Quality Requires A Joint Approach

ENSURING the quality of health services is as much the responsibility of the individuals offering them as of the systems and organisations in which they take place, Director-General of Health Dr Karen Poutasi says.

"Quality resides with both the individual as well as the hospitals and involves not only the development of appropriate regulations, but also ensuring doctors having the right systems in place to ensure they can safely manage and deliver new technology," Dr Poutasi said today

"Nuchal translucency is a case in point. It's been known for some time that some foetuses with some chromosomal abnormalities have thickening around the back of the neck which is visible on ultrasound examination of the pregnant mother at around 12 weeks.

"Development and refinement of the technique has subsequently given foetal medicine specialists tools to measure the thickening, and they then use the measurement to estimate the risk of certain chromosmal abnormalities such as Down Syndrome.

"Hence some NZ specialists, following the lead of their British counterparts, have begun to use this advance to offer pregnant women another way of screening for such conditions.

"Initially they trained under the supervision of the British specialists who developed the technology. They continue to work with them, ensuring that informed consent and appropriate counselling are available and feeding back their results for peer review and quality assurance.

"Screening always involves false positives and false negatives. Patients being offered screening must be informed of these risks."

"This is exactly the sort of approach the health sector should have - quality assurance programmes alongside the introduction and development of new technologies."

"However nuchal translucency measurement has also been taken up by other health professionals who are not plugged into the quality assurance programme. This is a real concern. Now that it has been brought to our attention, we are discussing the best way of dealing with it to ensure that quality is built in wherever nuchal translucency is available."

"All parents-to-be want to know their baby is healthy and whole. There will always be a demand for options which offer reassurance on this score. It is essential that as any such screening tests are developed quality assurance keeps pace with availability."

"We are already working on quality assurance and improvement with the introduction of the Health and Disability Services Safety Bill. This Bill provides a regulatory framework for safety and quality assurance.

"However it is equally important that hospitals continually focus on quality improvement systems, including credentialling which is another mechanism for ensuring professionals are competent to manage and safely deliver new technology as it is introduced, and it is important that professionals are credentialled to use that technology. Some hospitals already have credentialling processes in place, others are working on them.

"Quality is a multifaceted issue, and hence requires action at many levels. It behoves all of us working in the health sector to ensure quality is built into everything we do in our professional lives and that we build systems to focus on quality delivery."

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For more information contact: Selina Gentry, Media Liaison 04 496 2483 / 025 277 5411 or Frances Ross, Chief Media Advisor, ph: 04-496-2202, mobile: 025-512-833 Internet address: http://www.moh.govt.nz/media.html

Selina Gentry Media Liaison Communications DDI: 496 2483 Fax: 496 2010 mailto:selina_gentry@moh.govt.nz Ministry of Health

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