Quality System Assessment

The Quality Systems Assessment was implemented (2007) as one of the core elements of the Patient Safety and Clinical Quality Program to provide assurance regarding local systems of safety and quality and to ensure policy compliance.

Underlying methodology was drawn from a number of other industries, including mining, petroleum and finance. Those industries had shifted to a risk-based management approach for safety and quality, including the identification of risk followed by a proportionate response.

The program worked with local teams through four components:

  • Completion of a self-assessment survey at different organisational levels
  • Verification of the self-assessment by an external team of clinicians and managers
  • Feedback and reporting to participating organisations, as wells as the health system
  • Development of improvement plans for multiple levels in response to the findings of the self-assessment

2015 QSA Reports

Safer Systems Better Care (2014) continues to demonstrate local commitment to safety, learning and continuous improvement as part of the state-wide Quality Systems Assessment (QSA).

The 2014 cycle of the QSA reviewed local safety and quality systems relating to health care teams, nutrition care, pressure injury prevention and wound management systems. An online self-assessment received 1,800 responses from clinical teams and was followed up with more than 260 improvement conversations at multiple organisation levels.

All local teams received tailored local reports. The state level report aggregates findings, to show patterns of strength, risk and opportunity across NSW.

Four issues have been identified as warranting further effort for improvement:

  1. Locally appropriate governance to improve nutrition care
  2. Enhancing elements of high quality care "outside of traditional business hours"
  3. Clarity for clinicians in transition between electronic and paper medical records
  4. Implementation of processes to support effective governance of pressure injury prevention

2014 QSA Reports

Safer Systems Better Care (2013) is the sixth annual report of the Quality Systems Assessment (QSA) Program. This report demonstrates local commitment to clinical risk management and continuous learning at all levels and right across the NSW health system. Thank you.

Challenging our systems of safety and quality and how they translate into clinical practice at the patient level is an important part of the QSA process. Results from the 2013 process reaffirmed the strength of systems to support patient safety and clinical quality in NSW. The report identifies seven recommendations for proactive local improvement that the CEC will support by working with local teams and system-level partners:

  1. Continuity at transition of care that prioritises clinical need
  2. Continued implementation of antimicrobial stewardship programs
  3. Reducing risk from venous thromboembolism
  4. High safety local management of high-risk medications
  5. Preventing falls and harm from falls
  6. Integration between acute and community health
  7. Local environmental cleaning processes that reduce the risk of infection

2013 QSA Reports

The 2012 Safer Systems Better Care report is the fifth report of the annual QSA self-assessment. The Quality Systems Assessment (QSA) Safer Systems Better Care, 2012 report, presents the second system-wide census of key quality and safety activities undertaken in NSW. It shows substantial adherenceto best practice guidelines in many areas, and some important areas for quality and safety improvement. Three strategic themes emerge across public health organisations (PHOs) in the 2012 self-assessment, and from reflection on the results from the five-year cycle:

  • The need to improve communication and feedback at all levels of public health organisations;
  • The need to continue to invest in developing organisational capacity and excellence in quality and safety; and
  • The need to improve patient outcomes through building effective clinical teams.

2012 QSA Reports

The 2011 Safer Systems Better Care report is the fourth report of the annual QSA self-assessment and results reflect on four areas of assessment which represent areas of high risk to patients; paediatric management, sepsis, delirium and mental health. In addition to this main report and for the first time four supplementary thematic reports are available through the CEC website. In 2011 the number of clinical staff, facilities and departments involved in the program has increased with more than 1,500 respondents from all levels of all organisations. An impressive response rate of 99% was achieved.

The results show the need for follow-up action at several levels: by facilities and departments on introduction of paediatric observation charts; by local health districts (LHDs) on patient centred care; and by the Agency for Clinical Innovation and Clinical Excellence Commission (CEC) on a statewide direction for the management of delirium and sepsis.

Safer Systems Better Care, Quality Systems Assessment NSW Statewide Report 2011 (Released May 2012)
This report is a summary of data from the QSA self-assessment for public health organisations undertaken from September 2011 for eight weeks.

Supplementary reports from the 2011 QSA are also available:

2011 QSA Reports

Safer Systems Better Care, Quality Systems Assessment NSW Statewide Report 2010 (Released October 2011)
This report is a summary of data from the QSA self-assessment for public health organisations undertaken from September 2010 to November 2010.

Safer Systems Better Care, QSA Verification Report, Findings from 2011 On-site Verification Program of 2010 Self-Assessment (Released November 2011)
This report provides encouraging feedback on the verification of more than 16,000 responses to the 2010 QSA.

2010 QSA Reports

Rising to Excellence (Released June 2010)
Provides a summary of the key results from the CEC 2009 QSA self assessment.

2007/08 QSA Reports

Summary of Findings from the Area Health Services and the Children's Hospital at Westmead (Released November 2008)
Presents the results of the first QSA survey of Area Health Services and the Children's Hospital at Westmead conducted in late 2007.

First Stage Development - 2007

The CEC contracted the services of KPMG to develop the methodology, conceptual framework and a model assessment tool for the Quality System Assessment Program (QSAP).

Further Project Development - September 2007

Provides an overview of the project methodology, a report on the results of the activities of the project and considerations for the roll-out of the Program.

QSA Literature Review, 2007