Investigating Clinical Variation in Acute Care


The aims of the ACI Investigating Clinical Variation in Acute Care project are to identify clinical variation in the inpatient management of COPD, CAP and CHF and then assess if this variation may be unwarranted. 

This is achieved by:

  • audit tools that empower individual sites to assess their clinical practice and identify areas for improvement in partnership with the ACI
  • capacity building and access to clinical expertise to  support the identification and prioritization of opportunities for improvement
  • support for networking across sites to share improvement strategies from each other and build capacity across the system.


Unwarranted clinical variation (UCV) is an ongoing barrier to providing safe and effective care for patients. Recognising and addressing UCV has been identified as a shared priority across the NSW Health system.


The ACI Acute Care Portfolio has identified three priority areas – COPD, CAP and CHF – to undertake a project designed to identify variation in clinical care and determine if the variation is unwarranted. The development and implementation of quality improvement plans will then be supported in partnership with LHDs and SHNs.

Process: local discussion, data traingulation, local feedback, formal feedback, further support, collaboratives, forum, evaluation

Current work

The pilot for the project has been completed and an expression of interest has been sent to local health district and specialty health network chief executives.

The ACI will work with individual sites to complete clinical audits, identify areas for improvement and offer assistance with implementation and planning. The ACI is also embarking on a series of Collaboratives as a solution for dissemination of improvement strategies.


The 2017 Bureau of Health Information (BHI) ‘Healthcare in Focus’, will report on seven conditions that exhibit variation in mortality and returns to acute care; chronic obstructive pulmonary disease (COPD), community acquired pneumonia (CAP), congestive heart failure (CHF), acute myocardial infarction (AMI), ischaemic and haemorrhagic stroke and hip fracture. This project is in response to this report and in consultation with the ACI Reducing Unwarranted Clinical Variation Taskforce (RUCVT) and relevant clinical networks.


Key Dates

Pilot Sites

Implementation Sites


Related Initiatives

Further Details

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Michelle Frawley
Network Manager Acute Care Projects Team
02 9464 4625

Carmel Thorn
Network Manager Acute Care Projects Team
02 9464 4610

Page Top | Added: 13 March 2017 | Last modified: 13 March 2017

Michelle Frawley
Network Manager Acute Care Projects Team
02 9464 4625