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LOOKING BACK ON 2009
11th December 2009
Usually at this time of year we like to look ahead to the New Year but 2009 has been such a big year in health that we thought we take a few moments to pause and reflect.
From 1st June, for health and disability services that come under the Safety Act, their audit has been completed using the revised Health and Disability Services Standards NZS 8134:2008. Having completed in excess of 100 audits with these standards we are pleased to report that providers are doing well though there could be more attention paid to the new criteria. This self assessment document may help.
And for a broader overview for understanding NZS 8134:2008 click here.
As we know, aged care has been in the spotlight. This past year has seen the implementation of two key initiatives in aged care related to the sector standards, quality of care and public confidence. The genesis of this goes back to that fateful Belhaven incident in June 2008 and unfortunately a few weeks ago another high profile event with Rose a Lea and the DHB has again put the spotlight on aged care.
1. Publication of audit summaries:
- Earlier this year the MoH commenced publishing the list of certified aged care providers and this information includes: a) premises name, b) provider name, c) DHB, d) DAA , e) types of services with bed numbers (hospital and rest home / dementia) and f) certification end date and period (# of months).
- Since 1 July the list of Certified Providers for Hospitals and Rest home Services has also involved a published summary of the full certification audit. Ministry of Health
2. Spot (unannounced) surveillance audits
- The Minister of Health has identified that an unannounced audit would improve public confidence in aged residential care services and as a result, has supported the introduction of unannounced audits into the audit framework.
- Key objectives of the project included that a) it would have a focus on day to day service delivery as evidenced by auditor time spent observing, interviewing (consumers, staff and relatives) and matching clinical and quality documents to delivery of care, b) not increase audit activity within the health sector and c) include the DHB aged care contract components that satisfies the DHB contract monitoring needs simultaneously with HDSS auditing thereby minimising the need for DHBs to commission quality audits of the aged residential care sector.
- 22 aged care providers volunteered to participate in the MoH pilot project for spot (unannounced) surveillance audits. Site visits were completed in October and November and HDANZ had 6 clients involved in this pilot.
- The project is being independently evaluated and this report is due out later in January.
- Early feedback from providers is that these have not been as disruptive as may have been thought and is providing a good focus on service delivery.
- The spot audit approach continues from 1 January as an unannounced visit 3 months either side of the surveillance report due date.
Aged Care providers may find this special report of interest.
Things have been happening across the sector and a brief end of year snapshot includes:
Meeting the Challenge: Ministerial Group’s Report is being implemented with a number of structural changes to the health system that includes establishing a National Health Board as a unit within the MoH and consolidating of administrative functions across the 21 DHBs and shared service agencies. The changes are expected to deliver better value for money for a more sustainable health system with total savings of $700 million over the next five years likely and to be re-invested into front-line services.
Home Support services: The New Zealand Home Health Association (NZHHA) has recently strengthened their importance of quality to the public, funders and politicians by making full membership to be only available to providers who are certified to NZS 8158:2003—Home and Community Support Sector Standard.
Primary Care: The RNZCGP’s Cornerstone general practice accreditation programme has issued 375 certificates. Across primary care EOI applications have been accepted to develop business cases by 15 Feb to deliver “better, sooner, more convenient care.”
Serious and Sentinel Events: 30 Nov release of the 3rd report in DHB sentinel events and in 2008/09 DHBs reported 308 people treated in their hospitals were involved in an adverse clinical event that was actually or potentially preventable. Of this total, 92 died during the admission or shortly afterwards, though not necessarily as a result of the event. Ministry of Health Quality Improvment Committee
NEW STANDARDS FOR THE NEW YEAR
5th December 2008
On 26 September 2008 the Minister of Health approved the Health and Disability Services Standards 2008 (NZS 8134.2008). The Health and Disability Sector Standards (NZS 8134:2001) and the National Mental Health Sector Standard (NZS 8143:2001) have been amalgamated to significantly reduce duplication between these two previous standards. For services that come under the Health and Disability Services (Safety) Act 2001 these will come into force for Ministry of Health certificates that expire from 1 June 2009. For those providers in the sector that do not come under the Safety Act you are able to use these standards now for certification/accreditation of your service.
Copies of the 2008 Standards are available from Standards New Zealand (www.standards.org.nz).
Also, to assist providers with better understanding the new standards, here at HDANZ we have analysed and compared these standards with the previous set of sector standards. Because our report provides comparison at the criterion level it should complement and dovetail well with the Ministry of Health’s recent publication that provides a comparison at standards level -http://www.moh.govt.nz/moh.nsf/indexmh/certification-standards.
To assist with getting on board with the new standards you are welcome to download a copy of our detailed report: HDANZ’s Correlation Report for the new Health and Disability Services Standards NZS 8134.2008
CONGRATULATIONS TO HEALTH CARE PROVIDERS NEW ZEALAND
2nd September 2008
Health and Disability Auditing New Zealand would like to congratulate Healthcare Providers New Zealand for an enjoyable, well organised and successful conference held at Auckland's Sky City in August. The conference incorporated a great mix of political dialogue, business, clinical, networking and planning for the future, all of which reinforced the conference title: "Balancing Expectations between Consumers, Providers & Funders".
Congratulations to the winners of the Innovation Awards. The innovations of award winners, including a community radio show, were very obviously improving the quality of life of those in their care.
Our display for HDANZ’s onTrack web-based programme and auditor training and services, was kept very busy. For directors, Lisa Cochrane and Jim DuRose, it was a great chance to meet and talk with everyone about the challenges, issues and opportunities in the sector, as well as catching up with some of our current clients.
Fun was also high on the agenda with the Latin Extravaganza conference dinner and caricatures of some of those present being illustrated by Mark of MONSTAcartoons, As you can see, Jim found time to visit Mark for his own "portrait". The trade prize offered by HDANZ - a SkyJump voucher, for the ultimate example of safety and risk management was claimed and, although the winner has 6 months to build up the courage to make the jump, we understand the prize has been passed on to a younger family member.
Once again, congratulations to HCPNZ and to all those who contributed to a most enjoyable and successful conference.
INTERNATIONAL SOCIETY FOR QUALITY IN HEALTHCARE - ISQUA
18th August 2008
Effective leadership in quality and safety in health care means having access to the most recent information and best practice experience.
ISQua's international conferences provide a stimulating 'must attend' annual forum with exchange of information and updates on practice and policy development. Delegates include national health policy leaders and decision-makers, researchers, healthcare professionals in all disciplines, administrators, clinical organisations, standards and accreditation organizations, healthcare networks, providers and consumer organisations.
Each year the conference is held in a different city in the world in association with governments and other key organisations. In the past ten or so years, ISQua international conferences have been held in: 1996 Jerusalem, 1997 Chicago, 1998 Budapest, 1999 Melbourne, 2000 Dublin, 2001 Buenos Aires, 2002 Paris, 2003 Dallas, 2004 Amsterdam, 2005 Vancouver, 2006 London and Boston in 2007.
ISQua is now planning for Copenhagen from 19 - 22 October, 2008. To register or for further information on our conference, please see our website www.isqua.org
HEALTH AND DISABILITY SERVICES (SAFETY) ACT 2001
24th September 2007
The Ministry of Health is reviewing the Health and Disability Services (Safety) Act 2001 (the Act) with the aim of making the legislation work better. As part of this review, the Ministry has released a discussion document on the Health and Disability Services (Safety) Act 2001. There is also a submission form.
The Ministry has identified that: “This consultation is part of preliminary discussions around some of the more significant aspects of the review. The Ministry of Health is in an information-gathering stage and does not have a view on the best way to change the Act, or whether to stay with the status quo. Depending on submissions received from this round of consultation there may be a need for further in-depth consultation”.
While there may be aspects of the Act that could be improved we believe it is too early for a substantive change at this stage, says HDANZ Director David Hamer. David says that the focus on changing the auditing structure is very concerning and likely to undermine the intent of the Act – which is to encourage providers to continuously improve the quality of their service.
The Ministry is asking if the sector would prefer a single agency. We believe that this is a significant risk to the sector because the suggested single audit agency approach introduces a conflict of interest into the auditing regime. A single audit agency can be “captured” by the Ministry of Health. The effect on providers will be to discouraged them because the funder of services and the moderator of standards and also be the assessor. This will result in services feeling bullied and ultimately this approach will undermine commitment to quality as the provider community becomes progressively more alienated. The role of the Ministry should be to work with providers to foster quality improvement rather than functioning as the auditor.
You can download the HDANZ submission here click here
You can have your say by accessing the submission for at:
http://www.moh.govt.nz/moh.nsf/indexmh/health-and-disability-services-review-jul07?Open
