How to use Clinical Care Standards | Australian Commission on Safety and Quality in Health Care

National safety and quality standards and accreditation

Monitoring the implementation of clinical care standards helps healthcare services to meet some of the requirements of the:

National Safety and Quality Health Service Standards (NSQHS Standards) for acute services
National Safety and Quality Primary and Community Healthcare Standards (Primary and Community Healthcare Standards) for services that deliver health care in a primary and/or community setting.

Healthcare services are expected to implement the national standards in a way that is appropriate to the clinical services provided and their associated risks.

Actions 1.27b and 1.28

Under the Clinical Governance Standard, healthcare services are expected to support clinicians to use the best available evidence, including clinical care standards (Action 1.27b), and to monitor and respond to unwarranted clinical variation (Action 1.28).

Information about role of clinical care standards in accreditation is provided in the fact sheet on applicability of clinical care standards.

Fact sheet 11: Applicability of Clinical Care Standards

2023

Fact sheet or brochure

See the NSQHS Standards webpage for more information about all of the national standards.

Quality statements and what they mean

The quality statements in each clinical care standard are based on high priority areas for quality improvement. The statements are selected and developed based on information about current variation from best practice and evidence about what works in terms of treatments, procedures and processes. This information is gathered from current literature, key data sources and stakeholder input.

Supporting information is provided for each quality statement for:

Consumers, so they know the care they can expect for a particular clinical condition and can make informed decisions with their clinicians
Clinicians, to support decisions about appropriate care and have informed discussions with their patients about treatment options
Healthcare services, to inform them of the policies, procedures, and organisational factors that can enable the delivery of high‑quality care advise.

Key tip: Use the supporting information to inform your use of the quality statements.

Indicators and measurement

Measurement is a key component of quality improvement processes. A set of indicators is included in all clinical care standards to support clinicians and healthcare services to monitor how well they are implementing the care described in the standard.

The indicators are a tool to support local quality improvement activities. No benchmarks are set by the Commission for any indicator.

The Commission develops indicators by:

Reviewing existing Australian and international indicators
Considering appropriate quality improvement measures for the quality statements
Prioritising, reviewing, and refining indicators with the topic working group.

Indicator data may be collected from local sources through prospective data collection, retrospective chart audits or review of policies and protocols.

Indicator specifications

The definitions required for health services to collect and calculate indicator data are specified on the METEOR website. METEOR is the online registry for Australian metadata standards for statistics and information in areas such as health, housing and homelessness, aged care, Indigenous, disability, children, families and youth.

Key tip: Check the indicator specifications in METEOR to guide data collection. The specifications for each clinical care standard explain what to collect for the numerator and denominator, the applicable settings and other useful information.

Other quality improvement measures

Patient experience

Patient-reported outcome measures

Patient‑reported outcome measures (PROMs) are an emerging method of assessing the quality of health care in Australia. They are patient‑reported outcome measures based on the responses of patients to standardised, validated questionnaires without input from healthcare providers. They are often administered at least twice to an individual patient – at baseline and again after an intervention – or at regular intervals during a chronic illness.

The information contributed by patients filling out PROMs questionnaires can be used to support and monitor the movement of health systems towards person‑centred, value‑based health care.

The Commission is leading a national work program to support the consistent and routine use of PROMs to drive quality improvement at all levels of the health system, from the individual to service and systems. There is growing interest across Australia and internationally in the routine interrogation of patient‑reported outcome information for evaluation and decision‑making activities beyond the clinical consultation.

Find out more about patient reported outcome measures.

Other measurement for improvement activities

Principles of care

Clinical care standards are based on general principles for providing care that is:

Person-centred
Culturally safe
Equitable
Based on shared decision-making and informed consent.
Inclusive of carers and support people

When applying clinical care standards

Clinicians are advised to use their clinical judgement and to consider the individual patient’s circumstances, in consultation with the patient or their support people
Clinicians and healthcare services should ensure that practice and quality improvement activities support these principles.

Person-centred care

Person‑centred care is health care that is respectful of, and responsive to, the preferences, needs and values of patients and consumers. Clinical care standards support the key principles of person‑centred care, namely:

Treating patients with dignity and respect
Supporting patients’ participation in shared decision making
Communicating with patients and providing information about their clinical condition and treatment options in ways they can understand
Encouraging patients to participate in decision making and self-management of their clinical condition.

For further information, see the Commission's resources on person-centred care.

Cultural safety and equity

Addressing inequity requires recognition that people with different levels of advantage may require different approaches and resources to achieve the same healthcare outcomes.

When implementing this clinical care standard, cultural safety can be improved through:

Embedding an organisational approach to cultural safety
Specific considerations for patients described within the relevant quality statements.

Organisational approaches include:

Ensuring the use of interpreter services and cultural translators when this will assist the patient and is in line with their wishes
Considering the role of Aboriginal and Torres Strait Islander Health Workers and Practitioners and how their involvement could improve patient care
Identifying variation in healthcare provision or outcomes for specific patient populations – for example, based on ethnicity
Disaggregating data by Aboriginal and Torres Strait Islander status when using the indicators included in this standard. This will support identification of access and outcome issues so that improvements can be made
Implementing and monitoring the six specific actions for Aboriginal and Torres Strait Islander care outlined for acute care services in the National Safety and Quality Health Service (NSQHS) Standards, and equivalent actions in the Primary and Community Healthcare Standards.

For Aboriginal and Torres Strait Islander patients, care should be provided in a way that is respectful of, and responsive to, cultural beliefs and practices, while addressing the disparities faced by Aboriginal and Torres Strait Islander peoples.

For further information, see the Commission's User Guide to Aboriginal and Torres Strait Islander Health.

Shared decision making

Shared decision making involves discussion and collaboration between a patient and their clinician. It is about reaching the most appropriate healthcare decisions for patients by considering the patient’s values, goals and preferences together with the best available evidence about benefits, risks, and uncertainties of treatment. Find out more about the Commission’s work on shared decision making.

Carers and support people

The Australian Charter of Healthcare Rights (second edition) describes rights that consumers, or someone they care for, can expect when receiving health care. These rights apply to all people in all places where health care is provided in Australia.

Patients have the right to involve the people they choose in planning and making decisions about their health care and treatment. Support people may be family members, carers, friends or consumer advocates such as social workers.

Many health services employ different types of liaison officers, such as Aboriginal and/or Torres Strait Islander liaison officers, who can provide patients with advocacy, information and support to patients.

Where a clinical care standard refers to clinicians’ discussions with patients about their care, this should be understood to include support people if this is what the patient wishes, or a substitute decision‑maker if appropriate.

Informed consent

Contact

Contact the Clinical Care Standards team at ccs@safetyandquality.gov.au to ask questions or request further information.

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