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Ageing with excellence: Unravelling the power of auditing to enhance quality care!

Catherine Scott

Sundale Ltd

Auditing in aged care aims to improve the quality of care by reviewing care delivered against defined criteria and implementing changes based on the results. 

Internal quality audits are undertaken against the Aged Care Quality Indicators, and the external accreditation and certification measures compliance with the Aged Care Quality and Safety Standards. 

Providers need to regularly review clinical practice levels of activity, processes of care and outcomes, and benchmark performance data with external sources and other similar health service organisations. 

Having systems in place supports:

  • Monitoring variation in practice against expected health outcomes,
  • Providing feedback to care team members on variation in practice and health outcomes,
  • Reviewing performance against external measures,
  • Clinicians to regularly take part in clinical reviews of their practice,
  • The use of information on unwarranted clinical variation to inform improvements in safety and quality systems, and
  • Recording the risks identified from unwarranted clinical variation in the risk management system.

Undertaking audits and being accredited does not eliminate all risk to residents experiencing harm or adverse health events. It highlights the presence of safety and quality systems that support safe and reliable quality care are in place and risks of harm are identified and managed. 

The reasons for undertaking auditing and seeking accreditation include the following:

  • Compliance
    • Receiving a certificate of attainment,
    • Licensing implications, and
    • Funding and contractual requirements.
  • Verification
    • Verifies that the provider is authorised to provide care,
    • Reassures our residents, their families, and the broader community, and
    • Authenticates a provider’s claims of highly reliable care.
  • Quality
    • Demonstrates consistency between a provider’s words and actions,
    • Represents safety and efficacy of practices, and
    • Fosters positive health outcomes for residents.

Audits involve the entire organisation and generally represent four key steps:

  • Understanding the Aged Care Quality and Safety Standards and Quality Indicators,
  • Ensuring there are people, resources, and support to give effect to any required changes,
  • Using a combination of internal and external auditing resources such as the Aged Care Quality and Safety Commission, and
  • Completing regular self-assessments that bring together a provider’s evidence showing how they meet the above standards.

During internal audits and external accreditation, a process of triangulating evidence takes place whereby written evidence is compared against what is observed to be occurring in practice and then verified through resident, family, and staff engagement for confirmation.

Limb C, Fowler A, Gundogan B, Koshy K, Agha R. How to conduct a clinical audit and quality improvement project. IJS Oncology. 2017;2(6):e24.

Westbrook JI, Li L, Lehnbom EC, Baysari MT, Braithwaite J, Burke R, et al. What are incident reports telling us? A comparative study at two Australian hospitals of medication errors identified at audit, detected by staff and reported to an incident system. International Journal for Quality in Health Care. 2015;27(1):1-9.

Johnston G, Crombie IK, Alder EM, Davies HTO, Millard A. Reviewing audit: Barriers and facilitating factors for effective clinical audit. Quality in Health Care. 2000;9(1):23. doi: 10.1136/qhc.9.1.23.

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*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.