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Establishing Quality Health Standards (EQHS) Newsletter No.7

PDF and HTML version of the EQHS newsletters edition 7.

PDF versions: Establishing Quality Health Standards (EQHS) Newsletter 7 July - December 2010 (PDF 950 KB)

Welcome…

Welcome to the seventh EQHS Newsletter. In this edition, we reflect on the many achievements during the last year and take a sneak peak at what is to comein the new year within the EQHS world. We have had an incredibly busy year with an overwhelming response to the final funding round of the Accreditation Support Grants and Facilitator engagements.

We have also had a significant number of health services become accredited under clinical and organisational standards which has been a fantastic achievement. Some of these services have shared their experiences with us; including in this edition an exclusive interview with the CEO of Warlpiri Youth Development Aboriginal Corporation, Mt Theo Program.

There is also a number of changes within the EQHS world with a few farewells and welcomes. We wish to particularly thank the Affiliate Accreditation Officers who are about to leave or have left in the past few weeks, Karen Dunmore (from AHCWA) and Christine Ryan (from QAIHC). Your contribution has been invaluable and you will be missed.

Above all, we want to wish you all a very merry and safe Christmas. We look forward to working with you all in the New Year.

From the OATSIH Quality and Accreditation Team
Final Accreditation Support Grant Round CompleteThe sixth and final funding round of the Accreditation Support Grants (ASGs) closed on 15 September 2010. The response was overwhelming with 98 applications received; triple the usual amount of applications! Assessment is now complete with a sigh of relief from the assessment panel.

We are hoping to notify organisations of the outcome of the application process in early 2011.

ASGs have been extremely successful and have played a vital part in getting organisations over the line in achieving accreditation under Australia’s quality health care standards. We wish to thank everyone who submitted an ASG and wish you well on your path to accreditation.

For more information about Accreditation Support Grants, call the OATSIH Accreditation Information Line on 1800 723 676, or talk to your Affiliate Accreditation Officer or OATSIH Project Officer.

Interpretive Guide for ISO9001:2008 Standards

Following the successful introduction of the interpretative guides for the Royal Australian College of General Practitioners (RACGP) and Quality Improvement Council (QIC) Standards, aimed to assist Indigenous health organisations in the accreditation process, OATSIH is working with the ISO Standards copyright owner, Standards Australia, to produce a publication to interpret the ISO9001:2008 Quality Management Systems Standards (ISO Standards).

ISO9001:2008 is a set of organisational accreditation Standards. This is one of three sets of organizational Standards that OATSIH can assist eligible health organisations to meet through its Establishing Quality Health Standards (EQHS) Budget measure. The other two are QIC and EQuIP (Evaluation and Quality Improvement Program).

EQuIP provides both organisational and clinical accreditation while RACGP Standards leads to clinical accreditation only. While the QIC Interpretive Guide has been out for a while, OATSIH has noted an increase in organisations starting on the path to ISO certification. In line with this, many organisations have asked for an ISO Interpretive Guide. It is anticipated that this new guide will help organisations to make an informed decision about what standards to pursue for organisational accreditation.

The ISO Interpretive Guide is expected to be available mid-2011 and organizations that are eligible for support under EQHS will be sent copies.

Training & Development Scheme

The last Funding Round of the Long Term stream closed 19 November 2010. Congratulations to the 20 people approved for study in Semester 1, 2011 – we wish you well in your study.

Please Note - the Short Term stream will cease as at 31 January 2011. Applications cannot be accepted past this date.

On a sad note, we farewell Kym Phillips, our friendly TDS co-ordinator, as she leaves NTGPE to take up another opportunity and new challenges in another role. Thank you for your enthusiasm, passion and all your hard work with the TDS. We wish you well in your new endeavours.

Kym has been replaced by Alex Billeter. Alex comes from Florida and has been working in Oz since 2009. She has a degree in business administration, with majors in marketing and Business administration.

She joined NTGPE in Feb 2009 temping in the receptionist role and has moved into the position of TDS & Housing Administrative officer. She is friendly, enthusiastic and positive and always happy to talk to you.

Welcome Alex, we look forward to working with you!

New 4th Edition of the RACGP Standards Now Available!

The RACGP Standards for general practices (4th edition) are now live with a free PDF copy available on the College website at: http://www.racgp.org.au/standards.

This interactive version of the Standards will enable health services to make direct links to all the resources listed in the document and to cross reference relevant criteria.

The RACGP Standards for general practices (4th edition) was officially launched at GP10 – the RACGP annual conference - in October 2010. The RACGP's Computer security guidelines: a self assessment guide and checklist for general practices (3rd edition) is a free companion document which can be accessed at: www.racgp.org.au/ehealth/csg.

Also keep an eye out for the release of another free companion document by the RACGP called the Patient feedback guide. This new guide will be an essential resource for meeting Criterion 2.1.2, Patient feedback, in the 4th edition Standards.

RACGP has advised that for health services wishing to become accredited against the RACGP Standards, there will be a period of grace in the changeover from the 3rd to the 4th edition. This transition period will allow health services to become familiar with the 4th edition Standards, update practice systems and purchase new equipment as required.

QAIHC Safety & Quality Awards

On the evening of Thursday 9 December, at the Hilton Brisbane, the Queensland Aboriginal and Islander Health Council (QAIHC) held its annual Hall of Fame Awards dinner to induct outstanding individuals who have made significant contributions in the arena of Indigenous health. The Hall of Fame Awards dinner, was for the first time, also the venue for another expression of recognition, for quality, not for individuals, but organisations; the QAIHC Safety and Quality Awards.

When asked about the purpose of the awards, QAIHC’s CEO, Selwyn Button, said “the main intent of the quality awards is to recognise our member services commitment to safety and quality and continuous improvement”.

Selwyn Button also said the Safety and Quality Awards aren’t, “just about clinical outcomes but also business and operational outcomes. The benefits of accreditation for our services is about continuous improvement, capacity building and ensuring we bring high quality services by building their capacity to deliver those high quality services.”

“Just because we are talking about Aboriginal and Torres Strait Islander organisations, we shouldn’t expect second class or second rate services in terms of service provision for our mob coming into our services. What we’re saying is that in order to close the gap, we need high quality world class services and our community controlled services can provide that. The safety and quality awards are a recognition of our services working towards world class, quality services.”

The services recognised at these inaugural Safety and Quality awards were: Mackay Aboriginal and Torres Strait Islander Community Health Service; North Queensland’s, Mulungu Aboriginal Corporation; and Nhulundu Wooriba Indigenous Health Organisation at Gladstone.

Article submitted by QAIHC

Budja Budja Aboriginal Co-operative Celebrates Latest Achievement

Budja Budja Aboriginal Co–operative, located in Halls Gap Victoria, are pleased to announce that they have recently been successful in attaining AGPAL accreditation under RACGP standards.

Achieving accreditation for the first time is a huge achievement, but the fact that Budja Budja has less than ten staff shows the commitment to providing the local Aboriginal community with the highest quality health care.

Everyone at the practice has played a valuable role in working to meet the standards. It has given staff a real sense of pride to work in an accredited practice. Budja Budja Medical Practice proudly displays the AGPAL logo for all their patients to see.

Budja Budja staff say; “We want to communicate to our patients that their wellbeing is our priority. By being accredited, our patients know we are committed to providing quality care that meets the RACGP’s standards.”

Article submitted by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO)

A conversation with Susie Low, CEO, Warlpiri Youth Development Aboriginal Corporation (WYDAC), Mount Theo Program Background

The Mt Theo Program was started by the Yuendumu Community in 1993 to address chronic petrol sniffing in Yuendumu. The program has since broadened in nature and scope to provide a comprehensive program of youth development and leadership, diversion, respite, rehabilitation, and aftercare throughout the Warlpiri region.

Mt Theo Program dedicates itself to developing strength, health, meaningful pathways and leadership in Warlpiri youth. The sustainable, and notable, success of the program is based on the support, strength and character of Warlpiri youth and their communities, and the outstanding dedication of its staff. The program is governed by a Committee of 62 Warlpiri people.

Congratulations to you and your organisation on achieving ISO accreditation. How did you find the whole assessment process under ISO and what were your biggest challenges?
The process was very challenging, long and precise. It was something we wanted to do for a long time and it took about two and a half to three years to complete. It was a massive amount of work and the biggest challenge was probably continuing to function as a service while working toward accreditation as a priority.

How did you deal with these challenges while also inspiring your staff to prioritise accreditation?
It was a management process in the initial stages as we tried to get our heads around everything. As we started to develop policies, we passed them on to staff for their comment and input. The day to day running of our service continued as per usual, although at times we had to pull some people away from their day to day duties in order to go through everything together. A lot of the high level management tasks were passed to the Operations Manager and we also identified another employee as a Quality Officer.

What kind of support did you seek from OATSIH in terms of getting resources to achieve accreditation?
The main thing that we requested was a facilitator who turned out to be fantastic. The other things we asked for was funding for workshops and some IT support, along with registration costs.

What have been the major changes within the organisation since receiving ISO accreditation in terms of outcomes, improvements to your staff, managers and yourself?
There have been huge changes within the organisation. Staff and managers are now much clearer about their particular roles and responsibilities. They have really effective systems in place such as procedures and policies. They have a register for everything, such as equipments, suppliers, and assets. We are now on top of what we have and we can plan our services accordingly.

We now have people entering data into a quality system, which to them may just be about running their programs but what they are actually doing is entering data which we can analyse in the next six months which will allow us to make informed decisions and changes to continuously better ourselves.

Practices were previously only really understood and were not identified as procedures or protocols as they were not clearly documented. Although people did a fantastic job, the best they could, there was always times that we encountered problems. We basically felt we didn’t always have good control.

We now feel more efficient, transparent and sustainable. We flew through our most recent OATSIH risk assessment. We feel like if we all got hit by a bus, people could come in, read our systems and continue to run our service. The whole mindset of our staff has shifted to continuously trying to do things the best way we can.

That is such an amazing achievement; do you feel the clients have felt/noticed the changes in culture and improved practices?
Yes definitely. Stakeholders have provided quite positive feedback on our feedback register in terms of our efficiency and follow through. Clients have noticed that different activities are available as well as the activity hours being more concrete. Overall, the feeling in the community is that we are “doing it better!” Overall, there is a strong sense of community pride in the Program.

As CEO, how did you drive the accreditation process to help the organisation achieve this outcome?
To start with, I was just doing the work my self and talking to people about it very enthusiastically. They were shown through workshops how doing certain things would make thier job easier, and they all ran with it as they could see the value. It is now organisational culture to think about quality. There was a willingness to learn and grow among my young and enthusiastic team.

How did you find the ASG application process? How was it helpful in achieving accreditation? And did you feel you had enough support?
The ASG process could not have been simpler and it is all owed to the excellent facilitation support we received by our facilitator who basically took carriage of the process and made it far smoother than we thought possible. Her work with us was extremely valuable in achieving accreditation and I would definitely be looking at maintaining our working relationship in the future for continuous quality improvement of the organisation.

Because ISO is generic, did you find it hard to apply it to a health service setting?
A lot of it was straight forward however we constantly had to change the idea of ‘product’ to ‘service’. Every time I saw the word product, I would just automatically adapt my mind to say service.

What do you feel the ISO assessors were looking for during the site visit?
The main thing they were looking for was that we had appropriate policies and procedures in place and that continuous improvement was embedded into our systems and processes. Whether an issues was generated from an incident or a staff suggestion, they wanted to check that it was accurately recorded and that follow through had occurred.

They checked documents and notation of documents in terms of when they were reviewed and when they should be reviewed. They looked at whether internal audits were an ongoing process and that actions arising out of internal audits were followed through. Overall they wanted a demonstration that we were living and breathing the new system. We were so pleased with our unqualified recommendation.

Congratulations again and thank you for taking the time to talk to us. Thilani & Jess, Q&A

Ngalkanbuy’s Journey to Accreditation

Ngalkanbuy Health Service is managed by Miwatj Aboriginal Health Corporation. Ngalkanbuy Health Service is located at Galiwin’ku on Elcho Island approximately 500km from Darwin. It is a Northern Territory Growth Town. Ngalkanbuy originally signed up to undertake the RACGP Standards accreditation in 2000.

Following a recent audit, we have been notified by AGPAL that subject to clarification on a couple of issues Ngalkanbuy will receive accreditation. This has been a great achievement for all of the staff.

When we re-visited accreditation in 2009, we decided that we wanted to achieve best practice standards across the health service. We were assisted in this by the services offered by our OATSIH accreditation facilitator.

One of the outstanding features of our quality improvement program was the support and commitment from all staff to the process. It was essential that staff were a part of the whole process and had ownership over the changes implemented. This has been achieved and the experience, whilst being hard work, has been extremely positive.

There were many issues that faced Ngalkanbuy Health Service in becoming accredited. We are in a very isolated location, provide services to over 3500 people and are the only 24 hour health service on the island. The building we operate out of is old and was never originally intended to be a health clinic. The building was constructed in the 1980s as a small hospital. There have been renovations over the years mostly not within an AGPAL accredited standard. We have extremely limited facilities and support services.

We offer comprehensive health services and have a large representation of local people who make up our workforce of Aboriginal health workers, community workers, cleaners and transport staff. We are supported by registered nurses, general practitioners and visiting specialists. Often it is very difficult to get doctors and nurses over to the island which means that our local staff provide additional support and services and especially support continuity of care and follow-up of clients.

We took many positive initiatives as part of the program. We purchased and installed an Australian Standards incinerator, which means that we are now entirely self sufficient with our waste management. The incinerator meets Australian Standards for destruction of clinical waste which means clinical waste no longer has to be transported off the island. Another initiative was to write policies and procedures that were specifically for the service. With so many locum staff it is difficult to maintain systems and standards. Having policies that are specific to us and consistent with best practice standards makes it much easier to manage the service and monitor the standard of care provided.

The cleaning staff undertook additional training at Darwin Hospital which has made a huge difference to the way we manage the cleaning. This is an enormous job given our location and the geography and weather of the island. We were unable to obtain funding to provide a properly sheltered area for clients during the wet season but we are hoping to improve this in the future. We did however obtain funding for a new ambulance. For years we have been using a Toyota Troopy which was not properly fitted out and did not meet any OH&S standards. As the only provider of emergency health services on the island this has made a huge contribution to our ability to provide emergency care and treatment in a way that does not pose a threat to the safety of staff.

We have long been committed to staff professional development and continuing education and we now have formalised policies on this.

Our experience of implementing a quality improvement system has been so positive that we have decided to proceed to implementing the Quality Improvement Council Standards (QIC) and achieve accreditation with QICSA. This will be a two or three year journey and will require a lot of commitment and dedication from staff.

Ngalkanbuy Health Service may well be the first Aboriginal community controlled health service in the Northern Territory to receive QIC accreditation!

Ngalkanbuy Health will be the first remote AMS in North East Arnhemland to achieve AGPAL accreditation.

We are very proud of our achievements at Ngalkanbuy Health Service and continue to strive for excellence in health care for all people and in particular for the local Yolungu people.

Article submitted by Ngalkanbuy Health Clinic

Update - WANADA Alcohol and Other Drug Standards

In July 2010 WANADA began a project jointly funded by OATSIH and the WA Drug and Alcohol Office to develop AOD-specific accreditation standards. These standards are intended to offer a “clinical” alternative to AOD organisations that would otherwise have to seek organisational accreditation.

The new AOD accreditation standards would build on the existing WA AOD Quality Framework and cultural security will be embedded throughout the standards. These standards would be equivalent to RACGP accreditation, and provide an achievable first step for AOD organisations, that could then go on to seek organizational accreditation as the next step, similar to the accreditation pathway available to organisations with a GP.

Steve Einfeld, CEO, Quality Improvement Council (QIC) said that “the QIC endorses other standards and maps other standards against their own so there is no duplication, hence organisations could potentially be assessed against the new WANADA standards and QIC standards as part of the same accreditation visit/assessment”.

WANADA is expecting this project to be completed, with the standards endorsed by mid-2011. Consultative processes will commence in early February including jurisdictional workshops. Following the development of these standards WANADA intends to develop an Interpretive Guide for the new standards similar to the previously developed RACGP and QIC Interpretive Guides.

Indigenous Health Service Accreditation Implementation Group

On 30 November 2010, OATSIH held the second Indigenous Health Service Accreditation Implementation Group (IHSAIG) meeting. This group comprises NACCHO and Affiliate accreditation officers and standards agency representatives, and was established by OATSIH to assist with the implementation of EQHS support mechanisms. This meeting was a great opportunity for us all to reflect on our incredible achievements to date. Some of our major highlights include:

• 92% of our organisations are either accredited or working towards accreditation, and have either received a grant, accessed a Facilitator or have worked with their Affiliate.
• 46% of organisations are currently accredited; and 35 organisations have become accredited since EQHS. This figure has more then doubled since the first IHSAIG meeting 12 months ago, which is a huge achievement!

The Affiliates were congratulated on the work they are doing with their organisations. Currently 77% of organisations are working with their Affiliate in accreditation related activities!

IHSAIG was also a great opportunity for members to discuss options for supporting the sector after the cessation of EQHS on 30 June 2011.

Facilitators

All Facilitator engagements ceased at the end of August 2010. There was an overwhelming response with 31 new facilitator engagements executed between July and August (see table below for a breakdown by jurisdiction).

Overall, 154 organisations have chosen to work with an EQHS Facilitator over the last three years to assist them in achieving accreditation. Twenty three organizations have decided to request a Facilitator to assist them achieve organizational accreditation as well as clinical!

Walpiri Youth Development Aboriginal Corporation (Mount Theo Program) recently achieved organizational accreditation under ISO standards. Susie Low, the CEO of the organisation said in relation to their facilitator "the whole process was made simple because of the excellent facilitation support we received".

State/Territory	Number of organizations that have engaged a Facilitator
NSW	6
NT	6
QLD	4
SA	2
VIC	6
WA	3
TAS	4
Total	31

Congratulations

Since our last newsletter to you in February 2010, the following organisations have achieved accreditation with support provided under EQHS.

Nindilingarri Cultural Heath Service (WA)

ISO 9001 QMS Requirements - New accreditation

Barkly Region Alcohol and Drug Abuse Advisory Group Incorporated (NT)

ISO 9001 QMS Requirements - New accreditation

Walpiri Youth Development Aboriginal Corporation (Mount Theo Program) (NT)

ISO 9001 QMS Requirements - New accreditation

Budja Budja Aboriginal Cooperative (VIC)

RACGP - New accreditation

Amoonguna Health Service (NT)

RACGP - New accreditation

Nhulundu Wooribah Indigenous Health Organisation (QLD)

RACGP - New accreditation

Ceduna Koonibba Aboriginal Health Service (SA)

RACGP - New accreditation

Weigelli Centre Aboriginal Corporation (NSW)

QIC - New accreditation

Flinders Island Aboriginal Association (TAS)

RACGP - New accreditation

Gippsland and East Gippsland Aboriginal Cooperative (VIC)

QIC - New accreditation

Biripi Aboriginal Corporation Medical Centre (NSW)

RACGP - Re-accreditation

Ngalkanbuy Health Service (NT)

RACGP - New accreditation

Wurli Wurilinjang Aboriginal Health Service (NT)

RACGP - Re-accreditation

Umoona Tjutagku Health Service (SA)

RACGP - New accreditation

Gurriny Yealamucka Health Services Aboriginal Corporation (QLD)

RACGP - New accreditation

Changing faces of Q&A Team

After nearly three years , the Q&A team sadly farewells team leaders Wendy Richardson and Thilani Mulrine. Both are leaving the Department of Health & Ageing to go to the Department of Immigration and Department of Defence respectively. We wish them well in their new roles.

We also welcome Nicholas A Jones to the team. Nicholas will be commencing early in the new year.
A few words from NickPrior to joining the Quality and Accreditation Section I was working with DoHA on the implementation and management of the PIP Indigenous Health Incentive.
My earlier years were spent working with NGOs in direct service delivery in Victoria, mainly in the delivery of youth accommodation programs.

I followed that with a stint working in London on support programs to recently arrived asylum seekers. I then moved into the management of funding programs with the NSW Government where I was involved in developing the NSW service systems for people with disabilities, and later, for children in Out–of–Home–Care.

More recently, I headed up a project with the NSW Department of Human Services building the capacity of NSW Indigenous organisations to meet state accreditation requirements and to deliver increased services.

I am very pleased to have joined the Q&A Team and am looking forward to the opportunity to work with stakeholders on the delivery of the EQHS program.

If you are interested in participating in accreditation and/or would like to find out more about EQHS, please contact OATSIH by email: OATSIHqualityenquiries@health.gov.au or phone: 1800 723 676

Team Responsibilities	Contacts	Phone
Director	Sunita Dhindsa	02 6289 7569
Team Leader National Quality Network Activities Local Accreditation Support (Affiliates) Facilitators	Claire Clack Giselle De Ruyter Nick Jones	02 6289 3932 02 6289 4667 02 6289 3641
Team Leader Accreditation Support Grants Training and Development Scheme Sector Newsletter	Thilani Mulrine (until late January 2011) Jess Dalla	02 6289 7781 02 6289 2335
Team Leader EQHS Evaluation Continuous Quality Improvement & accreditation policy State & Territory Government Liaison	Rebecca Hosemans Aurysia Hii Giorgina Williams Brian Whitton	02 6289 4967 02 6289 4423 02 6289 8155 02 6289 8918

If you are interested in participating in accreditation and/or would like to find out more about EQHS, please contact OATSIH by email: OATSIHqualityenquiries@health.gov.au or phone: 1800 723 676