Identifying variations in quality of care in Queensland hospitals. Commentary

摘要: • Identifying and acting on variations from good practice is one of the critical tasks clinical governance. We describe aspect Queensland's post-Bundaberg governance arrangements: use variable life-adjusted displays (VLADs) to monitor outcomes care in 87 largest public private hospitals Queensland, which together account for 83% all hospital activity. VLAD control charts were created 31 indicators using routinely collected data, are disseminated monthly. About a third had run cases 3-year period that flagged at 30% level (local investigation). For three indicators, about five sufficiently cumulatively more deaths than statistically expected was highlighted state-wide review. VLADs do not provide definitive answers quality care. They used develop ideas why reported occur suggest possible solutions, be they ways improving data quality, casemix adjustment, or implementing system changes improve Critical approach there just monitoring -the tied with systems ensure investigation, learning action as result flag.