News

Looking back on 2009

11th December 2009

Usually at this time of year we like to look ahead to the New Year but 2009 has been such a big year in health that we thought we take a few moments to pause and reflect.

From 1st June, for health and disability services that come under the Safety Act, their audit has been completed using the revised Health and Disability Services Standards NZS 8134:2008. Having completed in excess of 100 audits with these standards we are pleased to report that providers are doing well though there could be more attention paid to the new criteria. This self assessment document may help.

And for a broader overview for understanding NZS 8134:2008 click here.

As we know, aged care has been in the spotlight. This past year has seen the implementation of two key initiatives in aged care related to the sector standards, quality of care and public confidence. The genesis of this goes back to that fateful Belhaven incident in June 2008 and unfortunately a few weeks ago another high profile event with Rose a Lea and the DHB has again put the spotlight on aged care.

1. Publication of audit summaries:

• Earlier this year the MoH commenced publishing the list of certified aged care providers and this information includes: a) premises name, b) provider name, c) DHB, d) DAA , e) types of services with bed numbers (hospital and rest home / dementia) and f) certification end date and period (# of months).
• Since 1 July the list of Certified Providers for Hospitals and Rest home Services has also involved a published summary of the full certification audit. Ministry of Health

2. Spot (unannounced) surveillance audits

• The Minister of Health has identified that an unannounced audit would improve public confidence in aged residential care services and as a result, has supported the introduction of unannounced audits into the audit framework.
• Key objectives of the project included that a) it would have a focus on day to day service delivery as evidenced by auditor time spent observing, interviewing (consumers, staff and relatives) and matching clinical and quality documents to delivery of care, b) not increase audit activity within the health sector and c) include the DHB aged care contract components that satisfies the DHB contract monitoring needs simultaneously with HDSS auditing thereby minimising the need for DHBs to commission quality audits of the aged residential care sector.
• 22 aged care providers volunteered to participate in the MoH pilot project for spot (unannounced) surveillance audits. Site visits were completed in October and November and HDANZ had 6 clients involved in this pilot.
• The project is being independently evaluated and this report is due out later in January.
• Early feedback from providers is that these have not been as disruptive as may have been thought and is providing a good focus on service delivery.
• The spot audit approach continues from 1 January as an unannounced visit 3 months either side of the surveillance report due date.

Aged Care providers may find this special report of interest.

Things have been happening across the sector and a brief end of year snapshot includes:

Meeting the Challenge: Ministerial Group’s Report is being implemented with a number of structural changes to the health system that includes establishing a National Health Board as a unit within the MoH and consolidating of administrative functions across the 21 DHBs and shared service agencies. The changes are expected to deliver better value for money for a more sustainable health system with total savings of $700 million over the next five years likely and to be re-invested into front-line services.

Home Support services: The New Zealand Home Health Association (NZHHA) has recently strengthened their importance of quality to the public, funders and politicians by making full membership to be only available to providers who are certified to NZS 8158:2003—Home and Community Support Sector Standard.

Primary Care: The RNZCGP’s Cornerstone general practice accreditation programme has issued 375 certificates. Across primary care EOI applications have been accepted to develop business cases by 15 Feb to deliver “better, sooner, more convenient care.”

Serious and Sentinel Events: 30 Nov release of the 3rd report in DHB sentinel events and in 2008/09 DHBs reported 308 people treated in their hospitals were involved in an adverse clinical event that was actually or potentially preventable. Of this total, 92 died during the admission or shortly afterwards, though not necessarily as a result of the event. Ministry of Health Quality Improvment Committee