21 Feb 2011
Catherine Rae has worked in quality and safety for ten years, recently moving on from her role as Quality and Risk Manager at Southern DHB. She was with the DHB (previously Otago DHB) for a total of 22 years in various roles, and was a member of the former national Quality Improvement Committee, as well as chair of the DHB Quality and Risk Managers Group for four years.
Catherine has now joined the Royal New Zealand Foundation of the Blind as Quality Manager. There are many similarities between the two sectors and she is looking forward to applying the same quality principles as those that have been implemented successfully in health.
She says she is encouraged by how the quality and safety agenda has progressed over the years, however, believes there is a way to go in terms of making our hospitals safer for patients and for the staff that work in them.
“The progress towards a no-blame culture is positive, but I feel more could be done to foster this culture and support staff to disclose when something goes wrong.
“For instance, I wonder how many boards are receiving information about the level of patient harm in their hospitals? Financial results and other information is routinely supplied to boards, however, quality and safety needs to be at the top of every board agenda.”
Catherine says she appreciated the opportunity to contribute to the work of the Quality Improvement Committee (QIC), as part of her DHB role. Many of the functions of QIC have now been taken over by the Health Quality & Safety Commission.
“The national release of serious and sentinel events by the QIC brought the national spotlight onto the issue of patient safety. This was the first time in New Zealand that such information had been shared publicly.
“I attribute the successful release of the information to an excellent communication strategy and to the leadership of Pat Snedden, the then chair of the QIC.
“Pat’s approach throughout the release was open and honest and he was passionate about emphasising a continuous improvement and learning focus. I believe this is a significant achievement of the committee, particularly in terms of fostering public understanding about errors in health.”
Catherine looks back on the other work of the QIC, which focussed on four funded national quality improvement programmes.
“Those programmes were infection prevention and control, safer medication management, improving the patient journey, and incident management.
“It was challenging selecting areas for improvement that all DHBs would see as a priority, because each DHB had differing needs and focus. Looking to the future, the work of the Commission is likely to be less project- or programme-orientated and may be well positioned to provide a wider range of assistance to improvement efforts across the health sector.
“My feeling is health services want to identify and prioritise their own quality and safety initiatives, rather than be directed to work on particular areas. The Commission will be a valuable resource in terms of supporting those initiatives and will, I am sure, build on the work already done in terms of the inclusion of the primary health sector.”
She believes an organisation’s culture is the essential factor in whether it succeeds in its quality and safety endeavours.
“Many things shape culture; one of the most influential elements being leadership. There are many strong leaders within our health services, however, there is an assumption that managers, clinicians and other health care staff come to the industry with an ingrained quality and safety philosophy and knowledge of quality improvement practices.
“We have high expectations that these people will lead and be involved in quality improvement activities, however, few have been provided with related educational opportunities. Many initiatives flounder due to our assumption that those involved have project management skills and are equipped with a suite of quality tools and lean thinking principles.
“It is imperative that quality improvement practices and leadership training become part of the core curriculum for those entering health. It is essential to first build this capacity if we are to succeed in our quality improvement efforts.”
Another area she believes needs investment is consumer involvement and participation in health.
“I’m not sure why New Zealand is so slow to respond in terms of consumer involvement, particularly when international trends and statistics prove that there are better health outcomes when patients and clients are involved in their own health care. This was on the QIC agenda but remains unfinished business. There are of course pockets of excellence in terms of consumer involvement in DHBs, however as I leave the sector, this is the primary area that I would like to see a national focus on.”
Catherine says that during her time with the DHB she was fortunate to work with a talented, committed and dedicated team.
“It has been a pleasure to work among them. I particularly value the support of my colleagues in the national DHB Quality & Risk Managers group. This group has been a significant source of learning for me and I know that support will continue as I move into my new role.”