TSANZ calls for mandatory accreditation for sleep centres

The Thoracic Society of Australia and New Zealand has called for the accreditation of sleep laboratories to maximise quality of care and ensure appropriate treatment.

This is part of a raft of recommendations made by TSANZ in its submission to the Thoracic Medicine Clinical Committee’s (TMCC) reviewing of respiratory and sleep items of the Medicare Benefits Scheme (MBS).

TSANZ president elect, Professor Allan Glanville, told the limbic the society had only 10 days to deliver its 28-page report, the result of a hastily organised survey of members that received 95 responses.

He congratulated members on their efforts, conceding however that it had been less than ideal.

“In retrospect this really did not give us enough time,” he said.

The society also addressed this in its submission.

“Our submission was developed in light of the objects enshrined in the TSANZ Constitution with specific reference to the need for TSANZ to promote the highest quality and standards of patient care and for TSANZ to advocate for and present to government, industry, the public and other bodies as appropriate, the resources and strategies required to ensure optimal care of patients, prevention of respiratory disease, and advancement of knowledge,” they wrote.

“The timeframes established by the Department for response to the report failed to let us undertake a comprehensive review with our members.

“We have been unable to develop robust evidence based responses to some of our recommendations due to the very short timeframes and would welcome feedback on what items in our submission require additional evidence and the process on how this might be best achieved.”

Sleep studies and the use of spirometry are currently under the TMCC microscope, with proposed changes set out in its recommendations document last month.

As reported in the limbic, the TMCC hopes the changes will address problems of under-utilisation of spirometry and over-utilisation of sleep studies as well as better remunerate health care professionals. He said the focus was on quality of care, governance and accountability across the field.

Professor Glanville said TSANZ saw the importance of making a submission, even given the short amount of time, and paid tribute to the solidarity members had shown by being involved in the survey.

“It’s a very powerful tool to enable and support quality outcomes,” he said.

And while the TSANZ welcomed the focus on improved quality in the report, it did raise concerns “that quality outcomes have not been sufficiently addressed in either the lung function or sleep items.”

“Our responses to this are addressed in the specific item numbers,” the authors wrote.

“We would welcome further discussions on ensuring that appropriate quality mechanisms are developed and implemented as part of the ongoing review of the MBS.”

Of the 19 recommendations made in the submission, most were overwhelmingly supported by survey respondents, particularly those seeking better Medicare rebates for fees and new items.

Almost 80% (78.8%) agreed with the recommendation that sleep laboratories should be accredited and the implementation of this should be phased in.

Professor Glanville said he was pleased to see such a strong result, as it indicated most members wanted change. However he is not expecting change to come easily or quickly.

“This has to be phased in and there will be push-back from parts of the community,” he told the limbic. “By having an overall accreditation process we can ensure that remuneration is tied to quality outcomes for patients.”

A similar number (80.8%) of TSANZ members supported the proposal to include cardio pulmonary exercise testing CPET where, as suggested, it is performed in an accredited lung function laboratory and in accordance with the TSANZ Laboratory Accreditation requirements for this test.

“Further discussion on the fee is warranted as this is a complex and labour-intensive test,” the submission reports.

Professor Glanville said the society had ‘aimed high’ with its list of recommendations, knowing some would probably not succeed.

“I think it’s likely they will take up some of our changes,” he said. “But then it will be up to us to drive the others.”


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