Dr Genevieve Dingle, University of Queensland
Despite the spiralling costs of alcohol-related harm, very little work has been undertaken to establish uniform parameters of quality care in alcohol detoxification and to understand the relationship between these parameters and treatment outcomes. Clinical indicators are critical to health care services as they provide an objective measure of detoxification processes. Indicators can also highlight potential problems, allowing staff to address them early, thus improving treatment outcomes.
In 2006, recognising the importance of good clinical indicators, AOD professionals from Queensland and New South Wales formed the Alcohol and Drugs Clinical Indicators Training (ADCIT) Committee. Their aim was to develop and trial a set of clinical indicators specifically for use in residential alcohol treatment centres. These indicators would provide an evidence-based measure of the quality and efficacy of alcohol treatment services in Australia. The seven indicators selected were:
- Thiamine prescribed during detoxification
- Completion of detoxification
- Seizures during detoxification
- The proportion of clients who completed 70% of the therapeutic program
- The proportion of unplanned discharges
- The proportion of discharges with written discharge plans
- The proportion of clients who attended a follow-up appointment
This study took place at two hospital treatment services one public, one private and involved clients from a range of cultural and socio-economic backgrounds.
This study found that the quality of detoxification services was high in both centres, and that the number of unplanned discharges and other adverse events, was low. Most of the participants attended at least 70% of the therapeutic program and also showed improvements at the three month follow up in both their mood and their level of alcohol consumption. Anecdotal feedback indicates that the information resulting from this study has led to service improvements. The next step in the development of the clinical indicators tool is to define benchmarks for each indicator.