1.2 – Telephone and electronic communications ► A. Our practice manages telephone calls, telephone messages and electronic messages from patients. 1.1.2 ► A 1.3 – Informed patient decisions ► A. Our patients can access information from the clinical team about proposed investigations, referrals and treatments, including the purpose, importance, benefits, and risks. 1.2.2 ► A ► B. Our patients receive information to support the diagnosis, treatment and management of conditions. 1.2.2 ► B 1.4 – Interpreter and other communication services ► A. Our practice uses an interpreter and communication services with patients who do not speak the primary language of our practice staff, excluding exceptional circumstances. 1.2.3 ► A ► B. Our practice uses appropriate communication services to communicate with patients who have a communication impairment, excluding exceptional circumstances. 1.2.3 ► B C. Our patients can access culturally appropriate, translated, or plain English resources. New Indicator 1.5 – Costs associated with care initiated by the practice ► A. Our patients are informed of the out-of-pocket expenses for health care they receive at our practice. 1.2.4 New Indicator ► B. Our patients are informed that there are potential out-of-pocket expenses for referred services. 1.2.4 New Indicator
► C. Our practice has a business risk management system that identifies, monitors, and mitigates risks in the practice. New Indicator ► D. Our practice inducts new practice staff and familiarises them with our systems and processes. 4.1.1 ► B ► E. Our practice team has the opportunity to discuss administrative matters with the principal practitioners, practice directors, practice management or owners when necessary. 4.1.1 ► E ► F. Our practice encourages involvement and from members of the practice team. 4.1.1 ► F 3.2 – Accountability and responsibility ► A. All members of our practice team understand their role in the practice. 4.1.1 ► A ► B. Our practice undertakes performance discussions with each team member. 4.1.1 G ► C. Our practice has a complaints resolution process. 2.1.2 ► B ► D. Our practice has at least one team member who has the primary responsibility for leading risk management systems and processes. 4.1.1 ► C 3.1.3 ► A ► E. Our practice has at one team member who coordinates the resolution of administrative and/or other complaints. 4.1.1 ► D 3.3 – Clinical communication ► A. Our clinical team discusses the practice’s clinical issues and support systems. 1.4.1 ► C 3.4 – Work health and safety ► A. Our practice supports the safety, health, and wellbeing of the practice team. 4.1.2 ► B ► B. Our practice team is offered or encouraged to obtain National Health and Medical Research Council (NHMRC) recommended immunisations, as appropriate to their duties. 5.3.3 ► H ► C. Practice team members are offered testing encouraged to test their natural immunity to diseases or immunisation status. 5.3.3 ► H 3.5 – Research ► A. Our practice ensures that all research is approved by an ethics committee and is indemnified. 4.2.1 ► H preventable
► E. Our practice transfers identified patient health information to a third party only after we receive informed patient consent. 4.2.1 ► G 7.4 – Information security ► A. Our practice has a team member who has primary responsibility for the electronic systems and computer security. 4.2.2 ► D ► B. Our practice does not store or temporarily leave the personal health information of patients where members of the public could sight or access that information. 4.2.2 ► A ► C. Our practice’s computers are accessible only via unique individual passwords that give access to information according to the person’s level of authorisation. 4.2.2 ► B ► D. Our practice has a business continuity plan and information recovery plan. 4.2.2 ► C ► E. Our practice securely transfers electronic patient health information. 4.2.2 ► F ► F. Our practice has appropriate procedures for the storage, retention and destruction of records. 4.2.2 ► G ► G. Only authorised people can access prescription pads, letterhead, administrative records, and official documents. 5.1.1 ► E ► H. Our practice has a policy on the use of email and social media. New Indicator
► C. Our clinical team is aware of the risks associated with equipment use. New Indicator 9.2 – Qualifications and training of non-clinical staff ► A. Our non-clinical undertake training appropriate to their role and our patient population. 3.2.2 ► A 3.2.2 ► B 3.2.3 ► A ► B. Our non-clinical staff are offered CPR training at least every three years. 3.2.2 ► C 3.2.3 ► B
Preface to of Standard 3: Clinical risk management Indicators in this Standard Each of the covered in these Indicators supports a practice’s implementation of an appropriate clinical risk management system, in order to ensure that quality care continues to be provided. New Indicators 3.2 A Having an open disclosure process promotes effective communication with patients when things go wrong, and supports the patient and their carer and/or family to achieve closure. Open disclosure can also improve the safety and quality of the services the practice provides to patients. This was identified as a gap in the 4th edition Standards. Mapping of the 5th edition to the 4th edition Standards 5th edition Criterion 5th edition Indicator 4th edition Criterion and Indicator 3.1 – Clinical risk management systems ► A. Our practice monitors, identifies, and reports near misses, errors and adverse events in clinical care. 3.1.2 ► B ► B. Our practice team makes improvements to our clinical risk management systems in order to prevent near misses, errors and adverse events in clinical care. 3.1.2 ► C 3.1.2 ► D 3.2 – Open disclosure A. Our practice has an open disclosure process based on the national Open Disclosure Framework. New Indicator
establish a system so that practitioners talk to trusted peers or supervisors for advice use a more formal process that includes conducting practice discussions about what went wrong and how to reduce the likelihood of it happening again use structured techniques to analyse the causes of an error and reduce the likelihood of its reoccurrence establish a system so that members of the practice team know how and to whom to report a near miss, or unanticipated adverse outcome, and that they can do so without fear of recrimination implement a clinical governance framework to help achieve a balance of ‘find it, fix it and confirm it’ functions in relation to improving the quality and safety of care... Find it: use tools such as clinical audits and performance indicators to identify where quality improvement programs could affect the quality of care delivered and improve patient health outcomes Fix it: once the gaps in quality care have been identified, you can implement strategies to address the Confirm it: measure the improvement using an effective evaluation process. Keep copies of the practice’s risk or critical incident register. Practices may want to have their Medical Defence Organisation (MDO) check and approve their process for recording and acting on near misses, errors and adverse events. Practitioners are increasingly referred to as ‘second victims’ of adverse events as they may feel that they have failed the patient[5]. This can lead to practitioners second-guessing their clinical judgement, knowledge. Practices could consider how they support practitioners after an adverse-event has occurred. Demonstrating how you meet this Criterion The following table contains ways for your practice to demonstrate how you meet the requirements of this Criterion. Items listed in red are mandatory to meet this Criterion. listed in black are optional to meet this Criterion. QI3.1► A Implement and maintain a clinical risk-management policy. Implement and maintain an incident or event register. Show that you conduct clinical audits demonstrating changes to clinical care that have reduced risk.
Preface to draft of Standard 3: Practice equipment Indicators in this Standard This Standard explains the equipment that practices are required to have to provide general practice services. Some parts of the practice facilities Standard in the 4th edition have now been included in this Standard, as these Indicators can be assessed together. New Indicators New Indicator Description and explanation Other comments 3.2 E Our practice has a defibrillator A number of stakeholders suggested that defibrillators be included in this edition of the Standards. This new Indicator is not mandatory. Mapping of the 5th edition to the 4th edition Standards 5th edition Criterion 5th edition Indicator 4th edition Criterion and Indicator 3.1 – Practice facilities ► A. Our practice facilities are fit for purpose. 5.1.1 ► A 5.1.3 ► A ► B. Our practice ensures that all patient consultations take place in a dedicated consultation or examination space. 5.1.1 ► B ► C. Our consultation spaces permit patient privacy and confidentiality. 5.1.2 ► A 5.1.2 ► B ► D. Our practice has a waiting area that accommodates the usual number of patients and other people who would be waiting at any given time. 5.1.1 ► C 5.1.1 H ► E. Our practice has accessible toilets and hand-cleaning facilities. 5.1.1 ► D ► F. Our practice is visibly clean. 5.3.3 ► E 3.2 – Practice equipment ► A. Our practice has equipment for comprehensive primary care and emergency resuscitation including: auriscope blood glucose monitoring equipment disposable syringes and needles 5.2.1 ► A