NSQHS standards implementation review

In this final article in the series from the Australian Commission on Safety and Quality in Health Care (the Commission), we review the progress of implementation of the National Safety and Quality Health Service (NSQHS) Standards since their introduction into health service organisations on 1 January 2013.
The aim of the NSQHS Standards is to promote and support safe patient care and quality improvement. The focus is on areas where evidence demonstrates that substantial risk of harm to patients exists and where action can be taken to prevent or reduce harm.
The NSQHS Standards were developed to be applied to all health services, regardless of setting, funding structure or service context. Public and private hospitals, day procedure services and public dental services in Australia are required to be accredited to the NSQHS Standards.
Implementation progress
Uptake of the NSQHS Standards has been positive and wide spread. Approximately 420 health service organisations will have been assessed by the end of 2013. Of these, 38 per cent are in the public sector and 62 per cent are in the private sector. As of August 2013, 254 health services had been assessed; 112 had their accreditation status confirmed, the remaining were finalising the process. There are also a range of services who are voluntarily being accredited to the NSQHS Standards, including private dental practices and community based health services.
Challenges with implementation
Health service organisations have found antimicrobial stewardship, medication reconciliation and consumer engagement some of the most challenging aspects of the NSQHS Standards to implement. Small health services have found the process of implementing the NSQHS Standards has required differed strategies to larger health services. Dental practices and community based health services recommend that the language used in the NSQHS Standards, which has an acute focus, be revised when the NSQHS Standards are reviewed.
In response to the challenges facing health services implementing the NSQHS Standards the Commission has released a Guide for Small Hospitals to assist small and rural health services; participated in workshops on Standard 3 Healthcare Associated Infection which discussed antimicrobial stewardship; commenced developing resources and interpretive guides specific to the dental and community services contexts; and continues to offer assistance and support to health services through the NSQHS Standards Advice Centre.
Support for health service organisations
The Commission continues to provide support for all health service organisations implementing the NSQHS Standards through:

• An Advice Centre for enquires from health service organisations, jurisdictions and accrediting agencies


• Network meetings for health service representatives providing an opportunity to focus on individual NSQHS Standards and share practical examples of implementation


• Accreditation Workbooks for hospitals and day procedures services


• An electronic tool to assist health service organisations to monitor their implementation progress and identify where gaps exist


• Safety and Quality Improvement Guides with detailed information to assist with implementation and interpretation of each NSQHS Standard


• Information provided on the Commission’s website which includes fact sheets, frequently asked questions, presentation and links to technical expert information, and


• Additional resources for health services to use in their own communication materials.

All of these resources can be found on the Commission’s website at www.safetyandquality.gov.au/our-work/accreditation
Feedback and evaluation of the impacts of the NSQHS Standards The Commission is monitoring the implementation of the NSQHS Standards through three separate evaluation processes. These include evaluations by the University of Newcastle and the University of NSW and work by the Commission on an evaluation methodology to understand the impact of the NSQHS Standards on patients. Knowledge gained from the evaluations is fed into review processes and presented regularly to stakeholders through seminars, presentations and publications produced by the Commission.
The Commission recently conducted an online survey for health services to provide feedback on the changes in their organisation since implementing the NSQHS Standards. 105 responses were received from a range of health service organisations. 82 percent of respondents noted positive changes during the implementation of the NSQHS Standards including:
“…general staff participation and asking questions”
“…a risk focus is applied more consistently to practice”
“…improved feedback from the Board”
“…increased accountability and auditing”
“…systems alignment and process redesign”
“…improved communication between services”
“…more consumer engagement”
Overall, the NSQHS Standards have been strongly supported and accepted nationally by a large number of health service organisations, stakeholder groups and individual champions.Further information on the NSQHS Standards is available via the Commission’s website www.safetyandquality.gov.au
More information
More information and resources to support implementation of the NSQHS Standards are available on the Commission’s web site at www.safetyandquality.gov.au or by contacting the Commission’s Advice Centre on 1800 304 056 or accreditation@safetyandquality.gov.au.