MEDIA RELEASE The accreditation process has improved quality and patient safety in Australian general practices but more could be done to provide evidence of clinical risk management, a new study has found. The study, conducted by the Greater Green Triangle University Department of Rural Health Centre for Research Excellence (GGT UDRH CRE), was the first in Australia to explore Australian General Practice Accreditation Limited (AGPAL) surveyors perceptions of the impact of accreditation on patient safety and to elicit suggestions for improving patient safety in Australian general practices. All 10 AGPAL surveyors interviewed agreed that accreditation had improved general practices performance in quality and safety. However, they noted areas that need further attention, including tighter clinical safety indicators and having sufficient verifiable evidence to demonstrate clinical risk management. Chief researcher from the GGT UDRH CRE, Dr Amr Abou Elnour, said accreditation has had a positive role in improving quality and safety in general practice and that tighter indicators requiring verifiable evidence would be a further step forward. The study found that improvements were made over time as a result of the accreditation process and included improvements in the physical environment of general practice, such as equipment safety, appointment systems, patient records and electronic records. Other improvements such as significant incidents registers and regular clinical meetings to discuss incidents and how to avoid them were also noted. Some participants mentioned that the systematic approach of accreditation provided a way to improve general practice systems, however doubts were expressed about the “one-off” nature of accreditation and sustainability of improvement efforts. There were mixed responses regarding general practice staff awareness of patient safety, with some surveyors believing it was linked to the role and responsibilities of staff. Most participants believed patient safety indicators included in the Royal Australian College of General Practitioners (RACGP) standards covered the physical environment of the practice such as infection control and sterilisation and physical access; however accreditation lacks the ability to effectively assess safety in clinical practice as distinct from this focus on safety processes in the physical environment. Participants confirmed that most general practices did not have sufficient evidence to demonstrate the existence of a clinical risk management system. The participants recommend approaches to improve the safety culture in general practice such as further education and training, instilling an interest in improvement and safety, establishing open communication practices and improved documentation. One solution could be the addition of extra procedures in the accreditation process that require evidence of clinical risk management. These could include having a significant incidents register; providing documentation of near misses or mistakes; and engaging in regular clinical meetings to discuss incidents and how to avoid them in the future. The study recommends that the Australian Primary Care Collaboratives (APCC) program add patient safety to its agenda for improvement. “Our study suggests the current “softness” around patient safety indicators in the accreditation process for general practice needs to be improved,” Dr Amr Abou Elnour said. “The inclusion of tighter indicators that require verifiable evidence is a step towards retaining the positive role of accreditation in improving general practice performance in quality and safety. “Given the APCCs previous success in general practice quality improvement, it would be an appropriate organisation to further improve patient safety in general practice.” The research was conducted by Dr Amr Abou Elnour, Andrea Hernan, Dr Dale Ford, Dr Stephen Clark, Professor Jeffrey Fuller, Associate Professor Julie Johnson and Professor James Dunbar. The GGT UDRH is funded by the Australian Government Department of Health and is a partnership between Flinders and Deakin Universities. To arrange an interview or photos please contact Rick Bayne on 0418 140 489
Posted on: Fri, 15 Aug 2014 09:12:32 +0000
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