RACGP’s new accreditation standards involved ‘less paperwork’, says leading practice manager

The sixth edition of the RACGP’s accreditation standards will be more “efficient” for practices, according to a practice manager involved in trialling the new requirements. 

Dr Keshav Dhawan (PhD) implemented a draft version of the standards at his Melbourne practice last year as part of an eight-month trial run by the college and AGPAL.

He says that he found that they were more streamlined and believes that they will help to reduce the paperwork burden for practices. 

“I could see how they played out day to day … it gave me a lot of confidence that these standards are practical,” said Dr Dhawan, who was recently named the Australian Association of Practice Management‘s practice manager of the year. 

The final version of the standards published last month includes requirements for new areas such as environmental sustainability, AI and antimicrobial stewardship.

Although not mandatory, they suggest practices embrace measures ranging from using recycled products and carbon offsets to reducing paper wastage and lobbying local governments for electric vehicle charging stations.

They also refer to only using the dishwasher when full, placing recycling bins in common areas and encouraging staff to walk or take public transport to work.

The environmental sustainability additions have been particularly controversial, but Dr Dhawan, who works as an AGPAL surveyor, said that he believed practices could meet these without leaving themselves worse off financially.

“Solar panels, for instance, are good for cold chain management — they can prevent a clinic from losing thousands of vaccinations if there is a power outage,” he said. 

“The feedback [from the trial] was that this was good for sustainability and for managing the practice.”

Practices will be required to facilitate “processes for members of the clinical team to obtain and document informed consent from patients when aspects of care will be delivered using AI”.

Practices must also discuss AI implementation with staff and ensure identifiable patient data are “not used by AI tools unless its use is clinically necessary, explicitly authorised and supported by documented governance and consent processes”.

The second section, focused on assessing and evaluating AI use, tells practices to have a process in place, including risk mitigation, before implementing AI tools.

Antimicrobial stewardship is a new focus under the clinical governance standard, requiring practices to provide staff and patients with resources on inappropriate prescribing.

This includes providing patients with information about antimicrobial resistance, with the college suggesting that practices could “display QR codes” linking patients to this.

But the sixth edition has 31 fewer mandatory criteria than its predecessor, which Dr Dhawan said would have a tangible impact on the amount of paperwork needed to meet accreditation.

“It is easier and it is asking you to explain in less detail,” he said. 

“That is going to reduce the amount of work the practice manager has to do.”

Dr Dhawan also supported the additions on AI, but he said there could have been more clarity from the college on how often practices should obtain patient consent for the use of AI scribes. 

In July, a report from advocacy group Digital Rights Watch warned that many practices were breaching privacy laws by regularly failing to get adequate consent from patients. 

“There is still a grey area, because sometimes it seems like we need consent once, and sometimes it seems like we need to get consent for every consult,” Dr Dhawan said. 

“I’m still reading into this and getting educated on it, so I would say that is the one area where I would like more clarity.”