Request for NSQHS Standards (second edition) commercial design files

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

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	–