DHBs improving performance on keeping patients safe

4 Apr 2014 | Health Quality Intelligence

Data for the October to December 2013 quarter released by the Health Quality & Safety Commission shows district health boards (DHBs) are making good progress on taking simple actions proven to help keep patients safe.

The quarterly report on the Commission’s quality and safety markers show DHBs are improving in their use of the World Health Organization (WHO) surgical safety checklist during operations, and in working to prevent older hospital patients from falling. The report also introduces a new marker on surgical site infections.

Commission chair Professor Alan Merry says it’s encouraging to see DHBs’ commitment to keeping the patients in their care safe from harm.

“We’re seeing some very encouraging results. The challenge now is to keep up the momentum so these improvements can be sustained and become practice as normal.”

The minimum required levels set by the markers for DHBs to meet are:

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

Prof Merry says at a national level DHBs are meeting or exceeding the minimum levels on all measures.

“It is very pleasing to see that national use of the surgical safety checklist was over 90 percent for the first time since the markers were introduced, with more than half of DHBs reaching or exceeding the level. It is important that the operating room teams really engage in this process, and that this does not become a mere “tick box” exercise – but my anecdotal impression is that engagement is improving as well.

“In another improvement on results last quarter, nationally 90 percent of older hospital patients were assessed for their risk of having a fall, and 86 percent of those assessed to be at risk received an individualised care plan that addressed the risks identified. Six DHBs had a high rate of risk assessments and a higher than average rate of care planning.”

DHBs also sustained their very high rates of use of safety procedures for inserting central line catheters to prevent a bloodstream infection called central line associated bacteraemia (CLAB).

Prof Merry says a pattern is emerging of some DHBs doing well in all measures, and others doing less well.

“This highlights the benefits of this reporting – DHBs can clearly see how they are tracking on each of the measures, including which areas need increased focus.”

The latest report introduces a new marker for surgical site infections, which are uncommon but can lead to pain, disability and death.

No DHB met the required level for administering an antibiotic an hour before the first incision was made, and only three DHBs met the level for using the recommended type of antibiotic. This suggests more knowledge is needed about the importance of giving the right kind of antibiotic at the right time, every time, to prevent surgical site infections. This message has since been a focus of the Commission’s national patient safety campaign Open for better care.

Quality and safety markers data for each DHB are published on the Commission’s website.

More information on the Open for better care campaign can be found at: www.open.hqsc.govt.nz.

Documents for download:

Last updated 07/04/2014