Activity-based funding for safety and quality: A policy discussion of issues and directions for nursing-focused health services outcomes research.

ABSTRACT

AIMS: A discussion of the implications and opportunities arising from the Commonwealth of Australia health care reform agenda; linking pricing with quality, with particular reference to directions for nursing-focused health services outcomes research directed to improve the safety and quality of health care practices. BACKGROUND: National activity-based funding in Australia is a policy-focused development. As the relationship between cost and quality becomes apparent, the role of clinicians and their contribution to high quality care has become a pressing issue for leadership, teaching, and research. DESIGN: Discussion paper DATA SOURCES This paper is based on seven years' experience as a member of a Commonwealth of Australia statutory committee-the Clinical Advisory Committee of the Independent Hospital Pricing Authority-and is supported by relevant literature and theory. IMPLICATIONS FOR NURSING To date, unravelling the linkage, especially causal relationships, between direct care nursing and patient safety outcomes has not been well established. New activity-based funding data elements developed for national implementation in Australia provide accessible and meaningful standardised data for measurement of never events, hospital-acquired complications, and preventable readmissions.