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Australian Commission on Safety and Quality in Health Care

Summer 2020-2021 News

Issue Monday 8 February

In this issue

Same care everywhere? Far from it!

NSQHS Standards Graphic

Healthcare variation – why does it happen and what can we do about it? Our online Better Care Everywhere: Healthcare Variation in Practice program series is now underway and answers these questions and more.

Join Australian healthcare leaders as they unpack healthcare variation in this series of free webinars with live Q&A, the first program of its kind dedicated to reducing unwarranted variation in clinical care across Australia.

Discover the key drivers of healthcare variation and practical ways to identify, investigate and address unwarranted variation, as we explore why Australians aren't getting the same care everywhere, how to prevent opioid prescribing problems, practical tips for vanishing variation, and using the NSQHS Standards Action 1.28 as a roadmap to better care.

If you haven’t already, visit our website to see the program and speaker line-up, and register now to join us over the next couple of weeks.

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COVID taskforce bolsters safety in hospitals

COVID-19 taskforce

Our National Clinical Taskforce, comprising some of the nation’s leading infection prevention and control experts, has now completed their review of the Preventing and Controlling Healthcare-Associated Infection Standard (HAI Standard) against current evidence about COVID-19 transmission. A revised draft standard has now been issued to states, territories, private health service organisations and accreditation agencies for further consultation before approval by the Commission’s Board early this year.

The new draft covers preventing, controlling and responding to infections that cause outbreaks, epidemics or pandemics – including novel and emerging infections like coronavirus – as well as healthcare-associated infections. Taking a precautionary approach, it accommodates lessons learned from the response to SARSCoV-2 (COVID-19) and supports health service organisations in implementing policies, processes and systems to provide a safe environment for patients and healthcare workers.

As the revisions primarily clarify existing requirements and reflect actions already taken in response to COVID-19, health service organisations are likely to find they are already meeting the requirements of the revised HAI Standard. Assessment to the revised standard will commence this year – we will keep you posted!

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Safer naming, labelling, selection and storage of medicines

Examining prescription drugs

Look-alike, sound-alike (LASA) medicines, with similar names and packaging, are one of the main causes of medication selection errors globally.

Our recently revised Tall Man Lettering List uses selective capitalisation for LASA medicine pairs to help clinicians differentiate similar medication names and reduce the risk of error. The medicine cloBAZam has now been added to the benzodiazepine class of medicines, based on adverse events reporting and its significant similarity – and likelihood of confusion – with another benzodiazepine, CLONAZepam. Discontinued medicine Lipazil and the similarly named Lipidil were also removed from the list of medicine name pairs.

As well as Tall Man lettering, barcode scanning, electronic alerts and separate storage locations are recommended to reduce the risk of harm associated with LASA medicines. See our Principles for the safe selection and storage of medicines for further advice and access to a survey tool to help identify risk-reduction strategies for your health service.

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Making every colonoscopy count

Colonoscopy Clinical Care Standard

More than 900,000 colonoscopies are performed in Australia annually.

The Commission’s Colonoscopy Clinical Care Standard helps ensure colonoscopies are used appropriately and performed safely to improve the likelihood of patient benefit and reduce the risk of harm. The standard includes four clinical indicators for monitoring the quality of colonoscopy units and is mandatory as part of the National Safety and Quality Health Service (NSQHS) Standards.

Our new colonoscopy resources include a consumer fact sheet and video, along with templates for referrals, reports and follow up letters, checklists, and fact sheets on informed consent and recertification. Also, if you missed our 2020 series of Colonoscopy Clinical Care Standard webinars for nurses, colonoscopists, GPs and quality managers, you can now watch all of the recordings on our website.

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New Antimicrobial Stewardship Clinical Care Standard

COVID-19 Latest Update

Our updated Antimicrobial Stewardship (AMS) Clinical Care Standard – with new and revised quality statements and indicators – was released in late 2020. Health services have until 1 January 2022 to implement the requirements of the new Clinical Care Standard.

The launch webinar was hosted by The Society of Hospital Pharmacists of Australia, and featured presentations by infectious diseases specialists Dr Kathryn Daveson and Professor John Turnidge.

Missed the webinar? Watch it on our website now, or catch the highlights in our 1–3 minute videos outlining changes made in the 2020 revision, antibiotic allergy delabelling, and transition arrangements for assessment to the NSQHS Standards.

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Antimicrobial stewardship for children

Doctor examining child

Antimicrobial Stewardship in the Care of Children is the latest addition to our Antimicrobial Stewardship in Australian Health Care Book.

With growing evidence that antibiotic exposure in very young children disrupts the developing gut microbiota – which is associated with increased risk of necrotising enterocolitis, fungal infections, childhood asthma, allergy, dermatitis and obesity later in life – protection of this young population is paramount.

Our new Chapter 14 covers antimicrobial use, resistance and stewardship for children and young people, factors influencing antimicrobial prescribing for this group, antimicrobial stewardship strategies and implementation in paediatric settings, and performance measurement.

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Reducing the rates – venous thromboembolism

VTE Guide

Venous thromboembolism (VTE) is one of the leading preventable causes of death in hospital, with pulmonary embolism accounting for 7% of all deaths in Australian hospitals every year.

However, data suggests many patients at risk of VTE – both nationally and internationally – do not receive the recommended preventive care.

The Commission has developed a new VTE Prevention Clinical Care Standard Implementation Guide to support health services in preventing VTE in hospital and post-discharge. The guide has practical tips for implementing the VTE Clinical Care Standard, along with prevention strategies, case studies and useful resources to assist in identifying those at risk of VTE and providing evidence-based preventative care.

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Cognitive impairment consumer rights in 10 languages

Covers for translations of cognitive impairment consumer rights

Everyone should know their rights when it comes to healthcare.

That’s why we have 10 language translations of our resource My Healthcare Rights – A guide for people with cognitive impairment, with important and accessible information about everyone’s right to safe and high-quality care. The guide is available in Arabic, Chinese (simplified and traditional), Dari, Greek, Hindi, Italian, Portuguese, Spanish and Vietnamese languages. An Easy English Guide, About healthcare rights for people with cognitive impairment, is also available.

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National Clinical Trials Governance Framework

The pilot of the National Clinical Trials Governance Framework is continuing across Australia until March. Insights from the pilot will inform the approach to national implementation later this year – stay tuned! The 14 selected pilot sites are currently receiving mentoring and undergoing a pilot accreditation assessment against the actions in the Clinical Governance and Partnering with Consumers Standards for clinical trial service provision.

Not part of the pilot? You can still provide voluntary feedback directly to our Clinical Trials Team by emailing CTGovernance@safetyandquality.gov.au.

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Careers at the Commission

Meet Gillian Giles, Director, Healthcare Variation …

Photo of Gillian Giles

What is your role, in 25 words or less?
I oversee the work of the healthcare variation program at the Commission.

What did you do before the Commission?
I worked for NSW Health in policy and planning roles, including a stint in the bunker during swine flu. Little did I realise then how helpful that experience would be in 2020.

What was your first job?
My first job as a teenager was working as a kitchen hand preparing the evening meal for residents in an aged care home. I was terrified. All I had to do was heat up a frozen dinner in an industrial-sized oven, but combined with all the extra requests it was beyond me. 'Could I have a tomato omelette, dear?', 'Please whip me up a cheese toastie', 'I’d rather have a salad'. I lasted three months. My first full-time job was as a speech pathologist at Liverpool Hospital. It was an exciting time – clinically we managed an incredibly diverse caseload, and professionally I felt lucky to work in a rapidly growing part of Sydney with all sorts of innovative projects.

The question I hear most often in my work is…
Why focus on healthcare variation? My answer – it is a critical component of high quality care. Unless you view health care delivery through a variation lens, you won’t know whether the care you are providing is appropriate. Are people missing out on the care they need? Or is the growth in the range of tests, technologies and treatments increasing the risk of diagnosing and treating people for conditions that would never have caused them harm? A focus on healthcare variation ensures that there are checks and balances in place at an organisational level for patients to receive the right care, and the right amount of care according to their needs and preferences, at the right time.

What are the top three things on your to-do list?
Releasing the fourth Australian Atlas of Healthcare Variation together with the talented healthcare variation team, running our first online program about healthcare variation, and celebrating these milestones with my colleagues as soon as we can all get together face to face.

What are you looking forward to in 2021?
Buffet restaurants and taking an international cruise. No, sorry. I’m actually excited about the next few sessions in our 
Better Care Everywhere: Healthcare variation in practice online program this month. It has been rewarding to work with so many inspiring health professionals across the country who are passionate about understanding healthcare variation to improve care. You can find out more about the program and register here.

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e: mail@safetyandquality.gov.au