Where there's a spark. - Institute for Healthcare Improvement

THE APAC FORUM ON QUALITY 

IMPROVEMENT IN HEALTH CARE 

19-21 September 2012, Auckland, New Zealand 

Where there’s a spark.

Where there’s a spark 

THERE’S A WAY FORWARD. 

4

Join with hundreds of health care 

leaders from nations around the world 

to ignite new ideas and shape the future 

of health care. The possible becomes 

real at the APAC Forum on Quality 

Improvement in Health Care. Now that 

you’re here, take full advantage of 

everything this one-of-a-kind event 

has to offer. 

Together, the Institute for Healthcare 

Improvement (IHI) and Ko Awatea 

have set the stage for you to “better your 

best” and affect real change in your 

organisation—and in health care at large. 

Over the course of three days, you have 

the opportunity to attend keynote 

presentations by health care thought 

leaders, participate in intensive workshops, 

and network with diverse professionals. 

New connections. New perspectives. 

New approaches to solving health care 

problems. Immerse yourself in the APAC 

Forum and imagine what you and your 

peers could spark. 

CONTENTS 

Agenda-at-a-Glance............Inside Cover 

About IHI and Ko Awatea............. pg. 5 

Welcome letter.............................. pg. 2 

Keynote speakers........................... pg. 3 

Pre-Conference intensives..........pgs. 4-5 

Thursday workshops..................pgs. 6-7 

Friday workshops......................pgs. 8-9 

Conference information.............. pg. 10 

Facility information..................... pg. 10 

Maps........................................... pg. 12 

THANK YOU 

to our main conference sponsor 

Share your APAC Forum experience with us using Twitter #apacforum 

1

AGENDA at -a-Glance 

WEDNESDAY 19 SEPTEMBER • PRE-CONFERENCE INTENSIVES 

9:00 AM – 3:00 PM I1: Patient- and Family- 

Centred Care: Partnerships 

for Improving the Patient 

Experience, Safety, and Quality 

Location: Auckland 1-2 (pg. 4) 

I2: Ready, Aim, Fire: 

A Systematic Approach to 

Improving Patient Safety 


I3: Achieving the IHI 

Triple Aim 

Location: Epsom 1-3 (pg. 4) 

I4: Chairs and Chiefs: The 

Role of the Board in Quality 

and Safety 

Location: Marlborough 1-3 (pg. 4) 

I5: Better Quality Through 

Better Measurement 

Location: New Zealand 

Ballroom 1 (pg. 5) 

I6: National Quality 

Improvement Day 

Location: Ko Awatea 

Note: this session ends at 4:00 PM 

(pg. 5) 

THURSDAY 20 SEPTEMBER • GENERAL CONFERENCE DAY ONE 

8:00 AM – 8:45 AM 

Powhiri/Welcome 

Location: New Zealand Ballroom 

8:45 AM – 9:00 AM 

Opening of the APAC Forum 


9:00 AM – 10:00 AM 

Keynote One: Maureen Bisognano 

Location: New Zealand Ballroom (pg. 3) 

10:15 AM – 11:30 AM Workshop Session A (All A workshops repeat as B workshops except for A1 and B1.) 

A1: Achieving the IHI Triple Aim 


(pg. 6 ) 

A2: Equity in Health Care: 

The What, The Why, and 

the How 


A3: Back to Basics: 

The Fundamentals of 

Improvement 


A4: Creating a 

Culture of Innovation 


A5: Patient- and Family- 




Location: Auckland 3-4 (pg. 6 ) 

11:30 AM – 12:30 PM 

Lunch 

12:30 PM – 1:45 PM Workshop Session B (All A workshops repeat as B workshops except for A1 and B1.) 

B1: The Changing Face of 

Health Care: The Asia-Pacific 

Story 


(pg. 6) 

B2: Equity in Health Care: 

The What, The Why, and 

the How 


2:00 PM – 3:15 PM Workshop Session C 

C1: Global Lessons: System 

Change Experiences from 

New Zealand and England 


(pg. 7) 

B3: Back to Basics: 

The Fundamentals of 



B4: Creating a 

Culture of Innovation 


C2: From the Top: The Role 

of the Board in Quality 

and Safety 


C3: Thinking Differently to 

Transform Care 


B5: Patient- and Family- 





C4: Measuring All-Cause 

Harm: Using the IHI Global 

Trigger Tool (GTT) 


C5: Future-Proofing 

Child Health 


3:30 PM – 4:30 PM 

6:00 PM – 10:00 PM 

Keynote Two: J. A. Muir Gray, MD 


A Night at the Museum: Dinner and Reception (Auckland War Memorial Museum) 

Complimentary round-trip shuttle service available from SkyCity Convention Center

FRIDAY 21 SEPTEMBER • GENERAL CONFERENCE DAY TWO 

7:45 AM – 8:45 AM 

Special Interest Breakfasts 

SIB1: Seismic Transformation—Lessons from 

the Canterbury Health System 

Location: Auckland 1-2 

Facilitators: David Meates, CEO, Canterbury District 

Health Board; Nigel Millar, MD, Chief Medical Officer 

and Geriatrician, Canterbury District Health Board 

SIB2: NHSi Co-Design Programme 


Facilitator: Lynne Maher, PhD, Director for 

Innovation and Design, NHS Institute for Innovation 

and Improvement, United Kingdom 

9:00 AM – 10:00 AM 

Keynote Three: Harry Pert, MD 


10:15 AM – 11:30 AM Workshop Session D 

D1: The Science of Allocative 

Decision Making —Investment 

and Disinvestment 


(pg. 8) 

D2: Research and Evidence 

in Primary Care 


D3: The Business Case: 

Investing in Quality 


D4: Building Capacity for 

Middle Managers 


D5: Building an Integrated 

Approach to Improvement 

with Lean, Six Sigma, and 

the Model for Improvement 


11:30 AM – 12:30 PM 

Lunch 

12:30 PM – 1:45 PM Workshop Session E 

E1: Creating Resilience in an 

Organisation: Preparing For 

an Unimaginable Disaster 


(pg. 9) 

E2: Right People, Right Skills: 

The Role of the Health Care 

Workforce in Quality 



E3: The Right Technology: 

Why Is It All So Hard? 


E4: Patients First: Building a 

Lighthouse in a Sea of Data 


E5: Effecting Change to 

Promote the Rational Use 

of Medicines—A Whole 

System Approach 

Location: Marlborough1-3 (pg. 9) 

2:00 PM – 3:00 PM 

Keynote Four: Donald M. Berwick, MD, MPP 


Special Evening Event 

A NIGHT AT THE MUSEUM 

THURSDAY 20 SEPTEMBER, 6:00 PM – 10:00 PM 

Complimentary round-trip shuttle service is available from SkyCity Convention Center 

Events Centre 

Auckland War Memorial Museum 

Domain Dr, Auckland Domain, Parnell 1142 

This is an evening to engage with innovative individuals both within, and related to, the Asia-Pacific 

health sector while dining on fine Kiwi cuisine. This key conference networking opportunity will 

allow for further connections through arts, music, and conversation. 

Featuring artists Marcus Winter and Tama Waipara and hosted by Pio Terei. 

Cost per person $NZ 100.00 

Cost per table of 10 $NZ 900.00 

Registration required—please visit the APAC Forum Registration desk at SkyCity to attend this event. 

This event sponsored by

Dear Colleagues, 

E nga mana, e nga reo, 

E nga karangatanga o te Ao hurihuri 

Naumai, haere mai ki te huihuinga rangatira o te Ao Hauora. 

Tena koutou, tena koutou, tena tatou katoa 

We never know what will spark a revolution. Thirty years ago in the United States, a small group 

of health care leaders got curious about the quality improvement and innovation methods used in 

commercial manufacturing, technology companies, and aviation. Their interest and early explorations 

sparked a movement to dramatically transform the quality of health care delivery, a movement that 

has now spread across the globe. Just a few years ago, Geraint Martin, the CEO of Counties Manukau 

District Health Board in New Zealand, had his own spark. He dreamed of bringing people together 

in one place, supporting learning and innovation, to catalyze and accelerate improvement across his 

district. That spark led to collaboration with the Institute for Healthcare Improvement (IHI), and the 

result is Ko Awatea (Maori for “dawning of the first light”)—a new learning and innovation center in 

Auckland, New Zealand, that focuses on the unique health needs of the local population. 

IHI and Ko Awatea want to welcome you to the APAC Forum on Quality Improvement in Health Care— 

an event we know will cause a spark and lead to a new dawn for health care across the Asia-Pacific region. 

For more than 20 years, IHI’s Forums have convened people from all corners of the health care 

system and beyond to share learning, make new connections, and ignite new ideas for how we can 

improve health care and give our patients the best health system possible. The APAC Forum is just 

this kind of event. Over the next three days, you’ll have the opportunity to learn directly from the 

leaders of the global movement to improve health and health care. Through the keynote addresses, 

workshops, and countless networking opportunities, you and your teams of doctors, nurses, and 

other health professionals have access to the very latest thinking on how to improve care in a rapidly 

shifting environment. 

What makes us even more excited for this Forum is the opportunity to learn from you. As the 

movement to improve health care spreads from continent to continent, we are consistently inspired 

by the fountains of ideas and innovations that spring up everywhere. Convening people who share a 

passion for better health and health care is the best method we’ve found for advancing the science of 

improvement and discovering and disseminating new methods and approaches. We know the next 

few days will be a wonderful two-way street of learning and inspiration. We’re so thrilled to welcome 

you to Auckland and the APAC Forum. Enjoy! 

Sincerely, 

Maureen Bisognano 

President and CEO 

IHI 

Jonathon Gray 

Director 

Ko Awatea 

2 Share your APAC Forum experience with us using Twitter #apacforum

KEYNOTES 

Opening of the APAC Forum: 

The Honourable Jo Goodhew, 

Associate Minister of Health 

Thursday 20 September, 8:45 AM – 9:00 AM 



Thursday 20 September, 9:00 AM – 10:00 AM 


Maureen Bisognano, President and CEO, 

IHI, previously served as IHI’s Executive 

Vice President and COO for 15 years. She is 

a prominent authority on improving health 

care systems, whose expertise is recognized 

by her elected membership to the Institute 

of Medicine and by her appointment to The 

Commonwealth Fund’s Commission on a 

High Performance Health System, among other distinctions. Ms. 

Bisognano advises health care leaders around the world, is a frequent 

speaker at major health care conferences on quality improvement, 

and is a tireless advocate for change. She is also an Instructor of 

Medicine at Harvard Medical School, a Research Associate in the 

Brigham and Women’s Hospital Division of Social Medicine and 

Health Inequalities, and serves on the boards of the Commonwealth 

Fund, ThedaCare Center for Healthcare Value, and Mayo Clinic 

Health System—Eau Claire. Prior to joining IHI, she served as 

CEO of the Massachusetts Respiratory Hospital and Senior Vice 

President of The Juran Institute. 

Keynote Two: J.A. Muir Gray 

Thursday 20 September, 3:30 PM – 4:30 PM 


J.A. Muir Gray, CBE, DSc, MD, FCLIP, is 

Director of the National Knowledge Service 

in the United Kingdom. The National 

Library for Health, a core service of the 

National Knowledge Service, will organise 

the best current knowledge and the National 

Knowledge service will deliver it to staff and 

patients wherever and whenever they need it. 

Sir Gray has recently been given the role of Chief Knowledge Officer 

for the National Health Service (NHS) and is closely involved 

in the provision of knowledge not only to clinicians but also to 

patients and those who manage health care. In his previous post as 

Director of Research and Development for the Anglia and Oxford 

Region, Sir Gray was in a position to support the UK Cochrane 

Centre in its early days, and to set up the Centre for Evidence- 

Based Medicine. For 10 years, he was Programmes Director for 

the UK National Screening Committee. Sir Gray is the author 

of Evidence-Based Healthcare, the third edition of which is in 

preparation, and joint author of The Oxford Handbook of Public 

Health Practice. His most recent books are The Resourceful Patient, 

Evidence-Based Surgery, and How to Get Better Value Healthcare. 

Sir Gray’s most recent venture in 2008 has been to set up a charity 

called Knowledge into Action. 

Keynote Three: Harry Pert 

Friday 21 September, 9:00 AM – 10:00 AM 


Harry Pert, MD is a General Practitioner in 

Rotorua, New Zealand. He is a visionary 

leader with a record of experience and 

leadership in both the College and 

Independent Practitioners’ Associations 

(IPAs). He founded one of the most 

innovative and successful IPAs in New 

Zealand, and has been a member of Royal 

New Zealand College of General Practice’s Quality Committee 

and Council. Dr. Pert has a reputation for innovation and openmindedness 

and is passionate about making a difference in general 

practice. Dr. Pert has taken a lead role in delivering seven 

successful national conferences and is a frequent speaker at 

many others throughout Australasia. Dr. Pert was elected President 

of the Royal New Zealand College of General Practice in 2009. 

Keynote Four: Donald M. Berwick 

Friday 21 September, 2:00 PM – 3:00 PM 


Donald M. Berwick, MD, MPP, FRCP, is 

the former President and CEO of IHI, an 

organisation that he co-founded and led 

for over 20 years. In July 2010, President 

Obama appointed Dr. Berwick to the 

position of Administrator of the Centers for 

Medicare & Medicaid Services, a position he 

held until December 2011. A pediatrician by 

background, Dr. Berwick has served on the faculty of the Harvard 

Medical School and Harvard School of Public Health, and on the 

staffs of Boston’s Children’s Hospital Medical Center, Massachusetts 

General Hospital, and the Brigham and Women’s Hospital. He 

has also served as Vice Chair of the US Preventive Services Task 

Force, the first “Independent Member” of the American Hospital 

Association Board of Trustees, and chair of the National Advisory 

Council of the Agency for Healthcare Research and Quality. He 

served two terms on the Institute of Medicine’s (IOM’s) governing 

Council, was a member of the IOM’s Global Health Board, and 

served on President Clinton’s Advisory Commission on Consumer 

Protection and Quality in the Healthcare Industry. Recognized as 

a leading authority on health care quality and improvement, 

Dr. Berwick has received numerous awards for his contributions. 

In 2005, he was appointed “Honorary Knight Commander of the 

British Empire” by the Queen of England in recognition of his 

work with the British National Health Service. Dr. Berwick is the 

author or co-author of over 150 scientific articles and four books. 

3

Pre-Conference 

INTENSIVES 

Pre-Conference Intensives: 9:00 AM – 3:00 PM 

I1: Patient- and Family-Centred Care: 

Partnerships for Improving the Patient 



Patient and family-centred care provides the framework and strategy 

for improving the experience of care, clinical safety, and quality. 

Partnerships with patients, clients, and families are essential in care 

and care planning and decision-making. These partnerships are also 

essential in health care redesign, quality improvement, and safety 

initiatives. High-performing health care organisations develop 

authentic, sustained partnerships; create a variety of ways to hear 

patient and family stories; and truly learn from patient and family 

insights and perspectives. Practical strategies and tools for achieving 

these aims will be shared in this session. 

At the end of this session, delegates will be able to: 

• Describe the core concepts of patient-, client-, and family-centred 

care and how they challenge traditional definitions 

• Discuss practical strategies for partnering with patients 

and families to improve quality and safety and transform 

organisational culture 

• Articulate the importance of opportunities to hear patient and 

family stories and use effective methods for facilitating patient 

and family panels 

Beverley Johnson, President and CEO, Institute for Patient- and Family- 

Centered Care, USA; Bruce Arroll, Professor, Department of General 

Practice and Primary Health Care, University of Auckland, New Zealand; 

Karen Hoare, PhD, Senior Lecturer, School of Nursing and Department 

of General Practice and Primary Health Care, University of Auckland, 

New Zealand 

I2: Ready, Aim, Fire: A Systematic Approach 

to Improving Patient Safety 


There is a great deal of activity in safety these days—but are we 

organising the work in a meaningful way that drives actual 

improvement for patients? In order to improve anything, you have 

to understand the problem you are trying to solve. This session will 

cover ways to develop tools to diagnose patient safety, how to set 

ambitious aims, and measures to track improvement. In addition, 

faculty will share an organising framework to put all the pieces together 

that ensures a systematic approach to measurable improvement. 


• Appraise the usefulness of diagnostic tools to improve the safety 

and quality at their organisation 

• Describe the use of aims in driving improvement in patient safety 

• Differentiate between projects, portfolios, and large system 

measures and the role each plays in improvement work 

Carol Haraden, PhD, Vice President, IHI, USA; Nellie Yeo, MBA, MN, 

Chief Quality Officer and Executive Director, National Healthcare Group 

Pte Ltd, Singapore 

I3: Achieving the IHI Triple Aim 

Location: Epsom 1-3 

IHI Triple Aim organisations pursue better health for populations, 

improve the experience of care, and lower per capita costs. This 

session will cover what faculty have learned from work on the 

IHI Triple aim over the last five years. 


• Articulate the framework needed to pursue the IHI Triple Aim 

• Share lessons learned from IHI Triple Aim regional sites 

John Whittington, MD, Faculty, IHI, USA; David Grayson, MB ChB, 

FRACS, Otolaryngologist and Clinical Lead, 20,000 Bed Days Campaign, 

Counties Manukau District Health Board, New Zealand; Peter Didsbury, 

MD, Chairman of the Board, ProCare Health Limited, New Zealand 

I4: Chairs and Chiefs: The Role of the Board 

in Quality and Safety 

Location: Marlborough 1-3 

This session will describe the role of governance, executive, and 

clinical leadership in overseeing quality and safety. Emphasis is 

placed on effective integration of aims and outcomes (quality, cost, 

service, satisfaction) and enhancing value to achieve savings in 

annual operation costs. Through the use of mock Board meetings, 

delegates will have the opportunity to wrestle with some of the 

most difficult problems faced by Boards and learn about best 

practices to overcome them. 


• List three changes they can apply to improve their Board’s 

oversight of quality 

• Discuss three innovative best practices each Board can 

implement today 

• Identify specific opportunities to decrease direct cost while 

improving quality 

Donald Berwick, MD, MPP, Former President and CEO, IHI, USA; 

Geraint Martin, BA, MSc, CEO, Counties Manukau District Health 

Board, New Zealand; Alan Merry, Professor of Anaesthesiology and Head 

of the School of Medicine, University of Auckland, New Zealand; Anthony 

Hill, Health and Disability Commissioner, Health and Disability 

Commission, New Zealand 


Wednesday 19 September 2012 

I5: Better Quality Through Better Measurement 

Location: New Zealand Ballroom 1 

Good decision-making is based on data that is collected and analysed 

in a systematic way. This session will provide a framework and practical 

recommendations for avoiding roadblocks during your quality measurement 

journey. How to link measurement and improvement strategies will also 

be discussed. Case studies and exercises will demonstrate the application 

of measurement principles to health care topics. 


• Distinguish between data for research, judgment, and improvement 

• Identify and build useful measures including operational definitions, 

sampling, and stratification 

• Articulate variation conceptually and statistically, and decide which 

control chart is most appropriate for their data 

Robert Lloyd, PhD, Executive Director, Performance Improvement, IHI, USA; 

Richard Hamblin, Director, Health Quality Evaluation, Health Quality and 

Safety Commission, New Zealand; Mary Seddon, Clinical Director, Ko Awatea, 

New Zealand 

Special Session 

I6: National Quality Improvement Day 

9:00 AM – 4:00 PM 

Location: Ko Awatea - Middlemore Hospital 

The National Quality Improvement Day is being held in 

association with the APAC Forum on Quality Improvement in 

Health Care. The day is jointly hosted by Ko Awatea at Counties 

Manukau DHB and the Health Quality & Safety Commission. 

The programme offers an opportunity for clinicians, 

researchers, administrators, and policy makers to present 

recently completed improvement projects. 

ABOUT IHI 

IHI is a leading innovator in health and 

health care improvement worldwide. For 

more than 25 years, we have partnered with 

an ever-growing community of visionaries, 

leaders, and front-line practitioners around 

the globe to spark bold, inventive ways 

to improve the health of individuals and 

populations. Together, we build the will for 

change, seek out innovative new models 

of care, and spread proven best practices. 

IHI is dedicated to advancing four critical 

aims: optimize health care delivery systems, 

drive the Triple Aim for populations, realize 

person and family-centered care, and build 

improvement capability. When it comes to 

raising the quality of health for all, IHI sees 

boundless possibilities, and while we see the 

walls in front of us, we will not rest until we 

reach the other side. 

Learn more at www.IHI.org 

ABOUT 

KO AWATEA 

Ko Awatea (dawning of the first light) is 

about improvement and transformation, 

so that we can provide the very best health 

care to our community. To achieve this 

health care revolution, Ko Awatea will bring 

together the best expertise and leadership 

that New Zealand and the world have to 

offer, providing a focus on continuous 

improvement while inspiring the sharing 

of ideas and sustainable best practices. Ko 

Awatea is partnered with a number of leading 

organisations, including Massachusetts-based 

Institute for Healthcare Improvement (IHI). 

Learn more at www.koawatea.co.nz 

5

WORKSHOPS 


9:00 AM – 10:00 AM (See pg. 3) 

A workshops: 10:15 AM – 11:30 AM 

B workshops: 12:30 PM – 1:45 PM 

All A workshops repeat as B workshops except for A1 and B1. 

C workshops: 2:00 PM – 3:15 PM 

Keynote Two: J.A. Muir Gray 

3:30 PM – 4:30 PM (See pg. 3) 

A1: Achieving the IHI Triple Aim 


IHI Triple Aim organisations pursue better health for populations, 

improve the experience of care, and lower per capita costs. This 

session will cover what faculty have learned from work on the IHI 

Triple Aim over the last five years. 


• Articulate the framework needed to pursue the IHI Triple Aim 

• Share lessons learned from IHI Triple Aim regional sites 

John Whittington, MD, Faculty, IHI, USA; David Grayson, MB ChB, 

FRACS, Otolaryngologist and Clinical Lead, 20,000 Bed Days Campaign, 

Counties Manukau District Health Board, New Zealand; Peter Didsbury, 

MD, Chairman of the Board, ProCare Health Limited, New Zealand 

B1: The Changing Face of Health Care: 

The Asia-Pacific Story 


If the 20 th century was the era of the hospital, then the 21 st century 

is the era of the system. The values and behaviours that characterised 

the delivery of health care in the last century will not be the values 

and behaviours that shape care in the future. Although all nations 

are facing similar problems, most have the same goal: To improve 

individual and population health while containing costs. How each 

nation approaches this in the 21 st century will differ according to 

their context and culture. 


• Summarise why the face of health care needs to change 

• Articulate the principles that will underpin success for nations 

large and small, and rich and poor 

Donald Berwick, MD, MPP, Former President and CEO, IHI, USA; 

Chien Earn Lee, MBBS, M. Med, FAMS, CEO, Changi General Hospital, 

Singapore; Kevin Woods, Chief Executive, Ministry of Health and Director 

General of Health, New Zealand 

A2/B2: Equity in Health Care: The What, 

The Why, and the How 


Although the social costs of inequities in health care are understood, 

they remain difficult to deal with despite a range of interventions by 

governments. Failure to address this issue leads to a triple whammy: 

Poor health outcomes for selected groups in society, increased costs 

for all social agencies, and the inability of those affected to contribute 

to their communities and countries. 


• Describe the concept of equity in health care and why it is 

important for nations to achieve it 

• Explain how different jurisdictions are approaching the challenge 

of achieving equity 

Pat Snedden, BA, B Com, Chair, Ports of Auckland and Former Chair, Counties 

Manukau DHB, Auckland DHB, Housing, New Zealand; Andrew Teuber, 

Chair, Alaskan Federation of Natives and Director, Alaska Native Tribal Health 

Consortium, USA; Lance O’Sullivan, MB ChB, General Practitioner, Kaitaia, 

New Zealand; Ross Bailie, MB ChB, MPhil, DM, Senior Principal Research 

Fellow, Menzies School of Health Research, Australia 

A3/B3: Back to Basics: 

The Fundamentals of Improvement 


So, you can explain what the letters PDSA mean. Great! But, are 

you able to successfully run multiple PDSA tests in one day, know 

when a change concept is ready for implementation, and then 

sustain the improvements? This workshop will provide a refresher 

for those who are stalled and a jump start for those who are new 

to the quality improvement journey. This session is built around 

the Model for Improvement (MFI) and will demonstrate how to 

link the three questions related to aim, measurement, and change 

concepts to the sequence for success. 


• Give an overview of the MFI 

• Specify the differences between testing, implementing, and spreading 

• Identify key concepts and tools that should be part of their 

QI toolkit 

Nellie Yeo, MBA, MN, Chief Quality Officer and Executive Director, 

National Healthcare Group Pte Ltd, Singapore 

A4/B4: Creating a Culture of Innovation 


The most successful and innovative organisations are those that 

encourage every employee to innovate, and then reward them 

for doing so. Innovation results from deliberate methods and 

organisational leadership actions. Through their behaviours, leaders 

create the conditions that either hinder or aid innovation. This 

session will illustrate practical frameworks that can be used by 

delegates in their own settings to transform health care services. 


• Identify seven dimensions of organisational culture that 

support innovation 

• Assess the culture in teams and organisations 

• Describe actions that they can take to enhance innovation in 

their organisation 

Lynne Maher, PhD, Director for Innovation and Design, NHS Institute for 

Innovation and Improvement, United Kingdom 

A5/B5: Patient- and Family-Centred Care: 

Partnerships for Improving the Patient 



Patient and family-centred care provides the framework and strategy 

for improving the experience of care, clinical safety, and quality. 

Partnerships with patients, clients, and families are essential in care 

and care planning and decision-making. These partnerships are also 

essential in health care redesign, quality improvement, and safety 

initiatives. High-performing health care organisations develop 

authentic, sustained partnerships, create a variety of ways to hear 

patient and family stories, and truly learn from patient and family 

insights and perspectives. Practical strategies and tools for achieving 

these aims will be shared in this session. 

At the end of the session, delegates will be able to: 

• Describe the core concepts of patient-, client-, and family-centred 

care and how they challenge conventional definitions 

• Discuss practical strategies for partnering with patients and families to 

improve quality and safety and transform organisational culture 

• Articulate the importance of having opportunities to hear patient and 

family stories and use effective methods for facilitating patient and 

family panels 

Beverley Johnson, President and CEO, Institute for Patient- and Family- 

Centered Care, USA; Bruce Arroll, Professor, Department of General 

Practice and Primary Health Care, University of Auckland, New Zealand 


Thursday 20 September 2012 

C1: Global Lessons: System Change 

Experiences from New Zealand and England 


The rise in demand for health care services has outstripped our ability 

to supply them. The quality of the care we provide is not always of 

the standard to which we aspire. Simply doing the same is no longer 

tenable, safe, or responsible. Counties Manukau District Health 

Board and its partners have committed to investing in staff through 

the development of Ko Awatea. In this session, faculty will describe 

a local initiative led by Ko Awatea with the aim to return to our 

community 20,000 days that are currently avoidable hospital bed 

days. Faculty will compare and contrast the Ko Awatea experience 

with that of the national QIPP programme in England. The QIPP 

programme was developed by the Department of Health to drive 

forward quality improvements in NHS care, while also making up 

to £20 billion of efficiency savings by 2015. 


• Specify the problems facing different health systems 

• Highlight what constitutes these systems of care 

• Summarise approaches that have, and have not, succeeded in 

delivering on the bold aspirations of these initiatives 


Board, New Zealand; Maxine Power, PhD, MPH, National Improvement 

Advisor and Safe Care National Work Stream Lead, QIPP, Department of 

Health, United Kingdom; Jonathon Gray, Director, Ko Awatea, Counties 

Manukau District Health Board and Professor of Health Innovation and 

Improvement, University of Auckland 

C2: From the Top: The Role of the Board in 

Quality and Safety 


This workshop will demonstrate the critically important role of an 

engaged, informed, and active Board of Directors in ensuring safety 

and quality. The presenters will emphasise real-life examples and 

practical advice for engaging Boards and leadership teams in the 

pursuit of better and safer care. 


• Outline the importance of the role of the Board in quality 

and safety 

• Identify the key questions Boards should ask with regards to 

quality and safety 

• Implement concrete steps to effectively engage Boards 

Maureen Bisognano, President and CEO, IHI, USA; Shelly Park, Chief 

Executive, Southern Health, Australia 

C3: Thinking Differently to Transform Care 


Innovation is a bit of a buzz word in health care, but it is here to 

stay. Innovation can make a real difference in quality, cost, and 

the patient experience. This session will illustrate how thinking 

differently can lead to doing differently—which in turn can lead to 

performance improvement. Participants will be equipped with tools 

that have been found to make a real difference in transforming care. 


• Use the steps of a process for innovation 

• Challenge and change usual thinking 

• Specify a range of tools adapted from other industries that should 

be part of their QI toolkit 

Lynne Maher, PhD, Director for Innovation and Design, NHS Institute for 

Innovation and Improvement, United Kingdom 

C4: Measuring All-Cause Harm: Using the IHI 

Global Trigger Tool (GTT) 


It’s safe to say that reducing harm is a priority at virtually every 

health care delivery organisation in the world today. Progress is also 

notable in many places when it comes to significant reductions in 

infections associated with use of central lines, ventilators, resistant 

bacteria, or with events such as preventable patient falls. That’s the 

good news. The mixed news is that when independent researchers dig 

deep into patient charts and look for signs (or triggers) of adverse 

events using the IHI GTT, they’re finding higher rates of harm than 

even the most committed improvers realise. The goal of this session 

is to learn how to use the IHI GTT to first understand your harm 

rates and to ultimately improve patient safety. 


• Distinguish between harm and error 

• Explain the value in measuring all-cause harm 

• Incorporate a measure of all-cause harm into current safety practices 

Carol Haraden, PhD, Vice President, IHI, USA; Gillian Robb, MPH, 

NZRP, Quality Improvement Manager, Ko Awatea, Counties Manukau 

District Health Board and Professional Teaching Fellow, University of 

Auckland, New Zealand 

C5: Future-Proofing Child Health 


Child health outcomes are poor in many parts of New Zealand, 

reflecting the relative poverty of many New Zealand children. 

While some determinants of child health are outside of our control, 

there are many issues where we can make an impact. The two 

paediatrician presenters of this workshop have extensive experience, 

both in improving child health in a large metropolitan city, and in 

a rural area: South Auckland and Hawke’s Bay. Faculty will share 

their experience and offer tips for getting the best out of 

community child health services. 


• Explain how readily available data can be used to improve 

service, performance, and outcomes 

• Describe how collaboration with other services can improve the 

effectiveness of interventions in the community 

• Identify two examples of interventions implemented in New 

Zealand that are changing childrens’ lives 

Russell Wills, FRACP, Paediatrician, Hawke’s Bay Hospital, New Zealand; 

Adrian Trenholme, BChir, MB, FRACP, Paediatrician, Counties Manukau 

District Health Board, New Zealand 

7

WORKSHOPS 

Special Interest Breakfasts: 7:45 AM – 8:45 AM 

(See Agenda-at-a-Glance for more information) 

Keynote Three: Harry Pert 

9:00 AM – 10:00 AM (See pg. 3) 

D workshops: 10:15 AM – 11:30 AM 

E workshops: 12:30 PM – 1:45 PM 

Keynote Four: Donald M. Berwick 

2:00 PM – 3:00 PM (See pg. 3) 

D1: The Science of Allocative Decision Making— 

Investment and Disinvestment 


For the past seven years, Auckland District Health Board (ADHB) 

has used a hospital-based health technology assessment committee 

called the Clinical Practice Committee (CPC) to evaluate new and 

existing health technologies to determine which of these should be 

implemented, restricted, or disinvested. To enable comparison of 

very disparate technologies, the CPC has developed a scoring tool 

that has proven useful when giving advice to ADHB managers. 

There is clear evidence that these scores are highly influential in 

determining if technologies are adopted. In today’s financiallyconstrained 

environment, it seems appropriate to use such evidencebased 

tools to determine where expenditure priorities ought to be. 

An overview of the work of the CPC will also be presented. 


• Describe two examples of how clinically-led groups were able to 

introduce new services and interventions in tough economic 

times 

• Explain the evidence-based approach that has been successfully 

implemented in the Counties Manakau District Health Board 

Gloria Johnson, Chief Medical Officer, Counties Manukau District Health 

Board, New Zealand; Stephen Streat, Medical Director and Intensive Care 

Specialist, New Zealand; Emma Parry, Clinical Director, Maternal Fetal 

Medicine, Department of Obstetrics and Gynaecology, Auckland District 

Health Board, New Zealand; Anita Fitzgerald, Clinical Practice Committee 

Manager, Auckland District Health Board, New Zealand 

D2: Research Evidence and Quality in 

Primary Care 


In this workshop, presenters will use practical examples from 

general practice and primary care settings to discuss to what extent 

research evidence can be translated into quality practice. Delegates 

will take part in a debate about five key issues. The first issue: What 

happens in cases like immunisation, where good scientific evidence 

can be translated into quality practice. The second: Leaping into 

the void of unmet need. Many of the present debates in screening 

pit reluctant evidence against obvious clinical need. How does 

the prudent clinician respond? Thirdly, we’ll use the case study of 

obesity and discuss why the application of available evidence seems 

so hard to translate into effective action. Next, we’ll explore 

adherence and the clinical reality of primary care. Finally, we’ll 

discuss the language of evidence, and how even objective evidence 

is prone to subjective bias. 


• Illustrate how research evidence can be translated into 

quality practice 

• Use insights from a debate to fuel current work practices 

Tony Dowell, Professor of Primary Health Care and General Practice, 

Deputy Dean, University of Otago – Wellington, New Zealand; 

Dee Mangin, Associate Professor and Director, Primary Care Research Unit, 

University of Otago, New Zealand 

D3: The Business Case: Investing in Quality 


All health care organisations and systems have an ethical, moral, 

and fiscal responsibility to ensure that their scarce resources are 

used effectively. Resources must be adequately allocated to improve 

health services to individuals and their families, and to improve 

the overall health of populations. This is particularly true in today’s 

tough financial times. 


• Articulate how one major health care organisation released 

$38 million through a rigorous approach to reducing waste 

and increasing value 

• Create the foundation for collaboration between clinical staff 

and Chief Financial Officers 


Board, New Zealand; Ron Pearson, Deputy Chief Executive, Counties 

Manakau District Health Board, New Zealand; Chien Earn Lee, MBBS, M. 

Med, FAMS, CEO, Changi General Hospital, Singapore; J.A. Muir Gray, 

CBE, DSc, MD, FCLIP, Director, National Knowledge Service and Chief 

Knowledge Officer, NHS, United Kingdom 

D4: Building Capacity for Middle Managers 


This interactive session will focus on the leadership attributes 

necessary for middle managers, specifically in regards to quality 

and safety. Faculty will look at leadership competencies and their 

relationship to health care improvement. In addition, faculty will 

describe how to deliver microsystem improvement with a high 

degree of ownership and engagement of all staff. 

At the end of the session delegates will be able to: 

• Describe how to build leadership flexibility 

• Explain one appropriate leadership style for microsystem 

improvement 

• Articulate how leadership and clinical practice improvement 

work together to deliver improved care for patients 

Bernie Harrison, MPH (Hons), RN, RM, Director, Clinical Leadership 

Development and Training, Clinical Excellence Commission, Australia 

D5: Building an Integrated Approach to 

Improvement with Lean, Six Sigma, and 

the Model for Improvement 


What approach to quality improvement does your organisation 

follow? Lean? Six Sigma? The Model for Improvement? All have 

value, and yet many organisations send mixed messages to their 

employees, lacking what Deming called “constancy of purpose.” 

Some organisations claim they are following one approach this 

month, then state that another approach will be used next month. 

This workshop will help participants clarify the similarities and 

differences between the three approaches and provide a framework 

for organising overall quality improvement strategy. 


• Describe the similarities and differences among Lean, Six Sigma, 

and the Model for Improvement 

• Determine which approach(es) are most appropriate for their 

organisation 

• Initiate a plan to build an integrated quality improvement strategy 

Robert Lloyd, PhD, Executive Director, Performance Improvement, IHI, 

USA; Greg Balla, BE, Director, Performance and Provider Development, 

Auckland District Health Board, New Zealand 


Friday 21 September 2012 

E1: Creating Resilience in an Organisation: 

Preparing for an Unimaginable Disaster 


When Christchurch was struck by a series of earthquakes in 

2010 and 2011, many organisations were not prepared for this 

unpredictable event or its aftermath. People in the Canterbury 

Health System, however, had been thinking about a disrupted 

working environment for quite a while. In this session, faculty will 

detail how scenario development was a catalyst for considering the 

unthinkable, and how this thinking was spread to thousands of 

people to prepare for the unimaginable. 


• Explain the value of planning for the long term 

• Describe a unique approach for large-scale change 

• Apply a framework in their own organisations 

Roger Dennis, Consultant, Innovation Matters, New Zealand 

E2: Right People, Right Skills: 

The Role of the Health Care Workforce 

in Quality Improvement 


Is your health system achieving great health outcomes? Have you 

been able to effectively manage chronic conditions, and are you 

ready to try new solutions? This workshop will identify current 

challenges in health care. We will consider local clinical networks 

and how the right people with the right skills can improve health 

outcomes in urban and rural settings. 


• Identify health system underperformance in a number of domains 

• Identify how the right people working with the right skills can 

generate quality improvement 

• Describe specific examples of workforces that are making a difference 

Gregor Coster, CNZM, MB ChB, MSc, PhD, Chairman, Counties 

Manakau District Health Board, New Zealand; Jo Scott-Jones, MB ChB, 

FRNZCGP, Chairperson, Rural General Practice Network, New Zealand; 

Shelley Frost, RN, Director of Nursing, Pegasus Health and Deputy Chair, 

General Practice New Zealand 

E3: The Right Technology: Why Is It All So Hard? 


Cost blow outs in health care delivery are often blamed on an 

explosion in expensive technologies. Manuel Castells, the renowned 

Spanish social commentator, states that investing and making the 

best use of the right technologies will be central to success for 

organisations and nations in the 21 st century. So is technology 

our foe or our friend? In this session, delegates will learn how the 

innovative use of new technologies can transform health care. 


• Describe how the innovative use of current technologies can 

transform health care 

• Explain principles, techniques, and approaches that can answer 

the hard questions about improving patient outcomes within a 

fixed budget 

J.A. Muir Gray, CBE, DSc, MD, FCLIP, Director, National Knowledge 

Service and Chief Knowledge Officer, National Health Service, United 

Kingdom; Ian McCrae, CE and Founder, Orion Health, New Zealand 

E4: Patients First: Building a Lighthouse in 

a Sea of Data 


Ever get the feeling you are drowning in measures? This workshop will 

provide a roadmap, a set of principles, and some practical examples 

of achieving the right balance when implementing measures. This 

session will discuss how to create measures that matter; how to 

democratise the process including balancing top-down consistency 

for benchmarking with bottom-up feedback and design; and how to 

align information. In addition, this session will provide road-tested 

measures to ensure a baseline and the ability to collect data. 


• Identify the focal points needed to drive a small number of measures 

• Identify and harvest information to inform effective measures 

• Ensure measures have broad input while remaining consistent in 

definition and purpose 

Andrew Terris, Programme Director, Patients First, New Zealand; 

Richard Hamblin, Director, Health Quality Evaluation, Health Quality 

and Safety Commission, New Zealand 

E5: Effecting Change to Promote the Rational 

Use of Medicines—A Whole System Approach 

Location: Marlborough1-3 

This workshop will explore ways of promoting evidence-informed 

patient- and family-centred care using the resources and skills of 

organised extended primary care networks linked in with secondary 

care. Faculty will present an example where the exponential rise of 

a dangerous, expensive, and ineffective prescribing practice was 

identified that was unnecessarily putting healthy babies and infants 

at risk. This alarming trend has been reversed by deploying a 

regional whole system approach, coordinated by a mature peer-led 

education programme based in Organised General Practice and 

Primary Care. The tension of balancing conflicting interpretations 

of evidence will also be explored. 


• Describe the key elements of this whole system approach to 

affecting change in prescribing 

• Contrast the tensions of balancing conflicting interpretations of 

evidence with patient choice 

• Identify additional complexities in their understanding of the 

influences on prescribers 

Les Toop, MD, MRCGP, Professor of General Practice, University of 

Otago Christchurch, New Zealand 

9

Conference 

INFORMATION 

Shuttle Service 

Shuttle transportation will be provided for the following events: 

I6: National Quality Improvement Day 

Wednesday 19 September 

Departing Schedule: 

7:30 AM and 8:00 AM 

From Albert Street entrance of SKYCITY Convention Centre to 

Ko Awatea – Middlemore Hospital 

Returning Schedule: 

4:00 PM and 4:30 PM 

From Ko Awatea – Middlemore Hospital to SKYCITY 

Convention Centre 

A Night at the Museum Reception and Dinner 

Thursday 20 September 

Departing Schedule: 

5:45 PM and 6:15 PM 

From Albert Street entrance of SKYCITY Convention Centre to 

the Auckland War Museum 

Returning Schedule: 

9:00 PM, 9:30 PM, 10:00 PM, and 10:30 PM 

From Auckland War Museum to SKYCITY Convention Centre 

Attendees who miss the scheduled pick-up and drop-off times will 

need to arrange separate transportation to the above events. We 

recommend that you use Auckland Coop Taxis (09) 300-3000 for 

your transportation needs around the city of Auckland. 

Thank You 

To Our Lead Conference Sponsor 

IHI and Ko Awatea would like to extend our thanks to 

the major sponsor of the APAC Forum, the Health Quality 

& Safety Commission New Zealand (HQSC NZ). 

Convention Service Desk (Business Center) 

The following range of support services are available at the 

Convention Services Desk located on Level 4 of the SKYCITY 

Auckland Convention Centre: 

• Word processing 

• Photocopying 

• Laser printing (colour or black and white) 

• Binding 

• PowerPoint assistance 

• Laminating 

• Faxing 

• E-mail 

• Internet 

The desk’s hours of operation are 8:00 AM – 5:00 PM. There are 

two additional locations: 

SKYCITY Hotel 

Located on level 2, one computer that can be used any time, 

not staffed 

SKYCITY Grand Hotel 

Located on level 7, one computer with printer that can be used any 

time, not staffed 

Fitness Centre 

The SKYCITY Grand Hotel offers a gymnasium with a 25 metre 

heated lap pool, sauna, and spa pool, and access to personal trainers. 

There is a fitness centre located on level 7 of the SKYCITY Grand 

Hotel. SKYCITY Hotel guests can use the air bridge and go 

through the Convention Centre to the Grand Hotel. 

Check Out & Luggage Storage 

Please check out of your guest room, at either the SKYCITY Hotel 

or SKYCITY Grand Hotel, by 11:00 AM on the final day of your 

stay. Please store your luggage at the bell stand located on the lobby 

level of each hotel. 

Complimentary Wireless Access 

Complimentary wireless access will provided to all APAC Forum 

delegates. To access complimentary wireless internet: 

1. Select “view available wireless networks” and connect to the 

SKYCITY Conference Network 

2. Open your internet browser 

3. When directed, enter the access code APAC2012 

Continuous Professional Development (CPD) 

This conference is endorsed by the Australasian College of Health 

Service Management (ACHSM) according to approved criteria. 

Attendance attracts 8 Continuous Professional Development (CPD) 

points as part of ACHSM’s CPD Programme if delegates attend the 

two-day General Conference programme only or 14 CPD points if 

attendance includes one of the pre-conference intensives along with 

the General Conference. 

Thank You to Our Sponsor 

www.aucklandnz.com 


Join us in Orlando, Florida, USA for IHI’s 24th Annual 

National Forum on Quality 

Improvement in Health Care 

9-12 December 2012 

defining moments 

www.IHI.org/Forum 

11

LEVEL 4 – CONVENTION CENTRE 

To access complimentary 

wireless Internet: 

1. Select “view available wireless 

networks” and connect to the 

SKYCITY conference network 

2. Open your internet browser 

3. When directed, enter the 

access code APAC2012 

Shuttle service pick-up and 

drop-off on Albert Street 

side of the Convention 

Centre street entrance. 

Information & 

Conference Registration 

Badge Edits, Payments, 

and Session changes 

LEVEL 5 – CONVENTION CENTRE 

Storyboard Display 

Presenter Lounge 

Exhibit Stands 

(Level 5 Promenade) 

Plenary Room Entrance 

(Plenary Room is the 

New Zealand Rooms 

combined) 

Exhibits

Where there's a spark. - Institute for Healthcare Improvement

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