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 three 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 (ED) 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 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
Click the drop-down arrow to see different KPI categories
0 – 49 years
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 95.2% | Actual 96.3% |
|
| Year 2020 | Target 95.2% | Actual 94.7% |
|
| Year 2019 | Target 94.4% | Actual 93.4% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 94.9% | Actual 96.2% |
|
| Year 2020 | Target 94.9% | Actual 96.2% |
|
| Year 2019 | Target 93.4% | Actual 95.6% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 94.1% | Actual 95.9% |
|
| Year 2020 | Target 94.1% | Actual 99.5% |
|
| Year 2019 | Target 93.5% | Actual 96.5% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 92.3% | Actual 95.1% |
|
| Year 2020 | Target 92.3% | Actual 96.3% |
|
| Year 2019 | Target 91.3% | Actual 95.9% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 86.0% | Actual 94.4% |
|
| Year 2020 | Target 86.0% | Actual 90.4% |
|
| Year 2019 | Target 83.2% | Actual 93.2% |
|
Commentary
Effective clinical engagement and coordination of care between the neurology, emergency and acute medical teams continues to result in excellent survival rates for patients experiencing this condition.
The performance of EMHS in the survival rate for stroke was met or exceeded target in all age ranges without exception. In the spirit of continuous quality improvement, all deaths are subject to a peer review as part of a morbidity and mortality review process, with actions taken to address issues and lessons learnt shared amongst clinical teams.
Acute myocardial infarction (AMI)
Results
Click the drop-down arrow to see different KPI categories
0 – 49 years
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 99.1% | Actual 97.7% |
|
| Year 2020 | Target 99.1% | Actual 98.9% |
|
| Year 2019 | Target 99.0% | Actual 100% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 98.8% | Actual 100% |
|
| Year 2020 | Target 98.8% | Actual 98.9% |
|
| Year 2019 | Target 98.9% | Actual 98.7% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 98.1% | Actual 98.9% |
|
| Year 2020 | Target 98.1% | Actual 98.1% |
|
| Year 2019 | Target 98.0% | Actual 98.6% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 96.8% | Actual 97.0% |
|
| Year 2020 | Target 96.8% | Actual 98.2% |
|
| Year 2019 | Target 96.5% | Actual 97.4% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 92.1% | Actual 94.6% |
|
| Year 2020 | Target 92.1% | Actual 94.4% |
|
| Year 2019 | Target 92.2% | Actual 94.8% |
|
Commentary
The performance of EMHS in the survival rate for acute myocardial infarction was equal to or exceeded target for all patients in the 50+ age ranges. This is largely attributed to our sustained timely access for patients to invasive coronary diagnostic and interventional procedures as well as effective inter hospital transfer arrangements of patients from Armadale Health Service (AHS) and St John of God Midland Public Hospital (SJGMPH) to Royal Perth Hospital (RPH).
The 0-49 years age group is slightly below target, representing a small number of complex cases. Monitoring will continue across 2022, with all deaths subject to a peer review as part of a morbidity and mortality review process. Actions taken to address issues and lessons learnt are shared amongst clinical teams.
Fractured neck of femur (FNoF)
Results
Click the drop-down arrow to see different KPI categories
70 – 79 years
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 98.9% | Actual 97.6% |
|
| Year 2020 | Target 98.9% | Actual 99.2% |
|
| Year 2019 | Target 98.9% | Actual 100% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Year 2021 | Target 96.9% | Actual 98.3% |
|
| Year 2020 | Target 96.9% | Actual 98.2% |
|
| Year 2019 | Target 96.1% | Actual 98.5% |
|
Commentary
The performance of EMHS in the survival rate for fractured neck of femur patients exceeded target in the 80+ years age group. The 70-79 years age group is slightly below target, representing a small number of complex cases. Monitoring of the fractured neck of femur pathway will continue across 2022 to actively identify any opportunities for improvement. In the spirit of continuous quality improvement, all deaths are subject to a peer review as part of a morbidity and mortality review process. Actions taken to address issues and lessons learnt are shared amongst clinical teams.
Period: 2019 – 2021 calendar years
Contributing sites: Armadale Health Service, Bentley Health Service, Kalamunda Hospital, Royal Perth Hospital, St John of God Midland Public Hospital
Data source: HMDC
Outcome one // Effectiveness KPI