1. Implications of the new National Safety & QualityStandards for Childrens Healthcare ServicesDebora PiconeCEO23 October 2012

2. Do the sick no harmIt may seem a strangeprinciple to enunciate as thevery first requirement in aHospital that it should do thesick no harm. Florence NightingaleFirst sentence of Preface to Notes on Hospitals (1859, 3rd.Ed.,1863),

3. Lapses in safetyHave enormous costs, both in terms of the impact on peoples lives and financially.For example, it has been reported that: Healthcare associated injury and ill health add 13 16% to hospital costs alone at least one dollar in every seven dollars spent on hospital care.

4. Australian Health Ministers 2006 agree to the public release of the Commission Discussion Paper 2008 endorse model of accreditation (national coordination of safety and quality accreditation and the NSQHS Standards) 2010 endorse Australian Health Service Safety and Quality Accreditation (AHSSQA) Scheme June 2011 final NSQHS Standards endorsed

5. Objectives Improve safety and quality for patients using the National Safety and Quality Health Services Standards as the focus for action Implement coordinated and consistent accreditation via an Australian Health Services Safety and Quality Accreditation Scheme

6. The NSQHS Standards Standard 1 Standard 2 Governance for Safety and Partnering with Quality in Health Consumers Service Organisations Standard 3 Standard 10 Healthcare Preventing Falls and Associated Harm from Falls Infections Standard 9 Standard 4 Recognising and MedicationResponding to Clinical SafetyDeterioration in Acute Health Care Standard 5 Standard 8 Patient Identification Preventing and and Procedure Managing Pressure Matching Injuries Standard 7 Blood and Blood Standard 6 Products Clinical Handover

7. National Coordination of Accreditation Health MinistersRegulators A program of national coordination in ACSQHCIncludes States, Territories and Commonwealth Develops and maintains standards Mandate the Standards Advise Australian Health Ministers Council on the and participation in the accreditation scheme scope of health service accreditation Approves Accrediting Agencies Oversee accreditation program content Receives relevant accreditation data Receive relevant accreditation data Liaises with regulators Be responsible for an escalating response where Reports to Health Ministers the Standards are not met Reports on assessment outcomeHealth Service Organisations Approved Accrediting Agencies Select an approved accrediting agency Meet the Standards. Maintain JASANZ/ISQua accreditation Assess and Provide data on the Standards Report Cooperate on methodology /assessment development

8. Flexible Transition There will be a flexible transition during 2013 The Commission and Jurisdictions will support Health Service Organisations and Accrediting Agencies in the transition to the AHSSQA

9. Performance Requirements proportions of core actions to be met Health services must meet 100% core actions Health Services have 90 days after receipt of report to rectify not met actions before determination made In the first 12 months of the scheme the period will be extended to 120 days Responsibility of jurisdictions for an escalating response where standard not met

10. Challenges Smaller hospitals Standards 2, 3 and 6 Understanding the process

11. Challenges2. Partnering with Consumers3. Preventing and Controlling Healthcare Associated Infections Hand washing AMS Cleaning, disinfection6. Clinical Handover

12. Assessment Process AHSSQA commences 1 Jan 2013 Health service organisations required to meet NSQHSS at first full accreditation after 1 Jan 2013 Health service organisations are likely to undergo mid-cycle assessment before being due for organisation wide assessment Standards to be used for mid-cycle assessment will include as a minimum: 1. Recommendations from past assessment processes 2. Organisations quality improvement plan 3. Standards 1, 2 and 3

13. Support ArrangementsTo support health services in the transition to the AHSSQAScheme, a number of additional services and resources are beingdeveloped by the Commission: Flexible accreditation arrangements for 2013 Establishment of an Advice Centre for the NSQHS Standards Establishment of health service support networks Safety and Quality Guides and Accreditation Workbooks

14. ACSQHC Web site

15. Advice Centre

16. Accreditation Workbooks

17. Safety and Quality Improvement Guides

18. Summary Improve safety Mandatory Partnership Flexible transition Greater focus on clinical issues