Safety and quality of care
The safety and quality of the care provided in Australia’s health system is important to all heart, stroke and vascular disease patients, their families and carers. A safe and high-quality health system provides the most appropriate and best-value care, while keeping patients from preventable harm (ACSQHC 2019).
At a national level, the Australian Commission on Safety and Quality in Health Care (ACSQHC) provides leadership to improve the safety and quality of health care in Australia.
Performance and safety reporting
A selection of indicators of safety and quality in the Australian health care system are reported through the Australian Health Performance Framework (AHPF) (NHIPPC 2017), Hospitals (AIHW 2026) and at a variety of other national, state and territory and local levels, including within individual services and clinical teams.
Two measures of safety in the AHPF that are relevant to patients with heart, stroke or vascular disease are:
- in-hospital mortality rate for acute myocardial infarction (AMI), heart failure and stroke
- unplanned hospital readmission for AMI and heart failure.
International comparisons
The OECD (Organisation for Economic Co-operation and Development) collates data on congestive heart failure in their integrated care indicators. The integrated care indicators report on readmissions to hospitals, mortality and prescribing. These serve as measures of the effective integration between different levels of care for congestive heart failure patients.
AIHW measured the readmissions to hospitals and mortality integrated care indicators using the National Health Data Hub (NHDH) for the reference year 2019. These were included in Health at a Glance 2025: OECD Indicators
Variations in practice
The Australian Atlas of Health Care Variation maps differences in health care use according to where people live. Health care variation is appropriate where it reflects difference in patients’ needs or preferences. When variation does not reflect these differences, it is considered unwarranted and represents an opportunity for the health system to improve.
Since 2015, 4 Atlases have been published, with the most recent version released in 2021. They have identified variations in hospital admissions for AMI, heart failure and atrial fibrillation, and in lengths of hospital stay for stroke, as well as variations in diagnostic procedures such as echocardiography and myocardial perfusion scans.
Reducing variation will involve a combination of approaches, including primary prevention, better care in the community including improved integration with hospital care, consumer enablement, more effective use of medicines, and greater use of exercise and cardiac rehabilitation programs (ACSQHC & AIHW 2021).
Clinical quality registries
Clinical quality registries collect and analyse clinical and other data to identify benchmarks for clinical performance and related variation in clinical outcomes. Registries report this information to clinicians to improve clinical practice, patient outcomes and the quality and value of health care.
Some examples of clinical quality registries in the cardiovascular field include (ACSQHC 2021):
- National Cardiac Registry (NCR)
- Australian Stroke Clinical Registry (AuSCR)
- Victorian Cardiac Outcomes Registry (VCOR)
- Queensland Cardiac Outcomes Registry (QCOR)
- Coronary Angiogram Database of South Australia (CADOSA)
- Australian and New Zealand Society of Cardiac and Thoracic Surgeons Database Program (ANZSCTS Database)
- Australian Genetic Heart Disease Registry (AGHDR).
The National Clinical Quality Registry and Virtual Registry Strategy 2020–2030 coordinates efforts to maximise the potential of registries to deliver improved cardiovascular care (Department of Health 2020).
AIHW (Australian Institute of Health and Welfare) (2026) Hospitals – Hospital safety and quality, AIHW, Australian Government, accessed 23 February 2026.
AIHW (2022) Better Cardiac Care measures for Aboriginal and Torres Strait Islander people: sixth national report 2021, AIHW, Australian Government, accessed 12 September 2024.
ACSQHC (Australian Commission for Safety and Quality in Health Care) (2019) The state of patient safety and quality in Australian hospitals 2019, ACSQHC website, accessed 6 April 2022.
ACSQHC (2021) Australian Register of Clinical Registries, ACSQHC, Australian Government, accessed 8 February 2021.
ACSQHC & AIHW (2021) The Fourth Australian Atlas of Healthcare Variation, ACSQHC, Sydney, accessed 12 September 2024.
Department of Health (2020) Maximising the value of Australia’s clinical quality outcomes data: A national strategy for clinical quality registries and virtual registries, 2020–2030, Department of Health, Australian Government.
NHIPPC (National Health Information and Performance Principal Committee) (2017) The Australian Health Performance Framework, COAG Health Council, Adelaide, accessed 12 September 2024.