Complication rates one in four for overnight hospital stays

Disturbing report details the secret dangers in our hospitals.

Make sure you need that surgery

Alarm bells are ringing over the safety of Australia’s hospitals following the release of a report that finds one in every nine patients – or about 900,000 patients every year – suffers a complication that is solely attributable to the hospital. If the surgery requires an overnight stay, the complication rate jumps to one in four.

A Grattan Institute report, released this week, documents the key reasons behind the disturbing figures, and names the culprits responsible for a lack of progress in improving safety.

The report, All complications should count: Using our data to make hospitals safer, states that the public has a right to know which are the best and worst performing hospitals in order to make informed decisions on where to undergo specific procedures. One facility may be better for heart operations, another for knee replacements.

The report says a “veil of secrecy” protects the poor performers, hinders patients’ decision-making and obstructs motivation for hospitals to lift their performance. The hospital safety statistics are collected, but bewilderingly are kept secret from patients, doctors and hospitals.

Media reports in the past 18 months have focused on a cluster of baby deaths at Bacchus Marsh Hospital in Victoria, the death of a boy in Frankston Hospital after he was given food despite staff being told he had allergies, and a sponge left inside a patient at Poplars Private Hospital in Sydney. Mistakes that could have been prevented.

“The additional risk of a complication at the worst-performing hospitals can be four

times higher than at the best performers,” the report finds. “If all hospitals lifted their

safety performance to the level of the best 10 per cent of Australian hospitals, the complication rate across the nation would fall by more than a quarter.”

“This has to change,” the report says. “Patients have a right to know the data on complication

rates in different hospitals and for different procedures, so they – and their GPs – can make better-informed decisions about how and where they are treated. Doctors and hospitals need to know how they are performing compared to their peers, so that they can learn from the best-performing hospitals and clinicians.”

Key recommendations include:

  • State and territory governments should set goals for reducing complication rates in public and private hospitals. They need to ensure the data is published widely so that patients and taxpayers can see which hospitals are improving and which are not.
  • Government should release detailed data on the performance of all hospitals, detailing the catastrophic to less harmful complications.
  • Private health insurers should release the information they gather on private hospitals; lower complication rates would mean quicker recoveries and lower premiums for their members.

Grattan Institute Health Program Director Stephen Duckett says: “Australians expect all hospitals to provide high-quality and safe care, but this report reveals that some hospitals achieve much better results than others.

“The reforms we recommend could cut the complication rate in Australian hospitals by more than a quarter.”

Opinion: We have a right to know which hospitals are safest

I can shop around on assorted websites for the best energy deals and interest rates. I can check the star ratings and reviews on AirBnB apartments before I book. I can go to TripAdvisor to find good restaurants and tours. I can leave feedback about Uber drivers.

But if I want to find a good doctor or the best hospital, I’m totally in the dark.

Information on which hospitals have the best records in terms of patient complication rates is collected but I can’t access it; hospitals can’t access it.

It’s extremely valuable, but it is not shared with the key parties.

Patients can’t ‘keep the bastards honest’, so to speak, by taking their business to the best performers; hospitals cannot learn best practice policies from their high rating peers.

A Grattan Institute report, All complications should count: Using our data to make hospitals safer, has found that one in nine patients who go into hospital in Australia suffers a complication, with that figure rising to one in four if an overnight stay is involved.

If all hospitals could duplicate the safety records of the top 10 per cent of hospitals, then an extra 250,000 patients would head home each year free of complications, the report says.

Hospitals and doctors must be permitted to access the Australia-wide complication rates data so they can learn from the best and improve in areas that need attention.

Patients must be permitted to shop around for the best care, to vote with their feet and head to the hospital they believe is most likely to send them home complication free. If there is one motivator that really works, it is the dearth of customers. Publish the figures annually and it would be easy to see who has lifted their game and who hasn’t.

Data is also collected, though again is not available to the general public, on which hospitals are best in specific areas of surgery. For instance, hospital A might be at the top of the heap in terms of hip replacements, while hospital B might be the jewel in the crown for heart bypass procedures. We deserve to know this information.

Private health insurers collect data on private hospitals but they, too, do not share with the public or between hospitals. As the report states: “Reducing complication rates would mean quicker recoveries and lower premiums for their members.” Lower premiums – another win for the consumer.

The report recommends a series of reforms – from more transparency to sharing data to learning from the best. It is up to state and territory governments to take heed.

We accept that any surgery involves risk, but when that risk is magnified by poor hospital procedure, we need to know. It could be a matter of life and death.

Do you have confidence in our hospital system?

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    COMMENTS

    To make a comment, please register or login
    Chris B T
    6th Feb 2018
    10:17am
    This post is only on "Reported" mishaps.
    All mishaps should be recorded, then you will have a Truer RECORD of these events.
    (;-(
    Anonymous
    6th Feb 2018
    3:05pm
    Doctors and surgeons bury their mistakes.
    VeryCaringBigBear
    6th Feb 2018
    4:12pm
    Overheard a doctor telling a cancer patient that he had survived 13 years which was more than most so he should be grateful. Cancer patient was not impressed at all since he felt the doctor was not doing all he could to help him keep the disease at bay.
    Chris B T
    7th Feb 2018
    10:24am
    Hospitals have more than just Doctors working in them.
    All could potentially be causing harm to you.
    (;-(#)
    Rosret
    6th Feb 2018
    11:12am
    Absolutely there should be listings. Remembering that when people present to hospital they are sick and sometimes its very urgent to quick assumptions often have to be made.
    However the medical profession are people. People are fallible and sometimes tired and over worked.
    Yet the medical professions track record can be improved if "the god" attitude is removed and they start operating as pilot crew are trained.
    Accidents can be lowered if the medical profession follow procedures - every time. They need a check list and they need a backup check.
    I know two instances where too tight constriction socks were put on patients. Both complained and were in agony all night but the staff made them keep them on as there were no larger sizes. One of the patients got gangrene. How simple a fix would that have been.
    1. Check supplies and reorder. 2. Check the patient is not suffering. 3. Refer to attending doctor if there is no stock and the socks are too tight. 4. Allow the patient to refuse item or medication if it causes adverse affects. 5. Allow patient to sign a document agreeing to refuse a specific item or medication.
    HarrysOpinion
    6th Feb 2018
    11:12am
    No confidence at all. It all seems like 'pot-luck'. You may get a good nurse or a doctor or a bad one. What the hell were they doing to me at 3 am in ICU without 1) waking me up first 2) explaining what they were doing 3) getting my consensus to proceed ???? How many other patients have encountered similar? How many unauthorised tests do these smart alec doctors at hospitals proceed? Are they real doctors or perverts that enter hospitals without any security checks?
    VeryCaringBigBear
    6th Feb 2018
    11:44am
    If a doctor doesn't ask before touching you you have them up for assault. No one is allowed to touch you without your permission.
    Anonymous
    6th Feb 2018
    3:06pm
    The Health system is going to pot because of the bungling, idiotic Li(e)beral Party and their Hillbilly mates.
    Blossom
    7th Feb 2018
    11:15pm
    Not all patients are able to respond in a way that is understandable. An unauthorised test may save your life. It is not always easy to wake a patient. I know one person in particular who is very hard to wake as he is a very heavy sleeper. You can even tickle his feet and it won't work unless you get exactly the same spot - then his leg jerks quite violently so don't be standing in the wrong place.

    I had a very unfortunate case whether to proceed with treatment which would help with pneumonia but wouldn't improve quality of life because of advanced terminal kidney failure for an immediate relative. The patient also had Dementia and was deaf so she then had no quality of life. As all they could do was keep her comfortable regards of any other treatment available I opted for Palliative Care. She had slept through lunch and dinner something she had never previously done. She had started getting very tired from being showered and occasionally was late eating her lunch but on this particular night it was extremely difficult to wake for her evening medication and some food to eat with it. She managed only a few teaspoons of custard, and she had previously been a good eater.and for the first time she couldn't sit up without being held. That was how quickly she suddenly deteriorated. During the time she was in Palliative Care (4 days) she only woke up briefly on 2 occasions. She didn't even stir when the sponged bathed her or rolled her from one side to the other.
    BrianP
    6th Feb 2018
    12:29pm
    And they wonder why so many people don't trust hospitals or surgeons.

    What is this government going to do to make this info available? (if nothing = No vote).
    Chrissy L
    6th Feb 2018
    12:41pm
    Following treatment in a private hospital for kidney stones I was discharged and sent home. Still feeling ill I went back to the Specialist who told me to go home and take Panadol. Feeling worse I went to my GP who put me on a antibiotic drip in his surgery until I could be readmitted to hospital. I had Septicemia and spent the next week in hospital being treated with heavy antibiotics. I could have lost my life. These type of situations need reporting so people can make an informed choice on who by and where they are treated.
    Rosret
    6th Feb 2018
    4:47pm
    ...and isn't it the most expensive script for Panadol you have ever had! I hear you.
    greygeek
    6th Feb 2018
    1:47pm
    I am in need of surgery in different areas, however, due to past experiences refuse to undergo any more operations! Why? Four times over the years, I have contracted post operative MRSA (Golden Staph). Despite constant testing I am not a carrier of the super bug. Each episode has required another admission post op to hospital for 7 - 10 days on antibiotics, now I am allergic to penicillin! 4 procedures, 4 different hospitals, 4 different surgeons!! I firmly believe it is a lack of hygiene on the ward. Even though there is a dispenser of hand sanitiser outside the door of every room, I have noticed staff do not always use it between patients. It could also be present in a room from a previous patient or neglectful cleaning! I have totally destroyed knees and saw an Infectious Diseases expert who advised that I would need to be hospitalised for 5 weeks in total, connected to a iv drip, oral, and injected antibiotics pre and post op and there would still be no guarantee I would not contract the bug! Yet, I am not a carrier! The medical professionals and the public need to know what is wrong with the system!
    Rae
    6th Feb 2018
    2:57pm
    MRSA killed my Dad but the death certificate listed the cause as cancer. I don't believe the figures.
    Anonymous
    6th Feb 2018
    3:09pm
    There needs to be a variety of hand sanitizers. The normal pinl Avagaard I'm allergic to.
    VeryCaringBigBear
    6th Feb 2018
    4:07pm
    Hand sanitizers don't work anywhere near as well washing in soap and water for at least 30 seconds.
    VeryCaringBigBear
    6th Feb 2018
    2:41pm
    If I am in hospital no one touches me before washing their hands in soap and water and I check all medication including seeing the package before taking anything. No pills in small white cups for me.
    Anonymous
    6th Feb 2018
    3:10pm
    Wise. Most nurses use new gloves as well.
    VeryCaringBigBear
    6th Feb 2018
    4:06pm
    Watch those mobile too. If they answer them then ask them to wash their hands again as they are one of the biggest carrier of infection bugs.
    Rosret
    6th Feb 2018
    4:50pm
    Very wise Bigbear. ...and touch as little as possible.
    KB
    6th Feb 2018
    3:04pm
    If you have a heart attack or stroke you will be sent to the hospital that has heart and stroke units. Patients does not always get to choose Mishaps can occur owing to non English doctors.

    6th Feb 2018
    3:05pm
    Question: "What's the difference between God and a doctor?"
    Answer: "God doesn't think he's a doctor."

    Doctors have a God complex.

    6th Feb 2018
    3:12pm
    The LNP is the main cause for our deteriorating health system. They've underfunded it to death.
    Anonymous
    6th Feb 2018
    5:05pm
    Oh, well done Knows-a-lot, somehow you have managed to take what is wrong with how doctors and nurses treat patients into a political statement. Again I ask, where is your proof for your allegation.
    Nan Norma
    6th Feb 2018
    6:38pm
    My husband landed in ICU after what should have been a straight forward operation. Apart from one male nurse, the others were totally useless.
    Rosret
    7th Feb 2018
    6:35am
    ...and isn't that a worry. I noticed a marked change in the medical profession after not having any need to visit hospital for several years.
    Are they getting slack or are they over worked?
    One registered nurse told me all the nursing staff wear the same uniform so you don't actually know who is a registered nurse. So the male nurse you said was really good may have been the only registered nurse on the floor and the others are what we used to call nursing aids.

    6th Feb 2018
    7:26pm
    if you like reading bull dust just read the comments in these columns of the likes of thinks he knows it all, the koala, greycheeks, all we need now is the comments of labor mick alias tremor to make it a branch meeting of the labor party.
    Blossom
    7th Feb 2018
    11:24pm
    One of the main issues I had was for me personally the room was too warm. I didn't have a high temperature at all.
    A problem at a lot of hospitals is simply that they just don't have enough nurses, and there seems to be even less at night. Not all patients manage to sleep all night. Some feel guilty if they take full allocated breaks as they know patients they are allotted have to wait a lot longer after they ring their bell for assistance. I have heard that quite a lot from people that have been in Private Hospitals as well as Public - not complaining about the treatment they received, just general observation. Some almost run from patient to patient amd are exhausted when their shift finishes.


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