Changes to assessment against NSQHS standards

A major review of the Australian Health Service Safety and Quality Accreditation (AHSSQA) Scheme has identified several opportunities to improve the way health services are assessed against the National Safety and Quality Health Service (NSQHS) Standards.

These improvements have been outlined in a recently released report undertaken by the Australian Commission on Safety and Quality in Healthcare. The report identifies six areas of the AHSSQA Scheme to be addressed and a total of 21 improvements to be implemented in a phased approach, starting with the implementation of the second edition of the NSQHS Standards from 1 January 2019.

This review is the most significant update to the process of assessing health services to the NSQHS Standards since the launch of the standards in 2013, and brings improvements to how assessments will be carried out — such as standardising assessment cycles, introducing short-notice assessments and undertaking repeat assessments for some health services.

“These standards are designed to protect the public from harm and improve the quality of health service provision. Having a rigorous accreditation scheme is essential for ensuring that the standards are operationalised effectively,” said the commission’s A/g Chief Medical Officer, Professor Anne Duggan.

“While there have been huge gains across the health system since the first edition of the standards came into effect in 2013, the one area that has attracted significant feedback from health services has been the quality of the supporting assessment process,” said Professor Duggan.

With the development of the second edition of the NSQHS Standards, the commission conducted a comprehensive review to identify improvements to the assessment process, to be phased in with the implementation of the updated standards from January 2019.

“Some health services were being assessed every three years, others every four years, and there was a wide variation in how assessments were being undertaken. The lack of consistency made it difficult to compare assessments accurately.”

Working closely with stakeholders across the health system, including state and territory health departments, clinicians, health service managers and consumers, the commission identified six areas of the AHSSQA scheme to be significantly improved. These areas are: the assessment process, the assessment team, the use of data, regulatory oversight, communication of assessment outcomes and resources and support for health services.

The revamped assessment process greatly strengthens the rigour and consistency of assessments by standardising how the assessments will be carried out. Assessment cycles have been standardised, short-notice assessments will be introduced and repeat assessments will be undertaken for health services found to have large numbers of areas for improvement.

The effectiveness and experience of the assessment team will be improved through the mandatory completion of a comprehensive orientation program. Consumers will be routinely invited to participate in the assessment process and will have much greater transparency on the outcomes of assessments with public reporting of results to be phased in from 2020.

The review also recognises the importance of engaging governing bodies (often boards) in the implementation of the standards and their assessments. Their role has been explicitly defined in the second edition of the NSQHS standards, and the new process requires an annual statement attesting that they have complied with NSQHS standards requirements.

“Strengthening the assessment process will help to further embed the systems, processes and thinking required for safety in the day-to-day operations of all health services. It’s about continuous quality improvement and always has been,” said Professor Duggan.

A Review of the Australian Health Service Safety and Quality Accreditation Scheme: Improving the reliability of health service organisation accreditation processes is available on the commission’s website.

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