Queensland Collaborative for Healthcare Improvement: A Model for the Development of Performance Measures and Quality Improvement Processes in Renal Dialysis

Background: Dialysis service delivery was identified by the Commonwealth as a high cost, high volume service. In response to this situation, funding was received for the planning, development and implementation of a quality program for a pilot group of renal services within Queensland I Iealth renal units in 2001. The program known as the Renal Collaborative now embraces all dialysis units within Queensland Health. Aim: The aim of the Renal Collaborative was to reduce variation in practice within Queensland Health renal units through data collection and feedback systems in order to promote service improvements in clinical practice. Methods: Evidence based guidelines developed by the Caring for Australians with Renal Impairment program provided a platform for the development of clinical indicators. Data collection utilised various statistical analysis methods. Feedback to clinicians was through on line access to the indicators, paper-based summary results and biannual meetings. Results: An effective shared learning model developed through efficient data collection of clinical information from all Queensland Health dialysis units was launched. Clinical staff from individual units now have the opportunity to identify service improvement through evaluating clinical interventions. Conclusion: The development and application of`ready to use' guidelines for dialysis services now permits timely conversion of clinical practice in dialysis areas into plausible clinical indicators and has assisted with data collection for benchmarking. The development of a highly successful collaboration of renal nursing and medical clinicians in dialysis has achieved quality improvement in renal services within Queensland Health.