DON'T BE SCARED OF ACCREDITATION
Who ever said they really love accreditation? Not too many people, that's for sure. Usually it brings an unwanted extra workload, on top of all the other day to day work that we do, making it feel more like an overwhelming chore for practice managers. I have led practice teams through 5 cycles of accreditation for 3 different practices and I must admit I might just be one of the rare few who does actually quite enjoy it! Once I became familiar with the process after a cycle or two, I began to think of it more as an opportunity to ensure the practice was doing the right thing and to see that it had appropriate policy and procedure in place, in order to provide optimal patient care and manage practice risks. On the survey day, it was a chance to show off the practice and the improvements that had been made since the last accreditation. I was lucky to work with practices where I was really proud of what had been achieved and when the survey visit was over, it was a chance for a team celebration.
Not that it was always perfect and once or twice the report came back with a minor action to be completed before accreditation was granted. Often there is fear of “failing accreditation”, which leaves practice staff worried that they might do or say the wrong thing on the day. If there is a mistake on the day or an area in which the practice is falling short of the standard, it does not mean you have failed, as there is always an opportunity to change what is needed after the survey visit, to meet the standards and become accredited. The accreditation bodies I have dealt with, (AGPAL and GPA) want you to succeed and in my experience, you are given a fair chance to do so.
Generally, the accreditation organisations give you at least 6 to 8 months to get prepared and this should give you plenty of time to review your policies and procedures and make sure that everything is up to date. Start gathering staff documentation early, as it sometimes takes time for everyone to remember to bring in paperwork such as CPD and vaccination information, to get your staff records up to date. You should make time for the whole practice team to understand what accreditation is about and what will be required of them. After all, the survey day is not just about the Principals or Practice manager. Several other members of your team will be interviewed, so they need to know what they need to know. This may involve doing some extra staff training and getting doctors to audit their records to ensure they are recording consultations well. Involving staff, ensuring that they do know the policies and procedures of the practice and coaching them to be able to respond to potential questions from the surveyor will help ensure everyone can do their best on the day. If you have prepared your staff well for accreditation and you make it a team effort, it will seem a lot less daunting when the surveyors arrive.
There is some really good online training if your staff need a refresher, and most of them provide certificates to keep on your staff records, which is also helpful for accreditation. Some training is free and others are pay per webinar, at reasonable costs especially if a few of your team can watch it together. Some good ones that I have used are:
The Triage Guide/training for practice staff Hand Hygiene Australia/training GPA webinars Digital-health Webinar -Train It Medical/Katrina Otto Staff Management and WHS Training –Australian Health Industry Group
Also keep a look out at your local PHN and AAPM to see if there are any staff education opportunities, especially sterilisation and cold chain management updates. If not everyone can go, ask the staff who do attend to give a presentation to other staff as part of a staff meeting. And of course all staff need an up to date CPR certificate. If lots of your doctors and staff require a CPR refresher, it can be a fun team building option to get a training provider into the practice and all do it together.
While working though your pre-survey questionnaire, you are likely to discover some policy and procedure documentation that you don't have, especially if it is your first accreditation. A few areas where I have found practices to be lacking in good documentation are policy and procedure about computer & information security and clinical coding, clinical governance and who the designated leaders are in your practice for specific tasks, protocols around medications including labelling of sample medications, and the business continuity plan including a pandemic plan. There are templates available for some of these things, but if you are a bit lost It may be worth considering using a practice management consultant to help you out with customising some templates, so they can be prepared much more quickly than starting from scratch. Your IT provider should be able to assist you with information to document how you protect your computers and information, and the Computer and Information Security Standards 2nd Edition, available on the RACGP website are a good guide on what you should have documented. Otherwise, it is really a case of working methodically through the questionnaire and if you find things that you need to get done still, write an action plan that you can work through. For accreditation, the detail is important but there are checklists available to help you ensure you have gathered all the documentation that you will need. You may like to use this checklist and help sheet. It doesn't all have to be perfectly completed at the time you do the questionnaire, as long as you know it needs doing and can work on getting it completed before the survey visit. And remember it doesn't all have to be done by the practice manager, so make sure you delegate tasks to other team members. Remember when you update any information in your policy and procedure manual, that you need to update it in any other location you keep it in, such as the steriliser or cold chain procedures kept in the treatment room. Information needs to be consistent across your practice.
Many of us forget to document the improvements we make in our practices, at the time we make them, so it is important that prior to accreditation you take time with your team to reflect on the changes you have made over the past few years, and take the time to write down the successes that you have had. For more on this and continuous quality improvement, take a look at the RACGP information on PDSAs. Documenting these cycles of change helps to bring the positives into focus and see why you should be proud to show off your practice on accreditation day.
If you are going through accreditation this year or next , take a deep breath and plan to get organised early with a little preparation each day. Good Luck!
As an aside, The National General Practice Accreditation Scheme commenced on January 1st this year. It won't make a lot of difference to practices at this stage, but gives additional choice in the accreditation agencies we can use, with 4 currently on the approved list. Practices accessing the PIP incentives program will need to be accredited by an approved agency. In the long run, it will also give practices access to national accreditation benchmarking data. If you wish to know more, you can subscribe to the PIP newsletter to keep updated. Accreditation still remains a voluntary process and the 5th edition standards are due later this year.
Carol Harding is a certified practice manager with over 12 years experience working in GP practices as a manager. Working as a management consultant she really enjoys working with practices to streamline their accreditation processes and supporting staff to be prepared and confident for their survey visit.