Last updated 31/03/2015

The Health Quality & Safety Commission is driving improvement in the safety and quality of New Zealand’s health care through the national patient safety campaign Open for better care.

The quality and safety markers (QSMs) will help us evaluate the success of the campaign and determine whether the desired changes in practice and reductions in harm and cost have occurred.

The QSMs are sets of related indicators concentrating on the four areas of harm covered by the campaign:

  • falls
  • healthcare associated infections:
    • central line associated bacteraemia
    • hand hygiene
    • surgical site infection
  • perioperative harm
  • medication safety.

The process measures show whether the desired changes in practice have occurred at a local level (eg, giving older patients a falls risk assessment and developing a care plan for them). The outcome measures focus on harm and cost that can be avoided. Process markers at the district health board (DHB) level show the actual level of performance, compared with a threshold for expected performance.

The markers chosen are processes that should be undertaken nearly all the time, so the threshold is set at 90 percent in most cases. Outcome measures are shown at a national level, to estimate the size of the problem that the campaign is addressing.

The markers set the following thresholds for DHBs' use of interventions and practices known to reduce patient harm:

  • 90 percent of older patients are given a falls risk assessment
  • 90 percent compliance with procedures for inserting central line catheters
  • 75 percent compliance with good hand hygiene practice
  • all three parts of the WHO surgical safety checklist used in 90 percent of operations.

For the first time in the October – December 2013 quarter we report the baseline of a new set of QSMs relating to surgical site infection. These all relate to hip and knee replacements. The markers are:

  • 100 percent of primary hip and knee replacement patients receiving prophylactic antibiotics 0-60 minutes before incision
  • 95 percent of hip and knee replacement patients receiving 2g or more of cefazolin
  • 100 percent of primary hip and knee replacement patients having appropriate skin antisepsis in surgery using alcohol/chlorhexidine or alcohol/povidone iodine.

By tracking the change in practice over time, we can measure the impact of the campaign.

The QSMs were developed in partnership with DHBs, all of which commented on early designs for the measures, which resulted in an improved set of markers. A copy of the letter sent to DHBs is here.

Quality and safety marker results are available by using the left-hand menu. Results at a glance for December 2014 are available here.