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  4. Getting It Right the First Time

Getting It Right the First Time

Getting It Right the First Time

At EMHS we want to get it right the first time and ensure the patients and consumers we care for are back to being healthy people as soon as possible.

To help us do this, we are committed to listening to the patient voice when looking at ways to improve our services.

Unplanned Readmissions for Selected Surgical Procedures

‘Readmissions to hospital within 28 days of discharge’ is an indicator of how well we are achieving our objective to provide universal access to services that are coordinated and provide continuity of care.

By measuring and monitoring this indicator, the level of potentially avoidable hospital readmissions can be assessed in order to identify key areas for improvement. This in turn can facilitate the development and delivery of targeted care pathways and interventions, which can help to ensure effective restoration to health and improve the quality of life of Western Australians.

Unplanned and unexpected hospital readmissions within 28 days rates are provided for the following surgical procedures:

  • knee replacement
  • hip replacement
  • tonsillectomy & adenoidectomy
  • hysterectomy
  • prostatectomy
  • appendicectomy.

Measuring unplanned readmissions for selected surgical procedures

Readmission rate is considered a global performance measure, as it potentially points to deficiencies in the functioning of the overall healthcare system. Good intervention, appropriate treatment together with good discharge planning will decrease the likelihood of unplanned hospital readmissions. A low unplanned readmission rate suggests that good clinical practice is in operation. These readmissions necessitate patients spending additional periods of time in hospital as well as utilising additional hospital resources.

The benchmark in each of the following categories is based on the best state-wide result within the five calendar years from 2012 – 2016.


Knee replacement

How do we measure up

The graph below shows the unplanned readmissions for selected surgical procedures rate for Armadale Health Service.

Chart: Unplanned readmissions of patient discharged following management of knee replacement


What the figures mean

This indicator counts the number of times patients have needed re-admission to hospital within 28 days of discharge after having had a knee replacement.

The benchmark is less than or equal to 23 readmissions for every 1,000 discharges, or about 1 in 43. A rate lower than the benchmark is desirable.

AHS results have been below the benchmark in all of the last 4 quarters for the period October 2020 to September 2021.


Hip replacement

How do we measure up

The graph below shows the unplanned readmissions for selected surgical procedures rate for Armadale Health Service.

Chart: Unplanned readmissions of patient discharged following management of hip replacement


What the figures mean

This indicator counts the number of times patients have needed re-admission to hospital within 28 days of discharge after having had a hip replacement.

The benchmark is less than or equal to 17.1 readmissions for every 1,000 discharges, or about 1 in 58. A rate lower than the benchmark is desirable.

AHS results have improved and have been highly performing below the benchmark for all 4 quarters.


Tonsillectomy and adenoidectomy

How do we measure up

The graph below shows the unplanned readmissions for selected surgical procedures rate for Armadale Health Service.

Chart: Unplanned readmissions of patient discharged following management of tonsillectomy and adenoidectomy.


What the figures mean

This indicator counts the number of times patients have needed re-admission to hospital within 28 days of discharge after having had a tonsillectomy or adenoidectomy.

The benchmark is less than or equal to 81.8 readmissions for every 1,000 discharges, or about 1 in 12. A rate lower than the benchmark is desirable.

AHS results have been above the benchmark in 2 out of the last 4 quarters for the period October 2020 to September 2021. These results represent very small case numbers, patients are often managed conservatively, being readmitted as a precaution with minor post-operative bleeding.


Hysterectomy

How do we measure up

The graph below shows the unplanned readmissions for selected surgical procedures rate for Armadale Health Service.

Chart: Unplanned readmissions of patient discharged following management of hysterectomy.


What the figures mean

This indicator counts the number of times patients have needed re-admission to hospital within 28 days of discharge after having had a hysterectomy.

The benchmark is less than or equal to 42.3 readmissions for every 1,000 discharges, or about 1 in 24. A rate lower than the benchmark is desirable.

AHS results have been above the benchmark in 2 out of the last 4 quarters for the period October 2020 to September 2021. While these results represent very small case numbers, several quality improvement actions have been identified from individual case reviews.


Prostatectomy

How do we measure up

The graph below shows the unplanned readmissions for selected surgical procedures rate for Armadale Health Service.

Chart: Unplanned readmissions of patient discharged following management of prostatectomy.


What the figures mean

This indicator counts the number of times patients have needed re-admission to hospital within 28 days of discharge after having had a prostatectomy.

The benchmark is less than or equal to 36.1 readmissions for every 1,000 discharges, or about 1 in 28. A rate lower than the benchmark is desirable.

AHS results have been below the benchmark in 3 of the last 4 quarters for the period October 2020 to September 2021. AHS review individual cases to identify any common factors that can be addressed to improve care.


Appendicectomy

How do we measure up

The graph below shows the unplanned readmissions for selected surgical procedures rate for Armadale Health Service.

Chart: Unplanned readmissions of patient discharged following management of appendicectomy.


What the figures mean

This indicator counts the number of times patients have needed re-admission to hospital within 28 days of discharge after having had appendicectomies.

The benchmark is less than or equal to 25.7 readmissions for every 1,000 discharges, or about 1 in 39. A rate lower than the benchmark is desirable.

AHS results have been consistently below the benchmark in all of the last 4 quarters for the period October 2020 to September 2021.

Complaints Numbers and Actions Taken

Listening to and acting on feedback from our patients, their families and their carers about our health services is one of the most important aspects of delivering high quality care.

Complaints about provision of health care services can be made by anyone who has contact with our services. People who complain often have some basic expectations, they want to:

  • be heard and understood
  • be respected
  • be taken seriously
  • be given support or assistance if required
  • have their concerns dealt with effectively and efficiently
  • be informed of the process, progress, findings and outcome
  • have appropriate action taken as a result of their complaint.

Communication issues underpin most complaints we receive, and most people who submit a complaint are simply looking for an explanation or apology. Another common motivation behind complaints is to prevent the same thing happening to others. This is why acknowledging complaints promptly and letting people know what's been done to prevent it happening again is so important.

The complaint management process is not intended to apportion blame but strives to resolve the complaint, if possible, and identify any aspects of service delivery which require change in order to effect improvement.

Measuring complaints numbers and actions taken

The Health and Disability Services Complaints Act 1995 and Regulations 2010 legislate for the annual provision of information relating to complaints received by the health service provider, and action taken, to the Health and Disability Services Complaints Office.

The key issues associated with a complaint about our health service are determined by EMHS staff in discussion with the person making the complaint. Identifying the issues in the complaint provides for effective resolution and allows all parties to have an understanding of the issues raised. Each complaint received must have at least one complaint issue identified, with the possibility for multiple issues to be identified in one complaint. Similarly each complaint will have at least one resolution achieved, with the possibility of multiple resolutions being achieved for one complaint.


Complaints rate

How do we measure up

The graphs below show the combined complaints numbers for Armadale Health Service.

Chart 1: Complaints rate per 1,000 bed days.

What the figures mean

This graph shows the rate of complaints for Armadale Health Service for the period July 2020 to June 2021. AHS encourages consumers to provide feedback on the care they receive and uses the feedback to continuously learn and improve the services they deliver.


Complaint issues

How do we measure up

The graph below shows the combined ‘top three’ categories of complaint issues for Armadale Health Service.

Chart 2: ‘Top three’ categories of complaint issues.

What the figures mean

The three most common categories of complaint issues were ‘Quality of clinical care’, ‘Access’ and ‘Communication’. Between them, these accounted for about 70% of all issues.


Complaint resolutions

How do we measure up

The graph below shows the combined ‘Top three’ resolutions to complaints for Armadale Health Service.

Chart 3: Complaint resolution.


*Note: One complaint may have more than one resolution, so the count of resolutions may be greater than the number of complaints.

What the figures mean

The most common resolution of complaints was Apology provided and Concern registered to assess if there is a common issue which needs to be addressed, especially if reoccurring.

Last Updated: 28/06/2022
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