Accreditation

The accreditation program aims to provide Australian Health Ministers with an alternative mode of accreditation, including standards that can be applied across all sectors of the health care system.

Consultation on the draft National Safety and Quality Healthcare (NSQH) Standards

The Commission is currently seeking comment on the draft NSQH Standards to refine the standards and ensure they are meaningful for health services, practitioners implementing safety and quality systems, and accreditation agencies using the standards to assess compliance, prior to piloting and reporting to Health Ministers in 2010.

A copy of the Consultation paper (PDF 3181 KB), including the draft NSQH Standards is available to download.

You are invited to make a written submission on the draft NSQH Standards. Written submissions should include:

• Name, organisation (if relevant) and contact details


• Responses to questions posed


• General comments


• Additional information, for example, any technical, economic or business information, or research-based evidence the Commission should be made aware of to support the views or comments.

All submissions should be received by close of business on 29 January 2010.

Submissions will be published on the Commissions website unless otherwise stated.

Submissions should be marked 'Consultation Paper on NSQH Standards' and sent to:
Mail: Consultation on NSQH Standards
Australian Commission on Safety and Quality in Health Care
GPO Box 5480
SYDNEY NSW 2001
Email: mail@safetyandquality.gov.au
Fax: (02) 9263 3613

Program Update

The review and implementation of the new model of national safety and quality accreditation for health service organizations has focused on the following:

Key areas of work

• Review of National Safety and Quality Accreditation Arrangements


• Development of an Alternative Model for Safety and Quality Accreditation


• Development of the draft National Safety and Quality Healthcare Standards


• Consultation on the draft National Safety and Quality Standards


• Piloting the draft National Safety and Quality Standards


• National Coordination of Accreditation


• Legislation and regulation review


• Accreditation Research Projects

A summary of these key areas of work are summarised below. Copies of reports and other documentation are available to download from the Commissions website.

Review of National Safety and Quality Accreditation Arrangements

The Commission commenced its review of National Safety and Quality Accreditation arrangements in November 2006, with the release of the 'Discussion Paper: National Safety and Quality Accreditation Standards' (PDF 358 KB). This paper detailed issues with the current safety and quality systems and standards and proposed a package of reforms including a national set of standards by which health services could be assessed. The findings of this consultation are included in the Report on Initial Stakeholder Consultation (PDF 1627 KB) and the Executive Summary of Report on Initial Stakeholder Consultation (PDF 250 KB).

Written submissions on Discussion Paper: National Safety and Quality Accreditation Standards

Development of an Alternative Model for Safety and Quality Accreditation

Following the initial review of National Safety and Quality Accreditation Arrangements, an alternative model of accreditation was developed by the Commission. This model proposes substantial reforms of the accreditation system, having the potential to influence far-reaching change. A second phase of consultation was undertaken with those groups directly affected by the proposed alternative model of accreditation, with the release of the Consultation Paper: An Alternative Model for Safety and Quality of Health Care (PDF 269 KB).

The final report 'Proposal on an Alternative Model for Safety and Quality Accreditation and Matters Relating to Costs and Duplication of Accreditation Processes' (PDF 690 KB) was presented to Health Ministers, who approved in-principle the Alternative Model for Safety and Quality Accreditation in April 2008. The Outcome of Health Ministers Meeting regarding Safety and Quality Accreditation Reforms (PDF 18 KB) is available to download.

Development of the draft National Safety and Quality Healthcare (NSQH) Standards

The first stage of implementing the accreditation reforms has focused on the development of a preliminary set of NSQH Standards.

The draft NSQH Standards focus on areas that are essential to improving the safety and quality of care for patients. The Standards provide an explicit statement of the expected level of safety and quality of care to be provided to patients by health services organisations and provide a means for assessing an organisations performance. The draft NSQH Standards were developed in collaboration with experts, the Commission's Accreditation Implementation Reference Group and standing committees, jurisdictions and key stakeholders.

The draft NSQH Standards address the following areas:

• Governance for Safety and Quality in Health Service Organisations


• Healthcare Associated Infection


• Medication Safety


• Patient Identification and Procedure Matching


• Clinical Handover

Piloting the draft National Safety and Quality Standards

The results of the consultation process will be used to refine the draft NSQH Standards and develop the tools and guidelines necessary for implementation.

A pilot study of the refined draft NSQH Standards will commence in the first quarter of 2010. The aim of the pilot study will be to test the NSQH Standards, supporting tools and guidelines, and to identify issues for implementation of the standards.

The pilot will involve representative organisations from a range of private and public health service providers where the NSQH Standards apply.

Once finalised it is expected the tools and guidelines will be freely available on the Commissions web site.

National Coordination of Accreditation

The coordination functions for a national body would include:

1. Developing, maintaining and regularly reviewing the National Safety and Quality Healthcare Standards
   
2. Determine eligibility criteria for the accreditation agencies to assess against the National Safety and Quality Healthcare Standards.
   
3. Support surveyor participation in accreditation
   
4. Receiving and analysing accreditation data
   
5. Reporting
   
6. Appeal Processes

Legislation and regulation review

The Commission commenced the review of legislation and regulation in mid 2008 with the establishment of a regularity Working Group comprised of jurisdictional legal and policy representatives. This group provided preliminary advice of current regulation of health services in each jurisdiction, proposed changes or reforms to regulation, regulatory mechanisms that could be used to mandate the Safety and Quality Healthcare Standards and issues involved in implementing compliance with the Safety and Quality Healthcare Standards.

The Commission engaged a consultant to undertake a further review of licensing and legislation. The key objectives of the review included:

• Identifying the regulator powers that exist in each state and territory


• Ascertaining jurisdictional preferences for regulatory change and


• Considering the use of the information to develop regulatory options to implementing the Safety and Quality Healthcare Standards.

Results are included in the report of the State and Territory Private Health Facility Licensing Legislation Mapping (PDF 365 KB).

Accreditation Research Projects

Literature review on accreditation surveyor management (PDF 110 KB)

Surveyor Participation in Accreditation - Completed June 2009 (PDF 816 KB)

Piloting of Short Notice Surveys in Accreditation - Completed May 2009 (PDF 779 KB).

Piloting of Patient Journey Methodologies in Accreditation - Completed February 2009 (PDF 593 KB).

Presentation by Professor Chris Baggoley for National workshop 30 Nov 2007 (PDF 1673 KB)

Cost analysis of accreditation report 15 February 2008 (PDF 399 KB)

Cost of Accreditation Analysis Report Appendices 15 February 2008 (PDF 894 KB)

Contact

Margaret Banks
Senior Programs Advisor
(02) 9263 3784
mail@safetyandquality.gov.au

Updated: 06 November, 2009

top of page