ISQua EEA Alignment
A working crosswalk between the ISQua EEA Principles for the Development of Health and Social Care Standards (6th Edition) and The ASF Standard — built so a reviewer can see directly which ASF criteria address which ISQua requirement, with links to live evidence.
Purpose and scope of this page
ASF’s interdisciplinary standards development team reviewed The ASF Standard against the ISQua EEA 6th Edition Principles, published March 2025 and mandatory for all ISQua EEA assessments from 1 July 2026 onward. The 6th Edition replaced the 4th Edition (6 Principles, 57 criteria) that ASF’s earlier internal audit work was based on, and introduced three entirely new Principles — Sustainable Care, Digital Care and Artificial Intelligence Systems for Care, and Supporting the Care Workforce — alongside splitting the former Principle 5 into two separate Principles (Person-Centred Care; Process of Care Delivery).
ASF’s initial submission strategy is incremental: the Hospital module is the reference implementation submitted first, with the remaining eight modules to follow once the Hospital submission has completed the full ISQua EEA process. This page is therefore built primarily around Hospital module evidence. Every one of ASF’s nine modules, however, now carries its own adapted versions of the three new Principle-aligned standards, built independently for each care setting rather than copied across — see the module-by-module table near the end of this page.
A note on methodology: For the three new Principles (6, 7, 8), ASF’s crosswalk below is built directly against the official ISQua EEA criterion text, criterion by criterion. For the six Principles carried over from earlier editions (1–5, 9), this page presents a structural correspondence — which ASF Hospital standards address that Principle’s territory — rather than a criterion-by-criterion match, since ASF’s working copy of the 6th Edition does not include the full criterion-level text for those Principles. ASF’s team cross-checks this structural mapping against the complete official document directly during submission preparation. Where ASF identified a genuine gap rather than a match, this page says so plainly rather than overstating coverage.
Full requirements checklist, cross-referenced to every ASF document: Requirements Crosswalk →
The nine Principles at a glance
| # | ISQua EEA Principle (6th Edition) | Criteria | ASF Hospital correspondence |
|---|---|---|---|
| 1 | Standards Development and Rating Methodology | 16 | ASF’s own standards development process — see How Standards Are Developed and the Public Standards Register, not a module criterion |
| 2 | Organisational Governance, Leadership and Management | 8 | Standard 7 — Governance & Management |
| 3 | Person-Centred Care | 11 | Standard 2 — Reception & Information; Standard 4 — Care & Treatment; Standard 9 — Refugee & Migrant Health |
| 4 | Patient/Service User Safety and Organisational Risk Management | 13 | Standard 5 — Safety & Emergency Preparedness; risk elements within Standard 4 — Care & Treatment |
| 5 | Process of Care Delivery | 12 | Standard 1 — Access & Arrival; Standard 4 — Care & Treatment; Standard 6 — Aftercare & Follow-up |
| 6 | Sustainable Care | 7 | Standard 18 — Sustainable Care — full criterion-level crosswalk below |
| 7 | Digital Care and Artificial Intelligence Systems for Care | 8 | Standard 19 — Digital Care and Artificial Intelligence Systems for Care — full criterion-level crosswalk below |
| 8 | Supporting the Care Workforce | 10 | Standard 20 — Supporting the Care Workforce — full criterion-level crosswalk below |
| 9 | Quality Performance | 5 | Quality-improvement elements within Standard 7 — Governance & Management |
Principle 6 — Sustainable Care 7 of 7 criteria reflected
The WHO defines an environmentally sustainable health care system as one that “improves, maintains or restores health, while minimizing negative impacts on the environment and leveraging opportunities to restore and improve it, to the benefit of the health and wellbeing of current and future generations.” ASF Hospital Standard 18 was built as a direct, criterion-for-criterion response to this Principle.
| ISQua | ISQua EEA criterion (official text) | ASF | ASF Hospital criterion |
|---|---|---|---|
| 6.1 | Organisations undertake a strategic-level review of the impact of environmental issues, sustainability of service provision, and how negative environmental impacts arising from activities can be mitigated. | 18.1 | Environmental Impact Is Actually Reviewed at Strategic Level |
| 6.2 | Organisations provide information to staff and patients/service users on the organisation’s strategic approach to environmentally sustainable care and its goals. | 18.2 | Staff and Patients Are Genuinely Informed of Sustainability Goals |
| 6.3 | Organisations monitor progress against defined goals for environmentally sustainable care and report on this progress to the governing body. | 18.3 | Sustainability Progress Is Actually Reported to Governance |
| 6.4 | Organisations consider the responsible stewardship of resources in their use of supplies and management of procurement. | 18.4 | Procurement Genuinely Considers Responsible Stewardship of Resources |
| 6.5 | Organisations manage their use of non-renewable energy — monitoring electricity, gas, oil and other fuel sources, and taking steps to reduce use of fossil-fuel energy. | 18.5 | Energy Use Is Monitored, With a Genuine Move Toward Renewable Sources |
| 6.6 | Organisations carry out an assessment of their carbon footprint to monitor and help reduce greenhouse gases produced through the care processes provided. | 18.6 | A Genuine Carbon Footprint Baseline Exists |
| 6.7 | Organisations consider their resilience to major environmental, climate or health emergencies which could disrupt service provision, and plan for a range of responses. | 18.7 | The Hospital Genuinely Plans for Environmental and Climate Resilience |
Principle 7 — Digital Care and Artificial Intelligence Systems for Care 8 of 8 criteria reflected
ISQua’s “digital care” covers remote monitoring, smartphone apps, wearables, virtual consultations, and remote result reporting; “AI” covers machine-learning and rules-based systems supporting diagnosis or individualised medicine. ASF Hospital Standard 19 reflects all eight ISQua criteria directly. This crosswalk originally identified 7.8 as a gap; a new criterion (19.8) has since been added to close it, propagated across all nine modules in a form genuinely fitted to each setting — see the module-specific note below the table.
| ISQua | ISQua EEA criterion (official text) | ASF | ASF Hospital criterion |
|---|---|---|---|
| 7.1 | Organisations have a documented process for the assessment, costing, implementation and ongoing management of digital care systems. | 19.1 | Digital Care Systems Follow a Genuine Assessment and Management Process |
| 7.2 | Organisations ensure the use of digital care does not disadvantage patients/service users unable to use digital devices or without internet access. | 19.2 | Digital Care Never Disadvantages a Patient Who Cannot Use It Core |
| 7.3 | Organisations have access to technical expertise to support the effective use of digital care systems. | 19.3 | Genuine Technical Expertise Supports Digital Care Systems |
| 7.4 | Organisations introduce and manage AI systems in accordance with national/regional AI legislation or regulation where it exists, or in its absence, available best-practice guidance. | 19.4 | AI Systems Are Introduced in Line With Law and Best-Practice Guidance |
| 7.5 | Organisations monitor and evaluate the use of AI systems for safe, high-quality care, with mitigation of unintended consequences. | 19.5 | AI Systems Are Genuinely Monitored for Unintended Consequences |
| 7.6 | Organisations consult with staff delivering care, prior to introducing AI systems, to understand practical implications and training needs. | 19.6 | Staff Are Genuinely Consulted Before an AI System Is Introduced |
| 7.7 | Organisations consider accountability arrangements for all care and treatment delivered with AI system support. | 19.7 | Accountability for AI-Assisted Care Is Explicitly Defined |
| 7.8 | Organisations inform patients/service users when aspects of their care are delivered with the use of AI systems. | 19.8 | Patients Are Genuinely Informed When Their Care Involves AI |
Medical Transport is a genuine, documented scope exception to 7.8. That module’s Digital Care & AI standard was deliberately built lean (3 criteria: dispatch reliability, data transmission security, route-override authority) because no AI-assisted clinical interpretation of a patient happens anywhere in medical transport — the AI touches backend dispatch logistics a patient never experiences or needs disclosure about, not a diagnosis or treatment decision. Adding a generic “patient informed of AI use” criterion here would have been padding without genuine substance, which the lightest-touch design of that module was built to avoid. All other eight modules carry a genuine, adapted 19.8-equivalent criterion — including Laboratory, where disclosure runs through the ordering clinician rather than directly to the patient, since a laboratory has no direct patient relationship of its own.
Principle 8 — Supporting the Care Workforce 9 of 10 criteria reflected
ISQua’s Principle 8 requires organisations to support the mental and physical wellbeing and professional development of their workforce, and keep people safe at work. The official source ASF’s team worked from (ISQua EEA’s own 6th Edition briefing materials) provides full criterion text for 8.6–8.10, which are explicitly marked new; criteria 8.1–8.5 carry over material from earlier editions and are mapped here at a structural level pending direct verification against the complete published document. This crosswalk originally identified 8.9 as a gap; a new criterion (20.9) has since been added to close it, propagated across all nine modules.
| ISQua | ISQua EEA criterion | ASF | ASF Hospital criterion |
|---|---|---|---|
| 8.1–8.5 | Carried-over criteria from earlier editions, generally covering workforce credentialing, competency, and training (exact official text not yet in ASF’s working copy — to verify directly against the complete 6th Edition document). | 20.1–20.3 | Every Member of the Workforce Is Genuinely Credentialed for Their Actual Role · Ongoing Competency Is Genuinely, Regularly Evaluated · Staff Have Genuine Access to Ongoing Education and Skill Development |
| 8.6 | Organisations take steps to protect staff from violence and aggression from individuals including patients/service users. | 20.6 | Staff Are Genuinely Protected From Violence and Aggression |
| 8.7 | Organisations have a systematic approach to gaining feedback from the workforce on their experience of working for the organisation, and implement improvement based on that feedback. | 20.7 | Workforce Feedback Is Genuinely Gathered and Acted On |
| 8.8 | Organisations monitor and analyse data on staff sick leave and reasons for leaving, using this to inform organisational learning and changes supporting staff wellbeing and retention. | 20.8 | Sick Leave and Attrition Data Genuinely Inform Organisational Learning |
| 8.9 | Organisations have processes to monitor, review and respond to issues of equality, diversity, inclusion and equity, in relation to recruitment, work allocation, scheduling and promotions across the workforce. | 20.9 | Equality, Diversity and Inclusion Across the Workforce Are Genuinely Monitored |
| 8.10 | Organisations support workforce wellbeing and psychological safety. | 20.4, 20.5 | Workforce Health and Safety Is Genuinely Protected · Workplace Issues Raised by Staff Are Genuinely Investigated and Resolved (substantial, not exact, overlap — psychological safety specifically is implicit rather than named) |
Both gaps this crosswalk originally identified are now resolved. ASF’s team would rather an ISQua reviewer see two honestly flagged, genuinely minor gaps discovered through ASF’s own review than find them independently — and would rather show the fix than leave a flag standing. Patient disclosure of AI use (19.8) and workforce EDI monitoring (20.9) are now live, with full guidance pages, across all nine modules, with one documented scope exception (Medical Transport, Principle 7 only — see above).
The three new Principles across all nine ASF modules
Hospital is the reference implementation above, but every ASF module carries its own adapted Sustainable Care, Digital Care & AI, and Supporting the Care Workforce standards — built independently for each setting’s genuine realities (for example, Telemedicine’s Digital Care & AI standard is deliberately scoped narrower, since platform reliability and data privacy are already covered elsewhere in that module; Medical Transport’s equivalent standard has three criteria rather than five, reflecting its genuinely minimal digital footprint).
| Module | Sustainable Care | Digital Care & AI | Supporting the Workforce |
|---|---|---|---|
| Hospital | Std 18 (7) | Std 19 (8) | Std 20 (9) |
| Ambulatory | Std 27 (7) | Std 28 (8) | Std 29 (9) |
| Long-Term Care | Std 11 (7) | Std 12 (8) | Std 13 (9) |
| Primary Health Clinic | Std 9 (7) | Std 10 (8) | Std 11 (9) |
| Fitness & Wellness | Std 10 (5) | Std 11 (6) | Std 12 (7) |
| Telemedicine | Std 9 (5) | Std 10 (6) | Std 11 (6) |
| Home Care | Std 9 (5) | Std 10 (6) | Std 11 (6) |
| Laboratory | Std 11 (5) | Std 12 (6) | Std 13 (6) |
| Medical Transport | Std 9 (5) | Std 10 (3) | Std 11 (6) |
Implementation timeline ASF is working against
- March 2025 — ISQua EEA publishes the 6th Edition Principles.
- June 2025 – June 2026 — Standards developers may elect assessment against either the 5th or 6th Edition.
- 1 July 2026 — 6th Edition becomes mandatory for all ISQua EEA assessments.
- Now — all nine ASF modules carry adapted 6th Edition-aligned standards, ahead of the mandatory deadline, with both gaps this crosswalk identified (7.8, 8.9) since closed across all nine modules (one documented scope exception: Medical Transport, Principle 7 only).
This page is ASF’s own internal working crosswalk, prepared to assist ISQua EEA reviewers and ASF’s interdisciplinary standards team; it is not an ISQua EEA publication. ISQua EEA 6th Edition criterion text for Principles 6–8 is sourced from ISQua EEA’s own briefing materials (O’Connor, ISQua EEA Head of Operations, November 2025) and should be verified against the complete, officially published 6th Edition document before formal submission.