15 Apr 2021 | Mental Health & Addiction Quality Improvement
Kia ora and welcome to this update from the mental health and addiction (MHA) quality improvement programme | Whakapai i ngā mahi hauora hinengaro waranga hoki. This update focuses on the programme approach to the end of June 2022. Thank you for your ongoing support of the programme.
In consultation with the MHA leadership group, the Māori advisory group and the consumer advisory group, the MHA quality improvement programme team has identified several next steps.
The programme is currently made up of five priorities. The focus to date has been on the first three priorities, and attention is now turning to the final two – ‘Maximising physical health’ and ‘Improving medication management and prescribing’. Work will also continue on the ‘Zero seclusion’ project. The ‘Connecting care’ and ‘Learning from adverse events and consumer, family and whānau experience’ projects will be transitioned back to district health boards (DHBs) as planned, with some ongoing support from the Commission’s MHA quality improvement programme team.
The table below shows the high-level approach for each priority area, with more detail provided later in this update.
|Connecting care: improving service transitions||
|Learning from adverse events and consumer, family and whānau experience||
|Maximising physical health||
|Improving medication management and prescribing||
The name of the Zero seclusion project has been updated. The updated name captures the importance of safety for the consumer, staff and whānau. It speaks of the need to ensure the dignity and mana of the consumer is preserved, including mana motuhake (self-determination), wherever possible, as is our obligation under Te Tiriti o Waitangi. It has been developed with input from our leadership group, Māori advisory group, consumer advisory group and sector representatives. The te reo name has been given by Ahuahu Kaunuku, the Commission’s Māori health outcomes team.
Eliminating seclusion is a challenging area and some good progress has been made. The most recent data (November 2020) has signals of positive change. There is a downward trend in national data for duration of seclusion in DHB mental health units, including for Māori and Pacific consumers. Ten DHBs have seen signals of improvement in a particular unit and indicator/population or have at times reached zero seclusion.
In consultation with our leadership group, Māori advisory group and consumer advisory group, we are planning for the project in 2021/22 and will be able to share more detail soon. Our focus areas include:
This project was planned to run from August 2018 to December 2019, but was extended to June 2020, at the request of DHBs. The timeline was then further extended to October 2020 in response to COVID-19-related constraints. Now that this extension period has ended, the project will begin to be transitioned to DHBs, with some support from the MHA quality improvement programme team continuing.
The team will:
This project was planned to run from September 2019 to July 2020, with preliminary workshops held with the MHA sector in March and June 2019, but was extended to November 2020, at the request of DHBs. Now this extension period has ended, the project will begin to transition to DHBs, with some support from the MHA quality improvement programme team continuing.
The team will:
The final two priority areas for the national MHA quality improvement programme – ‘Improving medication management and prescribing’ and ‘Maximising physical health’ – were due to begin in early 2021. However, because of the impact of the COVID-19 response and feedback from the MHA sector about current workload, we will be taking a different approach to the end of June 2022.
We will work with Te Pou on this priority area to define a specific project or projects that are informed by the evidence generated in the existing Equally Well collaborative, and which would benefit from a quality improvement approach. A group will be convened to scope the best topic to choose, using criteria such as impact on equity, ability to measure change and outcomes (data availability), potential to show change in a short timeframe, and transferable learnings. That group will include consumer and Māori representation, and representatives from the Commission’s MHA leadership group, primary care and non-governmental organisations, the Equally Well collaborative, Te Pou and the Commission.
At the start of 2022, we will start to scope a more comprehensive approach to Maximising physical health for the next three years (providing further MHA quality improvement programme funding is secured). This is likely to comprise a series of projects.
Rather than start a specific project now, we will begin a comprehensive scoping of this priority area to be certain our approach makes the most difference for people who use MHA services and is supported by the sector. A comprehensive quality improvement project will then be developed, and implementation will begin in early 2022, continuing for several years (providing further programme funding is secured).
No smaller project in the medication management and prescribing area will be undertaken in 2021.
The MHA quality improvement programme team is pleased to welcome Deirdre Maxwell, Karl Wairama and Amy O’Connell.
Deirdre is our new senior programme manager and will be starting on Monday 3 May. Currently, Deirdre is the general manager for the Northern Regional Cancer & Blood Service at Auckland DHB and has held this role since 2015.
As you may know, Roz Sorenson, our programme manager and manager of the Zero seclusion project, left the Commission at the end of December 2020. Roz was with us for four years and was instrumental in leading the team that has planned for and is now implementing the Commission’s MHA quality improvement programme.
Karl Wairama is our new project manager for Zero seclusion, and Amy O’Connell joins us as a data analyst. Karl comes to us from the Hawke’s Bay Civil Defence emergency management group, where he was team leader, community engagement. Before that he was project manager at Te Taiwhenua o Heretaunga in Hastings, where he created and ran programmes with youth, with a focus on mental health
Amy joins us from Victoria University of Wellington, where she graduated with a Master of Science in cognitive and behavioural neuroscience, with a research background in behavioural psychology.