Surveyors' perceptions of the impact of accreditation on patient safety in general practice

Amr Abou Elnour, Andrea L Hernan, Dale Ford, Stephen Clark, Jeffrey Fuller, Julie K Johnson and James A Dunbar
Med J Aust 2014; 201 (3 Suppl): S56-S59. || doi: 10.5694/mja14.00198


Objectives: To explore Australian General Practice Accreditation Limited (AGPAL) surveyors' perceptions of the impact of accreditation on patient safety and to elicit suggestions for improving patient safety in Australian general practices.

Design, setting and participants: We conducted semi-structured telephone interviews with a purposive national sample of 10 AGPAL surveyors from 2 July to 14 December 2012. All interviews were audio recorded, transcribed and summarised.

Results: All participants agreed that accreditation has improved general practices' performance in quality and safety. Participants noted specific areas that need further attention, including sufficient evidence for clinical risk management, which half the participants estimated occurs in about 5%–10% of Australian general practices. Tangible evidence of patient safety activities included having a significant incidents register, providing documentation of near misses, slips, lapses or mistakes, and engaging in regular clinical meetings to discuss incidents and how to avoid them in the future. Participants agreed that the accreditation process could be improved through the inclusion of tighter clinical safety indicators and the requirement of verifiable evidence of a working clinical risk management system.

Conclusions: Accreditation has had a positive role in improving quality and safety in general practice. The inclusion of tighter indicators that require verifiable evidence will be a step forward. The Australian Primary Care Collaboratives (APCC) Program has an opportunity to build on its previous success in general practice quality improvement to further enhance patient safety in general practice.

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  • Amr Abou Elnour1,2
  • Andrea L Hernan1,2
  • Dale Ford3
  • Stephen Clark4
  • Jeffrey Fuller5,2
  • Julie K Johnson6,2
  • James A Dunbar1

  • 1 Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, VIC.
  • 2 Centre of Research Excellence in Primary Health Care Microsystems, University of Queensland, Brisbane, QLD.
  • 3 Improvement Foundation Australia, Adelaide, SA.
  • 4 Australian General Practice Accreditation Limited, Brisbane, QLD.
  • 5 School of Nursing and Midwifery, Flinders University, Adelaide, SA.
  • 6 Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW.


The research reported in this article is a project of the Australian Primary Health Care Research Institute (APHCRI), which is supported by a grant from the Australian Government Department of Health and Ageing. The information and opinions contained in it do not necessarily reflect the views or policy of the APHCRI, the Australian Government, or the Department.

Competing interests:

Stephen Clark is CEO of Australian General Practice Accreditation Limited. Dale Ford is the Principal Clinical Advisor of the Improvement Foundation Australia.

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