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The eChartbook The Clinical Excellence Commission

CEC Quality and Safety Indicators
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In NSW, the Patient Safety and Clinical Quality Program (PSCQP) was established in 2004, following the Inquiry into Campbelltown and Camden hospitals [1].

The cornerstones of the PSCQP are:

  • A standardised system for managing, reporting and investigating incidents to ensure that risks are identified and steps taken to prevent recurrence
  • An electronic Incident Information Management System (IIMS) to support centralised reporting and recording of incidents
  • Establishment of clinical governance units in each (former) area health service
  • Development of a quality systems assessment (QSA) framework
  • Establishment of the Clinical Excellence Commission (replacing the Institute for Clinical Excellence) to support and promote systemic improvements.

The measurement and reporting of patient safety and clinical quality indicators is a key component of a quality health system [2]. Commissioner Garling stated in his recent review of acute care services in NSW public hospitals that "Public reporting of information about the health system and hospital performance... is the single most important driver for the creation of public confidence in the health system,engagement of clinicians, improvement and enhancement of clinical practice and cost-efficiency" [3].

This viewpoint is supported by international evidence, which indicates that the disclosure of quality information results in hospitals and clinicians reviewing their own performance in their own environment and making decisions to improve outcomes, in comparison with reliable benchmarks [4].

Building on previous Chartbook publication series, the eChartbook Portal continues reporting specific indicators of safety and quality by the Clinical Excellence Commission (CEC). The CEC has taken a lead role in promoting the collection and reporting of hospital-wide indicators in areas where international evidence has identified the highest vulnerabilities and/or the greatest potential for health gain. These include healthcare associated infections (HAI), management of the deteriorating patient, medication safety, effective use of blood products and the development of a Quality Systems Assessment survey.As with the more specific specialty-level clinical indicators, these hospital-wide measures will highlight issues that require further investigation, to accurately diagnose the nature of the problems and commitment to implement changes to address them. Previous editions of hardcopy Chartbook series published a section entitled 'initiatives in safety and quality' on a small set of hospital-wide indicators of safety and quality. As the CEC moved from hardcopy publication to web-based new eChartbook Portal, the Chartbook Advisory Group (CAG) members has suggested to include more safety and quality indicators specifically related to CEC projects and programs.

Data presented in the Initiatives In Safety and Quality section of eChartbook Portal covers following CEC projects/program related data:

  • Between the Flags (BTF)
  • Blood Watch Program
  • Collaborating Hospitals Audit of Surgical Mortality (CHASM)
  • Hand Hygiene Program
  • Incident Management System (IMS)
  • Medication Safety Self-Assessment (MSSA) Program
  • Patient Based Care
  • Sepsis Kills
  • Special Committee Investigating Deaths Under Anaesthesia (SCIDUA)
  • Quality Systems Assessment (QSA) Survey 2011
  • Healthcare Associated Infections (HAI):
    • Central Line Associated Bloodstream Infection (CLAB) in Intensive Care Units (ICU)
    • Staphylococcus Aureus Bloodstream (SAB) infections
    • Methicillin-Resistant Staphylococcus Aureus (MRSA) infections
    • Methicillin-Sensitive Staphylococcus Aureus (MSSA) infections.

The CEC is working in partnership with NSW Ministry of Health, clinicians and other relevant organisations on a wider range of indicators that can be used by clinicians to improve care and the outcomes of that care which will be gradually added in future on eChartbook Portal.


[1] Walker, B. Interim report of the Special Commission into Campbelltown and Camden Hospitals, Sydney.
[2] Marshall M N, & Brook RH. Public reporting of comparative information about quality of healthcare: Med J Aust. 2002 Mar 4; 176(5):205-6.
[3] Garling P. Final report of the Special Commission of Inquiry: Acute Care Services in NSW Public Hospitals. 2008; Sydney: NSW Government.
[4] Wilson R, Runciman W, Gibberd R, Harrison B, Newby L, &Hamilton J. The Quality in Australian Health Care Study. Med J Aust 1995; 163(9), 458-471.