title: Measurement for improvement: a survey of current practice in Australian public hospitals.
abstract: OBJECTIVE
  To identify patient safety measurement tools in use in Australian public hospitals and to determine barriers to their use.
  
  
  METHODS
  Structured survey, conducted between 4 March and 19 May 2005, designed to identify tools, and to assess current use of, levels of satisfaction with, and barriers to use of tools for measuring the domains and subdomains of: organisational capacity to provide safe health care; patient safety incidents; and clinical performance.
  
  
  METHODS
  Hospital executives, managers and clinicians from a nationwide random sample of Australian public hospitals stratified by state and hospital peer grouping.
  
  
  METHODS
  Tools used by hospitals within the three domains and their subdomains; patient safety tools and processes identified by individuals at these hospitals; satisfaction with the tools; and barriers to their use.
  
  
  RESULTS
  Eighty-two of 167 invited hospitals (49%) responded. The survey ascertained a comprehensive list of patient safety measurement tools that are in current use for measuring all patient safety domains. Overall, there was a focus on use of processes rather than quantitative measurement tools. Approximately half the 182 individual respondents from participating hospitals reported satisfaction with existing tools. The main reported barriers were lack of integrated supportive systems, resource constraints and inadequate access to robust measurement tools validated in the Australian context. Measurement of organisational capacity was reported by 50 (61%), of patient safety incidents by 81 (99%) and of clinical performance by 81 (99%).
  
  
  CONCLUSIONS
  Australian public hospitals are measuring the safety of their health care, with some variation in measurement of patient safety domains and their subdomains. Improved access to robust tools may support future standardisation of measurement for improvement.
authors.affiliation: Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Brand
authors.forename: Joanne
authors.initials: J
authors.lastname: Tropea
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Ibrahim
authors.forename: Shaymaa O
authors.initials: SO
authors.lastname: Elkadi
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Bain
authors.forename: David I
authors.initials: DI
authors.lastname: Ben-Tovim
authors.forename: Tracey K
authors.initials: TK
authors.lastname: Bucknall
authors.forename: Peter B
authors.initials: PB
authors.lastname: Greenberg
authors.forename: Allan D
authors.initials: AD
authors.lastname: Spigelman
mesh_terms: D001315:Australia; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D011787:Quality of Health Care; D017751:Safety Management / Q000379:methods*