Clinical Quality and Safety 

Our Performance in Clinical Safety and Quality

Ramsay Health Care's performance in patient safety and quality care is the highest priority for us as an organisation. We use clinical and patient experience data to identify high performance, evaluate how reliable and consistent patient experiences are, to reduce unwarranted variation and to drive opportunities for improvement. We translate clinical data into current outcomes, trends over time and evaluate improvement opportunities. Most importantly we are transparent and strive to provide you the patient with the information you need to make an informed decision that is right for you.

In order to measure our performance and truly know how our performance translates to patient outcomes and experience we need to gather information from a range of sources. For example, we gather data from clinical incident reporting, clinical outcomes, audits, patient experience surveys, patient feedback, clinical registries and clinical indicator sets that compare standardised outcomes both internally and externally (benchmarking).

Here at Ramsay Health Care we have robust processes to ensure clinical outcome data is reviewed in time frames relative to the risk, the greater the risk the more frequently and immediate our review. We have systems that ensure information is escalated to the highest level of the organisation if they pose an imminent risk to patients' safety. Otherwise we review clinical performance at monthly, quarterly and half yearly intervals. Here at RHC we also have systems to ensure patient outcome data is cascaded down to our frontline staff as well as escalated up to the highest levels of governance of the organisation.

Initiatives to improve your care

Coming to hospital for mental health care

To assess the improvement in a patient’s mental health, Ramsay Health Care uses the HoNOS (Health of the Nation Outcome Scales) which is an internationally recognised scale to measure progress of health and social functioning of people with a mental disorder. The HoNOS was specifically designed for use in general adult mental health services. On admission, and again prior to discharge, the patient's mental health is assessed. A decrease in the score on discharge indicates that there has been improvement in the patient's mental health since their admission.

To assess the improvement in a patient’s mental health, Ramsay Health Care uses the MHQ-14 (Mental Health Questionnaire), which is an internationally recognised scale. The MHQ–14 is a patient self–report measure consisting of items that address symptoms of fatigue, anxiety and depression and the impact of those symptoms on social and role functioning. On admission and again prior to discharge, the patient assesses their mental health status. An increase in the score on discharge indicates that the patient has noted an improvement in their mental health conditions since their admission.

HoNOS Score (A lower score on discharge is better)

MHQ-14 (A higher score on discharge is better)

Falls

The risk of falling increases according to age; with data suggesting that one third of people over the age of 65 years have one or more falls a year. Falls can occur at all ages, though the frequency and severity of fall-related injuries increases significantly with age. These injuries can include minor skin abrasions, joint dislocation, fractures and head injuries. These injuries may result in hospitalisation or an increased length of stay in hospital.

The risk of falling can greatly increase when admitted to hospital due to a range of factors including: illness and unsteadiness, adapting to a new environment, the introduction of new medications and walking in unsafe footwear or slippers.

What Ramsay Health Care does to reduce your risk

In 2015, Ramsay Health Care increased the focus on falls prevention in hospitals by appointing a National Falls Prevention Advisory Group. This group has standardised the approach to falls prevention across all Ramsay hospitals by targeting a structured risk assessment, policy and guidelines, equipment for falls prevention and clinical staff education.

Our hospitals use a number of strategies to prevent falls and these include: targeted hourly rounding of patients identified as high risk of falling; ensuring that call bells and personal items are within patient reach; call bells are answered promptly, and patients are assisted to the toilet at regular intervals. In addition, Ramsay Health Care has purchased low beds, falls mats, and patient alarms to minimise the risk of patients falling whilst in our hospitals.

What you can do to reduce your risk

Falls can be a major cause of injury.  We want to protect you from a fall during your hospital stay and you can help by:

• Becoming familiar with your surroundings
• If you need help, use the call bell to alert staff
• Wear supportive, flat, non-slip shoes – do not walk around in socks or pressure stockings (TED stockings)
• If you use glasses, hearing aids, a walking stick or walker, keep them in easy reach by the bedside, use the call bell to ask staff to assist you

Falls indicators are reported as a percentage of all patient days during the period. Ramsay Health Care participates in the Australian Council on Healthcare Standards (ACHS) Clinical Indicator Program and use their definitions for these indicators. The indicators are calculated by dividing the number of inpatient falls that meet the indicator criteria by number of days for all patients who were admitted.

Medications

Medicines are commonly used to treat a variety of conditions in the healthcare setting, and therefore, it is important to measure the risk of errors. Ramsay Health Care has a very low rate of medication errors due to its implementation of a range of medication safety strategies.

What Ramsay Health Care does to reduce your risk

Ramsay Health Care takes all medication errors very seriously. We encourage staff to report all medication errors as incidents, no matter how minor they may seem. All medication incidents are investigated and actioned and any serious medication incidents are investigated thoroughly and monitored by Ramsay’s National Clinical Governance Unit.

In addition, Ramsay Health Care has medication administration policies and processes in place which have been developed using best practice principles.

The Australian Commission on Safety and Quality in Health Care has introduced safety initiatives for medication administration and reconciliation and Ramsay Health Care has adopted these strategies.

What you can do to reduce your risk

We encourage you to be involved in the management of your medicines, if you have any concerns please discuss this with your doctor, pharmacist or nurse.

It is important during your stay with us that we know what medicines you are taking. Our doctors, pharmacists and nurses will ask you about the medications you take at home, including any complementary or alternative therapy medicines, for example vitamins, nutritional supplements, homeopathic medicines, Chinese or Ayurvedic medicines and Australian indigenous medicines. 

It is important you advise the staff of any allergies you have experienced or any reactions you have had to medicines taken in the past.

The serious medication error indicator is reported as a percentage of all patient days during the period. Ramsay Health Care participates in the Australian Council on Healthcare Standards (ACHS) Clinical Indicator Program and use their definitions for this indicator. It is calculated by dividing the number of patients who require medical intervention as a result of a medication safety incident by number of days for all patients who were admitted.

Hygiene and Infection indicators

We aim to minimise the risk of infection to patients, staff and visitors that come to our hospitals across Australia. Our infection rates have been consistently below the industry benchmark.

What Ramsay Health Care does to reduce your risk

Ramsay Health Care has a programs in place to detect and prevent infections that are common within health care hospitals. Visitors to Ramsay hospitals are encouraged through appropriate signage to use antiseptic hand rub located throughout our hospitals.

What you can do to reduce your risk

There are several ways you can assist in preventing an infection:

• Always wash your hands after using the toilet, bedpan or a commode
• Wash or clean your hands before eating
• Don’t be afraid to ask your doctor or staff caring for you, if they have washed their hands
• Avoid touching your wound or devices (for example fluid tubes into your arm or drain tubes)
• Let the care staff know if your wound or areas around any of the lines or tubes become red or swollen or painful
• Discourage visitors who may be feeling unwell
• Stop smoking before any surgery, as smoking increases the risk of infection

One of the most effective ways to prevent infection spreading amongst patients is for all health professionals to wash their hands. Hand hygiene is conducted in accordance with the ‘five moments’ that is; before touching a patient; before a procedure; after a procedure; after touching a patient; and after touching a patient’s environment.

Ramsay Health Care participates in the national hand hygiene strategy through Australian Commission on Safety and Quality in Health Care, and Hand hygiene audits are conducted three times per year.

Hand hygiene compliance is reported as the percentage of correct moments from all observed moments.