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Table 7 System level reform

From: Increasing the options for reducing adverse events: Results from a modified Delphi technique

Proposals Effect [1 = v.high 6 = negative] mean (std dev) Implement (months) Impact (months) Total (years)
7.1 Higher payments should be made throughout the public and private system for practices that are known to improve safety. Private insurance companies should be mandated to comply with this regulation. Practices known to improve safety might include (a) the use of approved protocols, (b) the performance of procedures in a hospital or facility specifically accredited for the procedure, (c) conduct of the procedure by a specifically accredited provider (several accreditation categories may be desirable). 2.13 (.92) 24 31 4.6
7.2 There should be independent analysis at the national level, as well as individual hospital analysis, of adverse events, to assist in the identification of rare but catastrophic events. 2.50 (.86) 11 27 3.2
7.3 A National Benchmarking Centre for Clinical and Public Health Outcomes should be established to provide hospitals and clinical managers with ready access to standardised outcomes measures for all treatments, particularly major adverse-event causing treatments. 2.41 (.80) 35 32 5.6
7.4 A National Centre for The Development of Clinical Guidelines and Clinical Pathways should be established to (a) promote evidence-based practice, (b) fund, support and disseminate evidence-based clinical guidelines, and (c) prepare model clinical pathways to assist hospitals plan and organise care. 2.27 (.88) 26 31 4.8