Survival rates for sentinel conditions
Rationale
This indicator measures performance in relation to the survival of people who have suffered a sentinel condition – specifically a stroke, acute myocardial infarction (AMI), or fractured neck of femur (FNOF).
These 3 conditions have been chosen as they are leading causes of hospitalisation and death in Australia for which there are accepted clinical management practices and guidelines. Patient survival after being admitted for one of these sentinel conditions can be affected by many factors including the diagnosis, the treatment given, or procedure performed, age, co-morbidities at the time of the admission, and complications which may have developed while in hospital. However, survival is more likely when there is early intervention and appropriate care on presentation to an emergency department and on admission to hospital.
By reviewing survival rates and conducting case-level analysis, targeted strategies can be developed that aim to increase patient survival after being admitted for a sentinel condition.
Target
Please see the 2023 target for each condition noted in the results per age group. Improved or maintained performance is demonstrated by a result equal to or exceeding target.
Stroke
Results
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0 – 49 years
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 95.6% | Actual 95.2% |
|
| Years 2022 | Target | Actual 94.7% |
|
| Years 2021 | Target | Actual 96.3% |
|
| Years 2020 | Target | Actual 94.7% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 95.1% | Actual 94.0% |
|
| Years 2022 | Target | Actual 99.0% |
|
| Years 2021 | Target | Actual 96.2% |
|
| Years 2020 | Target | Actual 96.2% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 94.7% | Actual 94.7% |
|
| Years 2022 | Target | Actual 97.2% |
|
| Years 2021 | Target | Actual 95.9% |
|
| Years 2020 | Target | Actual 99.5% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 92.7% | Actual 92.2% |
|
| Years 2022 | Target | Actual 94.4% |
|
| Years 2021 | Target | Actual 95.1% |
|
| Years 2020 | Target | Actual 96.3% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 87.6% | Actual 89.5% |
|
| Years 2022 | Target | Actual 89.8% |
|
| Years 2021 | Target | Actual 94.4% |
|
| Years 2020 | Target | Actual 90.4% |
|
Commentary
EMHS’ performance in the survival rate for stroke was slightly below target in 3 of the age ranges, with an increase in the complexity and acuity of cases contributing to rate of survival.
All inpatient deaths are subject to peer review as part of a morbidity and mortality review process to identify opportunities for quality improvement and organisational learning, and findings are shared amongst clinical teams.
EMHS’ performance in 2023 remains very comparable with prior years, and against all age ranges. While the performance in 3 groups fell marginally short of meeting the 2023 targets, actual performance has been relatively steady across the reported years.
Acute myocardial infarction (AMI)
Results
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0 – 49 years
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 98.9% | Actual 98.4% |
|
| Years 2022 | Target | Actual 99.4% |
|
| Years 2021 | Target | Actual 97.7% |
|
| Years 2020 | Target | Actual 98.9% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 99.0% | Actual 99.7% |
|
| Years 2022 | Target | Actual 99.0% |
|
| Years 2021 | Target | Actual 100% |
|
| Years 2020 | Target | Actual 98.9 |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 98.1% | Actual 98.6% |
|
| Years 2022 | Target | Actual 99.4% |
|
| Years 2021 | Target | Actual 98.9% |
|
| Years 2020 | Target | Actual 98.1% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 97.1% | Actual 97.6% |
|
| Years 2022 | Target | Actual 96.7% |
|
| Years 2021 | Target | Actual 97.0% |
|
| Years 2020 | Target | Actual 98.2% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 92.7% | Actual 92.6% |
|
| Years 2022 | Target | Actual 96.0% |
|
| Years 2021 | Target | Actual 94.6% |
|
| Years 2020 | Target | Actual 94.4% |
|
Commentary
EMHS’ performance in the survival rate for AMI remained within the acceptable target range or exceeded target for most age groups. This result can be largely attributed to patients obtaining timely access to invasive coronary diagnostic and interventional procedures, as well as more timely inter-hospital transfer arrangements for patients from Armadale Health Service (AHS) and St John of God Midland Public Hospital (SJGMPH) to Royal Perth Hospital (RPH).
Monitoring will continue throughout 2024, with all inpatient deaths subject to peer review as part of a morbidity and mortality review process.
Performance across the reported years has been steady and EMHS has continually achieved a percentage rating above 90 per cent in all age ranges for 4 years.
Fractured neck of femur (FNoF)
Results
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70 – 79 years
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 98.9% | Actual 99.4% |
|
| Years 2022 | Target | Actual 99.3% |
|
| Years 2021 | Target | Actual 97.6% |
|
| Years 2020 | Target | Actual 99.2% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2023 | Target 97.5% | Actual 97.0% |
|
| Years 2022 | Target | Actual 97.6% |
|
| Years 2021 | Target | Actual 98.3% |
|
| Years 2020 | Target | Actual 98.2% |
|
Commentary
EMHS’ performance in the survival rate for fractured neck of femur patients exceeded target in the 70-79 years age range and was slightly below target for the 80+ years age group.
Monitoring of the fractured neck of femur pathway will continue throughout 2024 to actively identify any opportunities for improvement. All inpatient deaths are further subject to peer review as part of a morbidity and mortality review process. Actions taken to address issues and lessons learnt are shared with clinical teams.
The results for 2023 are comparable with reported results from prior years, indicating that performance is steady and a high percentage of inpatients continue to survive a fractured neck of femur event.
Period: 2020 to 2023 calendar years
Contributing sites: Armadale/Kelmscott Memorial Hospital, Bentley Hospital, Kalamunda Hospital, Royal Perth Hospital, St John of God Midland Public Hospital
Data source: HMDC
Outcome one // Effectiveness KPI