Variation in the adoption of patient safety practices among New Zealand district health boards

2012 ◽  
Vol 36 (2) ◽  
pp. 163 ◽  
Author(s):  
Antony Raymont ◽  
Patrick Graham ◽  
Philip N. Hider ◽  
Mary P. Finlayson ◽  
John Fraser ◽  
...  
Keyword(s):  
Patient Safety ◽  
New Zealand ◽  
Improve Patient Safety ◽  
Falls Prevention ◽  
Mortality Data ◽  
Quality And Safety ◽  
Structured Interviews ◽  
District Health ◽  
Safety Practices ◽  
Health Boards

Objective. To investigate the adoption and impact of quality improvement measures in New Zealand hospitals. Method. Structured interviews with quality and safety managers of District Health Boards (DHBs). Correlation of use of measures with adjusted 30-day mortality data. Results. Eighteen of New Zealand’s 21 DHBs participated in the survey. Structural or policy measures to improve patient safety, such as credentialing and event reporting procedures, had been introduced into all DHBs, whereas changes to general clinical processes such as medicine reconciliation, falls prevention interventions and disease-specific management guidelines were less consistently used. There was no meaningful correlation between risk-adjusted mortality rates for three common medical conditions and related quality measures. Conclusion. Widespread variation exists among New Zealand DHBs in their adoption of quality and safety practices, especially in relation to clinical processes of care. What is known about the topic? There are a significant number of adverse events which may affect hospital inpatients. Many of these are preventable. In response, quality and safety processes and measures are being adopted across the sector. What does this paper add? The paper provides a description of the frequency with which a range of processes and measures have been adopted and demonstrates that adoption of these by New Zealand hospitals is patchy and monitoring is uneven. It suggests that the measures implemented do not appear to have impacted common mortality outcomes, though the findings may reflect the limits of feasible measurement of a probabilistic system. What are the implications for practitioners? Managers should monitor the implementation of quality and safety measures and evaluate them in terms of their direct effects.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals Safety Performance in Acute Medical Care: A Qualitative, Explorative Study on the Perspectives of Healthcare Professionals

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1543
Author(s):  
Lina Heier ◽  
Donia Riouchi ◽  
Judith Hammerschmidt ◽  
Nikoloz Gambashidze ◽  
Andreas Kocks ◽  
...  
Keyword(s):  
Patient Safety ◽  
Nursing Students ◽  
Healthcare Professionals ◽  
Improve Patient Safety ◽  
Safety Performance ◽  
Structured Interviews ◽  
Performance Skills ◽  
Work Environment Factors ◽  
Improve Patient

Healthcare professionals need specific safety performance skills in order to maintain and improve patient safety. The purpose of this study is to get a deeper understanding of healthcare professionals’ perspective in acute care on the topic of safety performance. This study was conducted using a qualitative approach. Healthcare professionals working in nursing were interviewed using semi-structured interviews. Using content analyzing, categories were identified which present aspects of safety performance; subcategories were developed deductively. A total of 23 healthcare professionals were interviewed, of which 15 were registered nurses, five were nursing students and three were pedagogical personnel. Nine (39.1%) were <30 years old, 17 (73.9%) were female, and 9 (39.1%) had a leadership function. Results highlight the importance of safety performance as a construct of occupational health rather than of patient safety, and the role of the organization, as well as the self-responsibility of healthcare professionals. Healthcare professionals should be more conscious of their role, have a deeper understanding of the interaction of individual, team, patient, organization and work environment factors.

scholarly journals Guidelines and Safety Practices for Improving Patient Safety

2020 ◽  
pp. 3-18
Author(s):  
Walter Ricciardi ◽  
Fidelia Cascini
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Development Process ◽  
Guideline Development ◽  
Improve Patient Safety ◽  
Safety Practices ◽  
Guideline Development Process ◽  
Improve Patient

AbstractThis chapter explains why clinical practice guidelines are needed to improve patient safety and how further research into safety practices can successfully influence the guideline development process. There is a description of the structured process by which guidelines that aim to increase the likelihood of a higher score are created. Proposals are made relating to (a) the live updating of individual guideline recommendations and (b) tackling challenges related to the improvement of guidelines.

scholarly journals What makes an effective Quality Improvement Manager? A qualitative study in the New Zealand Health System

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Adeel Akmal ◽  
Nataliya Podgorodnichenko ◽  
Tim Stokes ◽  
Jeff Foote ◽  
Richard Greatbanks ◽  
...  
Keyword(s):  
Quality Improvement ◽  
New Zealand ◽  
Leadership Competencies ◽  
Learning Needs ◽  
Structured Interviews ◽  
District Health ◽  
Clinical Quality ◽  
Interpersonal Competencies ◽  
Clinical Quality Improvement

Abstract Purpose Quality improvement is an international priority, and health organisations invest heavily in this endeavour. Little, however, is known of the role and perspectives of Quality Improvement Managers who are responsible for quality improvement implementation. We explored the quality improvement managers’ accounts of what competencies and qualities they require to achieve day-to-day and long-term quality improvement objectives. Design Qualitative exploratory design using an interpretivist approach with semi-structured interviews analysed thematically. Setting and participants. Interviews were conducted with 56 quality improvement managers from 15 (out of 20) New Zealand District Health Boards. Participants were divided into two groups: traditional and clinical quality improvement managers. The former group consisted of those with formal quality improvement education—typically operations managers or process engineers. The latter group was represented by clinical staff—physicians and nurses—who received on-the-job training. Results Three themes were identified: quality improvement expertise, leadership competencies and interpersonal competencies. Effective quality improvement managers require quality improvement experience and expertise in healthcare environments. They require leadership competencies including sense-giving, taking a long-term view and systems thinking. They also require interpersonal competencies including approachability, trustworthiness and supportiveness. Traditional and clinical quality improvement managers attributed different value to these characteristics with traditional quality improvement managers emphasising leadership competencies and interpersonal skills more than clinical quality improvement managers. Conclusions We differentiate between traditional and clinical quality improvement managers, and suggest how both groups can be better prepared to be effective in their roles. Both groups require a comprehensive socialisation and training process designed to meet specific learning needs.

scholarly journals The patient safety practices of emergency medical teams in disaster zones: a systematic analysis

2019 ◽  
Vol 4 (6) ◽  
pp. e001889
Author(s):  
Ussamah El-khani ◽  
Hutan Ashrafian ◽  
Shahnawaz Rasheed ◽  
Harald Veen ◽  
Ammar Darwish ◽  
...  
Keyword(s):  
Patient Safety ◽  
Improve Patient Safety ◽  
Case Reports ◽  
Clinical Care ◽  
Grey Literature ◽  
Case Series ◽  
Quality Data ◽  
Safety Practices ◽  
Emergency Medical ◽  
Medical Teams

IntroductionDisaster zone medical relief has been criticised for poor quality care, lack of standardisation and accountability. Traditional patient safety practices of emergency medical teams (EMTs) in disaster zones were not well understood. Improving the quality of healthcare in disaster zones has gained importance within global health policy. Ascertaining patient safety practices of EMTs in disaster zones may identify areas of practice that can be improved.MethodsA systematic search of OvidSP, Embase and Medline databases; key journals of interest; key grey literature texts; the databases of the WHO, Médecins Sans Frontieres and the International Committee of the Red Cross; and Google Scholar was performed. Descriptive studies, case reports, case series, prospective trials and opinion pieces were included with no limitation on date or language of publication.ResultsThere were 9685 records, evenly distributed between the peer-reviewed and grey literature. Of these, 30 studies and 9 grey literature texts met the inclusion criteria and underwent qualitative synthesis. From these articles, 302 patient safety statements were extracted. Thematic analysis categorised these statements into 84 themes (total frequency 632). The most frequent themes were limb injury (9%), medical records (5.4%), surgery decision-making (4.6%), medicines safety (4.4%) and protocol (4.4%).ConclusionPatient safety practices of EMTs in disaster zones are weighted toward acute clinical care, particularly surgery. The management of non-communicable disease is under-represented. There is widespread recognition of the need to improve medical record-keeping. High-quality data and institutional level patient safety practices are lacking. There is no consensus on disaster zone-specific performance indicators. These deficiencies represent opportunities to improve patient safety in disaster zones.

An application of PCA-DEA with the double-bootstrap approach to estimate the technical efficiency of New Zealand District Health Boards

2021 ◽  
pp. 1-25
Author(s):  
Antony Andrews
Keyword(s):  
New Zealand ◽  
Technical Efficiency ◽  
Health Care Providers ◽  
Average Length ◽  
Principal Component ◽  
Care Providers ◽  
District Health ◽  
Bootstrap Approach ◽  
Double Bootstrap ◽  
Health Boards

Abstract Using yearly panel data from 2011 to 2017 on New Zealand District Health Boards (DHBs), this study combines principal component analysis and data envelopment intertemporal analysis with the double-bootstrap approach to estimate the technical efficiency of health care providers along with the trend of efficiency performances. The results show that although most large DHBs have improved their level of technical efficiency between 2011 and 2017, the majority of medium- and small-sized DHBs have not seen any noticeable improvement in their level of technical efficiency. The results also show that large and tertiary DHBs operate at a high level of technical efficiency. In contrast, most of the medium- and small-sized DHBs posted some of the lowest technical efficiency scores. Furthermore, the results show that medium- and small-sized DHBs have a higher average length of hospital stays which is found to be associated with decreasing levels of technical efficiency scores.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

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