Quality Reporting
Quality Reporting Frequently Asked Questions
Frequently asked questions about quality reporting.
The Quality Reporting (QR) Project developing the Common Standards and a National Quality Reporting Framework aims to streamline current quality reporting processes and ensure the quality of services across all community care programs funded by the Australian Government.
This work is being conducted in partnership with State and Territory Governments and the community care sector. Initially the work was guided by the inter-jurisdictional body, the Planning and Accountability Working Group (PAWG) under the overarching direction of Community Aged Care Officials (CACO). Since April 2008, the Quality Reporting Working Party is guiding the work, also under CACO direction. Australian Healthcare Associates (AHA) were the project consultants who developed the Common Standards and the National Quality Reporting Framework.
Q: Which standards do service providers currently report against?
A: Some of these standards are:- the Accountability Reporting model developed for the providers of Community Aged Care Packages (CACP), Extended Aged Care at Home (EACH) and National Respite for Carers Program (NRCP)
- Quality Improvement Council Standards (QIC)
- the Australian Council on Health Care Standards (EQuIP)
- International Standards Organisation (ISO)
- Home and Community Care (HACC) Standards
- Disability Service Standards.
Q: How will implementation of Common Standards benefit the community care industry?
A: Service providers, clients and their carers will benefit from the implementation of Common Standards in a number of ways:Service providers will be assisted by a simplified and streamlined quality reporting system. The time service providers currently spend reporting the same aspect of quality across multiple programs may be reduced. They will also benefit from the introduction of the new approach to quality reporting which will encourage improvements in the quality of systems such as management systems. This may be expected to contribute directly to, and result in, improvements in the provision of the care itself.
Client and their carers will benefit from an ongoing improvements in the quality of services resulting from the introduction of the new approach to quality reporting.
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Q: What work has been undertaken by Australian Healthcare Associates?
A: AHA completed three major pieces of work:- A Stage 1 Report and Options Paper
- Development of Common Standards
- Development of supporting documentation to be used in reporting quality against the Common Standards, including guides for assessors and service providers and a self-assessment tool.
Q: What were the options identified in the research to streamline current standards?
A: The options were:- no change to existing standards
- standardising the language and structure of existing standards
- develop consistent standards based on HACC standards with some flexibility for specific programs and varying outcomes
- develop completely new standards and outcomes.
Q: What options were identified for the Reporting Approach ?
A: Three broad options were identified for the reporting frameworks:1. No change
2. Consistent reporting using a compliance-based approach (similar to HACC approach)
3. Consistent reporting using a Continuous Quality Improvement (CQI) approach (similar to CACP/EACH/NRCP approach).
The PAWG proposed a CQI approach (Option 3) as it had many advantages over a compliance approach (Option 2). CQI provided flexibility to providers in how they achieve outcomes and encouraged them to develop organisational structures and systems based on the principles of continuous improvement. This approach would assist providers to meet the standards on an ongoing basis.
The CQI approach included a requirement for a set of core outcomes, representing the quality outcomes to be achieved by all providers receiving government funding. Each component of the standards and approach would also be supported through comprehensive ongoing training and development provided to all community care service providers.
Q: What was the purpose of the Stage 1 Report and Options Paper?
A: This combined Report and Options Paper was a Mapping Exercise which reviewed the literature and fifteen (seven main government and eight other non-government e.g. ACHS-EQuIP, QIC, ISO9001:2000) quality reporting and monitoring systems currently in place in the community care sector across Australia and those used for Multipurpose Services.Another purpose of the paper was to identify options for enhancing and/or modifying those standards and a national framework to report performance against those standards.
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Q: What were the Key Findings of the Mapping Exercise?
A: Comparison of the standards for government-funded community care programs showed many areas of similarity. Other than the MPS Principles, all had a strong focus on:- individual consumer outcomes
- assessment
- review
- co-ordination and planning of consumer services
- informing consumers of their rights and service choices
While there was much similarity across government funded programs, there were also notable differences, such as:
- the CACP and the EACH standards did not explicitly address the areas of service management quality risk system or risk management and neither were formally monitored in the QR process
- the HACC standards did not specifically address the need for formal quality systems or risk management systems.
The literature review highlighted the need for the development of standards which were focused on client outcomes, that were measurable and encouraged CQI.
In relation to the various accreditation and other monitoring programs, there was much commonality with standards for government-funded community care programs in the area of management processes and systems.
Monitoring and reporting frameworks were also compared, in particular the HACC Program and the quality reporting trial for CACP, EACH and NRCP.
A 2005 review of the HACC Program quality reporting process and a survey to establish the sector response to the newly introduced Quality Reporting for CACP, EACH & NRCP found many areas of similarity between the Quality Reporting and HACC reporting approaches. In particular, all involved self assessment, desk top review, site visit and reporting. This design appeared to be widely accepted by service providers and was the approach adopted by the majority of recognised accreditation bodies.
However, major areas of difference between the HACC and Australian Government approaches were identified. They included:
- HACC took a more prescriptive, compliance approach, and the assessment tools enabled results to be provided in the form of a rating score for providers
- the Australian Government programs took a broader CQI approach, which was less specific in terms of requirements and did not provide a scoring or rating of providers.
Q: How will performance be assessed?
A: At this stage, no decision has been made about what mechanisms will be used to assess quality against the Common Standards. Draft guidelines for service providers and for assessors are being developed, including a self assessment tool. These guides will be piloted together with the Common Standards.However, the process for assessment is likely to comprise of:
- self assessment
- desk top review
- validation site visit
- reporting
- quality action plan
- follow up.
Q: Has the sector been consulted about the development of the Common Standards and the National Quality Reporting Framework?
A: Yes, the sector has been consulted twice:- In April-June 2007 the community care sector was consulted about Options 3 and 4, the Common Standards and their Expected Outcomes in their (then) state of development, as well as the proposed CQI reporting approach.
Background information, a series of questions about the project, the Standards and their Outcomes, and the reporting approach were compiled in a paper titled Streamlining Quality Reporting. This report was available on the Department of Health and Ageing's website, and was also distributed to the State and Territory jurisdictions. 128 responses were received from the sector. - In September-October 2007 the community care sector was consulted about the initial performance criteria developed after the first consultation. These are the criteria which service providers must satisfy to demonstrate they have achieved the Common Standards' Expected Outcomes.
The Common Standards and their newly drafted Performance Criteria were uploaded to the Departmental website. Flyers about the consultation and the availability of the information on the website were distributed at the 2007 ACSA National Conference. Forty-two replies were received.
Q: What was feedback from the April-June 2007 consultation?
A: The feedback indicated that the sector agreed on the proposed Common Standards, Expected Outcomes and the CQI approach. The feedback rejected Option 4, preferring Option 3 instead.Q: What was the feedback from the September-October 2007 consultation?
A: Eight major themes were identified in the feedback. The two biggest themes were the importance of appropriate terminology and a suitable place for elder abuse in the Common Standards. The other themes included brokerage, the growing importance of culturally sensitive service provision, measurability, special needs groups, mutual recognition and social independence.Q: What was the impact of these two consultations on the Common Standards?
A: The feedback from the two external consultations, along with internal feedback, was used to develop seven Common Standards with Expected Outcomes and initial Performance Criteria which were endorsed by the Planning and Accountability Working Group (PAWG) in December 2007 and by Community and Aged Care Officials (CACO) in February 2008 as suitable for piloting with a representative range of community care service providers.In February 2008, the PAWG also endorsed for piloting the Self-Assessment Tool and the Assessment and Providers' Guidelines which were drafted by the Project Consultants, Australian Healthcare Associates. This tool and the guidelines will be used by service providers when reporting quality against the Common Standards.
Q: When will the piloting of the Common Standards and the Tool and Guidelines occur?
A: A program for the piloting of the Common Standards and the assessment tool and guidelines is being developed.The work involved in the piloting will be progressed by the Quality Reporting Working Party focused on the development of common arrangements for quality reporting.
Issues such as training and technology requirements will be addressed during the piloting.
Q: How does the work on Common Standards fit with other reforms to community care?
A: Under a 2007-08 Budget initiative the Department of Health and Ageing is implementing a $1.6 billion package of reforms that will ensure older Australians can continue to experience quality, choice and affordability in aged care. Part of the work under this initiative aligns with the work on Common Standards to streamline quality reporting across community care programs and will provide clearer expectations about the quality of services for care recipients.Top of page