Implementation pack · Section 7.12

Institutional Culture and Accountability

Reconstituted quality and therapeutics committees with multidisciplinary representation and documented clinical governance input.

Status

Implementation pack in development

This implementation pack is in development. The framework content for the domain is published and available now.
01Purpose
Reconstituted quality and therapeutics committees with multidisciplinary representation and documented clinical governance input.
02ASQAT direction
Within 12 months, pilot hospitals should reconstitute quality and therapeutics committees with nursing, pharmacy, laboratory, and nutrition representation and document multidisciplinary input in clinical governance reviews.
03Desired institutional state
The desired institutional state for this domain has not been approved yet. The priority components below describe what the framework asks institutions to be able to show.
04Priority components
  • 01Nursing representation on quality and therapeutics committees
  • 02Pharmacy representation
  • 03Laboratory representation
  • 04Nutrition representation
  • 05Documented multidisciplinary input for sentinel event reviews
  • 06Antimicrobial stewardship
  • 07Nutrition support protocols
05Initial actions
A recommended action sequence will be published once approved. Actions are not invented beyond approved ASQAT content.
06Leadership responsibilities
Leadership responsibilities for this domain are in development.
07Workforce responsibilities
Workforce responsibilities for this domain are in development.
08Measurement
Measurement specifications for this domain are being developed. Indicator definitions are published only once the numerator, denominator and data source are agreed.
09Evidence expectations
Evidence expectations for this domain are being defined with the measurement specifications.
10Tools and resources
Implementation resources for this domain are currently in development. Approved policies, procedures, checklists and tools will be released through the resource library.
11Related domains
12Implementation evidence
No approved implementation evidence has been published for this domain yet. Case studies are published only after review of what was measured and how.