Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Quality Assurance Systems
3.5 The contribution of the Quality Co-ordinator was consistently acknowledged
in interviews but it was also said that the new systems were not working
effectively yet.
3.6 The investigation team heard evidence of no or very limited understanding of
the quality system from several staff. In light of the labyrinthine quality
system described above, this is hardly surprising.
4. QUALITY ACTIVITIES AND RELATED ISSUES
4.1 The Human Resources Manager, who is responsible for THL’s quality
programme, stated that “Tairawhiti Healthcare’s Business Plan strategies are
about quality of care for patients. Quality Assurance in terms of efficiency
and credentialling demonstrate that people can have confidence in the services
provided”. It appears that in addition to accreditation, other quality activities
in place at THL include Mortality and Morbidity meetings, monitoring of
indicators, audit programmes, clinical audit, incident reporting and complaint
management.
Accreditation
4.2 The key quality activity previously undertaken by THL appears to have been
questing after accreditation by Quality Health New Zealand. This is also a
strategy in the current Business Plan. Seeking accreditation has clearly been a
driving force in improving quality activity. In early 2000, in response to staff
concerns that the timetable was unrealistic, the Chief Executive informed the
Board that the Senior Management Group had decided accreditation was not
going to be a goal for 2000. The Chief Executive believed that “a strong
commitment to quality from the staff and ownership of accreditation as a
target was more important and would better sustain a quality improvement
approach than achieving the shorter deadline”. The Board directors made it
very clear to the Chief Executive that they did not share her view, and the
target stood.
4.3 Gisborne Hospital had previously had an accreditation survey on 13–16 July
1999. The survey report stated that there was early development of a Quality
Improvement System at Gisborne Hospital and a growing knowledge and
commitment to quality which included training of key staff in Clinical Quality
Improvement activity. As a number of the key standards were not
substantially achieved, Gisborne Hospital received nil accreditation.
4.4 THL said the accreditation survey was confidential to THL and Quality Health
New Zealand, and requested that it not be published in this report. I have
considered that request in accordance with the provisions of the Official
Information Act 1982 and the likely impact of disclosure on THL and the
implications for the health sector more generally. I have decided to refer to
the accreditation survey and some of the recommendations for the following
reasons.
4.5 It is well known in the health sector that THL received “nil accreditation”.
There is no shame in that; a number of health care providers have received that
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