| The standards and indicators below form
part of a national quality assurance project, formally known as CHASP (Community Health
Accreditation and Standards Program). They are primarily used by drug specialist agencies
as a bench mark to measure and improve organisational performance and to gain national
The manual from which these standards come, include:
- examples of indicators which can be used with the standards;
- a service development workbook: and
- other useful material to assist in the accreditation process.
These standards are one of the service delivery modules which are to be used as an
attachment to generic core standards of Quality Improvement Council (QIC) review and
They are provided here to prompt consideration of domains of organisational and
clinical review of practice. Agencies wishing to undertake formal review and/or
accreditation should contact:
Quality Improvement Council Limited - Ph (03) 9479 5630 Fax (03) 9479 5977
Health and Community Service Standards
Alcohol, Tobacco and Other Drug Services Module
(Note: all the following standards and indicators in the manual are
prefixed by ATD [Alcohol, Tobacco and other Drugs]. This prefix has been omitted for
convenience but should be included if referencing).
and Summary Guide to the Standards
Section 1 Assessment and Care
1.1 Policy and Resources
1.2 Registration, Allocation and Referral of
1.3 Participation in treatment and Care
1.5 Comprehensive Care Including Treatment
1.6 Continuity of Care
Section 2 Early Identification and
2.1 Policy resources and Planning
2.2 Comprehensive Accurate Early Identification and
2.3 Participation in Early Identification and
Section 3 Health Promotion and Harm
3.1 Policy and Resources
3.2 Planning and Coordination
3.3 Comprehensive Approach
3.4 Advocacy for Health
Section 4 Client and Program Records
4.1 Client Record System
4.2 Confidentiality of Client Records
4.3 Adequacy of Content of Client Records
4.4 Program Record System
Assessment and Care
Clients receive services which improve their health status and quality of life.
The physical, emotional, social cultural, spiritual and environmental aspects of their
health are addressed in a holistic manner. Harm caused by the use of alcohol, tobacco and
other drugs is minimised through the service's intervention.
The drug service operates in a manner consistent the the philosophy of harm
minimisation. It provides the opportunity for change in an individual through assessment,
treatment and care across the physical, mental and social aspects of health. The
involvement of clients in decision-making is emphasised within a multidisciplinary
approach. Work culture ensures that staff work practices aim to provide ready access for
clients to assessment, treatment and care services.
||Assessment is accurate, comprehensive and timely.
||Consumers receive comprehensive and appropriate
||Harm is minimised.
||Consumers actively participate in their own care.
POLICY AND RESOURCES
The drug service has policies and resources which
ensure the provision of high quality assessment, treatment and care services.
||The service has written policies on assessment,
treatment and care which have been reviewed within the last three years.
||All staff are aware of, and implement, the
policies of assessment, treatment and care.
||The service has the necessary resources to
provide high quality assessment, treatment and care.
||The service implements an effective model of
service delivery to meet the needs of clients with a dual diagnosis.
||The service provides or has access to the range
of services needed to assess, treat and care for physical, mental and social factors in
relation to drug use.
||Where there are identified gaps in services, the
service assists clients to get the care they need.
||The service has minimised waiting times for
and Support Programs (NASP)
||The service has policies and protocols for NASP
services which are comprehensive and based on current research.
||The service is able to provide NASP that meet
confidentiality, access and safety requirements.
Drug Withdrawal Service
||The service has protocols for withdrawal which
are consistent with current research.
||Appropriate staff use the withdrawal protocols.
Residential and Drug
||The service has a polity on any restrictions on
||The service ahs protocols for the prescribing,
administration and monitoring of any drugs used in detoxification, rehabilitation, or
Opoid Maintenance Service
||The service has protocols in place for the safe
prescribing and provision of registered opoid maintenance drugs. The protocols are
implemented by appropriate staff.
REGISTRATION, ALLOCATION AND REFERRAL OF CLIENTS
The drug service has
written procedures for registration, allocation and referral which ensure that people and
their personal details are dealt with appropriately and confidentially (whether by
telephone, letter, or in person).
||The drug service uses a uniform system to
identify and register clients of the service.
||All staff use written procedures for the
registration, allocation and referral of clients. The procedures include the legal
requirements for the registration of mandatory clients.
||The service implements effective allocation and
referral practices to meet the needs of clients with a dual diagnosis.
||The service records all contacts (by phone or in
person) with potential clients.
||Staff who assess and register people have had
appropriate initial and ongoing training.
||Appropriate information is given to clients at
the time they are registered.
||The service is responsive to clients' requests
regarding choice of therapist.
||The service has a protocol in place for transfer
of clients of opoid maintenance into or out of the service. The protocol is consistent
with legislation and relevant state guidelines.
PARTICIPATION IN TREATMENT AND CARE
The drug service ensures the
participation of clients in their treatment and care through a collaborative approach
between clients and staff.
||The service makes sure there is a co-operative
approach between clients and staff at all stage of contact including during the
development of the management plan.
||Staff discuss with clients the impact of their
drug use on different areas of their life.
||Staff discuss with clients any possible legal or
confidentiality problems if they mention illegal drug activities or crimes.
||Clients are supported in making informed
decisions about their health care and management plan.
||Staff explain to clients the purpose, value and
consequences of diagnostic and/or treatment methods that are available.
||Language-appropriate pamphlets, booklets and
articles on various health and drug issues are available in the service's reception area,
and are given to clients as part of their care.
||The service offers opportunities for clients to
participate in self help/support or user groups.
||The service ensures that the only people who are
suitably registered, prescribe and dispense medication, including opoids.
||Staff involved in the prescribing and dispensing
of medication, including opoid maintenance, give clients easy-to-understand verbal and/or
written information about its use.
||Staff explain to clients the activities that are
available at the service.
||The service informs clients of the availability
and suitability of other services and agencies that provide additional or alternative
||Clients are given feedback on their progress in
People using the drug service receive an appropriate,
accurate, comprehensive and prompt assessment of their needs.
||The initial assessment of clients gathers
relevant and sufficient information to develop an initial management plan.
||The service ensures that clients are assessed
promptly any by the most appropriate team members.
||Client consent is routinely sought for staff to
consult with multidisciplinary team members to help with comprehensive assessment.
||Provision is made for ongoing assessment, which
is structured and staged in a way that is sensitive to clients' readiness to discuss
||Staff ensure that clients have access to a
general health assessment for the early identification of health problems.
||Staff use specific protocols, which are
up-to-date with current professional practice, to guide assessment.
||The service ensures that assessment of Aboriginal
and Torres Strait Islander people or people from diverse cultures, is appropriate to their
language and culture.
||The service uses reliable and valid mental health
screening procedures that are routinely administered at assessment or admission.
COMPREHENSIVE CARE INCLUDING TREATMENT
The drug service provides access
to the range of services required to ensure clients' needs are comprehensively addressed.
||The service has access to a range of activities
and interventions within the program to enable a comprehensive management plan to be
available to the client.
||The activities and interventions offered by the
service are supported by evidence based research.
||The service uses specific protocols and
guidelines to carry out activities and interventions. These protocols are consistent
with current professional practice.
||The service assesses whether the activities and
interventions delivered to clients are of benefit.
||The service ensures that activities and
interventions ere appropriate to the language and culture of Aboriginal and Torres Strait
Islander people and people from diverse cultures.
||There are opportunities for staff to discuss and
review management plans.
||The service provides access and referral to
specialised groups, run by suitably qualified people.
||The service uses harm reduction strategies in its
||All staff providing services to individuals
comply with codes of ethics and standards of professional practice.
||Staff acknowledge and respond appropriately to
the difficulties clients experience during treatment.
||The service provides access to programs that
assist clients to develop necessary skills for life in the wider community.
||The service provides information and referral to
appropriate programs for family/friends of clients.
and Support Programs (NAPS)
||The NASP service follows guidelines, and services
are provided by staff in a sensitive, confidential and safe manner.
Drug Withdrawal Service
||Staff respond sensitively to the physical and
emotional pain and discomfort that occurs during the process of withdrawal.
Residential and Drug
||The residential or drug withdrawal service
provides or refers to a transitional program to assist in reintegration of the resident
back into their family and/or the wider community.
CONTINUITY OF CARE
The drug service assists clients to receive services
in a timely and appropriate order and takes steps to ensure continuity when more than one
service provider is involved.
||Where there are multiple providers of services,
arrangements are made for one staff member to have responsibility for co-ordination. the
client is consulted when these arrangements are being made.
||Guidelines are in place which describe the
circumstances under which broken appointments should or should not be followed up.
||the service has processes in place to provide
assistance to clients when waiting times interfere with continuity of care.
||Processes are in place to facilitate the
appropriate and timely referral of clients between services.
||The service has procedures to ensure adequate
information is passed on, with client consent, when referrals are made from the service.
||Contact is maintained, where appropriate, with
medical practitioners and other relevant professionals about progress of clients they have
referred to the service.
||The service is involved in shared care programs
with other agencies in the area.
||The service participates in meetings addressing
continuity of care issues.
||The service assesses the suitability of other
agencies to whom they may refer clients.
||The service provides for multiple episodes of
care. Information from previous episodes is utilised to ensure continuity of care.
||The service has a formal discharge process.
||The service provides access to support and
||When clients leave the service, they are given
information which could help them reduce harm associated with future drug use.
Early Identification and Intervention
The client receive services that detect, monitor and intervene in early stage health
problems to improve his/her health and quality of life.
The drug service identifies potential and early stage health problems in individuals,
including those related to drug use, to enable effective early intervention to improve
||Health and social problems of the community of
interest are systematically identified.
||Interventions are timely and effective.
||There is improved targeting of harm reduction
||Clients have improved health status and quality
POLICY, RESOURCES AND PLANNING
The drug service has policies, resources
and plans for activities which aim to prevent or reduce the harm related to drug use.
||The service has a written policy on early
identification and intervention, which as been reviewed within the last three years. Dual
diagnosis issues are addressed as a key priority within the early identification and
||The service has a plan that includes early
identification and intervention activities.
||The service uses written procedures, evidence
from current research and validated benchmarks to guide its early identification
||All staff identify possibilities for early
identification within their area of work.
||The service uses client and other data to
identify common problems in the community and plan appropriate early identification and
||Staff have access to appropriate
equipment.written materials for early identification.
||The drug service receives assistance from the
funding body/health authority in its early identification and intervention programs and
COMPREHENSIVE, ACCURATE EARLY IDENTIFICATION AND APPROPRIATE INTERVENTION
drug service uses comprehensive and accurate early identification methods and offers
appropriate interventions to help individuals maintain or improve their quality of life.
||The service uses a range of methods for the early
identification of health problems in clients.
||The service promptly refers people with
identified problems or contributing factors to the appropriate services.
||The service conducts early identification
activities for groups in the community.
||The service works with other organisations to
help them identify individuals whose use of drugs is potentially harmful.
||The service's early intervention activities
include a range of approaches.
||Staff explore with clients strategies that can
prevent or reduce the harm associated with their drug use.
SUPPORT PROGRAMS (NAPS)
||The service offers, or has the ability, to refer
to NAPS in a timely, efficient and effective manner.
PARTICIPATION IN EARLY IDENTIFICATION AND INTERVENTION
The drug service
organises accessible early identification and intervention activities which enable
people's informed participation.
||The service publicises its early identification
and intervention activities and encourages participation.
||Staff explain to people participating in early
identification and intervention activities the health problem or behaviour being
identified, the benefits and associated risks, and that participation in the activity is
||Early identification and intervention activities
take place in locations that are accessible and appropriate.
||The service promptly informs individuals
participating in early identification activities of their results.
||The service ensures that when clients are found
to be infected with HIV or Hepatitis, they are appropriately referred on for further
testing, treatment and advice.
||Following identification of problems, the service
involves clients in developing appropriate intervention strategies.
Health Promotion and Harm Prevention
The capacity of the client and community to protect and promote wellbeing is enhanced
through health promotion.
The drug service works in partnership with its community of interests and other
stakeholders to achieve improved health and reduction of harm.
||Community capacity to protect and promote health
and wellbeing is increased.
||Individual skills are developed.
||Health and social outcomes for individuals are
||Productive partnerships are established for the
promotion of health and wellbeing.
POLICY AND RESOURCES
The drug service has policies and resources to
promote and protect health and prevent harm in the community it serves.
||The service has written policies on health
promotion and harm prevention, which has been reviewed within the last three years.
||All staff use the service's policy on health
promotion and harm prevention.
||All staff have the opportunity to participate in
health promotion and harm prevention.
||The service has an identifiable health promotion
budget or ready access to funds to support health promotion and harm prevention.
||The service has a process to coordinate health
promotion or harm prevention activities which it conducts or in which it is involved.
||The service investigates opportunities for
additional sources of funds to support health promotion activities, and records results of
||Staff have access to appropriate audiovisual and
printed resource materials to support health promotion and harm prevention.
Materials are available in appropriate community languages.
||The service has access to a Health Promotion Unit
or Population Health Unit or Public Health Unit which provides a range of support to
facilitate health promotion activities.
PLANNING AND COORDINATION
The drug service plans and coordinates its
health promotion and harm prevention activities so that clear goals and appropriate
strategies are used, and the main drug issues of the community are addressed.
||National/state health promotion and harm
prevention priorities have been addressed in planning and adapted where appropriate.
||The service's health promotion and harm
prevention activities correspond to the identified issues in its community. These
activities reflect the service's health promotion and harm prevention policy.
||Health promotion and harm prevention is an
integral component of all activities of the service.
||The service uses a systematic process to inform
all staff of relevant current and planned health promotion and harm prevention programs.
||Opportunities exist for staff to consult with
team members, other agencies and community organisations about the health promotion and
harm prevention programs they conduct.
||The appropriate authority informs the service of
relevant media campaigns in a timely manner.
||Information about media campaigns is used to plan
supporting activities prior to, during and following the campaign.
The drug service promotes the health and
wellbeing of its defined community in a comprehensive way, by using a range of strategies
appropriate to the issues being addressed.
||The service conducts or participates in a range
of health promotion and harm prevention programs and activities that address physical,
mental and social factors in relation to health and drug use.
||The service works with local agencies and
community groups to strengthen community action in identifying health issues and in
promoting health and preventing harm.
||The service assists people to develop personal
skills for health.
||When conducting health promotion and harm
prevention activities, strategies are used that acknowledge and value participant'
||The service is involved in activities that seek
to create environments supportive to health.
||The service is involved in activities that help
develop public policies that promote health at the local level.
||The drug service orients its services towards
health promotion and harm prevention.
ADVOCACY FOR HEALTH
The drug service acts as an advocate to protect and
promote the health of the community in relation to drug issues.
||The service informs community members and
organisations about current drug issues and their potential impact on the community.
||The service encourages other agencies t adopt a
harm prevention and reduction approach.
||The service participates in public forums and
other activities in order to protect the health of the community
||The service provides feedback on issues of
local concern to state policy units to influence policy and legislation.
||The service uses public relations opportunities
to promote health and prevent/reduce drug related harm within the community.
||The service advocates for the provision of
accessible and appropriate Needle Availability Support Program (NAPS) services.
Client and Program Records
Clients receive coordinated services and programs which are responsive to individual
need. Personal information is documented in a comprehensive, accurate and respectful
manner, with confidentiality protected and individual rights to access respected.
The drug service systematically documents its assessment, treatment and care, health
promotion and harm prevention, early identification and intervention work to facilitate
evaluation and demonstrate effectiveness and accountability.
||Records ensure accountability to consumers and
||Individual/community outcomes can be demonstrated
through accurate records of all activities.
||Systems for accurate transfer of information
ensure integrated, coordinated service delivery.
||Performance is improved following data analysis.
||The service regularly monitors and evaluates its
||Client confidentiality is protected.
CLIENT RECORD SYSTEM
The drug service has a system that directs the
allocation, content and processing of client records.
||The service ensures that all client information
is placed in a common client record.
||The service has a written policy and procedures
to direct its client record system. The policy specifically addresses system security
issues regarding dual diagnosis clients, and relationships with other health program
||The service observes the appropriate state legal
guidelines for client records, and all appropriate staff are aware of these guidelines.
||Responsibility has been allocated for maintaining
the client record system.
||The service makes sure all staff understand and
follow the service's system and policy of client records.
||All client records are filed and stored so that
authorised staff can find them easily. A tracer system is in place.
||The service has access to advice and consultation
about its client record system from an appropriate person.
||The service ensures that notes are completed in
client records promptly.
CONFIDENTIALITY OF CLIENT RECORDS
The drug service ensures the
confidentiality of all its client records.
||There are adequate security arrangements to
prevent loss, defacement and unauthorised use of client records.
||Procedures are in place to ensure that the
confidentiality of client records is maintained, should their removal from the service or
transport between sites of a service be necessary.
||Procedures are in place to ensure the
confidentiality of material which is sent to another service.
||Where aspects of the client record system are
computerised, systems are in place to ensure confidentiality.
||The service ensures that client records are not
left unsupervised, and cannot be read by unauthorised people.
||The client's signed consent is recorded in
his/her client record when information is sent to other agencies or professionals.
||The service explains to clients that their client
records may be audited or used for data collection.
ADEQUACY OF CLIENT RECORDS
The client's record contains sufficient and
appropriate information to identify the client, explain the assessment, treatment and care
of his/her health, and to document progress and outcomes.
||Each client record contains a data base,
identification information, problem list, assessment, and care management plans.
||Documentation in the client record is
comprehensive, factual and sequential.
||Presenting and identified problems or issues are
recorded objectively in the client records.
||Client record entries are legible and show the
date, signature, name and profession of each health worker providing services to the
PROGRAM RECORD SYSTEM
The drug service has record systems for the
documentation of all programs, including group work and activities for early
identification and intervention, health promotion, and community development projects.
||The service has a uniform system of registration
that identifies the location of program records.
||A person has responsibility for maintaining the
system for program records.
||The service has a policy to guide the
implementation of its program records system.
||The service ensures staff understand and use the
system for program records.
||An effective tracer system is used for all
program records to ensure that staff can locate and retrieve them as required.
||The service has a uniform format to assist staff
to plan, implement, evaluate and document health promotion and harm prevention programs.