How and why safety and quality standards are evolving

In the last 50 years, the standards by which healthcare quality is measured by third party accreditors have evolved considerably.

Where hospitals were once assessed solely by clinical metrics, like hand hygiene and medication safety, they must now uphold rigorous standards in all aspects of care — from consumer engagement to patient communication.

“Safe communication is assessed with the same rigour as medication and hygiene protocols,” said Dr Karen Luxford, Group CEO of the Australian Council on Healthcare Standards (ACHS).

“We increasingly recognise that non-clinical metrics can be just as crucial as traditional, clinical ones, when it comes to maintaining quality health care.”

The impact of AI

Having worked in the sector for more than thirty years — and five years at ACHS — Luxford has witnessed this evolution firsthand.

But while she is no stranger to change, there is one trend keeping her on her toes — and set to alter ACHS’s approach more drastically than any other since its inception.

“We are continually adapting to keep up with artificial intelligence (AI),” Luxford said.

“We are starting to see AI being used in many areas of health care, and, while there are clear benefits of using it, we need to give equal attention to the ways in which it might impact on healthcare quality.”

While this may be true for any new fixture of the healthcare system, Luxford says AI is a different challenge.

“At its current speed of development, AI is outpacing legal frameworks, ethics principles and governance structures,” she said.

“So, we need to continually reassess these structures and ensure we are upholding safety standards in all aspects of health care, including the ever-growing use cases of AI.”

The importance of governance

To this end, ACHS recently sat down with AI experts at an Executive Innovation Forum, which was organised for its hospital and health service members.

“We discussed the safety and quality governance implications of AI, whether we can trust its output, and how we can decide if it is being used appropriately.

“And it all came down to good governance — ensuring you have the right policies and procedures to assess any new AI tool,” Luxford said.

What does good governance look like?

For Luxford, good governance is summarised as “the right processes, the right policies, and the right people” — and that includes everyone along the care continuum.

“It’s not just a matter for the board and executive team — good governance runs throughout an organisation. It should be just as visible to staff on the frontline as it is to those who sit behind desks,” she said.

In an AI context, Luxford also said some governance pillars currently needed more focus than others.

“Training in the AI space is so important,” she said. “We’re still seeing a large portion of healthcare services where staff aren’t properly trained in AI.

“Ideally, we need to upskill people to a level where they fully understand the benefits and risks, as well as implications for areas like patient privacy. If staff only know how to operate the technology and nothing else, that is not sufficient.”

Creating a safety culture is also paramount, she argued.

“You need systems and protocols in place, so that staff can proactively raise concerns and take precautions.”

Next phase of evolution

While adapting to the evolving technology landscape forms a major part of Luxford’s strategic plan this year, it is not the only megatrend she has to contend with.

She says addressing the next phase of evolution in healthcare accreditation will be challenging on multiple fronts.

“As well as technology uncertainty, we are dealing with global challenges, like climate change and workforce shortages.

“We know that hospitals contribute around 8% of the world’s carbon emissions, and that climate change is the WHO’s number one health issue.

“Our focus will be on making sure Australian healthcare providers are addressing this through their governance processes. All the while managing human resource constraints.”

As a market-leading provider of accreditation, training and healthcare consulting, ACHS is also focused on its own internal governance structures.

“We are always focused on how we can improve governance, internally, to ensure we are promoting and exemplifying the best standards,” she said.

Looking ahead

While the future may be littered with change, Luxford maintains a positive outlook.

While new technology may be the greatest challenge, it will also be a close friend — a tool to help keep healthcare standards as high as possible, she said.

“A key thing for us will be, how do we use all the amazing tools out there at our disposal, to make assessment processes more streamlined for all? And how can we use technology to free up staff for optimal performance,” she concluded.

Image: Supplied.