Commission Board member has first-hand experience of quality improvements

5 Apr 2011 | Health Quality & Safety Commission

As the CEO of Counties Manukau DHB, he has a strong operational understanding of the importance of clinical quality.

“It’s our core business to make sure people are cared for properly when they need treatment,” he says.

“It’s the most important thing we can do for patients, and we have to get it right.”

Mr Martin has overseen a number of changes at Counties Manukau DHB that have improved clinical outcomes for patients.

For example, work by senior clinicians has seen the rate of Central Line Associated Bacteraemia (CLAB) infections fall significantly, and numbers have stayed low in spite of admissions doubling with the expansion of the DHB’s ICU.

CLAB is a serious complication that can occur from a relatively simple ICU procedure, and has a mortality rate of 15 to 50 percent.

To achieve the decrease in CLAB numbers, clinical staff introduced a number of tools and processes, including a standardised checklist for inserting central lines, a line maintenance checklist, a central line pack including all the components needed for insertion, a database for entering line days, and visual reminders of progress which encouraged staff to become involved.

As a result, the DHB estimates it is saving about $280,000 each year from these measures.

“This is a good example of a quality and safety improvement that’s making a real difference to patients and is also saving us significant amounts of money, which we can then put back into our front line health services,” says Mr Martin.

In another achievement, the DHB’s Middlemore Hospital is the first large hospital in the country to reach the Government’s health target of shorter stays in emergency department, which Mr Martin attributes to clinical staff encouraging staff to re-think the way treatment and care is provided.

He says a three-step process was put in place to define and research problems, and to implement solutions.  This process involves all staff and, so far, is proving successful.

As well, staff are telling Mr Martin that the hospital is a nicer place to work as a result of the greater teamwork that’s occurring.

A third quality and safety initiative that Counties Manukau DHB is involved with is Ko Awatea, the still relatively new Centre for Health Services Innovation and Improvement based in South Auckland.

Mr Martin says the DHB’s close partnership with Ko Awatea provides valuable opportunities to roll out proven programmes, get value for money from health spending, and avoid unnecessary duplication of effort and resource.

Ko Awatea houses several centres for health system improvement, and focuses on South Auckland’s health challenges but with the intention of sharing the knowledge gained at both regional and national levels.

“For us here at Counties Manukau, this is about making real improvements in the way we deliver health services to our community, but it’s also about sharing the things we learn with others.”

Mr Martin has more than two decades of experience in front line health management, and he’s looking forward to making that experience count during his time on the Commission’s Board.

He says that strengthening accountability and reporting processes will contribute to quality improvements, enabling DHBs and other health providers to compare their performance and learn from each other.

One of the things he’s passionate about is encouraging active discussion of health quality and safety both locally and nationally.

“I want the Commission to really galvanise people to make a difference. There is a lot of great work going on already, and we want to build on that.”

Last updated 19/01/2012