National Safety & Quality Health Service Standards

National Safety & Quality Health Service Standards

Feb 14, 2017 0
onthepods,Working & training in healthcare

James talks to Associate Professor Amanda Walker about the NSQHS Standards, the National Safety & Quality Health Service Standards, also known as the National Standards. The NSQHS Standards are a framework for ensuring that all health services across the country provide a consistent standard of safe and quality healthcare.

About Amanda Walker

Amanda Walker is a Specialist in Palliative Medicine and is also working as a Senior Clinical Advisor at the Australian Commission on Safety and Quality in Healthcare. She has worked at the NSW Clinical Excellence Commission developing programs addressing Diagnostic Error and End of Life Care and she has worked as a clinician, educator, and administrator in South Western Sydney.

National Safety & Quality Health Service Standards

With Associate Professor Amanda Walker, Senior Clinical Advisor at the Australian Commission on Safety & Quality in Health Care

Introduction

The National Safety and Quality Health Service (NSQHS) Standards, also known as the National Standards, are a framework to ensure that all health services across the country provide a consistent standard of safe and quality health care.

 

  • There are 10 national standards (version 2 will decrease to 8 national standards) including:
    • Incident management system
    • Hand hygiene and aseptic technique
    • Blood safety programs
    • Antimicrobial stewardship
  • The Standards tell us what needs to be done, but not how it needs to be done – this allows for freedom locally to determine the best way of delivering on a standard for the local population (e.g., adapting a tool from ICU, to make it work on a surgical ward)
  • How they came about
    • There was an extensive consultation process around 2009, where consumers and clinicians from all states and territories gathered to identify the areas they felt were most important, to enable us all to get to best practice
    • They identified issues where the greatest number of patients were affected, and where there were gaps between the current situation and best practice outcomes (looked at existing evidence-based and achievable improvement strategies)
  • Why they are important
    • Focused on patient safety and improving patient care (rather than just looking at metrics such as ED wait times and surgical waiting lists)
    • Aim to minimise harm to patients (as 1 in 10 patients are harmed in our health system)
    • Ensures care of a certain standard no matter where you go in Australia
    • Ensures accountability for outcomes (important for patients and clinicians as well as taxpayers, asfor example, 20% of the NSW budget is spent on health care)
  • Junior doctors are at the frontline of patient care and service delivery and therefore well placed to determine if strategies are working or not
  • Safety and quality is the responsibility of everyone that works in health care
  • Junior doctors are accountable for ensuring patient care is the best it can be, and continuing to make it better
  • The National Standards are the framework for quality and safety, and accreditation is an external validation process to ensure this framework is adhered to
  • Looks at both delivery of care (e.g. hand hygiene) and outcomes (e.g. healthcare-associated infections)
  • Two components:
    • Annual self evaluation against a standard, to determine what evidence your facility has to demonstrate that they meet all standards
    • Every few years, a group of independent assessors audit whether you are doing what you say you are doing
  • Discuss in JMO group forum, e.g. General Clinical Training Committee or Patient Safety Committee
  • Participate in audits – speak with your boss, NUM or CNC about how to get involved
  • Undertake a quality and safety project
    • Benefits: quick turnaround time of a couple of months, quicker than a research project, don’t need ethics committee approval, adds value to your CV
    • PDSA (plan, do, study, act) cycle
      • PLAN – what’s the issue you’re trying to address and why doesn’t it work?
        • Think about the things that drive you nuts! Could they be done better? Then start working on it!
        • Choose a small and manageable problem and measure it
        • Speak with your NUM, CNC, DPET and local quality support unit – they can link you with people that can really help out
        • Identify a mentor or someone to discuss the project with
      • DO – implement your solutions in real life
      • STUDY – measure to see if what you’re doing now is better than before
      • ACT – implement a different solution until you get one that works, then write it up
  • Join a committee – most hospitals have a committee for almost every National Standard
  • Review a clinical incident
  • Join a root cause analysis (RCA) team
  • Other projects JMOs can get involved with:
    • Streamlining referrals to allied health
    • Comprehensive discharge processes
    • Medication reconciliation
    • Auditing antibiotic use in your unit
    • Review your own cannula insertions
    • Assess your diagnostic skills by following up diagnoses of patients you saw in ED
  • Quality and safety is everyone’s responsibility
  • JMOs can get involved in quality and safety in their own hospital through participating in audits, undertaking a project, joining a committee, or joining a root cause analysis team

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Tags: #accreditation,#Australian Commission on Safety & Quality in Health Care,#CEC,#Clinical Excellence Commission,#CNC,#Director of Prevocational Education and Training,#General Clinical Training Committee,#National Safety and Quality Health Service Standards,#NSQHS,#Nurse Unit Manager,#Patient Safety Committee,#quality and safety,#Root Cause Analysis,#tipsfornewdocs

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