Quality

Quality objectives Quality & Risk Service Certification Clinical audit Patient satisfaction surveys New Zealand Incident Management System

Waikato DHB Quality Plan 2008-09 Policies, procedures and guidelines

Quality objectives

Waikato DHB’s definition of quality is:

The provision of safe healthcare services which:

• are responsive to the patient's individual needs
• meet professional standards of clinical excellence
• meet national standards of healthcare service delivery
• are continuously monitored and improved.
  

Waikato DHB’s quality programme focuses on two key areas:

• quality assurance i.e. ensuring baseline quality standards are met
• quality improvement i.e. ensuring continuous improvement through quality projects, innovations, process improvement etc.
  

Waikato DHB is committed to implementing the initiatives specified by the national Quality Improvement Committee (QIC) and is leading the QIC Safety Improvement Programme.

All DHB staff, clinical leaders and managers are responsible for improving quality and participating in quality improvement initiatives and projects.  The DHB has many improvement projects under way, including:

• improving patient flow i.e. timeliness of healthcare delivery to patients as they move through community and hospital services
• Care Planning Project
• Discharge Planning Project
• Theatre Scheduling and Utilisation Project.

Quality and Risk Service

This service is led by Barbara Crawford, Manager Quality and Risk and includes the following:

• quality and risk planning, monitoring and reporting
• facilitation of selected quality improvement projects
• clinical audit
• infection control
• incident management
• serious event review using root cause analysis
• compliments and complaints management
• patient satisfaction surveys
• management of policies, procedures, protocols, guidelines
• certification and accreditation
• audit of key policy compliance
• provision of quality and risk education and forums to DHB staff and healthcare providers in the Midland region.

Certification

Certification is a legislative requirement under the Health and Disability Services (Safety) Act 2001.  This Act requires all hospitals with more than five 24-hour beds, both public and private, to comply with the following standards:

• NZS 8134:2001 Health and Disability Sector Standards
• NZS 8142:2000 Infection Control
• NZS 8141:2001 Restraint Minimization and Safe Practice
• NZS 8143:2001 National Mental Health Standard.
  

All of Waikato DHB’s hospitals (Waikato, Henry Bennett Centre, Thames, Tokoroa, Taumarunui, Te Kuiti) and continuing care facilities (Matariki in Te Awamutu and Rhoda Read in Morrinsville) have been audited and are certificated as being compliant with these standards.

Clinical audit

Clinical audit is a quality assessment and improvement mechanism in which clinical practice is reviewed and compared with best practice.  Its primary focus is to achieve improvements in healthcare outcomes for the patient, and effectiveness and efficiency of clinical care provided.

Each clinical service is expected to undertake clinical audits of its practice and to present the findings to the Clinical Board. 

Each clinical service also undertakes mortality and morbidity reviews where patient deaths and cases where the patient’s care has not resulted in expected outcomes are reviewed and learned from.

Patient satisfaction surveys

The Ministry of Health requires all DHBs to conduct regular patient satisfaction surveys for general hospitals and outpatient clinics, and – since July 2007 - annual surveys for Mental Health clients.

Overall patient satisfaction has been high for the past 10 years.

Results from surveys are used to identify opportunities for improvement and are provided to all DHB staff and managers for their information.

New Zealand Incident Management System

The purpose of this programme is to achieve a nationally consistent approach to the management of healthcare incidents across the health and disability sector through the identification, investigation and analysis of incidents and acting upon them as (or before) they occur to minimise the change of (re)occurrence of untoward outcomes in healthcare.
 

Primary objectives:

The programme is intended to achieve:

• reduced harm to patients,their families/whanau and to clinicians
• a culture and environment within which patient safety is paramount and
• implementation of an information system that will support the culture and assist providers in achieving the above.
  

For more detail, please refer to the NZ Incident Managment System website.