Hospital safety and quality

The quality and safety of care provided in Australia’s health system is of utmost importance to all patients, their families and carers, and to clinicians and health service managers. A safe and high-quality health system provides the most appropriate and best-value care, while keeping patients safe from preventable harm.

Informally, the term ‘safety and quality’ may be summarised as: the right care, in the right place, at the right time and cost. This section presents the latest performance information on safety and quality in Australian hospitals.  Explore topics such as hand hygiene and hospital infection rates, in more detail, via the links at the bottom of the page. For a broader overview on this topic, see the snapshot Safety and quality of health care.

Safety and quality bookmark 1

Staphylococcus aureus bloodstream infections in public hospitals have remained less than 0.8 cases per 10,000 patient days between 2015–16 and 2019–20.

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Safety and quality bookmark 2

150,060 hospitalisations involved at least one hospital acquired complication in 2019–20. Patients with a hospital acquired complication stayed longer in hospital.

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Safety and quality bookmark 3 

In Audit 2 2020, national compliance was 88.2% (national benchmark 80%).

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How is safety and quality of care measured?

The quality of care provided to patients admitted to hospitals can be measured in several ways. One way is to use data from hospitals to measure rates of:

  • Staphylococcus aureus (‘golden staph’) bloodstream infections (SABSI)
  • Hand hygiene compliance
  • Unplanned readmissions
  • Hospital-acquired complications and adverse events
  • Potentially preventable hospitalisations (PPHs).

Another way is to survey people about their experiences as admitted patients. Information gathered through administration data and patient surveys does not cover all aspects of hospital safety and quality. Certain aspects of safety and quality—continuity of care and responsiveness of hospital services—are difficult to measure and are not included here.

Hand hygiene

The COVID-19 pandemic affected many areas of people’s lives, including their use of health services such as hospitals. It also highlighted the importance of good hand hygiene to prevent the spread of disease. In response to COVID-19, the Australian Commission on Safety and Quality in Health Care promoted greater emphasis on using audit data to inform local quality improvement activities, and made Audit 2 (1 April to 30 June), 2020 voluntary for data submission. Audit 1 (1 November to 31 March) and Audit 3 (1 July to 31 October) remained mandatory for 2020. Nationally, less than two-thirds of hospitals supplied data during Audit 2 2020, compared to over three-quarters in the same period in 2019.

See hand hygiene for more information on the data, including factors to consider when interpreting these results. 

The current benchmark requires that at least 80% of hand hygiene moments be conducted when deemed necessary. The most recent hand hygiene results at a National level can be found on the Australian Commission for Safety and Quality in Healthcare (ACSQHC) website. 

This hand hygiene update on MyHospitals only reports on declared public hospitals (see Department of Health declared hospitals list). The following figures present hand hygiene compliance for all organisations participating in the NHHI (including those not reported on MyHospitals).

In audit period 2 (1st April to 30th June 2020):

  • the national hand hygiene compliance rate was above the benchmark (88.2%)
  • hand hygiene for each of the 5 moments was above the benchmark
    1. Before touching a patient: 85.3% 
    2. Before a procedure: 91.5% 
    3. After a procedure or body fluid exposure risk: 93.3%
    4. After touching a patient: 91.2%
    5. After touching a patient’s surroundings: 83.4%
  • the following health care worker groups did not meet the benchmark
    • doctors: 79.5%
    • ambulance workers: 74.5%

Hospital-acquired Complications

In 2019–20:

  • nearly 113,000 separations involved one or more hospital-acquired complications in public hospitals (or 2.1 in 100 separations)
  • 37,000 separations involved one or more hospital-acquired complications in private hospitals (or 1.0 per 100 separations).

The majority of hospital-acquired complications were associated with a healthcare associated infection, which affected 62,500 public hospital separations and 18,000 private hospital separations.

Potential Preventable Hospitalisations

In 2019–20, there were 555,600 potential preventable separations in public hospitals and 156,400 in private hospitals. These included:

  • 218,100 separations for chronic conditions (excluding diabetes) in public hospitals and 61,800 in private hospitals
  • 46,600 separations for diabetes complications in public hospitals and 9,000 in private hospitals
  • 57,400 separations for vaccine preventable conditions in public hospitals and 9,100 in private hospitals.

Potential preventable hospitalisations were highest for Indigenous Australians, people living in Remote and Very remote areas and people of the lowest socioeconomic status.

More data on Hospital safety and quality: