What are Clinical Practice Health Outcomes?

Clinical practice health outcomes refer to the measurable changes in health status resulting from the care that patients receive. These outcomes can include improvements in patient symptoms, reduction in disease severity, quality of life enhancements, and overall survival rates. Such outcomes are pivotal for evaluating the efficacy and quality of clinical interventions.

What is Variation in Clinical Practice Health Outcomes?

Variation in clinical practice health outcomes denotes the differences in health results among different populations or within the same population over time. These variations can stem from disparities in access to healthcare services, differences in treatment practices among healthcare providers, and diverse patient responses to similar treatments.

Below are some examples:

• Geographic disparities: Differences in health outcomes based on the geographical location of patients, which can affect access to healthcare facilities and specialized care.
• Socioeconomic status: Variations in outcomes influenced by the socioeconomic status of patients, including differences in access to healthcare, nutritional options, and living conditions.
• Clinical decision-making: Variability in treatment outcomes arising from different clinical decisions made by healthcare providers, such as differing prescription patterns or surgical approaches.
• Patient compliance: Differences in health outcomes based on how well patients adhere to prescribed treatment regimens, which can vary widely depending on individual circumstances and understanding.
• Healthcare provider skills: Variations due to the differing levels of expertise and training among healthcare providers, which can impact the quality of care delivered.
• Cultural factors: Outcomes that vary due to cultural beliefs and practices, which can influence how patients perceive and engage with healthcare services.
• Genetic predispositions: Variations in patient outcomes based on genetic factors that influence the efficacy of certain treatments for different individuals.

Why is Variation in Clinical Practice Health Outcomes Important?

Understanding and addressing variations in clinical practice health outcomes is crucial as it directly impacts patient safety and quality care. Identifying unwarranted variations can help in pinpointing areas needing improvement, thus enhancing healthcare equity and efficiency.

What is the "Variation in Clinical Practice Health Outcomes" Requirement?

According to NSQHS - 1 - Action 1.28, healthcare organisations are required to ensure their staff are trained so that levels of clinical practice activity, care processes, and outcomes are regularly reviewed and benchmarked against performance data from external sources and other comparable healthcare service organizations.

Relevant Standards

Failure to comply with the requirements could lead to an organisation being penalised or reprimanded.

What Skills do Staff Need for the "Variation in Clinical Practice Health Outcomes" Requirement?

Staff engaged in these processes need to have a variety of skills:

How to Assess Staff Competency in the "Variation in Clinical Practice Health Outcomes" Requirement?

Assessing staff competency involves both direct observation and feedback mechanisms to ensure that healthcare providers are proficient in identifying, reporting, and mitigating variations in clinical outcomes. Below are some methods to consider adopting:

1. Performance reviews : Regularly evaluating staff performance through direct observation during clinical activities to gauge adherence to protocols and the ability to manage varying patient outcomes effectively.
2. Self-assessment tools: Utilising self-evaluative tools that allow staff to assess their own skills and knowledge, complemented by peer reviews to provide insights into colleagues' competencies from those who work closely with them.
3. Regular feedback sessions: Conducting frequent discussions that provide staff with the opportunity to receive constructive feedback on their performance, discuss professional challenges, and identify areas for improvement in managing clinical outcome variations.

Strategies to Support Employees Enhance Skills in "Variation in Clinical Practice Health Outcomes"Requirement

Enhancing skills can be achieved through:

• Establish Data Comparison Frameworks: Develop a streamlined process for staff to consistently access and compare internal clinical data with external sources, aiding their understanding of standards and variances both within and outside the organisation
• Participation in Quality Registries: Create incentives or provide support for clinicians to participate in national and state or territory clinical quality registries. This could include allocating time during working hours for registry activities.
• Best Practice Workshops: Conduct workshops focused on understanding and adhering to best practices. These should include case studies that highlight variations in practice and discussions on aligning current practices with best practices.
• Root Cause Analysis Training: Provide training on conducting root cause analyses to understand the reasons behind practice variations, particularly those that deviate significantly from best practices or demonstrate unwarranted variations.
• Resource Allocation Reviews: Regularly assess and review resource allocations, including workforce distribution, to ensure they align with the needs dictated by best practice adjustments. This might involve reallocating resources to areas of higher need or adjusting staff roles based on competency assessments.
• Feedback Mechanisms: Enhance the feedback provided to the governing body and clinicians regarding clinical practices. This should include detailed reports covering the actions taken to align practice with best practices and outcomes of such actions.

Sample Training Plan for Variation in Clinical Practice Health Outcomes

A detailed training plan is critical for skill development in variation in clinical practice health outcomes:

Using the above needs assessment survey as an example - The skill requiring the most attention for variation in clinical practice health outcomes in healthcare are leadership skills and risk management and safety awareness. We can target learning initiatives to fill these gaps to enhance staff competency.

Staff Competency Assessment for Variation in Clinical Practice Health Outcomes- Example

Consider the following survey questions to evaluate staffs recognising and reporting adverse events:

Conclusion

Addressing variation in clinical practice health outcomes is essential for enhancing the quality of patient care and ensuring the efficacy of healthcare services. By effectively training staff to identify, analyse, and manage these variations, healthcare organisations can significantly improve patient outcomes and align more closely with best practices. Furthermore, organisations must provide continuous support through training programs and workshops that focus on current best practices and encourage a collaborative and interdisciplinary approach to healthcare.

References

• Australian Commission on Safety and Quality in Health Care, 2023. 'Clinical Governance Standard'
• Australian Commission on Safety and Quality in Health Care, 2023. 'NSQHS Action 1.28'
• Australian Red Cross, 2024. Adverse Events
• Australian Commission on Safety and Quality in Health Care, 2024. 'User Guide for Reviewing Clinical Variation'