Occasional Paper 10 - The Royal New Zealand College of General ...

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Key principles developed by participants • Quality must be driven from the front line (bottom up) but supported from the top • Formative approaches work best when quality comes from within. An externally driven compliance model it will not work • Only gather information that is useful to front line clinicians • Encourage diversity and team based approaches • Encourage communication of experiences – patients and clinicians • Allocate responsibility to lead and involve all sectors • Streamline and standardize data capture systems and methods to reduce variation and incorporate all essential requirements into one Practice Management System so it can be used for quality improvement • Prioritise important factors • CQI principles should be applied to all processes • Identify baseline standards & safety factors e.g. sterilisation, immunisation • Support external review by peers as an important part of quality improvement • Encourage primary health care teams to value and recognise quality team culture as critical • Practices must be successful as businesses before they can be successful as quality teams • Quality should be well resourced • The use of quality frameworks can be inspirational when they incentivise teamwork • National system – National standards or programmes e.g. Cornerstone, Te Wana, must align with the Primary Care Strategy • Make allowance for local variation – e.g. urban, rural, small. Regional systems – DHB/PHO/MSOs/IPAs, have the ability to prioritise enrolled populations • Involve everyone! © THE ROYAL NEW ZEALAND COLLEGE OF GENERAL PRACTITIONERS / Summary of Proceedings 2008 17
Conclusion – The way forward The growing leadership and knowledge base forming around primary care quality is apparent and the Quality Symposium has provided an opportunity to review emerging issues together. Considerable discussion during the course of the two days produced important outcomes, in particular the discussion and principles identified on Pay for Performance is testimony to the level of thinking. While the obvious workforce and related issues are an underlying problem, there was a clear focus on refinements needed to make progress in the health sector. Clear agreement and understanding of the way forward emerged. One, that there is agreement that much has been achieved in recent years but there are particular needs for the sector if further improvements are to be made. A second is to make progress on a national Quality Improvement Agenda There is clear support for a National Quality Framework for primary health care that includes prevention and learning approaches to improvement. Recognition that much of the structure is already in place reminds us just how far some aspects of the health reforms have changed the way care is offered. In particular, investments in IT initiatives now support health practitioners to provide better integration of care through improved information and capacity in practice management systems. The next step is to improve practice team and primary care capability through development of integrated practice environments where learning is paramount. This is an important next step and where the value of previous investment is realised through research, education, practice, resources (including people), and quality tools can be utilised to contribute to reductions in disparity and improvements in patient outcomes. Learning environments rely on multiple interventions that are systematic and sustained. Some of this is achieved through policy, funding and contracting but relies heavily on relationships, teams, communication and interdisciplinary collaboration where new ideas can be generated and ‘the right’ attitude or culture is important. 18 © THE ROYAL NEW ZEALAND COLLEGE OF GENERAL PRACTITIONERS / Summary of Proceedings 2008
Page 2 and 3: The Royal New Zealand College of Ge
Page 4 and 5: Contents Introduction .............
Page 6 and 7: The workshop established how interd
Page 8 and 9: Frameworks of quality Defining qual
Page 10 and 11: Day 2 - Quality Improvement Themes:
Page 12 and 13: Main points: • There is a need to
Page 14 and 15: 2. Pat Snedden, Chair, MOH Quality
Page 16 and 17: • Define the owner - there was ag
Page 20: References 1 Donabedian A. The seve

Occasional Paper 10 - The Royal New Zealand College of General ...

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