Quality framework for emergency departments

P28 V5

Document review

Timeframe for review: Every three years, or earlier if required.

Document authorisation: Council of Advocacy, Practice and Partnerships

Document implementation: Standards and Endorsement Committee

Document maintenance: Department of Policy, Research and Partnerships

Revision history

Version	Date	Pages revised / Brief Explanation of Revision
V1	Jul 2007	Approved by Council
V2	Mar 2012	Approved by Council
V3	Jul 2016	Approved by Council Change to ‘Purpose and Scope’ to include hospital-based emergency care services. Reference to National Safety and Quality Health Service Standards and Health Quality and Safety Commission incorporated under ‘Clinical Profile’ (i). Under ‘Education and Training Profile’, item b edited to reference the specialist emergency medicine training program. Inclusions under ‘Administration Profile’, such as EMER (c). Reference to the ACEM P395
V4	Sep 2019	New template adopted; content reviewed.
V5	May 2022	Updated to reflect new quality standards. Change to ‘Procedures and actions’ to reflect Quality Standards Reference to Quality Standards for Emergency Departments Reference to Quality Standards Toolkit Removed Appendix 1 Removed Appendix 2

Copyright

Australasian College for Emergency Medicine. All rights reserved.

1. Purpose and Scope

This document outlines the importance of establishing and maintaining a quality framework in emergency departments (EDs) and articulates the responsibility of the College and its members in that undertaking.

This policy applies to EDs and hospital-based emergency care services in Australia and Aotearoa New Zealand.¹

2. Position

ACEM believes that a quality culture is fundamental to the provision of the highest standard of care in EDs in Australia and Aotearoa New Zealand. The role of ACEM in promoting a quality culture in emergency medicine is to provide leadership and to develop quality standards that are applicable to the practice of emergency medicine at all levels.

3. ACEM Quality Standards

ACEM has developed Quality Standards for Emergency Departments and other Hospital-Based Emergency Care Services (the ‘Quality Standards’). The Quality Standards provide guidance and set expectations for the provision of equitable, safe, and high-quality emergency care in EDs and other hospital-based emergency care services in Australia and Aotearoa New Zealand. The Quality Standards cover five domains which represent the core priorities of the ED:

Clinical care patient pathway
Administration
Professionalism
Education and training
Research

Within each domain, there is a hierarchical structure which includes standards, objectives, and criteria. ACEM has developed a Quality Standards Toolkit (Toolkit) to use in conjunction with the Quality Standards. The Toolkit assists users in navigating the Quality Standards.

4. Cultural Safety

The Quality Standards include an overarching principle of Cultural Safety to acknowledge the disparities in health outcomes that occur across communities in Australia and Aotearoa New Zealand and all emergency health services must be committed to improving health equity across both countries. ACEM supports the definition of cultural safety provided by the Australian Health Practitioner Regulation Agency (AHPRA)¹:

Cultural safety is determined by Aboriginal and Torres Strait Islander individuals, families, and communities. Culturally safe practice is the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practising behaviours and power differentials in delivering safe, accessible, and responsive healthcare free of racism.

5. Recommendations

ACEM recommends that all:

a. EDs have a designated quality team with defined roles, responsibilities, and reporting lines. This team should include medical and nursing staff and may also incorporate clerical staff, allied health professionals and consumer representatives.

b. Health services and hospitals make the ACEM Quality Standards and Toolkit accessible to all ED staff.

c. EDs have a documented quality framework.

6. Related ACEM Resources

ACEM (2022). Quality Standards for Australian Emergency Departments and other Hospital-Based Emergency Care Services. Melbourne: ACEM.
ACEM (2022). Quality Standards for Emergency Departments and Hospital-Based Emergency Care Services Toolkit. Melbourne: ACEM.
ACEM (2020). P395 Policy on Internet Access in the Emergency Department. Melbourne: ACEM.

7. References

Australian Health Practitioner Regulation Agency. The National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025. Melbourne: AHPRA; 2020.