PHA Quality and Safety Framework
Strategic Intent and Objectives
- To develop a Quality and Safety “Framework” Document to assist the Private Health Insurance Industry with their contract negotiations with private hospitals and Day Procedure Centres.
- To establish a systematic approach to monitor and measure outcomes associated with the safe delivery of healthcare services provided by private hospitals and Day Procedure Centres.
- To ensure private hospitals and Day Procedure Centres are engaged in quality improvement programs that are continuous throughout the patient’s continuum of care.
- To maintain the confidence of the consumer and health insurance funds, that the delivery of healthcare services is continually assessed and monitored under the auspices of accreditation, clinical research and best practice models.
- To provide valid and objective statistics and information for healthcare providers in decision making processes internally and externally.
Executive Summary
The initial construct of the Quality and Safety framework document initially outlines the key performance indicators associated with good clinical governance.
The framework is based on the principles from AS/NZ 4360 on Risk Management; evidence based clinical research and development, best practice guidelines, accreditation requirements and industry standards.
The Quality and Safety document will provide all key stakeholders with a framework by which healthcare facilities and health insurance funds ensure consumers are provided with optimum clinical care and services when entering the health system.
The criteria within the document will also guide and enhance the hospitals ability to demonstrate their commitment to quality improvement.
Internal and external comparison and benchmarking reports can be obtained and used to validate and measure clinical performance.
Accreditation performance is based on the quality and safety criteria established through this working document.
It would be expected that current accreditation organisations would be able to demonstrate their ability to meet industry expectations.
Clinical risk indicators are to form part of the core mandatory criteria for hospitals and Day Procedure Centres under an established reporting structure to their respective health insurance provider.
The indicators described at this stage, outline the processes and systems to identify, analyse and control risks in relation to patient quality and safety.
The framework document includes consumer participation in relation to, the effectiveness, appropriateness and access to health services.
The deliverables from the Quality and Safety Framework will enable all participants to benefit in better patient care outcomes, performance recognition, financial rewards and be involved in a sustainable healthcare environment.
The PHA Quality and Safety Framework was developed in 2007 and is currently being revised by the Data Management Committee. The Framework is an internal PHA document and is available only to Member Funds upon request. For queries regarding this document please contact us
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