Extending facility accreditation to the evaluation of care: the Australian experience.

The Australian Council on Healthcare Standards (ACHS) has introduced clinical performance measures--clinical indicators--into the accreditation process. The indicators are developed with the assistance of the various medical colleges (professional associations of specialists). Sixteen such bodies are now in the program, with 150 draft indicators covering 90 areas of hospital practice. The development of a set of indicators passes through a number of stages to ensure their validity, and a process is in place to assess their reliability, reproducibility and responsiveness. The qualitative information available indicates a willingness on the part of health care facilities to address the indicators, and alter the process of care. It is anticipated that the quantitative information being collected in aggregate form will subsequently demonstrate an improvement in the outcome of care. Hospital specific information currently remains confidential to the ACHS and the particular health care facility. The public release of such information and the value of doing so remains undetermined.