In November 2009, Health Ministers endorsed Commission’s recommendation that hospitals routinely monitor and review a succinct set of indicators.These hospital-based outcome indicators can be generated by jurisdictions or private hospital ownership groups, which hold the source data, and reported back to provider facilities. The safety and quality value lies in developing the report-review-act cycle based on the routine supply of timely and targeted data back to hospitals. A number of jurisdictions are already undertaking a similar process with many of the same indicators.
The core, hospital-based outcome indicators recommended for local generation and review are:
CHBOI 1 Hospital standardised mortality ratio (HSMR)
CHBOI 2 Death in low-mortality Diagnosis Related Groups (DRGs)
CHBOI 3 In-hospital mortality for:
a) acute myocardial infarction (AMI)
c) fractured neck of femur, and
CHBOI 4 Unplanned/unexpected hospital readmission of patients discharged following management of:
a) acute myocardial infarction (AMI)
b) knee replacements
c) hip replacements
d) paediatric tonsillectomy and adenoidectomy
CHBOI 5 Healthcare associated Staphylococcus aureus bacteraemia (SAB)
CHBOI 6 Clostridium difficile infection (CDI).
Updated in 2015, the National core hospital-based outcome indicators specification is available for download. The specification is complemented by the CHBOI Toolkit which is used for local generation of CHBOI. The toolkit includes SAS code, technical notes to accompany SAS code, nationally generated coefficients and reference sets.
The CHBOI Toolkit has not been validated and is designed as a screening tool for internal safety and quality improvement. It is not intended to be used as a performance measure.
For more information about the CHBOI toolkit please email firstname.lastname@example.org
To download the CHBOI toolkit please and complete the agreement. You will also be asked for your contact details which will be kept to inform you of future updates. You will then be sent a link to your nominated email address to access the toolkit.
Melbourne Health has recently completed a literature review for the Commission. The Hospital Mortality Literature Review examines the usefulness and limitations of hospital mortality indicators. It is comprised of three parts, the body of the literature review, international case studies (Canada, United Kingdom, United States) and relevant appendices. The review focused on literature from 2010-2013.
Hospital Mortality Indicator Literature Review (PDF 831KB) (Word 563KB)
Hospital Mortality Indicator Case Studies (PDF 6.96MB) Part 1 (Word 11MB) Part 2 (Word 7MB)
Hospital Mortality Indicator Appendices (PDF 4.41MB) (Word 10MB)
To support local interpretation and use of hospital mortality indicators, the Commission has developed a publication Using hospital mortality indicators to improve patient care: A guide for Boards and Chief Executives (the Guide).
The Guide has been prepared for Boards and Chief Executives of hospitals and Local Hospital Networks (LHNs). It provides information on how hospital mortality indicators can be used to screen for potential safety and quality issues through existing clinical governance processes.
1.1 The Core hospital-based outcome indicators Toolkit (v3.0 and any subsequent versions) (CHBOI Toolkit) consists of the following four elements:
2.1 Copyright and other intellectual property rights in the CHBOI Toolkit are owned by the Australian Commission on Safety and Quality in Health Care (the Commission).
2.2 You are granted a royalty-free, non-exclusive licence to use, reproduce, modify and adapt the CHBOI Toolkit solely for the following purposes (the Permitted Purposes):
2.3 For the avoidance of doubt, you acknowledge that this licence to use the CHBOI Toolkit does not permit:
2.4 In using the CHBOI Toolkit, you must not use the Commission’s branding or logo without our written consent.
3.1 You agree, in relation to the use of the CHBOI Toolkit:
4.1 You acknowledge that the CHBOI Toolkit:
4.2 The Commission gives no warranty and makes no representation as to the accuracy, completeness or quality of the CHBOI Toolkit, or its suitability for your particular circumstances.
4.3 You use the CHBOI Toolkit at your own risk.
4.4 The CHBOI Toolkit should not be used as a mechanism for payment.
5.1 You waive any right to make a claim against the Commission in respect of any loss or damage however caused, which may be incurred or which may arise directly or indirectly in respect of your use of, or reliance on, the CHBOI Toolkit.
5.3 The right of the Commission to be indemnified under this clause is in addition to, and not exclusive of, any other right, power or remedy provided by law, but the Commission is not entitled to be compensated in excess of the amount of the relevant cost, liability, loss, damage or expense.
6.1 The Commission may amend the CHBOI Toolkit at any time, including adding or removing features, or may suspend provision of the CHBOI Toolkit.