Monday, 24 August 2015

Appropriateness of care in Australian hospitals is where art and science merge

Professor Joseph Ibrahim from SPHPM’s Department of Forensic Medicine has discussed new research by the Grattan Institute on appropriateness of care in Australian Hospitals recently published in the Medical Journal of Australia.

The study used routine hospital admission data (2010-2011) to find that an average of five different procedures that are not supported by clinical evidence happen more than 100 times a week, and there is great variation in hospital-specific rates of procedures that should not be done routinely.

The study is the first of its kind to quantify the extent of inappropriate care in Australian hospitals for a range of conditions.

Professor Ibrahim’s editorial observes the contemporary debate and concerns about patient safety and quality health care; and declares the findings of this new research a ‘call for action’ for medical practitioners and policy makers to engage in a sophisticated response to improve incidences of inappropriate care in Australian hospitals.

“Appropriateness of care is quintessentially where the art and science of medicine merge, where balancing the logic of evidence with the personal values of each individual patient leads to variation in care. However, personalised care does not justify inappropriate care,” Professor Ibrahim said in his editorial.

He said the study was a reminder that we still don’t have answers for ensuring high quality of care in hospitals, and as a result there is the potential for inadvertent adverse consequences.

“Instead of feeling disheartened we should embrace this opportunity to address appropriateness of care and be engaged and encouraging in our efforts to seek out the underlying factors and new solutions,” Professor Ibrahim wrote.

He went on to suggest incorporating the science of performance measurement with the science of human factors; a branch of applied science that draws on psychology, engineering, computing science, education, ergonomics and anthropology to improve patient care.

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