Individual Healthcare Identifier (IHI) quality checking in QST 111-22020347

The IHI in HI quality checking process aligns with Services Australia's Enterprise Quality Framework and the 7 quality principles.

The quality checking process:

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

In scope

The following work type is covered by this procedure:

Request or update an Individual Healthcare Identifier form (MS003).

Managers/Team Leaders make sure:

• quality checkers complete the process for quality checker accreditation
• quality checkers hold appropriate skill tags in the QST by sending an email to Quality Operations & Technical Support
• timely error feedback is discussed with Service Officer as part of the coaching conversation to support any learning and development opportunities
• analysis of errors - if errors were due to factors such as limited training, understanding the business rules, environmental or system based issues
• positive quality checking outcomes are acknowledged with the Service Officer
• analysis of data to identify learning needs or process improvement opportunities

Quality Checkers:

• carry out quality checks as specified in the sampling plan
• update and maintain technical knowledge, procedures and policies
• maintain a correctness standard for personal accuracy
• identify root cause analysis and identifying systemic issues
• report and escalate trends or concerns to their Team Leader
• give constructive and non-judgemental feedback, including appropriate reference materials such as Operational Blueprint
• explain the impact of errors and action to correct the error (where applicable) when giving feedback
• adhere to program business rules

Quality checkers must not check their own work. If their work is selected, it must be given to another staff member who has been trained to conduct quality checks.

Quality Team:

• provide support for quality checking in the QST
• provide relevant reports as required
• arrange QST training for quality checkers
• support the business with flexible and fit-for-purpose quality approaches

For accreditation, Quality Checkers must:

• have knowledge of relevant policies and procedures
• maintain a high correctness standard in the program they are checking
• have an understanding of the quality checking procedure
• meet accreditation standards annually

Quality Checking accreditation must be renewed annually.

See Quality checker accreditation for Health Service Delivery Division.

Pre-checks:

• apply to new starters
• apply when new processes are introduced

New starters have 100% of their work reviewed and corrected until deemed proficient. Any errors made in pre-check must be recorded as errors. Results are used to support ongoing training.

Program/ post-checks

These randomly select work completed the previous business day in PaNDA. The results are provided to management and external stakeholders as needed.

Targeted checks:

• apply in response to business triggers or when there is a consistent/long-term quality issue identified.
• apply to Aim for Accuracy process (Check the Checker) which is completed every 12 months. This is to confirm the accuracy of quality checking results. The process involves rechecking a representative sample of previously checked work to determine if quality checking procedures have been followed correctly

Pre-checks

Staff have 100% of their work reviewed until deemed proficient. As a guide, new starters are considered proficient in accordance with the Learning and Development training and consolidation plan.

Program/ post-checks

10% of the monthly IHI MS003 work type is selected for quality checking.

Targeted checks

To arrange these, Team Leaders send an email request to Quality Operations & Technical Support. The request needs to include the staff member’s details, the reason and the time required for the targeted check.

Timeframes

Pre-checks: consult with the Learning and Development Team for training and consolidation plan for this work type.

Program 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 4 calendar days. Exception: work will not be abandoned for 100% program quality checks.

Resources

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

• program specific processing systems
• PaNDA
• QST
• skill tags added on the QST

For quality checking, an error is information processed or keyed into the system that does not match the documents submitted or uploaded to the systems.

Critical and non-critical errors

Error codes are categorised as critical and non-critical.

An error is defined as critical when there is a potential risk to:

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

An error is defined as non-critical when it does not meet the above criteria. Generally, this relates to administrative errors.

Only critical errors are used to calculate the health status of the program.

Quality Checkers record in the QST the outcome of each quality check they complete.

The system sends an email in real time to the Service Officer and their Team Leader advising the quality check outcome.

Individual results are captured in the QST.

Quality checking feedback is sent by email to the Service Officer and their Team Leader. The email includes details about the check, the result (including any errors identified) and the quality checking dispute process.

Identifying underlying factors for errors

Team Leaders are to raise any underlying factors for errors, and:

• share with their team, or
• escalate to Consumer IHI and MHR SME to share with all teams

Managing and storing feedback

Feedback is recorded/ stored in the QST.

Correcting errors

Errors are corrected by:

• Quality Checkers as part of quality checking, or
• Consumer IHI and MHR SME Team Leaders if further resolution is required from the Digital Health Support Team

Critical errors

Quality Checkers must correct critical errors immediately, as they are identified.

Non-critical errors

Quality Checkers provide instruction in the feedback email. Quality Checkers are correcting non-critical errors.

Quality Checkers must consult their subject matter experts for questions about Individual Healthcare Identifier.

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

Quality checking procedures are reviewed and updated by the business and program in consultation with Quality Operations & Technical Support. The review ensures error codes are current and approved policy changes are included.

Any changes that require immediate action will be advised and updated accordingly. Any changes not critical to quality will be incorporated in the review of the procedures.