Quality in Australian Health Care Study 2: a national imperative for safer care

We argue for and outline the design of a second Quality in Australian Health Care Study (QAHCS2), 30 years after the original landmark study. A narrative review of historical developments in Australian patient safety since the publication of QAHCS in 1995, supported by international comparisons and contemporary evidence, was undertaken. QAHCS demonstrated that 16.6% of hospital admissions were associated with patient harm (conceptualised as adverse events), establishing patient safety as a national priority. In the three decades since, extensive reforms and new techniques and technologies have reshaped care, governance and standards. However, we lack benchmarked, large-scale, epidemiologically rigorous data on patient harm in contemporary Australian healthcare. QAHCS2, incorporating advances in digital records, automated adverse event detection and inclusion of primary care, would provide unique, actionable insights for Australia. QAHCS2 aims to determine whether care is safer now than in 1995, to evaluate national safety metrics and to benchmark Australia internationally. Without such evidence, healthcare improvement risks continuing without a reliable compass.