Measures of Hospital Performance
At Ashford Hospital, we take safety and quality seriously. To help patients make informed decisions, Ashford Hospital publishes a number of safety and quality indicators. This is just one part of our program to continually maintain and improve our high standards of safety and quality.
Quality can be defined and measured in many ways. At Ashford Hospital, quality is not just a simple measure – it is a comprehensive look at many aspects of a patient's experience. We have chosen to publish a range of clinical and safety measures which provide you with information about our performance in providing safe, quality healthcare. Click on the links below to view our data.
Ashford Hospital is fully accredited against The National Safety and Quality Health Service Standards, a mandatory set of standards established by the Australian Government for all public and private hospitals.
Accreditation involves a visit to the hospital from an independent team of expert health professionals who review the safety and quality of services provided. Our achievements are measured against industry standards by this review team. Hospitals are measured against ten overarching standards and many different criteria including patient care, medication management, clinical handover, infection control, complaints management and preventing falls.
Hospitals receive a rating for each one of these criteria – either satisfactorily met or not met. If a criterion is not met, the hospital is given an action that it must follow-up within three months to ensure the criterion is satisfactorily met.
Ashford Hospital received a full three-year accreditation following organisation-wide survey against the National Safety and Quality Health Service Standards in September 2016, gaining satisfactory met ratings in all the Standard’s Actions, including those that are still in the developmental stage.
The accreditation survey was carried out by the Australian Council on Healthcare Standards (ACHS). The surveyors were impressed with Ashford Hospital’s staff focus on patients, clients and carers. Staff demonstrated their commitment to the provision of quality care and cohesive team work in all aspects of clinical care reviewed. The hospital is well maintained and welcoming for patients and visitors.
Ashford Hospital’s commitment to quality improvement is ongoing, and current projects include:
- Implementation of a consumer engagement and participation framework
- Continued focus on consolidating strategies for Patient Centred Care
- Focus on improving discharge planning processes
- Improvement to medication safety practices
- Improving systems to assess, manage and care for patients with cognitive impairment, delirium or dementia
In addition to accreditation, Ashford Hospital is proud of the recognitions of excellence bestowed on its hospitals and staff.
Examples of recent awards are:
2017 Healthscope STAR Award Responsibility (Individual)
Kirsty Grant, Nurse Unit Manager, Ashford Hospital
2016 National BUPA Patient Choice Award Runner Up
Faye Bayot, Cardiac Surgical Unit, Ashford Hospital
2011 Healthscope Service Excellence Award
Roselyn Brown, Staff Development Coordinator, Ashford Hospital
Ashford Hospital has implemented numerous infection control procedures, and staff take every precaution to prevent infections. However, some patients have a higher risk of acquiring an infection in hospital. Patients with wounds, invasive devices (such as drips) and weakened immune systems are at greater risk of infection than the general public. We need to prevent infections because they may cause illness to the patient, resulting in a longer stay in hospital and a longer recovery time.
What are Healthcare Associated Infections?
Healthcare Associated Infections (HAI) are infections that occur as a result of healthcare interventions and are caused by micro-organisms such as bacteria and viruses. They can happen when you are being treated in hospital, at home, in a General Practitioner Clinic, a nursing home or any other healthcare facility.
Some infections occur after an invasive procedure such as surgery and can be treated with antibiotics. However, there are some infections such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile that are more difficult to treat because they are resistant to certain antibiotics.
The risk of getting these infections depends on how healthy you are, how long you have been in hospital, and certain medications that you take (including antibiotics).
These specific infections require the use of special antibiotics and, at times, special precautions which may include placement in a single room and the use of personal protective equipment such as gloves and gowns.
What we are doing to prevent infections:
Specialised Infection Control staff collect data on hospital acquired infections and analyse the data to identify patterns and trends. Infection rates are shared and discussed with clinicians in an effort to identify and implement the best practices to reduce the risks for infection.
There are two types of infections that we closely monitor at Ashford Hospital. Both are caused by bacteria. You may have heard of these:
- Staphylococcus aureus bacteraemia (often called “golden staph”) – known as “SAB” for short. This is a serious infection caused when this bacteria enters the blood stream
- Clostridium difficile – this is an infection of the bowel that causes diarrhoea
This graph shows the number of Staphylococcus aureus infections at Ashford Hospital compared with the Australian Government target. The graph shows the number of infections that occur for every 10,000 patient days. The national benchmark for Staphylococcus aureus bacteraemia in Australian public hospitals is no more than two cases per 10,000 patient days. Patients at Ashford Hospital on average have a very low number of infections.
This graph shows the number of Clostridium difficile infections at Ashford Hospital compared with the rate typical in other hospitals in Australia. Rates of infection typically vary from state to state. The rate varies from two to three cases per 10,000 days of patient care, so the industry rate reflects this range. The graph shows the number of infections that occur for every 10,000 patient days. Patients at Ashford Hospital on average have a very low number of infections.
Not all patients contract Clostridium difficile (Cdiff) in hospital - some patients are admitted already having this condition. The chart above shows all cases of Cdiff identified in hospital, both community and hospital-acquired. The chart below shows whether or not the patient was admitted already having this condition. Hospitals need to identify both types of patients in order to have the best chance of preventing Cdiff from spreading to other patients.
What we are doing to further reduce infections:
- Watching, auditing and measuring how often staff wash their hands using soap and water or hand sanitiser
- Routine use of gloves and specially sterilised equipment
- An Infection Control Nurse in each hospital, to investigate issues, educate staff and carry out strategies to reduce infections
- Use of specialised approved disinfectants for cleaning and disinfecting rooms, bathrooms, equipment and shared areas. High level disinfection and sterilisation are used according to national guidelines
- Placement of hand sanitiser dispensers in public areas throughout our hospital including hallways, near elevators and cafeterias, making this readily accessible to staff, patients, families and visitors
- If additional precautions are required, staff may wear gloves, gowns, masks and goggles
How can you help?
At Ashford Hospital, patients and visitors are part of the health care team. Hand washing is the most important way that patients and visitors can prevent the spread of infection in hospital. Waterless hand sanitiser can be as effective as washing with soap and water. Hospital staff will appreciate a reminder from patients or relatives if they forget to wash their hands.
There are a number of things you can do to reduce the risk of infection:
- Wash your hands carefully and regularly with soap and water and / or use hand sanitiser upon entering the hospital
- Cover your mouth and nose with a tissue when you cough or sneeze (or into your elbow if you don't have one). Clean your hands afterwards – every time
- Report any infection you have had, especially if you are still on antibiotics
- Make sure you take the full course of antibiotics you have been given, even if you are feeling better
- If you have a dressing or a wound, keep the skin around the dressing clean and dry. Let the healthcare worker looking after you know promptly if it becomes loose or wet
- Tell the healthcare worker looking after you if the area around the drips, lines, tubes or drains inserted into your body becomes red swollen or painful
- Let the healthcare worker looking after you know if your room or equipment hasn't been cleaned properly
- Stop smoking before any surgery, as smoking increases the risk of infection
- Reconsider your visit if you have an illness such as a cough, cold or gastroenteritis
- Wash your hands carefully with soap and water or use waterless hand sanitiser when entering and leaving a patient’s room
Hand Hygiene is another name for hand washing or cleaning. Hands can be effectively cleaned with either soap and water, or with waterless hand sanitiser. Both are equally effective. It is an expectation that all staff at Ashford Hospital frequently clean their hands. Hand hygiene is simple and is the most important way of preventing infections in hospital. Our hands may look clean but many germs are invisible to our eyes. We can unknowingly transmit bacteria and viruses to others and our environment. Germs can survive on unwashed hands for over an hour.
People (especially children) sometimes take short-cuts when they are supposed to wash their hands – particularly when there is no dirt visible. And unfortunately, hand hygiene is sometimes not well performed by health care workers.
What we are doing to improve hand hygiene:
It is important that we check whether healthcare workers are using correct hand hygiene. There is no magic way of knowing if a person has washed their hands. The accepted way of measuring hand hygiene is for a trained auditor to watch healthcare workers as they go about their day, treating patients in hospital. There is a government-approved organisation called ‘Hand Hygiene Australia’ that helps with this measurement. Ashford Hospital has a “gold-standard auditor” on site, accredited through Hand Hygiene Australia. This person is trained to check that staff are washing their hands as often as they should.
Each opportunity for hand hygiene is called a “moment”. Five Moments for hand hygiene have been identified by the World Health Organisation as the critical times when hand hygiene should be performed in hospital.
- Before touching a patient
- Before a procedure
- After a procedure
- After touching a patient
- After touching a patient’s belongings or surroundings
At Ashford Hospital we watch staff during each of these moments. The auditor records whether or not hand hygiene has been performed correctly by each staff member at each “moment”. At the end of the audit, an overall score is calculated. This is shown in the graph below.
This graph shows the percentage of moments where hand hygiene was performed correctly at Ashford Hospital compared with the Australian national benchmark. Staff at Ashford Hospital on average have a high rate of compliance with hand hygiene. The graph also shows that the hospital’s hand hygiene rate has improved over time. This suggests that our hand hygiene program is working.
The more hand hygiene moments are audited, the more reliable our figures. This figure shows how many hand hygiene moments were audited at Ashford Hospital in the most recent period audited. Note that smaller hospitals are required to audit fewer “moments” than larger hospitals.
When audits are performed, each professional group is checked – including doctors, nurses, cleaning and other hospital staff.
The graph on the left (below) shows which groups were audited. The graph right (below) shows the hand hygiene rate for different staff within the hospital. The graph shows that compliance rates for nurses are higher than for other staff.
What we are doing to further reduce infections:
The reasons for staff not performing hand hygiene may include:
- Time pressure – there just is not enough time to wash hands as often as necessary
- Hands do not appear dirty – but germs are there, even if they cannot be seen
- Problems with skin irritation – frequent washing with soap and water can cause dryness, skin irritation or damaged skin which makes washing uncomfortable
Improvement strategies may vary from hospital to hospital. At Ashford Hospital the following strategies are used:
- Conducting regular education programs for staff about infections and hand hygiene
- An Infection Control Nurse to investigate issues, educate staff and carry out strategies to reduce infections
- Placement of hand sanitiser dispensers in convenient areas throughout the hospital, including hallways and patient rooms - this makes hand hygiene readily accessible to staff, patients, families and visitors
- Monitoring the type of soap/hand sanitiser used, to minimise skin irritation
- In some areas - use of specially designed washbasins where water can be turned on and off without touching the tap
How can you help?
At Ashford Hospital, patients and visitors are part of the healthcare team. Hand hygiene is the most important way that patients and visitors can prevent the spread of infection in hospital. Waterless hand sanitiser is just as effective as washing with soap and water. Hospital staff will appreciate a reminder from patients or relatives if they forget to wash their hands.
There are a number of things you can do to reduce the risk of infection:
- Wash your hands carefully with soap and water or use hand sanitiser upon entering and leaving the hospital
- Wash your hands carefully with soap and water or use hand sanitiser when entering and leaving a patient’s room
- Observe hospital signage about hand hygiene
- If you are unable to find a hand sanitiser station, please ask staff for assistance
Patients are often in a weakened or confused state in hospital, and are more susceptible to falling. Falls are a leading cause of hospital-acquired injury, and frequently prolong or complicate hospital stays. At Ashford Hospital we document and investigate every fall and take action to reduce the number of falls that occur.
This graph shows the number of falls in Ashford Hospital compared with the rate typical in other hospitals from Australia, the UK and the USA. Falls are presented as a percentage of patient days – allowing us to compare Ashford Hospital with other hospitals of a different size. Patients at Ashford Hospital on average have a lower rate of falls than those in other hospitals.What we are doing to further reduce falls:
- Assessment of all patients for risk of falls
- Implementation of precautions to reduce the risk of falling. For example:
- non-slip socks
- bed and chair sensors which detect patient moving from bed
- use of lifting equipment and walking aids
- beds that are low to the floor
- physiotherapy assessments
- Analysis of falls incidents
- Spot audits to provide information about environmental factors
A pressure injury is an area of skin damage, such as a wound, sore or ulcer, or an area of persistent reddening, caused by direct pressure on the skin. This can sometimes occur when a patient is in one position and unable to move easily for a long period, although not every patient is at risk. Pressure injuries can range in severity from an area of reddened but intact skin to broken skin, which may involve varying degrees of underlying tissue damage.
Pressure injuries frequently prolong or complicate hospital stays. At Ashford Hospital we document and investigate every case and take action to reduce the number of pressure injuries that occur.
When patients are admitted to hospital, an assessment is performed of the skin to determine if any pressure injuries already exist and also to decide whether the patient is at risk of developing a pressure injury. Patients that may be at risk are those that:
- Are bedbound
- Have sensitive skin
- Have poor nutrition
- Are older
- Are taking certain medications or
- Have chronic illnesses such as diabetes or anaemia
Our hospitals have many strategies in place to prevent pressure injuries developing. If a pressure injury develops, the hospital staff do everything they can to help it heal as soon as possible.
One of the ways of monitoring the success of our prevention strategies is to check whether any patients have developed pressure injuries in hospital.
This graph shows the number patients at Ashford Hospital that have developed a pressure injury during their admission to hospital. The rate is shown in the pink bars. This is compared to the rate of pressure injuries in other Australian hospitals (the grey bar). The graph shows that patients at Ashford Hospital are less likely to develop a pressure injury compared with other Australian hospitals.
Sometimes, despite our best efforts, a patient does develop a pressure injury - however we aim to minimise this number.
What we are doing to reduce pressure injuries:
Improvement strategies may vary, examples are:
- A risk assessment is performed to identify patient that are vulnerable to pressure injuries
- Patients identified as ‘high risk’ are referred to the dietitian for nutritional assessment and advice
- Pressure relieving devices are used. These include specialised mattresses, cushions, wedges, sheepskins, water-filled supports, contoured or textured foam supports, heel protectors, gel-filled supports and bead filled supports
- Preventing exposure to excessive moisture or dryness
- Positioning: Regularly changing the position of the patient and encouraging walking or movement if possible
- Individual reporting: Examining each case of pressure injuries to determine why it occurred and how to prevent this happening again
- Education for nursing staff in pressure injury identification, prevention and management
- Patient education provided on pressure injury prevention at pre admission and or admission
- Referral to a wound management consultant in the event of a pressure injury developing or if admitted with a pressure injury
A blood transfusion is a procedure where you receive blood through an intravenous cannula (IV) inserted into a vein. You may need a blood transfusion if your body cannot make parts of your own blood, if your blood cells are not working properly, or if you have lost blood.
Blood contains red cells which are essential for carrying oxygen around the body. A blood transfusion may be given because of a shortage of red blood cells in the blood (anaemia), either because the body is not making enough of them, or because of blood loss. Sometimes the bone marrow, which produces blood cells, doesn’t work properly. The bone marrow can be affected by chemotherapy or diseases. In some cases anaemia can be treated with medicines but in other cases, a blood transfusion may be the best treatment.
Most people can cope with losing a moderate amount of blood without needing a blood transfusion, as this loss can be replaced with other fluids. However, if larger amounts of blood are lost, a blood transfusion could be the best way of replacing blood rapidly. A blood transfusion may be needed to treat severe bleeding, for example during or after an operation, childbirth or after a serious accident. There are are many useful resources for patients about blood transfusion available.
Transfusion does not just refer to blood – often other blood products are used. These include:
- Fresh blood components, such as red blood cells, platelets, fresh frozen plasma or cryoprecipitate
- Plasma-derivatives such as albumin, immunoglobulins and clotting factors
A blood transfusion can be lifesaving or significantly improve quality of life. Australia has one of the safest blood supplies in the world. However, as with all medical procedures, a blood transfusion is not completely free from risk. It is very important that all patients receive blood and blood product transfusions appropriately and safely. Blood transfusions are given to patients only where the doctor has assessed it as absolutely necessary.
Patients must give consent for a blood transfusion. Consent should be documented on a consent form or by documenting the discussed information in your medical record.
It is very important that transfusions are carried out by trained professional staff, using the techniques outlined in the National Safety and Quality Health Service Standards. This is double checked and audited on a regular basis in our hospital.
One way that we monitor the success of blood transfusions is by keeping track of any adverse reactions – both major and minor. Adverse reactions are rare, but can include:
- Incorrect blood / blood component transfused
- Transmission of infection, for example bacteria or viruses
- Transfusion related immune reaction
- Transfusion related acute lung injury
At Ashford Hospital we document and investigate every case and take action to reduce the number of adverse transfusion events that occur. Ashford Hospital has many strategies in place to prevent adverse transfusion events from occurring.
This graph shows the number of patients at Ashford Hospital that had a transfusion with NO significant adverse event. The rate is shown in the coloured bars. This is compared to the rate of transfusion events in other Australian hospitals (the grey bar). The graph shows that patients at Ashford Hospital are less likely to have an adverse transfusion event, compared with other Australian hospitals.
What we are doing to reduce the risk of adverse transfusion events:
The following strategies are used:
- Policies and procedures, consistent with national evidence based guidelines for pre-transfusion practices, prescribing and administration of blood
- Avoiding unnecessary blood transfusions by use of alternative medications, treatments and non-blood treatments
- Identifying any risk factors for adverse reactions, before the transfusion commences
- Careful cross-matching of blood groups to make sure no errors occur
- Education and competency training for nursing staff in blood transfusion administration
- Patient education and provision of written materials explaining blood transfusions
- Individual reporting: Examining each adverse transfusion event to determine why it occurred and how to prevent this happening again
- Careful monitoring of patients and taking close observations during administration of a blood transfusion
- Working closely with the pathology laboratory that provides the blood
- Monitoring and auditing compliance to transfusion policies and procedures
- There is a robust system for reporting and feedback for adverse events, incidents and near misses relating to transfusion practice
- Transfusions are not conducted at every hospital. If a hospital does not have sufficient experience in conducting a transfusion, the patient is moved to another hospital for this procedure
- ACHA participates on the Healthscope National Transfusion Governance Committee that oversees best practice standards for transfusion management in all hospitals – and also reviews adverse events nationally so that all hospital can learn from them
When a patient visits the Emergency Department at Ashford Hospital, the triage nurse carries out an assessment of how urgent the patient’s condition is. Each patient is assigned a triage category from 1 through to 5 on the Australasian Triage Scale. According to the best practice guidelines, patients must be seen for medical assessment and treatment within the following times:
- Category 1 patients must be attended to immediately (eg, cardiac arrest)
- Category 2 patients attended to within 10 minutes (eg, severe blood loss)
- Category 3 patients attended to within 30 minutes (eg, head injury but conscious)
- Category 4 patients attended to within 60 minutes (eg, sprained ankle, possible fracture)
- Category 5 patients attended to within 120 minutes (eg, cut not requiring stitches)
Patients that are category 1, 2 or 3 will be seen before category 4 and 5, even if they arrive in the department at a later time. If you visit an Emergency Department you can ask the triage nurse what category you have been assigned and this may give you an idea of how long you may be expected to wait.
All hospitals with Emergency Departments measure how quickly patients are seen in the Emergency Department. The graphs below show the percentage of patients in each Category that are seen within the recommended time at Ashford Hospital. On average, patients visiting the Emergency Department at Ashford Hospital are seen more quickly than in other Australian hospitals.
To see the emergency waiting times for Ashford Hospital, see below.
Emergency Department Waiting Times - Triage Catagory 1: Patients Seen Immediately
Emergency Department Waiting Times - Triage Category 2: Patients Seen Within 10 Minutes
Emergency Department Waiting Times - Triage Category 3: Patients Seen Within 30 Minutes
Emergency Department Waiting Times - Triage Category 4: Patients Seen Within 1 Hour
Emergency Department Waiting Times - Triage Category 5: Patients Seen Within 2 Hours
Many patients who come to Ashford Hospital have an operation in our theatres. Most operations require some kind of anaesthetic, administered by an Anaesthetist. After waking up from an anaesthetic, patients require close monitoring to make sure that their pain and conscious state, and observations such as blood pressure are all back to normal. This typically happens in the Recovery Unit. After a large operation, such as a heart bypass operation, an admission to the Intensive Care Unit may be planned, to allow close monitoring by specialised equipment. On rare occasions, other patients may have an unexpected reaction to an anaesthetic, and may require an unplanned admission to the Intensive Care Unit for monitoring.
Tracking the number of patients who have an admission to Internsive Care after an operation is one way that we can judge the quality of hospital care. Good nursing care can help reduce the rate of unplanned admission to Intensive Care and good monitoring can pick up any problems early.
This graph shows the percentage of patients admitted to Ashford Hospital that have required an unplanned admission to the Intensive Care Unit within 24 hours of their operation. The rate is shown in the green bars. This is compared to the rate of “unplanned admission to Intensive Care” in other Australian hospitals (the grey bar).
This graph shows that patients admitted to Ashford Hospital are slightly more likely to have an unplanned admission to Intensive Care compared with other Australian hospitals.
What we are doing to further reduce unplanned admission to Intensive Care:
Improvement strategies may vary from hospital to hospital, examples are:
- We review each admission to Intensive Care to check if there were any preventable factors
- Before operations, the nurses, doctors and anaesthetists carefully check each patient’s risks for anaesthetic
- The Theatre and Recovery Units use a consistent process for discharging patients either to the ward or to home, to make sure they have fully recovered from the anaesthetic
- If a patient has additional risk factors, sometimes an Intensive Care bed is planned and booked in advance, to make sure the post-operation monitoring is the best possible
- We monitor this data to make sure that the rate of unplanned admission to Intensive Care is not increasing
- We ring our patients prior to admission and ask them a series of questions to see if they may require additional clinical support whilst in hospital
For many operations and procedures (such as arthroscopy, colonoscopy) that are performed at Ashford Hospital, an overnight stay is not required. Patients are admitted a few hours before their operation or procedure, and go home on the same day, after they have recovered from their anaesthetic. After waking up from an anaesthetic, patients require close monitoring to make sure that their pain and conscious state, and observations such as blood pressure are all back to normal. This typically happens in the Recovery Unit. On rare occasions, patients may have an unexpected reaction to an anaesthetic or procedure, and may require an unplanned overnight stay in hospital, or transfer to another hospital.
Tracking the number of day patients who have an unplanned overnight stay after an operation is one way that we can judge the quality of hospital care. Good planning and medical care can help reduce the rate of unplanned overnight admissions.
This graph shows the percentage of day patients admitted to Ashford Hospital that have required an unplanned overnight stay or transfer to another hospital. The rate is shown in the blue bars. This is compared to the rate of “unplanned overnight stay for a day patient” in other Australian hospitals (the grey bar).
This graph shows that patients admitted to Ashford Hospital are less likely to have an unplanned overnight stay for a day patient compared with other Australian hospitals.
What we are doing to further reduce unplanned overnight admission:
- We review each unplanned transfer or overnight admission to check if there were any preventable factors
- Before operations, the nurses, doctors and anaesthetists carefully check each patient’s risks for the operation and recovery
- Pre-admission clinics are used to make sure the patient and staff are as prepared as possible for the operation or procedure
- The preadmission screening assessment identifies patients with risk factors which identify those most likely to need overnight stay, where the reason is unrelated to the procedure
- The Theatre and Recovery Units use a consistent process for discharging patients home, to make sure they have fully recovered from the operation
- If a patient has additional risk factors or requires more intensive monitoring, sometimes an overnight ward bed is planned and booked in advance, to make sure the post-operation monitoring is the best possible
- We monitor this data to make sure that the rate of unplanned transfer and admission to hospital is not increasing
After a successful hospital stay, the most important task for patients, families and staff is preparing for a successful discharge home. It is disappointing for everyone if a patient requires an unexpected readmission into hospital.
Tracking the number of patients who experience unplanned readmissions to Ashford Hospital after a previous hospital stay is one way that we can judge the quality of hospital care. One example of an unplanned readmission would be someone who is readmitted to the hospital for a surgical wound infection that occurred after his or her initial hospital stay.
It is important to note that unplanned hospital readmissions may or may not be related to the previous visit, and some unplanned readmissions are not preventable. Good discharge plans can help reduce the rate of unplanned readmissions by giving patients the care instructions they need after a hospital stay and by helping patients recognise symptoms that may require immediate medical attention.
The graph shows that patients admitted to Ashford Hospital are less likely to have an unplanned readmission compared with other Australian hospitals.
There is a limitation to this data. Currently no unique patient identifier exists that would allow us to measure unplanned readmissions to a different hospital. Therefore the unplanned readmission rates presented in this graph represent patients readmitted to the same hospital only.
What we are doing to further reduce unplanned readmission rates:
- We review each case of readmission to check if there were any preventable factors
- Check each patient’s risk for re-admission
- Use a consistent process for discharging patients that includes making sure patients understand their medications and other instructions
- Arranging prompt follow up care and ongoing appointments, eg, with Physiotherapist and General Practitioner
- We monitor this data to make sure that the rate of unplanned re-admission is not increasing
Ashford Hospital has an operating theatre suite and carries out many sessions of surgery every year. One of the ways of monitoring the success of surgery is to check whether any patients require an unexpected second operation – we call this “return to theatre”. There are many reasons why a patient may need a further operation – however where possible we aim to minimise this number.
This graph shows the percentage of patients having an operation or procedure at Ashford Hospital that have required a return to theatre during the same admission. The rate is shown in the blue bars. This is compared to the rate of “return to theatre” in other Australian hospitals (the grey bar).
The graph shows that patients undergoing surgery at Ashford Hospital are less likely to have an unexpected return to theatre compared with other Australian hospitals.
What we are doing to reduce unplanned returns to theatre:
- Careful monitoring of patients in recovery
- Ensuring patient’s level of pain is carefully assessed
- Reviewing every case when a patient requires a return to theatre, to work out the reasons why and how to prevent it in future
- Conducting thorough pre-operative evaluation including coagulation studies and anti-coagulant therapy management where indicated
- Pre-admission assessment of high risk patients to make sure all required tests and precautions are taken
Childbirth is a natural, normal event, and although you may choose to have your baby in hospital, it doesn’t mean that medical intervention will be required. Most babies are born without any difficulties and with the encouragement and support from Ashford Hospital staff. However, sometimes intervention by the Obstetrician, Paediatrician or Midwife may be required in order for a safe outcome for your baby.
After a baby is born, the hospital staff will do a thorough check of all aspects of the baby’s health, measuring their Apgar Score to check the baby’s breathing, heart rate, colour, activity and temperature. Some babies may require closer monitoring, help with breathing, body temperature, or further investigations. This sometimes happens in the Neonatal Intensive Care Unit. “Neonatal” means “around the time of birth”. This is a specialised unit with staff that are experts in dealing with newborn babies. In some cases, if an unborn baby has a specific medical condition, an admission to the Neonatal Intensive Care Unit may be planned even before delivery of the baby. On rare occasions, babies may be born with an unexpected medical condition, and may require an unplanned admission to the Neonatal Intensive Care Unit for treatment.
Tracking the number of patients who have an unplanned admission to the Neonatal Intensive Care Unit after birth is one way that we can judge the quality of hospital care. Good medical and nursing care during delivery and during the months of pregnancy can help reduce the rate of unplanned admissions to Neonatal Intensive Care. Good monitoring during labour can pick up any problems early.
This graph shows the percentage of babies born in Ashford Hospital that have required an unplanned admission to the Neonatal Intensive Care Unit. The data also includes unplanned admissions to the “Special Care Nursery”, which provides a lower level of care for babies that do not require intensive care. A number of admissions to the Special Care Nursery are precautionary. The rate is shown in the pink bars. This is compared to the rate of “unplanned admission to Intensive Care” in other Australian hospitals (the grey bar).
This graph shows that babies born at Ashford Hospital are less likely to have an unplanned admission to the Neonatal Intensive Care Unit compared with other Australian hospitals.
What we are doing to further reduce unplanned admission to Neonatal Intensive Care:
- We review each admission to Neonatal Intensive Care to check if there were any preventable factors
- Before a baby is born, and during the pregnancy, the midwives and obstetricians carefully assess and monitor the mother and baby for any risk factors, such as gestational (pregnancy) diabetes
- The Theatre and Recovery Units use a consistent process for discharging mothers and babies from the delivery suite to the ward, to make sure they have fully recovered from the birth
- If a mother or baby has additional risk factors, sometimes a Neonatal Intensive Care bed is planned and booked in advance, to make sure the post-natal monitoring is the best possible
- We monitor this data to make sure that the rate of unplanned admission to Neonatal Intensive Care is not increasing
Following the birth of a baby, the Doctor / Midwife assesses the baby's overall condition, including breathing, heart rate, colour, activity and temperature. A score known as the “Apgar score” is used to measure this, one minute and five minutes after birth. The highest Apgar score is 10. The five minute Apgar score is regarded as more important than the 1 minute score because it is believed to be more reflective of the baby's overall health.
At Ashford Hospital we measure the Apgar score for every baby born. This graph shows the percentage of babies born at Ashford Hospital that have a healthy Apgar score five minutes after birth. The rate is shown in the yellow bars. This is compared to the rate in other Australian hospitals (the grey bar). A healthy Apgar score is defined as a score of 7 or above.
The graph shows that the percentage of babies born at Ashford Hospital with a healthy Apgar score is higher than other Australian hospitals.
The birth of a baby is a very exciting time and we would like you to have the best possible experience. If you have an uncomplicated pregnancy, you will be admitted to hospital just before you give birth. The number of days you will spend in hospital after having your baby will depend on whether you have a vaginal delivery or a Caesarean section. Most patients stay a little longer in hospital after a Caesarean section.
It can be reassuring to know how long you will spend in hospital after your baby is born. The graph above shows the average length of stay at Ashford Hospital for childbirth. The length of stay in other Australian public and private hospitals is also shown. Many patients choose to stay in hospital for as long as possible after the birth, particularly for a first baby, however, it is important to note that you are free to go home earlier if you choose to do so. Women having a baby at Ashford Hospital and other Australian private hospitals stay longer in hospital than patients in Australian public hospitals.
Many organisations today are measuring quality in health care using varying criteria. Evaluating this information can be difficult and time-consuming since not all measures reflect the same information from one report to another. However, it is important for patients to ask questions and look at quality information to ensure they are getting the efficient and effective care they need.
Ashford Hospital is a member of the Adelaide Community Healthcare Alliance Incorporated (ACHA). ACHA and its contracted manager Healthscope, supports transparent public reporting of healthcare quality data and actively participates in initiatives of the following organisations.
Australian Commission on Safety and Quality in Healthcare (ACSQHC) – The Australian Commission on Safety and Quality in Healthcare (the Commission) was established in 2006 by the Australian, State and Territory Governments to lead and coordinate national improvement in safety and quality. Healthscope (ACHA’s contracted manager) - has representation on the Private Hospital Sector Advisory Committee and several key working groups.
Australian Institute of Health and Welfare - The Australian Institute of Health and Welfare (AIHW) is a major national agency set up by the Australian Government under the Australian Institute of Health and Welfare Act to provide reliable, regular and relevant information and statistics on Australia's health and welfare.
MyHospitals Website – This website lists all public and private hospitals in Australia, along with information about waiting times for elective surgery and emergency department access. Healthscope (ACHA’s contracted manager) - has representation on the MyHospitals Development Advisory Committee.