Professor Anne Duggan on understanding and acting on variation

13 Sep 2016 | Building Leadership & Capability

‘Variation: the good, the bad and the inexplicable’ was the topic covered by Professor Anne Duggan, Senior Medical Advisor at the Australian Commission on Safety and Quality in Health Care, at the latest Open Forum: International Speaker Series event held in Wellington on 30 August 2016.

Professor Duggan talked about engaging clinicians in understanding and acting on warranted and unwarranted variation. She said that reducing unwarranted variation is a priority for countries with developed health systems, including the US, UK, Australia and New Zealand.

'Much of the reason we are not getting the value from health care that we want is down to unwarranted variation. Reducing this variation is a high priority to drive better-value care,' Professor Duggan said.

Professor Duggan said that we need to understand more about the impact of low-value procedures, and the flip side of that, which is a lack of care that would be of benefit.

'We need to look at things differently and to think about care in terms of the value it provides to society.'

She said an example from Australia of a low-value procedure was arthroscopies for people over 55 with arthritis.

'The first Australian Atlas of Healthcare Variation found large variation and a high rate of arthroscopic procedures in this age group.

'We know arthroscopies don’t benefit the majority of this group. When we provide low value care we expose individuals to greater harm than benefit and deprive the community of resources that could be better used elsewhere.'

Richard Hamblin, the Health Quality & Safety Commission’s Director Health Quality Evaluation said: 'If we stopped doing low-value care, we would have more time to do high-value care, and to do it better.'

'We can do the wrong things extremely well, but they are still the wrong things. Undertaking unwarranted treatment or procedures also brings the risk of patient harm – unnecessary procedures are a quality and safety issue.'

He said the health system tends to focus on one-to-one treatment and care, not on the value of care for a whole population.

'We are very volume focused – ‘do as many on the list as you can’. Whereas we need to focus on the overall value and outcome of the health care we provide.'

Presentations from the event, including Professor Duggan’s slides, are available below.

Last updated 20/12/2016