Collopy B T
ACHS Care Evaluation Program 1989-1999.
Int J Qual Health Care. 2000 Jun;12(3):211-6. doi: 10.1093/intqhc/12.3.211.
The Australian Council on Healthcare Standards (ACHS) established the Care Evaluation Program (CEP) of clinical performance measures in its accreditation program to increase the clinical component of that program and to increase medical practitioner involvement in formal quality activities in their health care organizations. From the introduction of a set of generic indicators in 1993 the program expanded through all of the various medical disciplines and from January 2000 there will be 18 sets (well over 200 indicators) in the program. More than half of Australia's acute hospitals (covering the majority of patient separations) are monitoring the indicators and reporting clinical data twice yearly to the ACHS. In turn they receive a 6-monthly feedback of aggregate and peer comparative results. The ACHS policy had no specific requirement for a set number of indicators to be monitored and it was not mandatory to achieve any specific data threshold to be accredited. However, where an organization's results differed unfavorably from those of its peers some action was expected. Qualitative information is also sent to the CEP and this has enabled a determination of the effectiveness of the indicators. There is documented evidence of improved management and numerous examples of improved patient outcomes. The program remains unique in the scope of the medical disciplines covered and in the formal provider involvement with indicator development. Both the clinical component of accreditation and clinician involvement in quality activities have been increased in an educational process. However, not all of the indicators are of equal value and a reduction in the number of indicators to a 'core' group of the most reliable and responsive ones is in process.
澳大利亚医疗保健标准委员会（ACHS）在其认证项目中设立了临床绩效衡量护理评估项目（CEP），以增强该项目的临床部分，并提高医生对其医疗保健机构正式质量活动的参与度。自1993年引入一套通用指标以来，该项目已扩展至所有医学学科，到2000年1月，该项目将有18套指标（远超200项指标）。澳大利亚半数以上的急症医院（涵盖了大多数出院患者）正在监测这些指标，并每年向ACHS报告两次临床数据。相应地，它们每6个月会收到一次汇总结果和同行比较结果的反馈。ACHS的政策对需监测的指标数量没有具体要求，获得认证也不强制要求达到任何特定的数据阈值。然而，如果一个机构的结果不如同行，就需要采取一些行动。定性信息也会发送给CEP，这有助于确定指标的有效性。有记录证明管理得到了改善，还有许多患者预后改善的实例。该项目在涵盖的医学学科范围以及医疗机构正式参与指标制定方面仍然独具特色。在一个教育过程中，认证的临床部分和临床医生对质量活动的参与度都有所提高。然而，并非所有指标都具有同等价值，目前正在将指标数量减少到一组最可靠、最灵敏的“核心”指标。
