Skip to main content
Your browser has 'Cookies' disabled, alert boxes will continue to appear without this feature.

Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standard 4.1 Practice systems

Our practice demonstrates effective human resource management.

Criterion 4.1.1

Human resource system

Our practice supports effective human resource management.

Indicators

► A. All members of our practice team have position descriptions and can describe their role in the practice.

► B. Our practice has an induction system that orientates new GPs and other members of our practice team to the practice’s specific systems.

► C. Our practice team can identify the person(s) with primary responsibility for leading our practice’s quality improvement and risk management processes.

► D. Our practice team can identify the person(s) who coordinate the seeking of administrative feedback and the investigation and resolution of administrative and/or other complaints.

► E. Our practice team can discuss administrative matters with the principal GPs, practice directors or owners when necessary.

► F. Our practice can show evidence of regular practice discussions that encourage involvement and input from members of the practice team.

G. Our practice has a system to monitor team members’ performance against their position descriptions.

Explanation

Key points

  • Practice team members need clarity regarding their role and responsibilities in the practice
  • Practice team members need to know who is responsible for various aspects of the practice’s operations, including who has primary responsibility for quality improvement, risk management and infection control
  • Practices need a system for assisting new members of the practice team to learn their role (ie. induction and monitoring of progress in their new role)
  • Team discussions support good team performance
  • Indicator C cross references to Criterion 3.1.3 Clinical governance.

Good human resource management supports good clinical care

Research from both general practice and other industries supports the importance of attention to human resources. For example, the alignment of role, competence and (where required) licensing was identified by the authors of a study of high performing clinical teams as a common element.

General practitioners and other staff need documented position descriptions that outline their roles, responsibilities and conditions of employment. A position description establishes the role of the employee within the organisation, documents the parameters of the responsibilities and duties associated with that position and forms the basis for evaluation and lines of accountability. Recruitment, training and development, performance evaluation, remuneration management and succession planning can all be based on the parameters of a position description. Position descriptions should be signed by employees to indicate that roles and responsibilities are acknowledged and understood.

Desired characteristics of general practice teams

The RACGP position statement on GPs and their teams suggests the following attributes are desirable for a general practice team:

  • a just, supportive, transparent, cohesive and collaborative culture, which is associated with improved patient outcomes and enhanced patient safety
  • defined goals, including an identifiable overall practice ‘mission’ and specific, measurable operational objectives that are shared by all team members
  • a ‘systems’ approach that includes the development of both clinical systems and administrative systems
  • division of labour, including the delegation of tasks and assignment of tasks among team members, based on the principles outlined earlier in these Standards
  • effective training, both for the functions that people routinely perform and cross training to substitute for other roles in cases of absences or changed/increased work demands
  • excellent communication, including supportive interpersonal communication through well designed communication structures and processes.

Induction program

It is important for the practice to have an induction program for new GPs (including registrars and locums) and other new staff to assist new members of the practice team to perform their roles.

New GPs and staff need to understand the day-to-day operations of the practice as well as key occupational health and safety issues, such as infection control and the processes for maintaining the privacy and confidentiality of patient health information.

It is useful for new staff to have an understanding of the local health and cultural environment in which the practice operates. For example, if the practice is located in an area with a high level of problems caused by illicit drug use, it is useful for new staff to understand the practice’s policy concerning management of Schedule 8 medicine prescribing. Furthermore, staff and GPs in particular need to be aware of key public health regulations (such as reporting requirements for communicable diseases or mandatory reporting of child abuse) that will affect how they work. General practitioners need to be made aware of local health and community services including pathology, hospital and other services they are likely to refer to in the course of normal consulting.

Practices that have not employed new staff in the past 3 years are not required to have an induction program already developed. However, these practices need to be able to describe what they plan to do when employing a new staff member.

Leadership

It is important that the practice team has identified leaders in areas such as clinical care, information management, complaints/patient feedback and human resources. It is possible a single individual within the practice may assume all these leadership responsibilities. In some practices, however, leadership will be undertaken by different members of the practice team, although leadership of clinical care would remain the responsibility of a principal GP.

This criterion cross references to Criterion 3.1.3 Clinical governance in achieving safe, high quality clinical care. In the clinical area, leadership might include convening a practice meeting to review the quality of care provided or the mentoring of new GPs. It might also mean instigating a plan to monitor the management of patients on particular treatments such as warfarin with a view to improving the way the practice manages these patients overall.

In order to respond to patient feedback and make improvements, practices need to identify the person in the practice with primary responsibility for examining issues raised by patients and facilitating improvements in the practice.

Teamwork

Research in Australia and the USA confirms that teamwork is important to the quality of care. The research literature identifies teamwork as an important success factor in a number of safety initiatives across different industries.11

Regular discussions where all staff are encouraged to have input are important in building a high performing team. In general, the decisions made at staff meetings should be documented along with the person responsible for implementing the related action.

It is important for practices to cultivate a just, open and supportive culture where individual accountability and integrity is preserved, but there is a wholeof- team approach to the quality of patient care.

It is important that all members of the practice team have the opportunity to discuss administrative issues with the practice directors and/or owners when necessary. When the practice is owned by a person or body other than the practising GPs, then GPs and other staff need to have defined systems for discussing administrative matters with the owner(s). These discussions do not necessarily require a formal staff meeting, although this is desirable, particularly in larger practices.

Resources

The Australian Association of Practice Managers publication The Guide: AAPM business manual for healthcare is available for purchase from www.aapm.org.au.

Standard 4.1 Practice systems

Our practice demonstrates effective human resource management.

Criterion 4.1.1

Human resource system

Our practice supports effective human resource management.

In a nutshell

Having a good HR management system means that your health service is better positioned to deliver good clinical care. Effective human resource management, even for smaller health services, is important. It should include key elements such as clearly defined roles and responsibilities for all staff, provision for appropriate induction and training, HR administration processes, two-way communication and a performance management process. It should also provide for leadership in key aspects such as quality improvement, risk management and infection control, a good induction or orientation process and effective communications systems. Providing for effective staff support and development processes is also a good staff retention strategy.

Key team members

  • CEO/director
  • Health service manager
  • Human resources manager
  • Senior clinical and administrative staff

Key organisational functions

  • Human resources management
  • Orientation/induction processes and package for new staff
  • Communication policies and procedures
  • Quality and safe clinical practice
  • Risk management and control
  • Staff complaints process
  • Staff records
  • Staff training
  • Cultural safety workplace policy and processes

Indicators and what they mean

Table 4.1 explains each of the indicators for this criterion. See Criterion 4.1.1 Human resource system of the Standards for general practices for more information about key elements of good human resource management in a clinical environment.

Table 4.1 Criterion 4.1.1 Human resource system
IndicatorWhat this means and handy hints
▶ A. All members of our practice team have position descriptions and can describe their role in the practice. Staff roles and responsibilities need to be clearly defined in a documented position description, and to be understood by your individual staff members. The best position descriptions are those that can be utilised to form the basis for staff planning, evaluation and lines of accountability.

Ideally, a position description would include:
  • an overall description of the job, with general areas of responsibility listed
  • the essential functions of the job
  • the required knowledge, abilities and skills
  • the required education and/or experience
  • the line of accountability
  • a description of physical demands (including OH&S requirements)
  • a description of the work environment (including OH&S requirements)
  • any cultural safety requirements.
The position description needs to be updated as a staff member’s roles and responsibilities change.
▶ B. Our practice has an induction system that orientates new GPs and other members of our practice team to the practice’s specific systems. Induction is crucial for all ACCHSs. It provides an opportunity to orientate new staff members not only to the day-to-day operations of the health service but also to the social, cultural and community information and knowledge of the local Aboriginal and/or Torres Strait Islander community.

An induction system could orient new staff members to the following:
  • the day-to-day operations of the health service
  • the service’s clinical risk-management processes
  • occupational health and safety
  • infection control
  • quality improvement
  • local social and cultural practices and traditions
  • local and regional (and sometimes state and interstate) health and community services
  • clinical governance system
  • key policies and procedures
  • privacy and confidentiality of patient health information (including relevant communication policies)
  • cross-cultural communication and orientation
  • the local health environment (including relevant key public health regulations and local public health issues)
  • specialised protocols for rural or remote regions (such as patient travel or emergency evacuations).
▶ C. Our practice team can identify the person(s) with primary responsibility for leading our practice’s quality improvement and risk-management processes. Your health service has an identified leader (or leaders) in the key areas of continuous quality improvement and risk management. This criterion cross-references with Criterion 3.1.3 Clinical governance, where safe, high-quality care is achieved by ensuring accountability and consistency.
▶ D. Our practice team can identify the person(s) who coordinate the seeking of administrative feedback and the investigation and resolution of administrative and/or other complaints. Your health service has an appointed person or persons responsible for coordinating and seeking administrative feedback and managing complaints. This could be a health service or human resources manager.

Some of the issues that may fall within this area include feedback or complaints on:
  • policies and procedures
  • staff/patient complaints
  • recruitment and employment
  • communication structures and processes
  • occupational health and safety
  • performance management.
▶ E. Our practice team can discuss administrative matters with the principal GPs, practice directors or owners when necessary. An open communication channel between staff members and management is crucial to maintain a high standard of human resources management. Administrative/HR systems, like clinical systems, are subject to quality improvement and risk management. The two systems are interrelated, and when problems and issues are identified and addressed, this will lead to better outcomes for both human resource management and health service delivery.

Your health service could have a communication system in place for staff members to discuss administrative matters with management. This could include a process for two-way communication with the board. The communication system would also include a complaint handling procedure, which ensures that confidentiality and due process is observed at all times.
▶ F. Our practice can show evidence of regular practice discussions that encourage involvement and input from members of the practice team. It is important that your health service encourages a culture of fairness, support, transparency, cohesion and collaborative relationships between management and staff. In general, this will lead to improved patient outcomes and enhanced patient safety, as well as enhanced staff satisfaction.

Regular team meetings amongst administrative staff, clinical staff and whole of health service staff are a good way to maintain a high level of involvement and input from all staff members. These meetings need to be conducted in an open and transparent manner, and to be clearly documented.
G. Our practice has a system to monitor team members’ performance against their position descriptions. Documented position descriptions form the basis of staff accountability and performance evaluation. Recruitment, training and development, performance review, remuneration management and succession planning can all be developed from a good position description.

A performance management policy and process is an important mechanism to allow managers to regularly and systematically review staff performance, guide staff development and plan future roles and tasks through a two-way communication process. This policy could also allow for more informal ongoing supervision and feedback, and for the management of underperforming staff and unacceptable behaviour.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can ensure that it has an effective human resource system. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

The health service has a human resources policy and plan, linked to its business plan. This covers policies and procedures to address recruitment and selection, induction, performance management, training and development, management and leadership.

All staff have documented position descriptions that outline the responsibilities of their job and upon which annual performance reviews are based. Position descriptions are updated, if required, after the annual performance review. Staff members who have been delegated responsibility for specific roles have these responsibilities included in their position descriptions. These roles may include complaints management, information technology, risk-management systems, cleaning, infection control, sterilisation, vaccine management, quality improvement.

There is an induction program, tailored to individual needs. It includes general items such as:

  • welcome to the service
  • administration, telephone procedures and appointments
  • triage and medical emergencies
  • processes for patient management
  • patient health records and confidentiality
  • human resourcesjob descriptions and specific roles, staff appraisals, training
  • occupational/workplace health and safety
  • infection control including standard precautions and immunisation
  • schedule 8 drugs (if kept on the premises)
  • clinical autonomy for GPs and other health professionals
  • complaints and patient feedback process and who is responsible
  • clinical risk-management system and who is responsible
  • organisational structure
  • multidisciplinary teamwork
  • cultural awareness and security.

Health professionals also have a specific induction checklist for clinical matters in addition to the general staff induction process. When completed this is placed in the employment file and includes the following:

  • prescriber number, provider number and medical registration details
  • Medicare information: online claiming for Medicare and the Department of Veterans’ Affairs, Practice Incentives Program (PIP), Service Incentive Payments and General Practice Immunisation Incentive Individual General Practitioner details and forms
  • Australian Childhood Immunisation Register: application, Agreement under section 46E(2) of the Health Insurance Act 1973, bank account details for immunisation providers, General Practice Immunisation Incentives Practice report (G11020A) request
  • Health Professional Online Services (HPOS) application, registration for prescription shopping program, National Prescribing Services (clinical audits and activities for PIP)
  • Aboriginal and Torres Strait Islander health assessment and chronic disease management processes
  • evidence of training in
    •  cultural awareness and security
    •  multidisciplinary teamwork
    •  clinical governance
    •  updating the health service information sheet
    •  setting up appointment sessions and appointment times in appointment book (paper-based or electronic)
    •  infection control
    •  computers: username and password for main server, clinical and accounting software, installing public key infrastructure if applicable, login process, prescription sheets, resource access, training in clinical software, if required
    •  occupational health & safety and service policies: proof of immunisation or consent or refusal of offer form signed, confidentiality form signed, working with children check undertaken
    •  clinical: clinical guidelines, pathology and x-ray providers, local hospitals, specialist referral, ECG and spirometry, emergency trolley, equipment and doctors/retrieval bag(s), emergency retrievals/evacuations, drug cupboard content, access and dispensing process.

Team work, including cross-disciplinary teamwork, is encouraged, and efforts are made to bring staff from different areas together so that they can work collaboratively on an issue or task. Time is allowed for team meetings every fortnight.

Managers of all areas have management and leadership skills training.

Showing how you meet Criterion 4.1.1

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how you meet the criterion.

  • Keep up-to-date staff employment files.
  • Show that you cover the human resource system in staff interviews.
  • Maintain an organisational chart.
  • Document and define the recruitment process.
  • Use induction templates/checklists.
  • Maintain position descriptions with defined accountability and responsibilities.
  • Keep a complaints ledger.
  • Maintain accessible communication channels, such as regular staff meetings.
  • Show that you maintain a policy and procedure manual outlining human resources matters.
  • Keep minutes of staff, clinical and OH&S meetings.

Related RACGP criteria

Search Standards Advanced Search
Search Interpretive guide Advanced Search

The Royal Australian College of General Practitioners

General enquiries

Opening hours 8:00 am-8:00 pm AEDT

1800 4RACGP

1800 472 247 | +61 (3) 8699 0300 (international)

Follow us on

Follow RACGP on Twitter Follow RACGP on Facebook Follow RACGP on LinkedIn


Healthy Profession. Healthy Australia Logo

The Royal Australian College of General Practitioners (RACGP) ABN 34 000 223 807
RACGP House, 100 Wellington Parade, East Melbourne, Victoria 3002 Australia

Terms and conditions | Privacy statement