NSQHS Standards: second edition now available

The second edition of the NSQHS Standards takes into account new evidence and feedback from the health sector on the first edition, resulting in a set of standards that is simplified, reduces duplication, has an increased clinical focus and addresses important clinical gaps.

The primary aims of the National Safety and Quality Health Service Standards (NSQHS Standards) are to protect the public from harm and to improve the quality of health service provision.

The NSQHS Standards were developed by the Australian Commission on Safety and Quality in Health Care in partnership with the Australian, state and territory governments, the private sector, clinicians, patients and carers.

In 2011, Australian health ministers mandated that the NSQHS Standards would be implemented in all Australian hospitals and day procedure centres. As of 30 June 2017, 1319 hospitals and day procedure centres have been assessed to the NSQHS Standards.

To ensure that the NSQHS Standards remain current and consistent with best practice and continue to address areas of priority for safety and quality in health care, the commission has updated them, releasing the second edition in November 2017.

The second edition of the NSQHS Standards builds on the substantial achievements of the first edition and will drive better, safer care for patients and consumers in Australia.

The second edition has taken into account new evidence and feedback from across the health sector on how to improve on the first edition. This has resulted in a set of standards that is simplified, reduces duplication, has an increased clinical focus and addresses important clinical gaps.

The first edition

The first edition of the NSQHS Standards provides clinical and organisational risk mitigation strategies designed to reduce the occurrence of high-prevalence adverse events. The areas covered are:

• Governance for safety and quality in health service organisations.
• Partnering with consumers.
• Preventing and controlling healthcare-associated infections.
• Medication safety.
• Patient identification and procedure-matching.
• Clinical handover.
• Blood and blood products.
• Preventing and managing pressure injuries.
• Recognising and responding to clinical deterioration in acute health care.
• Preventing falls and harm from falls.

To meet the NSQHS Standards, health service organisations must put in place safety and quality systems that improve the safety and quality of care provided to patients and consumers. In fact, ensuring these systems exist is the purpose of the NSQHS Standards. The NSQHS Standards direct safety and quality outcomes that must be achieved, but allow flexibility for health service organisations to implement actions in a way that suits their specific requirements, including their patients’ risks and the complexity of the services that they provide.

Impact of the first edition

Key improvements associated with implementation of the NSQHS Standards (first edition) include:

• A decrease in the rates of healthcare-associated infections.
• Better documentation of adverse drug reactions and medication histories.
• A decrease in rates of intensive care admissions after cardiac arrest and the rates of in-hospital cardiac arrest.
• A reduction in antibiotics prescribed due to improvements in antibiotic stewardship.

The NSQHS Standards have driven improved governance in health service organisations by helping to expand the roles of governments, executives, boards, clinicians and consumers. The NSQHS Standards include an emphasis on empowering consumers and patients in contributing to decision-making around the governance, design and delivery of health services, and this has had an impact throughout the health system.

What’s new in the second edition

The second edition aims to improve care for patients at risk of poor health outcomes and fills some of the important safety and quality gaps that were identified by the health sector in the first edition. The second edition includes new content on mental health and cognitive impairment, health literacy, end-of-life care and Aboriginal and Torres Strait Islander health.

There are eight standards in the second edition replacing the 10 NSQHS Standards in the first edition. As with the first edition, the eight standards cover areas of health care that have been identified as involving high risk for patients, and which could be addressed by preventative actions and in which improvement is warranted. These are:

1. Clinical governance.
2. Partnering with consumers.
3. Preventing and controlling healthcare-associated infection.
4. Medication safety.
5. Comprehensive care.
6. Communicating for safety.
7. Blood management.
8. Recognising and responding to acute deterioration.

Transitioning to the second edition

The NSQHS Standards have been approved by the COAG Health Council and were released on 28 November 2017. Accreditation to the second edition begins from January 2019.

The commission will provide support to health service organisations as they prepare for the implementation of the second edition of the NSQHS Standards. Much of the content in the second edition will be familiar and detailed resources will support the transition to the second edition and implementation of the new content areas. The NSQHS Standards Advice Centre is available for any questions.

NSQHS Standards Advice Centre: 1800 304 056

accreditation@safetyandquality.gov.au

Margaret Banks, BSc, Grad Dip (Physio), MHA, Grad Cert Management, Dip AICD, FACHM.

*Margaret Banks has worked as the National Standards Program Director with the Australian Commission on Safety and Quality in Health Care since July 2006. In this time she has worked with stakeholders, consumers and jurisdictions to develop and implement the National Safety and Quality Health Service Standards and a program of systematic accreditation reform across the Australian health system.

Prior to this appointment she worked with the Department of Health and Ageing, the Australian Health Workforce Advisory Committee and the NSW Health Department on matters relating to workforce. She has also worked as a physiotherapist for nine years in both Australia and Papua New Guinea, and held an Adjunct Professorship with the University of Technology Sydney.

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