Acute Quality Systems

Quality Framework

A strong commitment to safety and quality underpins everything that we do.

We strive to deliver safe environments and systems of work to support our healthcare professionals in providing the safest possible care. We achieve this through a strong clinical governance framework.

Clinical Governance

Clinical Governance is the system by which Health Care Managers and clinicians share responsibility and are held accountable for patient safety, minimising risks to consumers and for improving the quality of clinical care.  We actively seek patient/consumer feedback and participation, to assist us to continually improve our services.

The framework structure consists of key organisational elements to effectively improve the quality of healthcare we deliver:

  • Governance, leadership, and culture
  • Community and consumer involvement
  • Competence and education
  • Information/knowledge management and reporting

The Quality and Risk Subcommittee, reporting to the Board of Management, is responsible for monitoring and improving performance against standards, the identification and mitigation of risk, and compliance with legislation and contractual obligations.

It consists of 10 members and comprises consumer representatives, Board members, medical professionals and EHI executive

SCV Clinical Governance Framework.pdf (

Mandatory Training and Performance Reviews

Euroa Health recognises that ongoing education is an integral component of our Quality and Safety policy.   All staff undergo mandatory training each year as a condition of their employment, which includes:

  • Infection Prevention and Control
  • Hand Hygiene
  • Basic Life Support
  • General Evacuation
  • Fire Awareness and Extinguisher Training
  • Manual Handling
  • Medication Calculations Competency
  • Open Disclosure and Management of Adverse Events
  • Bullying and Harassment

Staff participate in annual performance and development reviews with their manager, discussing achievement of set goals and planning the coming year. In addition to their mandatory training, staff are encouraged to advance their skills with a range of on-line, in house and externally provided education.


Accreditation is an important part of our safety and quality program.

The accreditation process measures our hospitals’ performance against the National Safety and Quality Health Service Standards (NSQHS) established by the Australian Commission on Safety and Quality in Healthcare (ACSQHC).

The NSQHS is the benchmark that all public and private hospitals across Australia must meet to maintain their accreditation status

Accreditation certificate

Private Hospital Patient Charter

Private patients’ hospital charter | Australian Government Department of Health

Euroa Health Open Disclosure Policy

Click here to view EH Policy

Medical and Allied Health Credentialling

Euroa Health has an obligation to ensure Medical, and Allied Health Practitioners meet the credentialing and scope of practice requirements to practice safely and within their scope of experience, knowledge, and skills.

Credentialing refers to the formal process used to verify the qualifications, experience, professional standing and other relevant professional attributes of medical and allied health practitioners for the purpose of forming a view about their competence, performance and professional suitability to provide safe, high quality care services within the organisation.

In addition, all Medical, Allied Health and Nursing clinicians must have current registration with the Australian Health Practitioners Regulation Agency (AHP)

Credentialing and scope of clinical practice for senior medical practitioners policy | Better Safer Care