Reports and PublicationsCEC Media releases are located here >> |
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Incident Management in the NSW Public Health System |
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| Published: July 2008 | |
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Six-monthly Report Series:- July - Decmber 2007: The Clinical Excellence Commission is pleased to release Incident Management in the NSW Public Health System 2007, July to December. This report follows on from the previous annual series on adverse events in the NSW health system. Additional reports will be issued every six months and will be available as a matter of course on the CEC's website. The adverse events report series is part of the ongoing collaboration between the Clinical Excellence Commission and the Quality and Safety Branch of the NSW Department of Health. Six-monthly Report Series |
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Quality of Healthcare in NSW: A Chartbook 2007 |
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| Published: April 2008 | |
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The Clinical Excellence Commission is pleased to release Quality of Healthcare in NSW: A Chartbook 2007. The Chartbook aims to make the NSW health system better and safer for patients. The CEC Chartbook and additional materials can be downloaded here: |
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The Collaborating Hospitals' Audit of Surgical Mortality (CHASM) |
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| Published: March 2008 | |
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The Collaborating Hospitals' Audit of Surgical Mortality (CHASM) is a systematic peer-review audit of deaths associated with surgical care. The CHASM program has the support of the NSW State Committee of the Royal Australasian College of Surgeons (RACS), the Clinical Excellence Commission (CEC) and NSW health system and is similar to audits of surgical mortality being established in Australian states. |
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Annual Report 2007 |
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| Published: August 2007 | |
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"This report marks the halfway point in the first Five Year (2003-08) Strategic Plan for the Clinical Excellence Commission (CEC). At any point in a journey, there is a number of ways in which we can look at our progress. The first is to stop and reflect on just how far we have come. The second is to ask the questions 'are we on the right track?' and 'have we come far enough?'. The third is to look to the future and plan the remainder of the journey. Of course, each of these is important, but only part of the necessary self-awareness. I hope that, as you read through and consider the various programs, projects and campaigns highlighted in this volume, you will catch our vision for the safety and quality of public healthcare delivery in NSW." - Professor Clifford F Hughes AO |
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Giving A Voice To Patient Safety In New South Wales |
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| Published: October 2007 | |
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This monograph is the final in a series prepared by the Centre for Clinical Governance Research at the University of New South Wales for the Clinical Excellence Commission. The aim of the series is to shed light on what has become one of the most important questions in health care practice and management: what do we know about patient safety and what we can do about it? |
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Quality Systems Assessment Program |
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| Published: August 2007 | |
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This paper is the 2007 QSA Implementation Update. It addresses the assessment model for the QSA program, the three levels of organisational focus, and the self-assessment process. It also answers how the QSA will respond to changes in the health system, what happens after submitting the activity statement,
and how the Area Health Services, Justice Health and the Ambulance Service of NSW can prepare for the staged roll out of the QSA program. |
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Annual Report 2006 |
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| Published: March 2007 | |
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The 2006 Annual Report looks at some of the achievements and highlights of the year, which include the initiation of new programs in hand hygiene, falls prevention, transfusion medicine, communication and venous thromboembolism. 2006 saw multiple initiatives in education for quality improvement as well as the development and piloting of an area health service level QSA tool, and the progress of programs in cardiovascular care, children’s emergency care and medication safety. In addition to the launch of several new publications, the commencement of two special reviews and advances in strategic planning through state-wide workshops, the Clinical Excellence commission strengthened its commitment to collaboration through various partnerships, it reinforced it's suppport for research in patient safety and quality improvement and it rolled out several information management initiatives such as a detailed analysis of Incident Information Management System (IIMS) data. As well as looking at the highlights, the annual reports details how the CEC measures its performance against seven key result areas (KRAs) outlined in its Strategic Plan 2005–2008, consistent with the functions outlined in the NSW Clinical Excellence Commission Directions Statement. |
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Analysis of first year of IIMS data Annual Report 2005-2006 |
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| Published: December, 2006 | |
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Released by the Minister for Health on 20 December 2006, this inaugural report provides an overview of the first complete year of statewide IIMS data, with a focus on clinical notifications. The report provides valuable insights into the nature and number of clinical incident notifications occurring in the system, and a platform for sustainable clinical improvements. Similar reports will be published annually. The report complements the Patient Safety and Clinical Quality Program: Third Report on Incident Management in the NSW Health Public Health System 2005-2006, which was also released by the Minister for Health on 20th December 2006. |
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Data Collections and Reports to Inform the Patient Safety and Clinical Quality Program |
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| Published: December, 2006 | |
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For too long it has been difficult for busy clinicians to get information to support safety and quality initiatives. The CEC has recognized this issue and has engaged the Information Management Directorate (IMD) to provide a document for the benefit of active, busy clinicians. It is acknowledged that the CEC make no representations as to the ‘completeness’ of the information contained in selected publications. We value your input regarding extra material that would be useful, in addition to extra sources or different ways in which we could make it more useful to you in future versions. It is our aim to maintain the utility of this information with regular updates and additions.
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Patient Safety |
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| Published: October, 2006 | |
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This is a report of eight Inquiries into alleged poor health care. Three are from Australia: from Perth (King Edward Memorial Hospital), Melbourne (Royal Melbourne Hospital) and Sydney (Campbelltown-Camden). The remainder are from Scotland (Glasgow’s Victoria Infirmary), England (Bristol Royal Infirmary), Slovenia (Celje Hospital), New Zealand (Southland DHB) and Canada (Winnipeg Health Sciences Centre). |
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Children's Emergency Care Project Toolkit |
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| Published: October, 2006 | |
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The purpose of this toolkit is to showcase tools developed by the pilot site teams in implementing the paediatric emergency care guidelines. It includes experiences of the pilot site teams and draws together a number of strategies and tools that they have found useful in implementing the guidelines. It also draws on the experience and resources utilised by other improvement projects that have been undertaken by the Clinical Excellence Commission in partnership with other health care agencies. These are:
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Annual Report 2005 |
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| Published: January 2006 | |
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The 2005 Annual Report details how the CEC will build on the work the strong foundation of the ICE and
the legacy of Dr O’Rourke under the
leadership of Professor Clifford Hughes
AO, who was appointed Chief Executive
Officer in January. It includes the CEC Directions Statement, and the guiding set of principles embodied in the NSW Patient Safety and Clinical Quality Program. This document outlines CEC's strategic plan including key drivers and imperatives, goals and performance indicators and key outcomes for 2004 - 2008. 2005 saw the appointment of several new Directors, as well as expansion of the premises to include both Sydney Hospital and Maquarie Street, Martin Place. In May 2005 the CEC was also privileged to have the Minister for Health launch the toolkit entitled “Improving Patient Access to Acute Care Services”. 2005 also saw the wrap up of several projects; Chronic Care, Medication Safety and the Patient Flow and Safety Collaborative along with the Towards a Safer Culture Program. Further information is available in the report. |
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Guide to the Activities of the Special Committee Investigating Deaths under Anaesthesia |
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| 2000–2003 | |
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This is the first guide to the activities of the Special Committee Investigating Deaths Under Anaesthesia (SCIDUA) to be produced under the auspices of the Clinical Excellence Commission. After an introduction to the role of the Special Committee, this report looks at notification of deaths to the NSW Special Committee, the Special Committee’s administration and the Special Committee’s workload and processes. It also contains feedback from the Special Committee to anaesthetists which outlines how the Special Committee publicises its findings to individual anaesthetists and the scientific community. |
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Patient Safety Research |
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| Published May 2005 | |
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This monograph has been prepared as part of a program of research on safety and quality undertaken for the Clinical Excellence Commission (CEC) in New South Wales by the Centre for Clinical Governance Research at University of New South Wales. It seeks to assess the patient safety literature and suggest a way forward for clinical teams in providing safer healthcare. |
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National Medication Safety Breakthrough Collaborative |
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| Published: May 2005 | |
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The overall aim of the National Medication Safety Breakthrough Collaborative (NMSBC) was to reduce harm caused by medication use by 50 per cent in participating organisations over the course of the collaborative. In total, 100 health service teams from around Australia (47 in Wave 1 and 53 in Wave 2) participated in the NMSBC. The teams represented metropolitan, regional and rural areas, the public and private sectors, and both large and small facilities. Each team attended an orientation session and four learning sessions and participated in three action periods within a 12-month period to reduce medication-related patient harm. |
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Improving Patient Access to Acute Care Services Toolkit |
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| Published: May 2005 | |
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This Toolkit is designed to be an aid to you and your organisation should you choose to embark upon the journey to improve patient access to acute services. The Toolkit is a compilation of strategies and ideas from multiple sources. It is aimed at hospitals providing acute adult medical and surgical care, although many of the principles may be applicable in obstetric, paediatric and mental health services. |
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CEC Directions Statement |
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| Published: August 2004 | |
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The CEC Directions Statement outlines the role of the CEC in the NSW Patient Safety and Clinical Quality Program, the priniciples underpinning the program and the goverance and activities of the Clincial Excellence Commission. |
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ICE Annual Report 2003/04 |
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| Published: November 2004 | |
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The 2003/2004 Annual Report foreshadowed the formation of the Clinical Excellence Commission (CEC), replacing the former Institute for Clinical Excellence (ICE). The CEC was launched by the Minister for Health, the Hon Morris Iemma1 MP on 24 August 2004. In launching the Commission, the Minister paid tribute to the work of ICE’s founding Chief Executive Office, the late Dr Ian O’Rourke who passed away on 16 August 2004. Just weeks prior to his death, Dr O’Rourke was actively involved in developing the framework for the transition to the new organisation. This report outlines the progress of several of the programs that were underway in 2003/2004, including the Towards A Safer Culture Program, the National Medication Safety Breakthrough Collaborative, the Children’s Emergency Care Project, the NSW Chronic Care Collaborative, the Safety Improvement Program and the Patient Flow and Safety Collaborative. |
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Meningococcal ReportReport of the review of administrative and system issues arising out of two patient deaths attributed to Meningococcal Disease |
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| Published: June 2005 | |
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This is the final report of the review of administrative and system issues arising out of two patient deaths attributed to meningococcal disease.The Clinical Excellence Commission was not asked to further review matters in relation to two particular patients that have already been dealt with by other review processes. Rather, its brief was to review systems in place for the assessment, diagnosis and treatment of meningococcal disease in two health services generally, and in two specific hospitals, to identify areas of improvement and to recommend actions to achieve those improvements. |
