National Standards Program updates and consultations

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Assessment to the NSQHS Standards
- The Impact of the NSQHS Standards
- National Standards Program updates and consultations
- NSQHS Standards (second edition)
- Information for health service organisations undergoing assessment to the NSQHS Standards
  - Steps for implementing the NSQHS Standards
- Information for dental practices undergoing assessment to the NSQHS Standards
- Information for accrediting agencies
- Resources to implement the NSQHS Standards (first edition)
- NSQHS Standards Advisories (first edition)
- Australian Health Service Safety and Quality Accreditation Scheme
Clinical Care Standards
- Overview of the Clinical Care Standards
  - Clinical Care Standards Advisory Committee
- Current consultation
- Acute Coronary Syndromes Clinical Care Standard
  - Project Information
  - Endorsements
- Acute Stroke Clinical Care Standard
  - Project Information
  - Endorsements
- Antimicrobial Stewardship Clinical Care Standard
  - Project Information
  - Endorsements
- Cataract Clinical Care Standard
  - Project Information
- Colonoscopy Clinical Care Standard
  - Topic working group and endorsements
  - Colonoscopy Clinical Care standard pilot project
- Delirium Clinical Care Standard
  - Project Information
  - Endorsements
- Heavy Menstrual Bleeding Clinical Care Standard
  - Project Information
  - Endorsements
- Hip Fracture Care Clinical Care Standard
  - Project Information
- Osteoarthritis of the Knee
  - Project Information
  - Endorsements
- Third and fourth degree perineal tears
- Venous Thromboembolism Prevention Clinical Care Standard
  - Topic working group and endorsements
- Peripheral Venous Access
Clinical Communications
- Clinical Handover
- Patient-Clinician Communication
- Resources
  - External Links
  - Clinical Handover Presentations
Clinical Trials
- Clinical Trials Consultation
- Project Information
- Resources
Safe and high-quality care for patients with cognitive impairment
- Caring for Cognitive Impairment campaign
- Cognitive impairment resources
Credentialing of clinicians
Colonoscopy Safety and Quality
Comprehensive Care
- Comprehensive Care Standard
- Conceptual model for Comprehensive Care
- Comprehensive Care Resources
- Essential elements for comprehensive care delivery
End-of-Life Care
- Information for patients, families and carers
- Tools and resources for health services
- Request End-of-Life Care Audit Tools
- End-of-life care projects across Australia
Falls Prevention
- Falls prevention resources
- Latest falls prevention research and practice
General Practice accreditation
- Accrediting agencies assessing general practices
Healthcare-Associated Infection Prevention Program
- Infection Prevention and Control Online Modules
- Antimicrobial Stewardship (AMS) and Healthcare Associated Infection (HAI) resources and links
- Antimicrobial Stewardship
- Infection Prevention and Control Signage
- Carbapenemase-Producing Enterobacteriacaea (CPE) Guide
- National Hand Hygiene Initiative
  - Hand Hygiene Australia
- National Infection Control Guidelines
- National HAI Surveillance
- Clostridium difficile infection
Indicators of Safety and Quality
- Avoidable Hospital Readmissions
- Potentially preventable hospitalisations and potentially avoidable deaths in Australia
- Patient-Reported Outcome Measures
- Classification of Hospital Acquired Diagnoses
- Hospital-acquired complications
- Australian Sentinel Events List
- Core, Hospital-based Outcome Indicators
  - CHBOI Toolkit Terms of Use
- Australian Hospital Patient Experience Question Set (AHPEQS)
  - Review of patient experience and its measurement in Australian hospitals
- Practice-level indicators of safety and quality for primary health care
  - Practice-level indicators of safety and quality for primary health care consultation – Written Submissions
Information Strategy
- National arrangements for clinical quality registries
  - Testing and validating the Draft Operating Principles and Technical Standards
- Health Information Standards for Safety and Quality
Knee Pain
Live Literature Searches
Medication Safety
- Safer medicines administration
- Paediatric prescribing positioning statement
- High Risk Medicines
- NSMC audit system
- National Standard Medication Chart (NSMC) auditing
- NIMC National Audit Reports
- Medication charts
- NIMC VTE Prophylaxis Section
- Medication reconciliation
- Safer naming, labelling and packaging of medicines
- Electronic medication management
- Quality use of medicines in hospitals
  - Hospital QUM individual indicators
- Medication Safety Tools and Resources
- National Residential Medication Chart
- Paediatric National Inpatient Medication Charts
  - Paediatric NIMC Seminar 7 May 2009: Report
- NIMC Private Hospital and Private Hospital Day Surgery Versions
Mental Health
- National Standards in Mental Health Services
- Recognising and responding to clinical deterioration
- Medication Safety in Mental Health
- Mental Health Advisory Group
- Emergency mental health contact details
Open Disclosure
- The Australian Open Disclosure Framework
- Implementing the Open Disclosure Framework
- Open disclosure programs, policies and information
  - Open disclosure at Mater Health Services, Brisbane
- Open Disclosure projects and priorities
Information for Consumers
- Translated resources and alternative formats
- Specific health conditions
- Healthcare safety and quality
- Working with your healthcare providers
- Be aware of button batteries
Patient and Consumer Centred Care
- Person-centred healthcare organisations
- National Safety and Quality Health Service Standard 2: Partnering with Consumers
- Health Literacy
- Useful resources
Patient Identification
- Patient / Procedure Matching Protocols
- Specification for a standard patient identification band
Primary Health Care
- Consultation process on patient safety and quality improvement in primary health care (closed)
Prioritising clinical practice guideline development
Recognising and Responding to Clinical Deterioration
- Training and Competencies
- Recognising and Responding to Deterioration in Mental State
- Implementing Recognition and Response Systems
- Evaluating Recognition and Response Systems
  - Audit Tools and Quality Measures for Recognition and Response Systems
- Observation and Response Charts
- Tools and Resources to Support Implementation of the National Consensus Statement
- Past events
Safety in e-Health
- Certification framework for digital mental health services
- My Health Record clinical safety program
- My Health Record in Emergency Departments Project
- Electronic discharge summary (EDS) systems
- Safety Issues at Transitions of Care: Pain points relating to clinical systems
- Cumulative hospital-level antibiogram
- Structured microbiology requests and reports for healthcare-associated infections
Shared Decision Making
- Webinars on Shared Decision Making
- Decision support tools for patients
- Resources and publications
Transvaginal Mesh
- Resources for consumers, clinicians and health service organisations – transvaginal mesh
  - Care Pathway for the Management of Stress Urinary Incontinence (SUI)
  - Care Pathway for the Management of Pelvic Organ Prolapse (POP)
- Senate Inquiry
- States, territories and private health services
- Useful Links
- Consumer forums to discuss transvaginal mesh

Safety and Quality > Our Work > Assessment to the NSQHS Standards > National Standards Program updates and consultations

Update

Now available: NSQHS Standards User guide for health service organisations providing care for patients with cognitive impairment or at risk of delirium

Closed Consultations

Consultation on draft NSQHS Standards User Guide for Medication Management in Cancer Care

Decision Regulation Impact Statement (RIS)

Update

Now available: NSQHS Standards User guide for health service organisations providing care for patients with cognitive impairment or at risk of delirium

4 June 2019

The main purpose of the User Guide is to suggest strategies that health service organisations can consider for implementation that are linked to the NSQHS Standards. Read more…

Closed Consultations

Consultation on draft NSQHS Standards User Guide for Medication Management in Cancer Care

Consultation on the draft NSQHS Standards User Guide for Medication Management in Cancer Care is now closed.

The Commission is now reviewing the information received during the consultation process. This information will be used to finalise the resource.

Decision Regulation Impact Statement (RIS)

1 February 2018

The Commission has released the Decision Regulation Impact Statement (RIS) as the final stage of a consultation process undertaken by the Commission to review the first edition of the National Safety and Quality Health Service (NSQHS) Standards.

The Office of Best Practice Regulation (OBPR) assessed the Decision RIS as compliant with the Australian Government’s RIS requirements and accepted the Commission’s recommendations.

The second edition of the NSQHS Standards was released in November 2017. The NSQHS Standards (second edition) addresses gaps identified in the first edition, including mental health and cognitive impairment, health literacy, end-of-life care, and Aboriginal and Torres Strait Islander health. It also updates the evidence for actions, consolidates and streamlines standards and actions to make them clearer and easier to implement.

The Commission has developed resources to support health service organisations to implement and prepare for assessment to the NSQHS Standards (2nd ed.). These resources are available for download from the Commission’s website.

The NSQHS Standards (2nd ed.) will be assessed from 1 January 2019.

Decision RIS (PDF 356KB) (Word 209 KB)

<<	Jun 2019					>>
M	T	W	T	F	S	S
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Isolated rectocele	GoR*
Posterior Colporrhaphy (PC) is the procedure of choice	B
Levatorplasty associated with high rate of dyspareunia	B
PC reduced prolapse with equal functional outcome compared to transanal approach	B
Fascial plication is superior to site specific posterior vaginal repair	C
No evidence demonstrating benefit for synthetic or biological graft	C
Those with combined vaginal prolapse and bowel symptoms benefit from colorectal and gynaecologist collaboration	C
Ventral rectopexy and vaginal graft is unnecessary for isolated rectocele	D

Vault prolapse (post hysterectomy)	GoR*
Sacral colpopexy (SC) has significant anatomical and functional advantages when compared with a broad group of vaginal surgery (± mesh)	A
Transvaginal apical mesh confers no advantage when compared to native tissue repairs	A
Uterosacral and sacrospinous colpopexy have similar efficacy for apical prolapse	B
Laparoscopic SC has advantages over both robotic and open approach however the learning curve with the laparoscopic approach is significant	B
Sacrospinous ligament fixation and abdominal sacrocolpopexy have equivalent success rates	B
Vaginal apical suspensions appropriate in those not suitable for SC (Delphi)	C

	GoR*
Vaginal hysteropexy is equally effective as vaginal hysterectomy with apical suspension and is associated with reduced blood loss and operating time	B
Vaginal hysterectomy with apical suspension has a lower reoperation rate for prolapse than abdominal sacro-hysteropexy	B
Salpingectomy ↓ risk of ovarian cancer in women retaining ovaries at the time of hysterectomy	B
Bilateral salpingo-oophorectomy (BSO) at hysterectomy in post-menopausal women ↓ rate of ovarian cancer without ↑ morbidity	B
SC with hysterectomy is not recommended due to high rate of mesh exposure	B
Supracervical hysterectomy has a lower rate of mesh exposure than hysterectomy and SC	B
Sacro-hysteropexy has a ↑ reoperation rate for prolapse than SC with hysterectomy	C
Supracervical hysterectomy has ↑ rate of recurrent POP compared to SC and hysterectomy	C
Although data is not complete, vaginal based apical suspensions should generally be considered for uterine prolapse reserving SC for recurrent or post hysterectomy prolapse	C

Isolated cystocele	GoR*
Anterior Colporrhaphy (AC) is generally recommended however permanent synthetic mesh could be considered for recurrent prolapse if women understand the risk/benefit profile	A
Non-autologous grafts offer no significant advantage over AC	B
Native tissue repair is recommended, but carries a higher risk of prolapse recurrence	B
Mesh repairs are associated with higher risk of adverse events	B
Mesh repair may be considered for recurrent prolapse after patient informed and accepts the risk/benefit	B
Adjunctive fascial slings may be used to prevent recurrent prolapse in high grade cystoceles	C

Prolapse surgery and lower urinary tract functions	GoR*
Women with POP + SUI
Surgery for POP + SUI shows a higher rate of cure of urinary incontinence in the short term	A
Combined POP + SUI surgery carries a higher risk of adverse events	A
Women with POP + occult SUI
POP + occult SUI equals POP and continence surgery (consider staged procedure)	B
Women with POP + occult SUI are at risk of development of incontinence post POP repair alone, with some proceeding to additional SUI surgery at a later date	A
Combined POP + SUI surgery reduces the risk of post operative incontinence	A
Combined POP + SUI surgery increases the risk of adverse events	A
Continent women with POP
POP without occult SUI does not require concomitant continence surgery	B
Women with POP and Overactive Bladder (OAB)
There is low level (inconsistent) evidence to suggest that operative repair can improve OAB symptoms	C

	GoR*
Perioperative physiotherapy did not reduce the rate of recurrent prolapse	A
Stage 3 or Stage 4 prolapse	B
Low volume surgeons have ↑ rate of complications compared to high volume surgeons	B
Patient age < 60 years	C
Less experienced surgeons have higher rates of recurrent prolapse after transvaginal surgery	C
Preoperative widened genital hiatus or levator defects on urinary signs and symptoms: data are inconclusive	D

	GoR*
Inferior outcomes to pubovaginal slings for primary repair, possibly with less voiding dysfunction	B
Outcomes similar or slightly less than synthetic MUS however longer operating time and recovery, slower return to activities of daily living and more prolapse in medium term	B
Laparoscopic approach when performed same technique as open has similar success rate with less morbidity than open approach	B
Lower rates of success, with higher retreatment rates, when compared to pubovaginal slings for primary repair	B

	GoR*
The most extensively researched option for SUI establishing efficacy and safety profile	A
As effective or more effective than colposuspension or pubovaginal sling with less perioperative and post-operative morbidity	B
Recommended surgical treatment female SUI	C

Retropubic versus transobturator mid-urethral sling	GoR*
In the short-term there are similar success rates for retropublic and transobturator	A
Obturator tapes slightly quicker, with less blood loss, bladder perforation and voiding dysfunction difficulties. Most of these differences were small and the complications are readily able to be managed.	A
However in the medium term (>5 years) the reoperation for recurrent SUI greater in obturator group and a small number developed groin pain (3-4%) that is difficult to treat.	B
Retropubic considered as the preferred procedure with transobturator reserved for those patients with a hostile abdomen	C

Retropubic versus transobturator mid-urethral sling	GoR*
In the short‐term there are similar success rates for retropubic and transobturator mid urethral slings	A
Obturator tapes are slightly quicker, with less blood loss, bladder perforation and voiding dysfunction difficulties. Most of these differences were small and the complications are readily able to be managed.	A
However in the medium term (>5 years) the reoperation for recurrent SUI greater in obturator group and a small number developed groin pain (3-4%) that is difficult to treat.	B
Retropubic considered as the preferred procedure with transobturator reserved for those patients with a hostile abdomen	C

Pubovaginal (fascial) sling	GoR*
Similar success rates compared to MUS with longer operating time and possibly higher voiding dysfunction; fascial sling has lower rates of chronic pelvic pain, no risk of erosion or extrusion, and higher rates of post‐operative morbidity	B
Lower rate of bladder perforation during surgery compared to MUS.	B
Fascial sling has higher patient satisfaction and treatment success compared to colposuspension	B
Involves a longer operation, post‐operative hospital stay (2–3 days) and recovery period than MUS	B
Consider in women wishing to avoid mesh‐related complications	–

	GoR*
May be a useful option for recurrent SUI with a well supported urethra	B
Greater symptomatic improvement was observed with surgical treatments, although the advantage needs to be balanced against risk of intervention	C
Consider in women wishing to avoid mesh‐related complications	–