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Programs Quality System Assessment

Logo with QSA treatment and program title

NSW has an excellent health system that is committed to patients, their carers and our staff. Health system resilience is the key to public confidence in better care.

Resilience means that a system stands up under pressure, recovers quickly and, most importantly, learns when it fails. A resilient system is one that must continually learn, improve and adapt to changes in its environment. Continuous learning and improvement is key to system resilience.

The Quality Systems Assessment (QSA) has been one vehicle contributing to resilience in our health system. Working directly with local teams and local priorities, the QSA supported continuous learning and improvement to prevent and reduce patient harm.

Quality Systems Assessment

Program Overview

The Quality Systems Assessment was implemented (2007) as one of the core elements of the Patient Safety and Clinical Quality Program to provide assurance regarding local systems of safety and quality and to ensure policy compliance.

Underlying methodology was drawn from a number of other industries, including mining, petroleum and finance. Those industries had shifted to a risk-based management approach for safety and quality, including the identification of risk followed by a proportionate response.

The program worked with local teams through four components:

  • Completion of a self-assessment survey at different organisational levels
  • Verification of the self-assessment by an external team of clinicians and managers
  • Feedback and reporting to participating organisations, as wells as the health system
  • Development of improvement plans for multiple levels in response to the findings of the self-assessment

QSA program has four components

The QSA has evolved with feedback since 2007, but in recent times there have been large changes in the context of our health system. This includes the introduction of the National Safety and Quality Health Service Standards and greater devolution of decision making towards the front line of care.

A consultative review of the QSA functions has been an important step to ensure alignment of purpose, priorities and resources between CEC and local teams

Future Functions of the QSA

Review of the QSA started in June 2015 with broad internal consultation to understand perceived strengths, weaknesses, opportunities and threats for the QSA. The internal consultation feedback informed an external consultation process where more than 70 health service clinicians and managers were interviewed on their experiences with the QSA.

Consistent feedback on the future functions of the QSA included:

  • Enhanced systematic assessment and improvement of the safety culture at all organisational levels
  • Maintaining a multi-level view of the system
  • Enhancing peer to peer interactions through a site visit process
  • A greater focus on understanding and creating conditions of success, rather than audit and compliance
  • Clearer networking between pillar agencies in alignment with local priorities
The summary report can be found here.

The CEC is now working to define the next steps with local teams through a newly formed Organisational Development and Human Factors Directorate.


Please direct your queries and correspondence to:

Program Lead, Quality Systems Assessment
Locked Bag 8
Haymarket NSW 1240

Phone: (02) 9269 5622 Fax: (02) 9269 5599