Healthcare compliance is about ensuring healthcare facilities or organisations follow and meet the requirements stated in acts, guidelines, and laws.
In Australia, this is even more complex as the regulations and their implementation may differ for each state and territory.
One such example would be the COVID-19 vaccine mandate for residential aged care workers. The 8 states and territories have released their respective public health orders in which the scope, exemption, and commencement date differ for each of them.
Thus, your healthcare management leaders must be very careful about the laws that apply to the organisation and implement healthcare compliance measures effectively. Otherwise, you could risk facing huge penalties or sanctions.
So what are the steps to ensure complete healthcare compliance in Australia?
Step 1: Stay informed
First and foremost, healthcare organisations should seek to learn and understand the right practices and standards in order to stay on top of regulations.
For Australia’s healthcare, the Department of Health has set multiple standards. The Department of Health is then assisted by regulators such as the Therapeutic Goods Administration, Aged Care Quality and Safety Commissioner, Private Health Insurance Ombudsman, and many more.
These regulators aim to protect the public by ensuring healthcare compliance in several areas. To list a few:
- National Registration and Accreditation Scheme for health practitioners;
- Aged Care Quality Standards;
- Privacy Act 1988;
- Private Health Insurance;
- Public health funding schemes (i.e. Medicare);
- Health incentive programs, and;
- Therapeutic Goods Act 1989.
It is vital to know the regulations that apply to your organisation in order to develop company policies and procedures that comply with them.
Additionally, regulations are ever-changing. You should constantly keep up with the adjustments and new implementations to stay compliant.
Some of the ways are monitoring updates on government agencies’ and regulatory bodies’ websites, and attending relevant industry conferences and meetings. These methods will ensure you get the latest updates and stay abreast of new or potential regulatory changes for the industry. You would then be able to react to changes more efficiently.
However, while it is vital to read and comprehend the acts, guidelines, and laws, it can be difficult to do so. Healthcare organisations may lack the expertise and resources.
It would then be advantageous to engage a specialised and experienced legal counsel to review the regulations and alert you when operational changes are required. Alternatively, you can form an in-house professional team to keep track of regulatory changes.
Step 2: Implement policies and procedures
After understanding what you have to comply with, the next step is to implement the policies and procedures the healthcare providers have to abide by.
Following the regulations closely, craft your policies and procedures. Your employees should be able to easily understand them.
Thereafter, you will need to communicate and educate employees on the implemented measures to generate buy-in. Employees should understand the importance of ensuring healthcare compliance and why certain policies and procedures are necessary.
You could also involve your employees in the crafting of policies and procedures. Employees would more likely abide by the policies and procedures to which they have a say and have contributed to.
In addition, there should be punishments or sanctions imposed for compliance breaches. This would deter employees from refusing to comply with the policies and procedures.
Step 3: Conduct internal compliance audits
There might be times when employees miss out on regulations or even take advantage of loopholes in the healthcare compliance system. This is where internal compliance audit comes into play.
Internal compliance audit is a comprehensive review of a healthcare organisation’s adherence to regulatory guidelines. It is carried out by compliance officers or outsourced professionals to measure the level of compliance, identify bottlenecks and gaps in current practices, and treat any non-compliance.
First, the auditors would perform a risk assessment to identify the processes with potential or existing risks in the healthcare organisation. They then prioritise the processes by the likelihood of their risks occurring and the significance of the risks’ impact on organisational goals.
Thereafter, the auditors develop an audit plan. The plan would document the details of each risk-causing process so you can determine which high-risk areas to address. They would also schedule the internal audits regularly throughout the year.
Finally, the auditors execute the plan and obtain findings from it. The healthcare management would need to review the report and assess whether there is a need to adjust or implement policies and procedures to better achieve healthcare compliance.
With internal compliance audits, healthcare organisations can ensure they are staying compliant with regulatory requirements. Employees would also be less likely to breach the regulations when checks are in place.
Step 4: Adopt compliance tools
Healthcare compliance can be extremely overwhelming. Your organisation will need to constantly fork out resources to maintain it, which eventually increases operational costs. Fortunately, the adoption of compliance tools can help to mitigate these negative effects.
Compliance tools utilise technology to automate and streamline risk identification and mitigation. This takes away the burden on employees to monitor the changing regulations and compliance levels in the organisation. They also aid in developing policies and procedures that align with the regulations and support compliance training and education.
There is no one-size-fits-all or all-in-one compliance tool. Consider what is suitable and necessary for your healthcare organisation before adopting them!
Here are some tools we recommend:
Visitor management system
Adopting an effective visitor management system helps to ensure compliance with the COVID-19 regulations such as social distancing and health declarations. It controls the number of visitors entering the healthcare facility and restricts people who are not allowed in the vicinity. You can also freely adjust the parameters based on the regulations at your healthcare facilities so you stay compliant.
Furthermore, the visitor management system allows you to track footfall and gain visitorship insights so that you can better allocate your resources.
Billing compliance software
Billing and coding regulations are some of the most complex requirements to meet for healthcare compliance. A billing compliance software will help to keep personal and sensitive information secure and ensure compliance with the privacy act.
This software also captures any billing or coding errors and flags them out before employees take any further action. Hence, you will achieve compliance coupled with greater efficiency.
Vaccination management system
With vaccination gradually becoming mandatory for most Australian healthcare and aged care workers, it is critical to ensure your healthcare organisation quickly adapts. Instead of manual checks on your workers’ vaccination statuses, you can adopt a vaccination management system.
Vaccination management systems help to automate sign-ins of your workers, approving entry of only those who are vaccinated. Workers simply need to upload their vaccination evidence onto the system and have them verified. The system also stores the information securely to enable faster check-ins in the future.
Additionally, the system monitors and updates itself on the changing state regulations, enabling the automatic adjustment of entry policies and requirements. Hence, you can be assured your healthcare organisation stays compliant with the vaccine mandate.
Stay on top of government regulations by following the four steps above. Most definitely, you should adapt them and implement other tools and processes to suit your organisation’s needs.
An effective healthcare compliance strategy is one that will achieve 100% compliance and minimise costs.
Lastly, ensuring complete healthcare compliance in Australia is tedious and complex, however being non-compliant is even more devastating. Thus, you should make compliance one of the key priorities in your organisation.