Reliable, helpful assessors will do well in private market: expert

Agencies that offer aged care providers reliability and clarity in their site assessments at a competitive price will be those who succeed in the new market of privatised accreditation services, according to a healthcare standards expert.

Agencies that offer aged care providers reliability and clarity in their site assessments at a competitive price will be those who succeed in the new market of privatised accreditation services, according to a healthcare standards expert.

Further, accreditation services that provide high quality and helpful feedback to aged care providers following assessments will gain a desirable reputation in the sector.

Dr Cathy Balding
Dr Cathy Balding

That’s according to Dr Cathy Balding, director of Qualityworks and Adjunct Associate Professor, Health Services Management at La Trobe University School of Public Health, commenting on the government’s decision to open up aged care accreditation services to private agencies.

As Australian Ageing Agenda reported last week, Assistant Minister for Social Services Mitch Fifield has said there will be “robust requirements” for organisations seeking to provide accreditation services, but experts have warned that having multiple assessment agencies can challenge the consistency of standards.

Dr Balding agreed that the changes to accreditation services would add another layer of complexity to an already complex issue.

However, she said the issue of inter-rater reliability, or the degree of agreement between different assessors, was a challenge for all models of accreditation – including the current one.

“There’s nothing to say that assessors from one agency will have better inter-rater reliability between them than if you have multiple organisations,” Dr Balding told AAA. “Aged care organisations still worry about the different messages they get from different assessors, even when they’re all ostensibly from the same organisation. That will remain an issue.”

While there has been fresh concerns that privatising aged care accreditation services could result in a move towards low-cost agencies being chosen, Dr Balding said she did not believe that there was any relationship between price and quality in Australian accreditation generally.

“Low prices may not necessarily mean low-quality assessing… You can charge a lot and still have bad auditing and bad assessing,” she said.

Hospital sector experience

Dr Balding said the acute care sector had seen “big changes” since the overhaul of its accreditation regime and the introduction of the National Safety and Quality Health Service standards by the Australian Commission on Safety and Quality in Health Care in 2011.

Under that scheme, accrediting agencies assess and accredit hospitals and health services against the 10 standards, and provide assessment data and notifications to the commission and state health departments, which regulate the sector.

“It’s been interesting to watch and you’d have to say there have been pros and cons,” Dr Balding said of the acute sector’s accreditation regime change.

While the Federal Government has still not provided any further detail on the changes to aged care accreditation, Senator Fifield told AAA last week there would not be “multiple accreditation bodies”. While there would be one accreditation framework operating under the Quality Agency, “there would be competition and options as to who actually provided those accreditation services,” he said.

With multiple agencies to be conducting site assessments in aged care, Dr Balding suggested the Quality Agency would need to take the lead on bringing those entities together to collect feedback from assessors and providers, and disseminate lessons learned.

She said the commission had done this well in the acute sector, meeting regularly with the various accrediting bodies to discuss issues such as the inter-rater reliability of assessors, consistent assessor training and interpretation of the standards.

Dr Balding noted it had been a “slow burn” in the acute sector regarding the entry of new accreditation and assessing agencies coming into the sector. “That’s taken a long time to permeate, for people to consider other organisations; people stick with what they know,” she said.

Related AAA coverage:

Implications of accreditation changes come into focus 

Budget 2015: Changes to accreditation announced

Tags: accreditation, cathy-balding, la-trobe-school-of-public-health,

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