Health care safety and quality

The safety and quality of care provided in Australia’s health system is of utmost importance to all patients, their families, and carers. A safe and high-quality health system provides the most appropriate and best-value care, while keeping patients safe from preventable harm in the delivery of that care (ACSQHC 2020).

This page provides an overview of some key elements of the healthcare safety and quality monitoring arrangements in Australia.

Ensuring and improving safety and quality

Australia’s health system is often considered relatively high performing when compared with other countries (OECD 2023; The Commonwealth Fund 2021). However, in any health care system there are ongoing challenges and areas for improvement, and the need for monitoring of different aspects of the delivery and outcomes of care. 

Ensuring the safety and quality of health care in Australia is a shared responsibility of a number of agencies, professional groups and regulatory bodies and is an important focus of government policies and community discussion. Some of the key agencies that play a role include the:

• Australian Commission on Safety and Quality in Health Care (ASQHC) which provides leadership to improve the safety and quality of health care at the national level, including through the development of clinical care and quality standards and overseeing model national accreditation schemes for healthcare services
• Australian Health Practitioner Regulation Agency which administers the national registration system for health professionals
• Therapeutic Goods Administration which regulates aspects of the supply, manufacturing and advertising of goods used in healthcare such as prescription medicines, vaccines, medical devices and blood products.

Other bodies that play a role include:

• specialist teams in states and territories and in individual health services that work to monitor and improve the safety and quality of the care being provided across the system or in their organisation,
• various agencies involved in accrediting health services, and
• the Independent Health and Aged Care Pricing Authority, which aims to ensure the efficiency of public hospital services, while ensuring the safety and quality of care delivered.

Performance and safety reporting

It is a key role of the AIHW to report a wide range of information on the many different dimensions of the performance of Australia’s health system. Monitoring the performance of the health system in this way helps inform governments, service providers and the public about how effective, efficient and appropriate the system is and whether it is achieving good outcomes for patients and the wider community.

Information, data and resources made available by the AIHW includes:

• Australia’s health – AIHW’s biennial report on the health of Australians
• a national ‘front door’ to information on Australia’s health performance
• reporting on indicators in the Australian Health Performance Framework
• MyHospitals, which includes detailed information on the characteristics and performance of the hospital system at the national, state and local levels.

Some specific measures of hospital safety reported on the MyHospitals safety and quality pages include:

• healthcare-associated Staphylococcus aureus (‘golden staph’) bloodstream infections
• hand hygiene compliance
• hospital-acquired complications.

Data are also available for potentially preventable hospitalisations which can be used as a measure of the accessibility and effectiveness of primary and community healthcare services.

Patient reported measures

Other important measures of the performance of the health system come from the patients themselves in the form of feedback on their outcomes and experiences with a range of healthcare providers. It has been an expectation for many years, for example, that under health service accreditation standards set by the ACSQHC that health services routinely survey patients to obtain their patient’s perspectives on the care provided and their experiences as a patient.

Patient reported experiences

The Australian Bureau of Statistics also conducts an annual Patient Experience Survey covering various aspects of the health system, including hospitals and dental professionals.

In 2022–23, most people reported positive experiences of health care provided by their health care practitioners (ABS 2023). For example:

• A high proportion of people who saw a general practitioner (GP) felt that their GPs always listened carefully to them (71%), 80% felt their GPs always showed respect, and 71% felt their GPs always spent enough time with them.
• In relation to medical specialists, 78% of people felt that their specialists always listened carefully to them, 83% felt their specialists always showed respect, and 79% felt their specialists always spent enough time with them.

Recent Patient Experience Surveys have also included questions about patients’ experiences using telehealth services. For those who had had a telehealth consultation with a healthcare practitioner for their own health in the last 12 months (28% of people aged 15 and over), 81% reported that their telehealth practitioners always listened carefully, 84% reported that their telehealth practitioners always showed respect, and 79% reported that their telehealth practitioners always spent enough time with them.

The AIHW also reports on patient experiences with mental health services, through the Your Experience of Service (YES) survey. For information on this survey and other information about patient experiences with mental health services, see Mental health services in Australia.

Patient reported outcome measures

Patients can also contribute directly to the effectiveness (and hence, the overall quality) of health services through participation in activities to collect patient-reported outcome data associated with their care. These measures are used to obtain information from patients on their health status, using standardised and validated questionnaires, reflecting the things that are important to them.

When used before and after (or throughout) a course of health care, information on the self-reported changes in health status are considered to be measures of health outcomes. Typically, the surveys used would measure aspects such as overall health status, severity of symptoms such as pain, measures of daily functioning and psychological symptoms.

Patient reported outcome measures have long been used as part of clinical quality registries and research activities to evaluate health interventions. But they are increasingly being used and promoted in real-world healthcare settings as part of the routine delivery of care. For example:

• Through the Australian Palliative Care Outcomes Collaboration program, palliative care providers can use standardised validated clinical assessment tools to periodically measure and benchmark patient outcomes and information about the care setting. This information can be used by clinicians to improve their own clinical practices and also inform clinical practices more generally. For more information, see Palliative care outcomes.
• The National Outcomes and Casemix Collection is a nationally agreed data collection for the routine collection and reporting of changes in clinical outcomes for people receiving care from Australian public mental health services. The standardised clinical measures used are completed by the clinician or the consumer. For more information, see Consumer outcomes in mental health care.

Where do I go for more information?

For more information on safety and quality of health care, see:

• MyHospitals
• Australia’s health performance
• International comparisons
• Patient experiences in Australia by small geographic areas in 2019–20
• Australian Commission on Safety and Quality in Health Care 
• Independent Health and Aged Care Pricing Authority National Benchmarking Portal
• Australian Bureau of Statistics’ Patient experiences

For more information on this topic, see Health care quality and performance.