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What’s different?

This is a brief summary of key changes between the 3rd and 4th editions of the RACGP Standards for general practices.

Structure of the 4th edition Standards

• Same 5 sections and same number of Standards
• 3 less criteria and 38 less indicators.

References to legislation

In general, references to legislation have been removed in the RACGP Standards for general practices (4th edition) as federal, state/territory and local legislation override any non-legislative standards.  On occasion, legislation is cited in the Standards where it is particularly important to a defined aspect of general practice eg Criterion 4.2.1 Confidentiality and privacy of health information.

Criteria and Indicators in the 4th edition Standards

• Criterion 1.2.2 Informed patient decisions
  
  Our practice gives patients sufficient information about the purpose, importance, benefits, risks and possible costs associated with proposed investigations, referrals or treatments to enable patients to make informed decisions about their health.
  
  Change - New emphasis on possible costs as a component of informed decision making; 4 indicators (3 flagged and 1 unflagged) reduced to 3 flagged indicators

• Criterion 1.2.3 Interpreter and other communication services
  
  Our practice provides for the communication needs of patients who are not proficient in the primary language of our clinical team and/or who have a communication impairment.
  
  Change - new emphasis on patients with special needs

• Criterion 1.2.4 Costs associated with care initiated by the practice
  
  Our practice informs patients about the potential for out-of-pocket expenses for health care provided within our practice and for referred services.
  
  Change - combines 3rd edition criterion 1.2.4 costs within our practice and criterion 1.2.5 costs for referred services;5 flagged indicators (total) reduced to no indicators

• Criterion 1.3.1 Health promotion and preventive care
  
  Our practice provides health promotion, illness prevention and preventive care and a reminder system based on patient need and best available evidence.
  
  Change - broader scope;6 flagged indicators reduced to no indicators

• Criterion 1.4.1 Consistent evidence based practice
  
  Our practice has a consistent approach for the diagnosis and management of conditions affecting patients in accordance with best available evidence.
  
  Change - combines 3rd edition criterion 1.4.1 evidence based practice and criterion 1.5.3 consistent approach;7 indicators (total) reduced to 4 flagged indicators

• Criterion 1.5.1 Continuity of comprehensive care and the therapeutic relationship
  
  Our practice provides continuity of comprehensive care to patients.
  
  Change - combines 3rd edition criterion 1.5.1 continuity of comprehensive care and criterion 1.5.2 continuity of the therapeutic relationship; 5 flagged indicators (total) reduced to 2 flagged indicators

• Criterion 1.5.2 Clinical handover (new)
  
  Our practice has an effective clinical handover system that ensures safe and continuing health care delivery for patients.
  
  Change - new criterion;1 flagged indicator

• Criterion 1.7.1 Patient health records
  
  Change - refined definitions of ‘active patient’ and ‘active patient health record’; new flagged requirement for practices with hybrid medical record systems to record in both systems the location of clinical notes for each consultation; new flagged requirement to record the person the patient wishes to be contacted in an emergency; new flagged requirement to record Indigenous status (with information collected via a standard question); new unflagged requirement for working toward the recording of other cultural backgrounds; 4 flagged indicators increased to 6 flagged indicators

• Criterion 1.7.2 Health summaries
  
  Change – flagged requirement for active patient health records to contain a health summary increased from 50% to 75% of active patient health records; new unflagged requirement on the use of standardised clinical terminology (such as coding) to enable data collection for the review of clinical practice; 4 flagged indicators reduced to 2 flagged indicators and 1 unflagged indicator

• Criterion 2.1.2 Patient feedback
  
  Our practice seeks and responds to patients’ feedback on their experience of our practice to support our quality improvement activities.
  
  Change – new emphasis on collecting patients’ feedback on their experience of a general practice and using the data to drive quality improvement; new flagged requirement for practices to use a validated questionnaire approved by RACGP or practice-specific methods approved by RACGP to collect patient feedback; new unflagged requirement to inform patients about practice improvements; new RACGP guide:  Learning from our patients.

• Criterion 3.1.1 Quality improvement activities
  
  Our practice participates in quality improvement activities.
  
  Change – stronger emphasis on active whole-of-practice engagement in quality improvement; 2 indicators (1 flagged and 1 unflagged) now 2 flagged indicators

• Criterion 3.1.2 Clinical risk management systems
  
  Our practice has clinical risk management systems to enhance the quality and safety of our patient care.
  
  Change – broader focus on multiple systems; 2 indicators (1 flagged and 1 unflagged) increased to 5 flagged indicators; 3 new flagged indicators cover deviations from standard clinical practice, implementation of improvements, contingency plan for adverse events

• Criterion 3.1.3 Clinical governance (new)
  
  Our practice has clear lines of accountability and responsibility for encouraging improvement in safety and quality of clinical care.
  
  Change – new criterion with 2 flagged indicators requiring leaders with designated areas of responsibility and the internal sharing of information about safety and quality improvement 

• Criterion 3.1.4 Patient identification (new)
  
  Our patients are correctly identified, at each encounter with our practice team.
  
  Change – new criterion with 1 flagged indicator requiring a patient identification process using three approved patient identifiers

• Criterion 3.2.1 Qualifications of general practitioners
  
  Change – unflagged indicator on CPR training now flagged

• Criterion 3.2.2 Qualifications of clinical staff other than medical practitioners
  
  Change – more emphasis on multidisciplinary clinical team; unflagged indicator on CPR training now flagged

• Criterion 3.2.3 Training of administrative staff
  
  Change – more specific focus on training relevant to a role; 3 indicators (2 flagged and 1 unflagged) reduced to 2 flagged indicators; CPR training now flagged

• Criterion 4.2.1 Confidentiality and privacy of health information
  
  Our practice collects and safeguards the confidentiality and privacy of personal health information in accordance with National Privacy Principles.
  
  Change – combines 3rd edition criterion 4.2.1 confidentiality and privacy of health information and criterion 4.2.3 transfer of patient health information; direct reference to legislated National Privacy Principles; total of 10 flagged indicators reduced to 8 flagged indicators

• Criterion 4.2.2 Information security
  
  Change – combines 3rd edition criterion 4.2.2 information security and criterion 4.2.4 retention and destruction of patient health information; total of 8 flagged indicators reduced to 7 flagged indicators; new flagged requirement for a designated staff member with primary responsibility for electronic systems and computer security

• Criterion 5.1.1 Practice facilities
  
  Change – 12 indicators (10 flagged and 2 unflagged) reduced to 8 indicators (7 flagged and 1 unflagged); new flagged requirement for one or more height adjustable beds per practice

• Criterion 5.2.1 Practice equipment
  
  Change – 4 flagged indicators increased to 5 indicators (4 flagged and 1 unflagged); new unflagged requirement for practices to have a pulse oximeter

• Criterion 5.3.1 Safe and quality use of medicines (new)
  
  Our clinical team prescribes, dispenses and administers appropriate medicines safely to informed patients.
  
  Change – new criterion replacing 3rd edition 5.3.1 Schedule 8 medicines and 5.3.3 perishable materials; 4 flagged indicators covering information for patients, access to current information on medicines, accurate medicines lists, and the acquisition, storage, administration, supply and disposal of medicines

• Criterion 5.3.3 Health Care associated infections
  
  Our practice has systems that minimise the risk of health care associated infections.
  
  Change – replaces 3rd edition criterion 5.3.4 infection control; new focus on preventing health care associated infections; 7 flagged indicators increased to 9 flagged indicators; new flagged requirement for general practices to designate a person with primary responsibility for co-ordinating infection control processes; new flagged requirement for the practice to be visibly clean; expanded requirement for ongoing staff education; new flagged requirement for patient education on the transmission of communicable diseases

Last Modified: 5 November 2010
Authorised By: Standards