The challenge of regulating care for older people in AustraliaBMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7310.443 (Published 25 August 2001) Cite this as: BMJ 2001;323:443
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The article titled The challenge of regulating care for older people,
was printed in the 25 August 2001 copy of the BMJ. It raised some
interesting points in relation to accreditation and as President of the
Australian Council on Healthcare Standards (ACHS), a non-government
organisation that accredits all types of health care organisations in
Australia, I thought a response was required.
J. Braithwaite outlined an accreditation system in Australia that
needed to move more towards a regulation approach. A historical outline of
aged care regulation and aged care specific accreditation was discussed
and the basis for his discussion on accreditation was aged care
accreditation undertaken by the Aged Care Accreditation and Standards
The Aged Care Accreditation and Standards Agency is only one
accreditation body that accredits aged care organisations within
Australia. The inference within the article is that the issues outlined
about the Aged Care Accreditation and Standards Agency are the same for
all health care accreditation agencies, which they are not.
The ACHS has accredited residential aged care organisations for many
years. With the establishment of the Aged Care Standards and Accreditation
Agency by the Commonwealth Government under the Aged Care Act 1997, the
ACHS aged care membership dropped. This drop was due to the financial
pressures put onto aged care organisations and because of the duplication
of effort experienced. Despite this drop more than 150 organisations that
offer residential aged care continue to implement the voluntary Evaluation
and Quality Improvement Program (EQuIP) of the ACHS. These organisations
implement the two accreditation programs perceiving the benefits from
The ACHS EQuIP focus is on quality improvement rather than audits. It
is a peer assessment process that utilises standards that meet
international standards. The program has self-assessment as the core tool
for implementation of the standards and quality improvement. This approach
to accreditation is supported by the The International Society for Quality
in Health Care (ISQua) which defines accreditation as:
A self-assessment and external peer assessment process used by health care
organisations to accurately assess their level of performance in relation
to established standards and to implement ways to continuously improve.
It is important to note that another accreditation agency accredits
residential aged care organisations in Australia and that whilst this body
has many similar standards to the Aged Care Standards and Accreditation
Agency it also has many different features, notably a greater emphasis on
the continuum of care and improving performance.
Eva Raik (Dr)
Australian Council on Healthcare Standards
Competing interests: No competing interests