Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Quality Assurance Systems
meeting these objectives. Each area within the organisation has been charged
with meeting objectives which evolved through the accreditation process.
2.7 Quality Health New Zealand Accreditation surveyors previously noted the
need for a comprehensive approach in July 1999. Following the unsuccessful
accreditation survey in 1999, Quality Health New Zealand and THL developed
a Quality Action Plan. This included proposed actions and timeframes to
guide THL to meet accreditation standards. The draft document was tabled at
the Core Quality Group meeting on 23 March 2000. However, limited
evidence was available to the investigation team regarding the use of this
document. THL noted, however, that the plan was widely circulated, and
progress evaluated and reported to SMG.
3. PERCEPTIONS OF QUALITY
3.1 The definition of quality used at THL is incorporated in the Quality and Risk
Management Policy. Quality is defined as:
“The totality of characteristics of an entity that bear on its ability to
satisfy stated and implied needs.”
3.2 This definition may be contrasted with that adopted by the Institute of
Medicine, where the focus on the patient is manifest:
“The degree to which health services for individuals and populations
increase the likelihood of desired health outcomes and are consistent
with current professional knowledge.” (Lohr, KN, (ed), Medicare: A
Strategy for Quality Assurance. National Academy Press, Washington
DC, 1990.)
3.3 A member of the SMG stated that this group has put in place processes to
review Quality Health New Zealand standards. Managers are responsible for
ensuring quality in their service. The SMG is focused on accreditation as an
end in itself, rather than quality as a goal. At the corporate level there was a
strong emphasis on accreditation and policies and procedures.
3.4 The Human Resources Manager, to whom the Quality Co-ordinator reports,
stated:
“Quality is the responsibility of each manager. The manager has to
match the organisation quality plan with action plans.”
“Clinical Directors are accountable for quality in medical areas. The
assumption is that the Clinical Director will be accountable for
disseminating information on quality standards including the revised
incident report form.”
It is unclear how these expectations were transmitted to the relevant staff.
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