Australian Immunisation Register (AIR) quality checking in QST 111-22020000

The AIR program quality checking process aligns Services Australia’s Enterprise Quality Framework and the 7 quality principles.

See the Resources page for a link to the Enterprise Quality Framework.

The quality checking process:

• helps Team Leaders and Quality Checkers to identify AIR process improvements
• ensures consistency in quality checking

Managers/Team Leaders must ensure:

• Quality Checkers complete the process for Quality Checker accreditation before performing quality checks
• Quality Checkers hold appropriate skill tags in the QST by sending an email to Quality Operations & Technical Support
• Quality Checking error feedback is discussed with Service Officer as part of the coaching conversation to support learning and development needs
• they analyse any errors. For example, did the errors occur because there is limited training, understanding of the business rules, environmental or system based issues
• positive quality checking results are discussed with the Service Officer
• they analyse data to identify learning needs or process improvement opportunities
• quality checks are done as specified in the sampling plan
• they notify senior management of serious error which places the agency’s reputation at immediate risk
• they escalate systemic issues
• the quality checking outcomes disputes is followed

Quality checkers or Local Peer Support (LPS) must:

• carry out quality checks as outlined in the sampling plan
• update and maintain technical knowledge, procedures and policies
• maintain a correctness standard for personal accuracy
• complete root cause analysis and identify systemic issues
• report and escalate trends or concerns to their Team Leader
• give constructive and non-judgemental feedback. Include reference materials such as Operational Blueprint
• explain the impact of errors and action to be taken to correct the error (where applicable) when giving feedback
• examine system information/source documents to make sure Australian Immunisation register processes are in line with business rules, policies and procedures
• make sure they do not check their own work. If a quality checker’s own work is selected, it must be passed to another accredited quality checker to check

Quality team must:

• provide support for quality checking in the QST
• provide relevant reports as needed
• arrange QST training for Quality Checkers
• support the business with flexible and fit for purpose quality approaches

Quality Checker accreditation must be renewed annually. See Quality Checker accreditation for Health Service Delivery Division for more information.

To be accredited, quality checkers must:

• have knowledge of relevant policies and procedures and/or know where to find them
• meet accreditation standards annually
• renew Quality Checker accreditation annually

Pre-checks will be applied to new starters and when there are new processes introduced into the Programme. Staff will have their work reviewed and corrected until deemed proficient. These results are not included in accuracy of processing results.

See Resources for a link to Quality Checking New Starters Policy

Programme/post-checking randomly selects work completed the previous business day in Processing and National Demand Allocation (PaNDA). The results are provided to management and stakeholders as needed.

Targeted checks for AIR are completed for:

• staff when there is a substantial new process introduced or an identified quality issue
• Aim for Accuracy process (Check the Checker) which is completed every 12 months. This confirms the accuracy of quality checking results. The process involves rechecking a sample of previously checked work to decide if quality checking procedures have been followed correctly

Pre-check

New starters will have 100% of their work checked until they reach the program accuracy KPI, with a minimum of 40 activities per work type checked.

Programme/post-checks

A risk based approach will determine the bias in the sample.

The sample is prioritised according to the risk of the work type:

• High risk work items checked at 2.3%
• Medium risk work items checked at 2.2%
• Low risk work items checked at 2.0%

Targeted checks

Team Leaders can submit a Quality Targeted Check Request form for specific targeted checks.

Source documentation

AIR transactions selected for quality checking will be obtained from work types allocated through the Processing and National Demand Allocation (PaNDA) tool. Source documents will be obtained through PaNDA and/or the Practice Profile.

Quality checking is also performed on the following documentation (where applicable):

• scanned applications
• supporting documentation, for example, accreditation certificate for a practice relocation
• faxes
• letters
• Medicare mainframe AIR system pends

Note: if a notation has been made, this becomes part of the source (supporting) documentation that is subject to quality checking. This will be in the form of notations in PaNDA, CDMS, and/or Medicare mainframe.

Quality checks are undertaken daily on a random sample of work.

• Pre-checks - quality checks are normally done within 1-2 business day of the work being completed
• Programme/Post checks - where possible quality checks are completed within 4 calendar days of being allocated in the QST. At the end of the month any program check not completed is automatically abandoned after 3 calendar days

Resources

Quality checkers must have access to the following to undertake quality checks:

• Program specific processing systems
• Processing and National Demand allocation (PaNDA)
• Quality and Support Tool (QST)

Checkers must consult Local Peer Support (LPS) if they have any questions about quality checking.

Enquires about quality checking process or issues with submitted checking results that cannot be resolved on site should be directed to Quality Operations & Technical Support by email.

Note: when in training direct disputes to a Trainer/Floor-walker in the first instance.

An error is information processed or keyed that does not match the documents supplied, or the supporting documents uploaded on the systems.

Critical and non-critical errors

The error codes are categorised as critical and non-critical.

A critical error is when there is a potential risk to:

• a customer's:
• privacy
• eligibility
• payments
• application assessment being finalised
• record
• the agency's reputation

A non-critical error is when it does not impact the above criteria. Generally, this relates to administrative errors.

Note: only critical errors are used to calculate the accuracy of processing results.

See Resources for lists of error codes.

Each time a quality check is completed, the Quality Checker records the outcome in the Quality and Support Tool (QST). A system-generated email is sent in real time to the Service Officer and their Team Leader advising them of the outcome. Individual results are captured in QST.

Feedback is emailed to the Service Officer and their Team Leader. It gives details about the:

• check
• result (including any errors identified)
• quality checking dispute process

Method for managing and storing feedback

Feedback is recorded/stored in the Quality & Support Tool. Discussion notes about the feedback should be detailed in coaching sessions.

Correcting Errors

Critical /Non-critical errors - Quality Checkers provide instruction in the feedback email. Service Officer’s correct critical/non-critical errors.

If errors have been identified, action must be taken to correct the error. Errors are to be corrected by the original processing Service Officer. Where corrections cannot be made by the original processing Service Officer, the Team Leader will be responsible for ensuring the corrections are undertaken.

The Quality Checking procedure is reviewed by the business/programme and in consultation with Quality Operations & Technical Support. The review ensures that the error codes are current and approved policy changes are included.

Changes needing immediate action will be updated accordingly. Changes that are not critical to quality will be included in the review of the procedure.