Clinical Safety Standard

Explanatory notes

The Clinical Safety Standard provides a framework for healthcare services to address and mitigate risks to safety and quality commonly encountered in primary and community healthcare services.

As the Primary and Community Healthcare Standards apply to a wide range of primary and community healthcare services, there may be actions that are not applicable in some service contexts. The Not applicable actions page outlines the circumstances where it is not necessary to implement individual actions. A healthcare service that delivers a broad range of services may have different actions applicable across its service.

Clinical governance and quality improvement to support clinical safety

By implementing the Clinical Governance Standard and the Partnering with Consumers Standard, a healthcare service will establish an individualised clinical governance framework. The systems and processes that make up the clinical governance framework are used to implement the Clinical Safety Standard.

Preventing and controlling infections

Each year, many infections are associated with the provision of health care and affect a large number of patients and, in some cases, consumers and members of the workforce. These infections:

• Cause considerable harm and may increase risk of morbidity, and death
• Increase the use of healthcare services
• Place greater demands on the workforce.

Infection prevention and control within healthcare settings aims to minimise the risk of transmission of infections and the development of resistant organisms.

The actions relating to this criterion have accommodated lessons learned from the response to the SARS-Cov-2 (COVID-19) pandemic to support healthcare services to prevent, control and respond to infections that cause outbreaks, epidemics or pandemics, including novel and emerging infections.

Medication safety

Medicines are the most common treatment used in health care. Although appropriate use of medicines contributes to significant improvements in health, medicines can also be associated with harm.¹ Because they are so commonly used, medicines are associated with a higher incidence of errors and adverse events when compared with other healthcare interventions. Some of these adverse events are costly, and up to 50% are potentially avoidable.² Errors affect both health outcomes for consumers and healthcare costs. Standardising and systemising processes can improve medication safety by preventing medication incidents.

Comprehensive care

Safety and quality gaps are often reported as failures to provide adequate health care for specific conditions or in specific situations or settings, or to achieve expected outcomes in certain populations. The actions relating to comprehensive care aim to address the underlying issues related to many adverse events, which often include failures to:

• Provide continuous and collaborative health care
• Work in partnerships with patients, carers and families to adequately identify, assess and manage patients’ clinical risks, and find out their preferences for health care
• Communicate and work as a team (that is, between members of a healthcare team involved in a patient’s health care).

Communicating for safety

Communication is a key safety and quality issue in health care. The actions relating to communicating for safety recognises the importance of effective communication and its role in supporting continuous, coordinated and safe patient care.

Communication is inherent to patient care, and informal communications will occur throughout healthcare delivery. It is not intended that these actions will apply to all communications within a healthcare service. Rather, the intention is to ensure that systems and processes are in place at key times when effective communication is critical to patient safety, for example, during transitions of care.

Recognising and responding to serious deterioration

Serious adverse events are often preceded by observable physiological and clinical abnormalities.³ Other serious events such as suicide or aggression are also often preceded by observed or reported changes in a person’s behaviour or mood that can indicate a deterioration in mental state. Early identification of deterioration may improve outcomes and lessen the intervention required to stabilise patients whose condition deteriorates.⁴

References

1. Roughead EE, Semple SJ, Rosenfeld E. Literature Review: Medication Safety in Australia [Internet]: Australian Commission on Safety and Quality in Health Care; 2013 Available from: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/literature-review-medication-safety-australia.
2. Roughead E, Semple S, Rosenfeld E. Medication safety in acute care in Australia: where are we now? Part 1: a review of the extent and causes of medication problems 2002–2008. Aust New Zealand Health Policy. 2009;6(1):1-12.
3. Buist M, Bernard S, Nguyen TV, Moore G, Anderson J. Association between clinical abnormal observations and subsequent in-hospital mortality: a prospective study. Resuscitation. 2004;62:137-141.
4. Calzavacca P, Licari E, Tee A, Egi M, Downey A, Quach J, et al. The impact of Rapid Response System on delayed emergency team activation patient characteristics and outcomes--a followup study. Resuscitation. 2010 Jan;81(1):31-35.