Journal of quality in clinical practice
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The aim of this study was to examine the effectiveness of the seamless model of management on the quality of care for emergency department (ED) patients. This was a pre- and postintervention study of comparing post intervention data with the baseline on several variables of interest. The intervention was the seamless model of ED management, designed and implemented as a response to the challenge of increasing work load at the ED. ⋯ We report a successful restructuring process that used routinely collected clinical and administrative data to highlight problems. Using these data and through a systematic planning process, appropriate strategies for restructuring were developed by emergency staff in partnership with the hospital executive. Significant improvements in waiting time and patient care were clearly demonstrated.
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The Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S) project has been established to form a register of new surgical procedures which have been assessed for their safety and efficacy. The ASERNIP-S project systematically reviews the evidence and produces recommendations on the future use of surgical procedures in clinical practice. Further data may be collected to provide information on the outcomes of procedures in use in Australia. ⋯ This research identifies procedures that will impact on clinical practice in the near future. Dissemination of information from ASERNIP-S assessments, both locally and internationally, is important for quality improvement. The ultimate aim is for appropriate changes in practice to ensure the highest quality of Australian healthcare.
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In 1989 the Australian Council on Healthcare Standards (ACHS) embarked on a programme to develop acute health care clinical indicators in conjunction with the Australian medical colleges. Through a carefully structured stepwise process this collaboration established a 'World first' in 1993 with the introduction of the first set of indicators into the ACHS Accreditation programme. The programme remains unique in the formal involvement of providers in the development process and in the scope of the clinical areas covered in acute health care. ⋯ The process of indicator refinement, however, will continue and it is likely that a reduction in the total number of indicators will occur with a core group of the more 'robust' indicators remaining. Further directions in indicator development are likely to be in the area of multidisciplinary care and in the assessment of longer-term outcomes. In addition to measures of the quality of care, hopefully, in time, health care providers will also take part in the establishment of measures of the appropriateness of that care.