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Quality standards in Aboriginal and Torres Strait Islander health

Project summary

The project came out of a roundtable convened by OATSIH in October 2006 where the issue of a Sector wide accreditation regime was discussed. At that roundtable there was unanimous support for the concept of accreditation being a way to ensure Aboriginal and Torres Strait Islander people received the best possible care available no matter where they lived.

The specific focus of the project was to consider the current literature, to facilitate extensive engagement with the Sector and to provide advice to OATSIH on:

  • Accreditation standards that could be applied to the sector
  • The most feasible approach to implement accreditation against those standards
  • The support needed throughout the Sector in order to achieve such accreditation.

Project implementation

  • Review of the literature and mapping of accreditation standards against ACCHO domains of service activity.
  • Consultation interviews with representatives from Aboriginal health organisations, affiliate organisations and the accreditation industry.
  • Regional workshops involving Aboriginal health sector representatives


  • First and foremost there is overwhelming support within the sector for the concept of accreditation. Every organisation consulted in this project which had gone down the pathway to accreditation retained a positive view of its benefits despite some enormous obstacles encountered during the process.
  • Within the Sector there is a range of services, not all funded by OATSIH, being provided which could be subject accreditation. Consequently there is a plethora of accreditation regimes within the Sector which an organisation is either required to undertake or could potentially undertake voluntarily.
  • Of the 20 organisations that have gone through an accreditation process, 18 reported a range of difficulties.  The key themes which emerged from the analysis of these responses included:
  • Administrative and Process Issues
  • Orientation and preparation
  • Overburden of administration
  • Accreditation language
  • Workforce and capacity issues
  • Different accreditation frameworks
  • However, there are parts of the accreditation frameworks that we were advised are particularly useful. For instance, nearly all informants reported that they were satisfied with the accreditation coverage of clinical services. The process was found to be useful and relevant for processes such as sterilisation, vaccinations, filing systems.

Summary of main messages

Accreditation – that voluntary accreditation containing a continuous quality improvement element is of great benefit to the recipients of a health service as a means of ensuring an agreed standard of quality, care and safety.

Standards – that accreditation standards for the sector:

  • Be client focused, with clients receiving best quality care according to established standards for safety and quality
  • Acknowledge and enhance community control and community participation
  • Be generalisable across the health sector and not confined to the Aboriginal community controlled sector
  • Build a culture of continuous quality improvement 
  • Be adaptable and flexible to meet the needs of a diverse range of service settings
  • Lead to a rationalisation of reporting and accountability regimes
  • Be seamless, avoid duplication and support mutual recognition across standards
  • Demonstrate accountability to stakeholders
  • Promote quality management within service providers
  • Be workable for Aboriginal Health Services and accreditation agencies.

Continuous quality improvement (CQI) – that a CQI function be considered mandatory within any accreditation system that applies within the sector.

Governance of accreditation – that any accreditation regime has a form of ‘separation of powers’ in which the roles of the services, standards agencies, assessment agencies and government are consistent with agreed and clearly articulated roles.

Domains of activity – that the accreditation framework includes the following domains:

  • Clinical services
  • Social health
  • Business services
  • Advocacy
Created: 03 May 2012 - Updated: 16 July 2013