User Guide explains how health services can work with their clinicians and use data to improve the appropriateness of clinical care. It describes six key steps for implementing Action 1.28, includes practical case studies and provides a wide range of resources to support health services review clinical variation.
Healthcare Variation and the Clinical Care Standards
In response to findings from the Atlas series, the Commission has developed several Clinical Care Standards (CCS). CCS are statements that describe the care patients should be offered by health professionals and health services for a specific clinical condition or defined clinical pathway in line with current best evidence. These include the Cataract CCS, Colonoscopy CCS, Heavy Menstrual Bleeding CCS, Osteoarthritis of the Knee CCS and the Third and Fourth Degree Perineal Tears CCS.
Better Care Everywhere: healthcare variation in practice program series
The Better Care Everywhere program series is the first online program of its kind dedicated to reducing unwarranted variation in clinical care across Australia. Under the program, a series of online presentations and webinars with live Q&A sessions will feature high profile healthcare experts and clinicians. This program replaces the face-to-face conference of the same name.