Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Quality Assurance Systems
6.15 THL replied that the Clinical Nurse Educator supported the IV resource nurse,
and theatre staff are available for her to be released to do the training.
Ongoing education: medical
6.16 The Clinical Audit Stage Two concluded there is high participation in formal
continuing medical education programmes together with speciality training
and conferences. A consultant stated “there is good medical education money
available for doctors at Gisborne hospital”.
7. OPINION
Organisational care
7.1 The right to receive good quality care is central to the Health and Disability
Commissioner Act and the Code of Consumers’ Rights. The statutory
purpose, set out in section 6 of the Health and Disability Commissioner Act
1994, is “to promote and protect the rights of health consumers” or patients.
At the core of patients’ rights is the right to receive services of an appropriate
standard (section 20(1)(f)). This key right is affirmed in Right 4 of the Code,
entitled the ‘Right to Services of an Appropriate Standard’.
7.2 A quality assurance system is no more or less than the system that an
organisational provider, such as a hospital, puts in place in order to meet its
ethical duty and (by virtue of the common law and the Code) legal duty to
provide services of an appropriate standard. Although a quality assurance
system cannot guarantee that the care actually delivered to patients is
appropriate, it seeks to ensure (‘assure’) that the structure, policies and
procedures of the hospital will result in staff providing appropriate care for
patients.
7.3 There is evidence of decisions being made that impacted on THL’s ability to
maintain an effective quality system and ultimately on the standard of the care
that is delivered. A significant example is the disestablishment of the ICU
Clinical Nurse Leader position (discussed in chapter 1). There is no evidence
of any monitoring of indicators to measure the impact of this decision. Further
examples are the lack of analysis of the impact of the vacant Director of
Nursing and Clinical Nurse Educator positions on the provision of nursing
services.
7.4 THL had a strong emphasis on accreditation and policies or procedures, but
limited emphasis on other aspects of quality, such as credentialling and
monitoring quality and clinical indicators.
7.5 It is evident that the system that existed to ensure quality of care at Gisborne
Hospital in 1999-2000 was a ‘quality assurance system’ in name only. As an
organisational provider, THL did not have in place a system to ensure that the
services provided at Gisborne Hospital complied with the legal standard of due
care (“reasonable care and skill”) specified in Right 4(1) of the Code.
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