Quality initiatives in Wairarapa DHB

While scanning through background information on Wairarapa DHB north of Wellington, New Zealand. I came across these tidbits on continuous improvement and quality care.

The executive manager for Quality, Cate Tyrer has created a quality improvement team. Rather than a single person, responsible for this role, Cate has created a cross functional team of six people across six functions in the hospital. Each of these people have a fully paid day per fortnight away from their normal duties to meet and focus entirely upon quality of care and service issues. These people cannot be pulled from this role, their absence must be rostered for and their cost is covered by the QA budget.

Results to date have far exceeded expectations and are believed to be more comprehensive than had a single person been charged with the QA role.

Because the people involved in this continuous improvement team are highly experienced staff and clinicians, who work at the coalface on the other days of their roster, they experience the very things they talk about, they are respected by their colleagues and they are listened to. They also have to work with the ideas they propose.

Some of the ideas generated to date include empowering nursing staff to monitor and if necessary put a hold on medications if prescribing was below the standards requried for the national medication charts.

In one ward, minor errors of medication prescribing were noted, not life threatening but again below standards, missing signatures etc, boxes not selected when they should be. It was felt that staff preparing medications were being interrupted unnecessarily thus contributing to a lack of throughness.

A red duct tape square was placed around the medicine cabinet. A sign to all others that when two nurses were standing inside the duct tape square they were to remain uninterrupted.

The quality team identified that by adding codes to theatre lists they could identify those that had surgery cancelled and prioritise them when rescheduling theatre.

The quality team has also been successful in helping to develop an operating theatre orientation program for midwives, a midwives education program for theatre staff and coordinating service to improve the discharge process.

It’s the simple things that often have the greatest impact. I was reminded of this recently during a stay at our house in Hokitika on the West Coast, South Island of New Zealand. We are renovating. A slow and expensive process as it is very part time. Two little things we put in place recently had the greatest impact. A shelf in the porch to keep gumboots and outdoor shoes dry when the rain pours into the porch ($8) and a net curtain over the bathroom window ($3) – small, simple, inexpensive and with an impact worth a mint.

Those are my thoughts for the day (along with an apology for my absence from this blog over the past month, bad social media etiquette)

Let The Journey Continue

John Coxon



About John Coxon

Principal consultant for John Coxon & Associates, a management consultancy working with boards and management teams in healthcare, aged care and not for profit organisations to develop effective strategic planning processes and social enterprise business plans
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