Assessment Methodologies - Achieving Accreditation

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2 Assessment Methodologies - Achieving Accreditation Dr Stephen Clark Group Chief Executive Officer Australian General Practice Accreditation Limited (AGPAL) and Quality Innovation Performance (QIP) 2

3 Presentation overview 1. The AGPAL Group of Companies. 2. Australia s health care system and health reform. 3. Standards and the importance of Standards in General Practice. 4. Components of a Standard criterion, explanation and indicators. 5. AGPAL s role in General Practice Accreditation and six step accreditation process. 5. AGPAL s accreditation support resources. 6. Benefits of accreditation and improved outcomes. 3

4 About the AGPAL Group of Companies The AGPAL Group of Companies Australian General Practice Accreditation Limited (AGPAL) Quality Innovation Performance (QIP) QIP Consulting, and QIP International 4

5 About AGPAL Australian General Practice Accreditation Limited (AGPAL) is a leading independent provider of accreditation services for: General practices Medical deputising services After-hours services Aboriginal medical services, and Royal Flying Doctors 5

6 About AGPAL AGPAL was established in 1997 AGPAL is a not-for-profit health promotion charity Accredits general practices against RACGP Standards for general practices 4th edition AGPAL is owned by the profession including: Peak Medical Groups Consumers 6

7 About QIP Quality Innovation Performance (QIP) is a certification and accreditation organisation dedicated to supporting health and community services. QIP is a not-for-profit health promotion charity As part of the AGPAL Group of Companies, QIP provides accreditation and assessment services for the entire continuum of care within Australia. QIP has developed accreditation programs that follow patients as they progress through the Australian health system. 7

8 The AGPAL Group of Companies continuum of care model 8

9 About Australia s health care system Provided by both private and government institutions. Australian Federal Minister of Health administers national health policies, elements of which are operated by state governments. National health reform has resulted in an expansion of accreditation and quality improvement services across community and health care services with Australia. All primary and secondary health care organisations will eventually need to be accredited against the applicable National Safety and Quality Health Service Standards (NSQHS). 9

10 About Australia s health care system The NSQHS Standards provide a nationally consistent statement of the level of care consumers should be able to expect from health services. There are 10 NSQHS Standards focusing on the areas that are essential to drive the implementation and use of safety and quality systems. Profession specific standards, such as the RACGP Standards for general practices, are align themselves to the applicable areas within the NSQHS Standards. 10

11 About Australia s health care system Government support: Medicare universal health care scheme publically funded. Providers of Practice Incentives Program and payments. Pharmaceutical Benefits Scheme considerably subsidises a range of prescription medications. 11

12 Accreditation in Australia General Practice The Royal Australian College of General Practitioners (RACGP) Standards for general practices 4 th edition. Standards developed by the profession for the profession. One of the pillars of safety and quality within the Australian health care system. Provide a template for quality care and risk management in Australian general practice. 12

13 Accreditation in Australia General Practice The RACGP Standards are designed to ensure delivery of safe and high quality primary health care within Australia. Have evolved with the changing landscape. Provide a framework for continuing development. 13

14 Components of a Standard General Practice The Standards made up of: Five sections - Practice services, rights and needs of patients, safety, quality improvement and education, practice management and physical factors; 15 Standards; 41 Criterion; and 140 Indicators. 14

15 Components of a Standard Criterion Criterion describes key components of the Standard. Example: Criterion Health promotion and preventative care Our practice provides health promotion, illness prevention and preventative care and a reminder system based on patient need and best available evidence. 15

16 Components of a Standard Explanation Explanation provides a description and explanation of key aspects of the criterion. Example: Key points Practices need a systematic approach to health promotion, preventive care and early detection and intervention Practices are encouraged to provide patients with information about health promotion and illness prevention 16

17 Components of a Standard Indicators Example Flagged Indicators Mandatory A. Our practice has at least one dedicated consulting/examination room for every member of our clinical team working in our practice at any time. Unflagged Indicators Discretionary H. Our practice waiting area caters for the specific needs of children. 17

18 AGPAL Accreditation Process Six step process Registration Self-assessment Application Accreditation Survey Decision Continuous Quality Improvement 18

19 AGPAL Accreditation Process By registering with AGPAL, general practices gain unlimited access to accreditation support and resources to begin their quality improvement journey. Clients register for accreditation via the AGPAL website. AGPAL s integrated IT systems populate with new client information and prompt our finance team to issue a registration invoice. 19

20 AGPAL Accreditation Process Prompts are sent to AGPAL s Client Liaison Officers who then make contact with the new client. A unique client ID, username and password is generated to allow new clients to access AGPAL s: Online self-assessment tool, AccreditationPro, and Client resource library, known as QbAY 20

21 AGPAL Accreditation Process Self-assessment is an internally led process whereby a general practice determines the degree to which it meets the requirements of the RACGP Standards. AGPAL s web-based self-assessment tool, AccreditationPro, plays a unique role in guiding general practices throughout the entire self-assessment process. 21

22 AGPAL Accreditation Process AccreditationPro, allows practices to work through the evidence requirements of the RACGP Standards, allowing them to input information and upload documents to indicate their compliance. Links to customisable templates, resources and requirement explanations are also provided. 22

23 AGPAL Accreditation Process Saving the self-assessment as they go, AccreditationPro allows practices to break down the process, allocating specific Standards to specific members of the practice team. If a particular Standard requirement within the self-assessment is not met by the practice, AccreditationPro allows for an action plan to be created for practices to complete prior to submission of their self-assessment. 23

24 AGPAL Accreditation Process Prior to application for accreditation, practices use AccreditationPro to check they have completed all self-assessment requirements by ensuring all sections are marked as complete. To apply for accreditation, the practice submits its completed self-assessment to AGPAL. Submission of self-assessment is a paperless and fully automated process through AccreditationPro. 24

25 AGPAL Accreditation Process Submission of the self-assessment indicates a practice is ready for the accreditation survey. When the self-assessment is submitted via AccreditationPro, an automated alert is provided to prompt AGPAL s finance department to issue a client invoice. Accreditation planning commences on receipt of payment. 25

26 AGPAL Accreditation Process AGPAL s survey teams are made up of a general practitioner and a co-surveyor, usually an experienced practice nurse or practice manager. Surveyors use AGPAL s online surveyor portal to demonstrate their availability for accreditation surveys and are allocated clients accordingly. Once allocated, the survey team reviews a practice s self-assessment by logging in to the AGPAL Surveyor version of AccreditationPro. 26

27 AGPAL Accreditation Process This self-assessment review allows surveyors to identify any key areas of concern / clarification prior to conducting the on-site accreditation survey. The suvrey team liaises with the practice to determine a mutually convenient accreditation on-site survey date. An on-site accreditation survey usually occurs three months before the practice s registration/accreditation expiry. 27

28 AGPAL Accreditation Process During an on-site accreditation survey, the AGPAL Surveyors will interview members of the practice team (e.g. GP, practice manager) and review documentation (e.g. policies, educating and training certificates) and practice equipment (e.g. vaccine fridge, medicine cabinet). While on-site, AGPAL Surveyors are able to log in to AccreditationPro to directly enter their findings against the RACGP Standard requirements. 28

29 AGPAL Accreditation Process Prior to an accreditation decision being made, AGPAL Surveyors complete their accreditation report in AccreditationPro and submit their findings via this channel. A decision is made about a practice s accreditation status by an independent AGPAL Accreditation Decision Maker, taking into consideration all available evidence contained within AccreditationPro. 29

30 AGPAL Accreditation Process If areas of non-compliance are identified practices are given a period of time, know as Natural Justice, to rectify and provide evidence to demonstrate their compliance before a final accreditation decision is made. If a practice is awarded their accredited status, this is flagged within AGPAL s IT systems and a Client Liaison Officer is then able to formally congratulate the practice team. 30

31 Accreditation Survey Common areas of non-compliance Criterion Clinical risk management systems Standard 4.2 Management of health information Criterion Vaccine potency Criterion Healthcare associated infections 31

32 Accreditation Survey Most highly compliant areas Over 99% of AGPAL accredited practices are compliant with the following criterions. Criterion Clinical autonomy for general practices Criterion Engaging with other services Criterion Presence of a third party Criterion Scheduling care in opening hours 32

33 AGPAL Accreditation Process Once accreditation has been achieved, the practice is identified as accredited on the AGPAL website and provided with a number of marketing resources provided to promote their achievement to their local community. Practices continue to implement quality improvements throughout a three year cycle. Evidence of continuous quality improvements and implementation processes formulate part of the RACGP Standard requirements. 33

34 AGPAL s Accreditation Resources AccreditationPro, AGPAL s web-based self assessment tool QbAY, AGPAL s web-based library of resources and templates AGPAL publications including Quality News magazine and AGPAL Assist e-bulletin Ongoing general practice education and training Materials to help practices promote their accredited status Dedicated AGPAL Client Liaison Team support 34

35 Accreditation Resources AccreditationPro Overview 35

36 About AccreditationPro One of the first electronic self-assessment systems in Australia. Minimises time and effort in preparation and submission of the online self-assessment. Reduces the amount of paper work involved in the accreditation process. Guides health services through the self-assessment process. Provides helpful prompts regarding required evidence. Produces a list of the team members who are likely to be interview during the self-assessment process. 36

37 About AccreditationPro Automatically generates a self-assessment workbook with action plan. Links to extensive online resources and templates. Provides a quality framework for the practice. Accessible by the whole practice team. 37

38 Financial Incentives Practice Incentive Program (PIP) PIP is an Australian Government Department of Human Services program. PIP is aimed at supporting general practice activities that encourage continuing improvements and quality care, enhance capacity and improve access to health outcomes for patients. To be eligible for PIP practices must be accredited or registered for accreditation against the RACGP Standards. Practices must apply for specific PIP payments, meeting the requirements for each incentive they apply for. 38

39 Financial Incentives Levels of PIP payments for general practice PIP payments are generally based on a measure of the practice size known as the Standardised Whole Patient Equivalent (SWPE) value. Taking the SWPE value into consideration and depending on the incentives a practice applies for, depends on the calculated amount of PIP funding received. For example, one of the offerings linked to the PIP Asthma Incentive is payment to GPs for each completed cycle of care for patients with moderate to severe asthma at a rate of $100 per patient per year. There are a number of incentives offered by PIP. 39

40 Benefits of AGPAL Accreditation Improved patient safety. Effective risk management. Patient assurance that a high level of care is provided. Building a culture of quality within the practice environment. Developing staff skills and engaging the practice team in continuous quality improvement. Increased recognition from insurance providers. Eligibility to access financial incentives such as the Practice Incentive Program (PIP) from Medicare. 40

41 Questions? 41

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