After 26 years as a QPA surveyor and more than three decades working across primary care, Collean Guest has seen accreditation evolve dramatically.
During that time, she’s worked across almost every corner of Australian general practice, and despite all the changes she has seen come and go, one fundamental truth has remained constant.
“Accreditation is not an exam. It’s not about a pass or a fail. It’s about providing you with resources and empowerment to understand the standards and move forward in that quality improvement ethos.”
Tell us about your role as a QPA surveyor.
I’ve been a surveyor for around 26 years, alongside a career in general practice management and primary healthcare.
I’ve worked across large and small practices, Medicare Locals, Primary Health Networks, Aboriginal health services, after-hours clinics and now telehealth, so I understand accreditation from many different perspectives. That experience helps me relate to the challenges practices face every day.
What do you enjoy most about being a surveyor?
I enjoy playing my part in hopefully making change and improving healthcare access for patients. When you’ve been involved for a long time, you get to see positive changes come to fruition, and it’s rewarding knowing you’ve contributed to that journey.
What are the signs of a practice with strong quality systems?
Usually, you get a feel before you even arrive. The self-assessment tells part of the story, but once you walk through the door you can usually tell whether the standards are being lived and breathed throughout their day-to-day operations not just put in place for accreditation purposes.
Practices often feel nervous before accreditation. What do you tell them?
The first thing I say is that this isn’t a pass or fail situation. I tell them, “please don’t take it personally if there are things you maybe need to address. It’s about improving, and we can always do something better no matter how good we think we are.”
Once people understand that I’m here to support improvement and not catching them out, the whole day becomes much more productive.
Where do practices most commonly need support?
Risk management and infection control remain two of the biggest areas. One misconception I often encounter is when practices tell me they’ve had no incidents or near misses over the past three years. To me, that is immediately a red flag. There is no such thing.
Reporting incidents isn’t about blame – it’s about protecting patients, protecting staff and making sure the same thing doesn’t happen again.
What makes accreditation successful?
A whole-of-practice approach. The best outcomes happen when reception staff, nurses, GPs and managers all understand why quality systems matter and everyone shares responsibility. If accreditation sits with one person alone, it’s much harder to sustain.
What do you value about working with QPA?
QPA has always had a more mentoring, coaching approach in helping practices understand the standards properly – why they’re doing things, what’s in it for them and how they achieve it. That philosophy has always resonated with me.
What do you enjoy about the role outside of the survey visit?
One of the unexpected rewards of this accreditation work has been where it has taken me. I’ve visited places like Christmas Island, King Island, Flinders Island and remote Aboriginal communities – places I would probably never have experienced otherwise.
It’s been an incredible privilege to see healthcare delivered in so many different settings across Australia.