Australian clinical review / Australian Medical Association [and] the Australian Council on Hospital Standards
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A brief account of the obstacles faced during the introduction of hospital accreditation in Australia is provided, with some insight into the politics of change in health care. Some observations are made concerning critical elements of the accreditation program and the implications for the future of the Australian Council on Healthcare Standards.
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The National Confidential Enquiry into Peri-operative Deaths (NCEPOD) is now established in the United Kingdom (excluding Scotland) as a voluntary, confidential system designed to review the clinical practice which precedes a death within 30 days of surgery. The Enquiry is comprehensive, widely representative and authoritative. To date, two reports have been published and there is an ongoing programme planned. The influence of these reports on the practice of anaesthesia and surgery in Britain is undeniable.
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An analysis was made of 82 public hospitals surveyed by the ACHS in 1990 that had received recommendations for improvement within their Accident and Emergency service. The major areas requiring attention included quality assurance, scope of service, policy and procedure manuals, signposting and the appointment of a medical practitioner responsible for the service. The analysis also revealed that 90% of the recommendations for improvement made by ACHS surveyors at a previous survey had been fully or partially implemented upon resurvey in 1990.
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Eight hundred and ninety-eight patients of the Royal Women's Hospital, Brisbane were surveyed by phone and questionnaire to identify their hospital related child-care needs. In addition, staff in acute admitting areas of the hospital were asked to provide details of child-care problems. Twenty-five (5.2%) of the sample reported hospital related child-care problems, 166 (39.7%) respondents stated that they would use a hospital child-care service on a casual basis and 45 (10.8%) that they would use one for the duration of their stay.
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The study was undertaken to evaluate the use of the Paediatric Evaluation Protocol (PAEP) in the Princess Margaret Hospital for Children, Western Australia. A random sample of 557 patient records was reviewed using the United States Paediatric Appropriateness Evaluation Protocol (AEP). ⋯ Thirteen per cent of admissions and 10% of days of stay may have been medically inappropriate in the year of study. The PAEP is a useful tool for utilization review in children's hospitals in Australia and may with benefit be modified.