Fourth Atlas 2021 - General recommendations

7a. Governing bodies to prioritise review of audit data, consistent with Action 1.28 of the National Safety and Quality Health Service (NSQHS) Standards for the following topics:

i. Early birth

ii. Tonsillectomy and myringotomy

iii. Lumbar spinal surgery

iv. Gastroscopy and colonoscopy.

7b. Health service organisations to promote documentation in the healthcare record of a patient’s diagnosis, or provisional diagnosis, in relation to their investigation and management. This can be used to improve the appropriateness of care, and should be communicated to the patient to increase their understanding of their care.
 

7c. The Commission to identify priority areas for development of nationally agreed, specialty-specific clinical quality and appropriateness indicators, and work with clinical colleges, professional societies and jurisdictions to develop these.

7d. Clinical colleges and professional societies to mandate clinical audit, using agreed specialty-specific indicators where these exist, as a requirement of continuing professional development.

7e. Clinical quality registries:

i. As part of their governance framework, all clinical quality registries to include sets of indicators for quality and appropriateness of care, to be used for clinical audits at a health service organisation and clinician level

ii. To provide health service organisations and clinicians with regular reports showing their data for these indicators and how their data compares with data from other services

iii. To develop and publish their indicator sets in METeOR (National Metadata Online Registry).
 

7f. Health service organisations to:

i. Require clinicians to participate in data collection and quality improvement activities of relevant clinical quality registries, with the aim of improving patient outcomes

ii. Ensure that data and analyses from clinical quality registries are used efficiently in clinical peer review meetings; that records are kept of these meetings, including the clinicians who have attended them and any actions that are being taken to improve care as a result of the discussions; and that the results are reported to and reviewed by the organisation’s governing body as part of the clinical governance framework. 

7g. The Australian Government Department of Health to develop guidance for Primary Health Networks about the development of nationally consistent Health Pathways, aligned with the Commission’s clinical care standards.

7h. The Australian Government Department of Health’s health workforce unit to:

i. Map the specialist medical workforce by geographical area

ii. Quantify the supply of newly trained specialists entering the workforce, by geographical area

iii. Work with clinical colleges to understand projected specialty workforces

iv. Map the current workforce by clinical specialty (including nursing, midwifery and allied health) relevant to priority clinical conditions to identify where there are areas of over and undersupply. Mapping the workforce for non-surgical management of back pain (e.g. physiotherapy, chronic pain management) should be a priority v. Develop strategies to prevent oversupply in particular geographical areas, with the objective of building capacity in rural and remote areas (rather than fly-in-fly-out arrangements) and reducing the personal and financial cost of population exposure to low value care driven by oversupply.

7i. The Commission to recommend validated Patient reported outcome measures (PROMs) for:

i. Pregnancy and childbirth

ii. Low back pain.