Are you ready for the new NSQHS Standards?

By Margaret Banks*
Friday, 03 August, 2018

Are you ready for the new NSQHS Standards?

One of the great, untold stories of modern health care is the extent of safety and quality improvements that have occurred in the Australian health system over the past several years.

Rates of healthcare-associated infections and deaths due to deterioration in physical condition have decreased, adverse drug reactions and medication histories are better documented, and fewer and more appropriate antibiotics are prescribed due to increased antibiotic stewardship, to name just a few improvements.

Many of these gains stem directly from the commitment and hard work of the clinicians, managers and countless other health professionals responsible for implementing the National Safety and Quality Health Service (NSQHS) Standards.

The purpose of the standards, mandated by national health ministers, and first launched by the Australian Commission on Safety and Quality in Health Care in 2011, are to protect the public from harm and improve the quality of health service provision.

Starting in 2013, every acute health service across Australia has been assessed against the NSQHS Standards at least once, with many assessed twice or more. With the release of the second edition of the NSQHS Standards in 2017 we embark on the next stage of this quiet revolution.

Assessments against the new standards start on 1 January 2019

With assessments against the new standards only months away for some health services, the key question for all health organisation workers — from board members to frontline clinicians and management — is: are we ready?

Australia is recognised as having one of the safest health systems in the world, but providing health care is a complex process, and constant improvements and changes must be made to maintain and improve upon this high standard.

So what does this mean for the second edition of the NSQHS Standards?

For starters, important gaps in the first edition, including mental health and cognitive impairment, health literacy, end-of-life care, and Aboriginal and Torres Strait Islander Health have been addressed. The second edition also updates the evidence for actions, and consolidates standards and actions to make them clearer and reduce duplication — instead of 10 standards and 256 actions there are now eight standards and 148 actions.

All actions in the second edition must be implemented, and while the standards are easier to use, the bar for assessment has been raised. The new standards address important clinical gaps and have an increased clinical focus that carries through to the assessment process, which has itself been reviewed to ensure it is rigorous and effective.

This revamped assessment process includes an extensive assessor orientation program, use of a structured process to ensure each action is rigorously evaluated and importantly, requires that assessors spend more time in clinical areas, not just reviewing documentation and administrative processes.

Ensuring safety is everybody’s business

One of the most profound improvements to the landscape over the past five years is the idea, now pervasive, that improvements to health care is ‘everyone’s business’, and not just the responsibility of safety and quality managers.

I urge you — irrespective of your role — to read the new standards and get to know them. After all, ensuring safe care is a core part of ‘your’ business.

There is still a way to go in our collective safety and quality journey, but with assessments against the second edition NSQHS Standards almost here, we have reached an important landmark.

With your assistance and the diligent commitment of thousands like you across the health network, over the next five years we will see the second edition standards translate into even greater improvements in safety and quality for the Australian health system.

Preparation checklist:

1. Read the standards — there is new material. Identify what applies to you and get to know it.

2. Use the National Standards website — this is your first point of reference. Read the factsheets and download the relevant resources.

3. Do a gap analysis — we have developed an online tool to help you:

          a. identify gaps in your quality and safety governance

          b. draft an action plan to address them

          c. produce simple reports on your progress

4. Get up to speed on changes to the assessment process — use the information on our website to understand:

          a. when to schedule your next assessment

          b. what the assessment will involve

          c. what assessment pathway is right for your service

5. Get your governance right — if you are a member of a governing body, the new standards come with a set of specific responsibilities. You can find a user guide developed specifically for governing bodies on our website.

6. Talk to your accrediting agency to confirm schedule and type of visit.

7. Inform and involve the people throughout your organisation, because without everyone being involved, you will not successfully implement the changes needed.

8. Thank them for their commitment to patient safety.

For more information, visit:




*Margaret Banks has been Director of the National Standards Program with the Australian Commission on Safety and Quality in Health Care since July 2006. Working closely with the Australian Government, states and territories, clinicians, consumers and other stakeholders, she has led the development and implementation of both editions of the NSQHS Standards and a supporting program of systematic accreditation reform across the Australian health system.

Image credit: ©

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