Focus On Quality Health Care
1 December 2001
Health Minister Annette King says a commitment to quality throughout the public health system is the best way of minimising adverse outcomes for patients.
"The past year has been notable for the number of measures the Ministry of Health and the sector has started work on, set up or are about to put in place as part of the health sector's ongoing quality improvement programme to minimise harm."
Mrs King's comments follow today's presentation of research by Professor Peter Davis at a National Health Committee workshop in Wellington.
The research, Adverse Events in New Zealand Public Hospitals: Principal Findings from a National Survey, was carried out using 1998 data from 13 hospitals. The results have been published as an occasional paper by the Ministry and supported by the National Health Committee.
Mrs King said the research was a valuable contribution to increasing the understanding of adverse events, and will act as a stimulus for further research and efforts to improve the safety and quality of health care.
"Health care is ultimately a human endeavour and 'to err is human' but I believe that in New Zealand we have put in place a number of measures to ensure quality is built into the work we do."
She said a Health Sector Quality Improvement Strategy setting out the components of a high-quality public health system for all New Zealanders was being developed.
The National Health Committee's discussion document on quality improvement, Safe Systems Supporting Safe Care, was the first phase of the Strategy, and will provide the broad framework within which the Ministry will develop further details.
"The discussion document found problems were not generally caused by one person's actions, but by a combination of various actions and decisions from the system level to the individual level. The research presented today provides the supporting evidence.”
Mrs King said the Quality Improvement Strategy would pull together many pieces of work already occurring in the health sector, including project work underway to implement credentialing systems for senior medical staff.
“Credentialing means that patients can be more certain medical staff have the appropriate training, qualifications and experience, and will involve peer review and clinical audits. At Middlemore Hospital, credentialing of medical staff is well underway."
In another step toward minimising adverse outcomes, new Health and Disability Sector Standards have been introduced for hospitals, rest homes and residential disability services.
"These are already improving safety levels, the quality of care in hospitals and other facilities throughout New Zealand. It is expected compliance with the standards will become law once the Health and Disability Services (Safety) Bill is passed this year."
Mrs King said by early next year she hoped the Health Professionals' Competency Assurance Bill would have been introduced to Parliament.
"The Health Professionals' Competency Assurance Bill will be a comprehensive piece of legislation that will take in a range of health professional Acts of Parliament including the Medical Practitioners Act and will include complaints and disciplinary processes."
Other steps taken over the past year to reduce adverse events included the release of revised guidelines and a new workbook outlining the steps hospitals and health practitioners can use when investigating sentinel events.
The workbook release coincided with a visit to New Zealand by internationally renowned health care expert Dr Donald Berwick. Dr Berwick held a workshop with District Health Boards on how to improve the quality of health care.