Accreditation in General Practice

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Accreditation in General Practice

• Margaret Gordon
• Practice Nurse Co ordinator
• Whitehorse Division of General Practice
• 28.2.07

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Aims of this session

• To provide an overview of the accreditation
  process
• To provide an overview of the RACGP 3rd Standards
• Practical tips on preparing for accreditation
• Policies and procedures
• Surviving the survey visit.

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History of Accreditation

• Accreditation has broad aims
• To attain the highest quality of practice in a
  gradual and achievable manner
• Provide a publicly recognisable measure of
  quality
• Be voluntary, but have tangible benefits
• Be for a defined period
• Be non punitive
• Be in the hands of the profession

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AGPAL facts (2006)

• 4650 practices registered with AGPAL
• 50 accredited Aboriginal Medical Services
• 22 accredited Medical Deputising Services
• 5 accredited Royal Doctor Flying Services
• 4271 practices have achieved 1st cycle
• 3347 practices have achieved 2nd cycle
• 95 practices have achieved 3rd cycle

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Tangible benefits of Accreditation

• Gateway to a range of benefits
• Professional satisfaction, pride staff
  empowerment
• Strong professional bargaining power
• Only access to PIP from 1/1/2002
• Recognition by RACGP QA CPD Program
• Market advantage
• Ultimately, improved health outcomes.

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Concerns with Accreditation

• Stress for staff
• Increased workload, poor delegation
• Cost time, new equipment and systems
• Change management
• New Standards each round is different

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RACGP 3rd Standards

• Released in 2006
• All practices accrediting or re accrediting from
  1st January 2007 are assessed against the 3rd
  Standards
• Copies are available from RACGP, at a cost of 88
  for members, 132 for non members.

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Assessment of the Criterion

• Variety of ways to demonstrate meeting the
  standards
• Interview GP, practice nurse, admin staff
• Direct observation
• Patient health records
• Documentation
• Patient feedback ( survey or discussion group)

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Whats Changed?

• Language Our Practice
• Team approach
• Shorter 15 standards(16), 44 criteria (75), 173
  indicators (272)
• Focus on clinical risk (eg recalls and reminders)
• Enhanced explanations
• Flexible wording and extensive glossary

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Whats Gone?

• Regular patients of the practice can have an
  appointment for a non-urgent matter within two
  days
• Limit of no more than six consultations per hour
• (NB The requirements for preventative care and
  comprehensive notes in the standard may impact on
  those GPs with high turnover)
• Duplication more consolidated

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Myth Busters

• Practices DO NOT have to
• Have a purpose built vaccine fridge
• Have a defibrillator
• Have an ECG (must have timely access to)
• Have a Spirometer (must have timely access to)
• Have adjustable height beds
• Keep a register of significant events
• Keep a register of complaints

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Criterion 1.5.4 System for follow up
of tests and results

• Three pages of explanation
• The RACGP obtained legal opinion on these issues
  and that is reflected in the explanation
• ? F. Our practice has a system to recall
  patients with clinically significant tests and
  results
• ? G. Our practice has a written policy to follow
  up and recall patients with clinically
  significant tests and results

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Criterion 1.7.2 Health summaries

• ? A. At least 90 of our active patient health
  records contain a record of allergies in the
  health summary
• ? B. At least 50 of our active patient health
  records contain a health summary. A satisfactory
  summary includes, where appropriate
• adverse medicines events
• current medicines list
• current health problems
• past health history

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Preparing for Accreditation

• Hold a staff meeting delegate tasks or areas of
  workload
• Support staff to achieve their goals in their
  area use resources available
• Allocate adequate time to accreditation issues
  may need extra staff hours
• Be systematic in your approach

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Preparing for Accreditation

• Check support services available through your
  Division
• accreditation support
• infection control assessments
• Sterilization support
• Cold chain management
• Consider change management techniques

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Plan Do Study -Act
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Arranging the visit

• Surveyors organize the visit to suit your
  practice
• Must be within normal working hours
• Allocate adequate staff on the day
• Allocate adequate time for staff and GP
  interviews
• Organize parking facilities, catering etc if
  required

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Double Check!

• Staff records current registrations, evidence
  of ongoing education and immunisation
• Infection control sterilization, cleaning,
  spills management, waste management, sharps
• Health records -Summaries, allergies, phone
  calls, recalls, results management, home visits
• Check consumables use by dates systems,
  samples, vaccines, lotions, Drs bags
• Schedule 8 record books and storage

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Policy Procedure Manual

• Not compulsory for accreditation, but recommended
  for best practice and quality improvement.
• Use the resources available
• Your Division
• AGPAL
• Dandenong Division (www.dddgp.com.au)

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Policies Procedures

• A policy is a statement to clarify an issue
• A procedure defines how the issue will be
  achieved within the practice
• Examples see handouts.
• Workshop writing a policy and procedure

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Resources Available

• Melbourne Division of General Practice
• Ph 9347 1188 www.mdgp.com.au
• Northern Division of General Practice
• Ph 9416 7689 www.ndgp.com.au
• AGPAL
• Ph 1300 362 111 www.qip.com.au/library
• GPA Accreditation
• Ph 1800 188 088 www.gpa.net.au
• RACGP
• Ph 8699 0414 www.racgp.org.au