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Author: Tanya

Psychosocial hazards and psychological safety in the workplace

Posted on by Tanya

Potential risks to physical safety in the workplace are often easy to identify. However, potential psychological hazards aren’t always as easy to spot, yet can cause just as much harm to a person who is impacted by them.

As an employer, you have a duty to protect your employees from risks to their health, including psychological health. It’s important to note that every jurisdiction has different laws and regulations about psychological safety. Your obligations as an employer will be shaped by the rules that apply to you, however much of the guidance available is useful for employers as best practice even where it is not mandatory.

What are psychosocial hazards?

A psychosocial hazard is a hazard that arises from, or relates to, 

  • the design or management of work, 
  • a work environment, 
  • plant at a workplace, or 
  • workplace interactions and behaviours 

and has the potential to cause psychological harm or injury (Work Health and Safety Regulations 2011 (Cth) section 55A).

Depending on the nature of the workplace, some psychosocial hazards may always be present, while others may temporarily arise due to some change in working conditions. For example, the risk of emotional trauma connected to the loss of a patient in aged care is high and ever-present due to the nature of the work, whereas a psychosocial hazard connected to working increased hours due to staff shortages because of illness is likely to be temporary in nature. In many cases, one or more hazards will interact, and the effects compound to create a greater risk of harm.

Types of psychosocial hazard

There are three broad categories of psychosocial hazards that employers must manage: 

  1. The working environment – includes hazards such as working in high risk areas, working in remote or isolated areas or working unusual shift patterns. 
  2. The work itself – does the work require unusually high or low levels of mental load, does the work involve exposure to traumatic events or material, and is the workload unreasonably high? 
  3. Interpersonal conflicts – including between staff, poor management of the workforce, or mistreatment of staff by consumers. 

Personal issues faced by staff outside the working environment may compound their risk of psychological harm. While employers can’t control these hazards, they may be able to work with staff to ensure that the workplace does not contribute to the staff member’s risk of psychological injury.  

Appendix A of the model Code of Practice – Managing psychosocial hazards at work 2022 (Cth) provides a detailed example list of common psychosocial hazards, and potential control measures for each.

What is the current legislative status?

Most states and territories have implemented the model Work Health and Safety laws. As of April 1 2023, some jurisdictions have updated their Work Health and Safety Regulations and introduced a Code of Practice to specifically cover psychological safety and psychosocial hazards. Victoria’s psychological safety falls under its Occupational Health and Safety Act, and reforms are currently underway to better incorporate psychological safety into the existing occupational health and safety regulations.

See the below table for a brief summary of the psychological safety legislative requirements per jurisdiction, or refer to Safe Work Australia for more detailed information. 

What do I have to do to manage psychosocial hazards?

In all jurisdictions, employers have a duty to ensure the health and safety of their workers where “reasonably practicable”. This includes considering: 

  • whether the hazard was reasonably foreseeable; 
  • the potential severity of the harm that could occur; 
  • whether the organisation or its management knew or should have known about the hazard; 
  • whether there are any available and suitable methods of controlling the risk from the hazard; and
  • the cost of managing the risk. 

Other benefits of good psychological safety

In addition to making sure you’re meeting your legal obligations, good management of psychosocial risks can flow on to benefit the organisation. 

Demonstrating care for the wellbeing of employees and making work a mentally healthy place can boost staff retention rates, while staff who aren’t affected by psychological injury are less likely to require time off work, leading to more predictable and consistent rostering.  

Checking in with the workforce about psychological health can aid the organisation in understanding the challenges and difficulties staff are facing, while reviewing policies and processes for psychological safety can lead to operational changes improving service delivery.  

How SPP can help

We’ve updated these resources for you, which are available in SPP’s Reading Room: 

  • Info Sheet: Psychological Safety in the Workplace
  • Policy: Psychological Safety for Staff

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How an effective call bell system can improve service provision 

Posted on by Tanya

An effective call bell system is a key part of safe and quality care delivery in facilities providing services to care recipients. It can play an important role in risk mitigation, staff management and ongoing continuous improvement processes, and also helps demonstrate to your care recipients your organisation’s commitment to safe and high quality services.  

Promptly responding to call bell requests from care recipients can aid in risk management and the prevention of issues such as falls or pressure injuries. Long or delayed response times for call bells can be a sign of policy or procedure issues relating to the staff model or communication. Monitoring call bell response times and the reasons for the calls can contribute to identifying opportunities to improve service delivery.

It’s therefore vital for organisations to have processes and procedures in place to provide this assistance for their care recipients.  

1. Staff management

One of the most important aspects of a call bell system is the provider’s ability to respond to requests in a timely way. To achieve this, facilities must manage their staffing and rostering to support their staff’s ability to respond to call bells. Failure to roster enough staff, overburdening staff with too many responsibilities, and a lack of communication around expected responsibilities, priorities and processes are all common explanations for high call bell response times. 

2. Standards compliance

While you won’t find call bells specifically mentioned in standards requirements, there’s a lot of indicators that can be supported by good call bell response practices. For example, in a number of Provider Performance Reports, the Aged Care Quality and Safety Commission has referred to call bell response times and reporting as relevant to its assessment of compliance by providers with: 

  • Standard 3(3)(b) – Effective management of high-impact or high-prevalence risks associated with the care of each consumer; 
  • Standard 7(3)(a) – The workforce is planned to enable, and the number and mix of members of the workforce deployed enables, the delivery and management of safe and quality care and services; and 
  • Standard 8(3)(d) – Effective risk management systems and practices.  

As another example, for care facilities following NSQHS, call bell system management and reporting is relevant in relation to the Clinical Governance Standard and the Comprehensive Care Standard.  

3. Quality improvement

Reviewing call bell response records can form an important part of an organisation’s continuous quality improvement processes. Accurate records of the reasons for each call bell use, as well as response times, are useful for verifying care recipient and staff feedback and/or complaints and highlighting where improvements can be made in service procedures. Commonly listed reasons for response times outside the target window indicate opportunities for organisations to review current processes and how they impact safe and quality service delivery. 

How SPP can help

We’ve developed a new policy template for providers with call bell systems to optimise their call bell procedures. The template will help providers set response time KPIs, clarify staff responsibilities, and put in place regular reporting and analysis.  

In addition, our SPP self-assessment platform allows providers to link their call bell records as evidence against relevant Standards. 

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What’s New in Medication Management?

Posted on by Tanya

A growing number of Australians are remaining at home as they age rather than living in residential aged care facilities.  Many are moving into facilities at an older age, or when they develop conditions requiring greater care. In addition, the rise of polypharmacy (the use of multiple medicines by one person) and chronic disease raises increased challenges for medication management. In 2019, the Council of Australian Governments Health Council announced the Quality Use of Medicines and Medicines Safety as Australia’s 10th National Health Priority, in recognition of the increased risks of harm relating to the use of medicines.

The Department of Health and Aged Care has recently updated its Guiding Principles in response to this National Health Priority and the societal changes relating to medication management, with three Quality Use of Medicines (QUM) resources. These guidelines are not prescriptive, but demonstrate best practice for providers when managing consumer medications. They ensure consistency of care across the spectrum of care settings, with broadly standardised expectations of healthcare providers in medication management.  

Each set of guiding principles includes some overarching general principles, which inform the implementation of the specific remaining principles. They are designed to be used in conjunction with relevant legislative, profession-specific and accreditation requirements, and affirm a patient-centred, whole-of-organisation approach to care, as well as strong clinical governance. 

All three QUM documents are now consistent with other standards, such as the Aged Care Quality Standards, as well as aligning with each other for a cohesive approach to medication management.  

For example, Guiding Principle 1 (Person-centred care) is common to both the RACF and Community principles, and connects to Guiding Principle 8 (Sharing decision making and information about medicines with the individual receiving care) of Continuity in Medication Management. The diagram to the left shows where principles in the three documents overlap. For more information about the areas of commonality and differences between the three guiding principles, take a look at this guide from the Department of Health. 

1. Guiding Principles for Medication Management in Residential Aged Care Facilities (RACFs)

These Guiding Principles build on the 2012 RACF Medication Management principles, with the addition of two leading principles, Person-centred care and Communicating about medicines. Both align the Guiding Principles with Standard 1 (Consumer dignity and choice) of the Aged Care Quality Standards, and aim to actively engage consumers with their care. Other existing principles have been reorganised, combined, and renamed for greater consistency with the broader network of safety and quality standards. 

2. Guiding Principles for Medication Management in the Community

The Community Medication Management guiding principles have evolved from their 2006 predecessor and, similar to the RACF principles, have new principles relating to person-centred care and communication, to “promote a person-centred partnership and systems-based approach when support is being provided to people living at home”. The previous guiding principles have also been adjusted to match the wording of the RACF guiding principles, where they share common best practice. 

3. Guiding Principles to Achieve Continuity in Medication Management

Finally, the 2005 Continuity in Medication Management guiding principles have been updated to reflect current priorities and best practices relating to consistent, safe, and quality care across healthcare providers and at transition of care, including the addition of a Safety and quality systems principle.

BNG and Medication Management

We’ve updated our Medication Management policy document to reflect some of the key changes in the new Guiding Principles documents, available now in the Reading Room. In addition, we also have a range of templates that can be used as a starting point for your organisation to develop a comprehensive approach to medication management that:  

  • best suits the needs of your clients and the services you provide, and  
  • ensures your service delivery is in line with current best practice.  

Looking for more information?

The Australian Government Department of Health and Aged Care has created fact sheets for each new set of Guiding Principles, explaining each principle and some key tasks for achieving them: 

Medication management needs work?

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NSQHS Accreditation Assessments for HSOs: What’s Changing? 

Posted on by Tanya

From July 2023, the National Safety and Quality Health Service (NSQHS) Standards assessment procedure for accreditation of hospitals or day procedure services (Health Service Organisations, or HSOs) will be changing, with mandatory short notice accreditation assessments replacing the existing announced and voluntary assessments.  

Why the change?

The move to short notice assessments is intended by the Australian Commission on Safety and Quality in Health Care (the Commission) to “support the continuous implementation of the NSQHS Standards and reduce the administrative burden of preparing for accreditation assessment”.

The new process is designed to move the focus of assessments from preparation for assessment, to assessment of day-to-day practice. It is intended to support and emphasise continuous self-assessment by HSOs of their compliance with the NSQHS Standards, as well as their implementation of continuous quality improvement strategies.

The Commission requires that HSOs have systems and processes in place to keep their self-assessment documentation up to date, and conduct reviews of their self-assessment and their compliance status at least every three months.  

When will we be assessed?

Short notice accreditation assessments will occur: 

  • at least once within each three-year accreditation cycle;  
  • at least 4 months before the HSO’s accreditation expires;   
  • no sooner than 6 months after the previous assessment; and 
  • within 4 years of the previous assessment. 

HSOs therefore need to be ready for an accreditation assessment at any time. HSOs may request up to 20 business days per accreditation cycle to be excluded from assessment. These are days where a short notice assessment would either directly impact the provision of the service to consumers or the consumers of the service would be unavailable.

When will we be given notice of an upcoming assessment?

The notice period for an upcoming assessment will differ depending on the HSO’s location and/or the specific services provided. 

  • If you are an HSO in a metropolitan, rural or regional area with public transport options, you will be given 24 hours’ notice of assessment. 
  • If you are an HSO in a rural or remote area with either no or restricted public transport options, you will be given 48 hours’ notice of assessment.  

For some HSOs where special permissions must be sought to conduct assessment, such as services in some Aboriginal communities, fly-in fly-out services or services operating in prisons, your assessment notice may be up to 4 weeks to accommodate these requirements. 

For more information, see the Commission’s fact sheet, or feel free to contact us if you have any questions about the new assessment changes.

The importance of active, continuous self-assessment

Regular self-assessment of your compliance with the NSQHS Standards will maintain a focus on identifying opportunities to improve your service delivery. It forms an important step in the cycle of active, continuous quality improvement. As well as tracking compliance with each standard, your self-assessment process should also incorporate improvement opportunities that you identify through consumers’ feedback and complaints, and also from any incidents or near misses that occur. 

Ideally, your streamlined self-assessment system should include: 

  • A chronological record of all the compliance gaps and improvement opportunities you identify, and when you’ve addressed them; 
  • The ability to collaborate on and track improvements, including by assigning responsibility for certain tasks to team members;  
  • A compliance status report that you can generate at any point in time; and 
  • The ability to store and link documentary evidence of your compliance with each standard (for example, relevant policies and procedures that are implemented across your organisation).

How SPP can help

Our NSQHS self-assessment modules allow providers to understand the requirements of the Standards in detail, collate all identified improvement opportunities through an individually curated action plan, and review and report on their compliance status at any time.   

They also provide a helpful way to link relevant evidence against each standard, streamlining the self-assessment process and ensuring that your evidence of compliance is kept up to date. 

SPP also has self-assessments for other standards within the National Safety and Quality family, including for: 

  • Digital Mental Health,  
  • Mental Health for Community Managed Organisations, and  
  • Primary and Community Healthcare. 

In addition, SPP provides a deep pool of resources in our Reading Room (such as policy templates and info sheets) covering all aspects of organisational good governance to help HSOs work towards best practice.  

You can find our NSQHS Standards self-assessments in SPP by searching for ‘NSQHS’ in the Standards tab or under the ‘Australian National Standards’ subheading in that same tab. 

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