Executive summary
This report subjects NSW health and the operations which it undertakes into scrutiny. It analyses the issue of safety and quality of health car services which the system offers. It focuses mainly on the corrective measures which have been put into the system to improve service delivery in reference to safety and quality. Generally the report discusses performance measures which NSW health has used as benchmarks to the quest to improve service delivery to the community. The method which these performance measurements have been employed also feature in the report.
Introduction
Performance measurement can be explained as the complement to process execution. In health care, it can be said to be the assessment of delivery (Smith et al 2005). It aims at providing information that can be used to improve the delivery of services. Performance measurement tries to define the parameters under which programs reach target results. The fundamental rationale behind performance measurement can always be identified as improvement of performance (Smith et al 2005). This report identifies safety and quality of healthcare services as one of the publicized failures to the NSW health. The report further aims to establish the use of performance measurement can be of help in improving the safety and quality healthcare services. The government of New South Wales established this public health care system to offer quality health care to the citizens of NSW. The system faces many problems in the quality of patient care. This report highlight majority of those issues and the response NSW health have put to try and improve service delivery. The criticisms leveled upon NSW health have given the organization an incentive to improve. There are numerous methods that can be employed to improve the safety and quality of heath care services (Smith et al 2005). The methods which integrate the use of performance measurements are discussed.
Safety and quality
Safety and Quality from the benchmark at which people gauge the effectiveness of a health care system. Safety of healthcare services has become a critical issue in recent years. The rising numbers of high profile incidences which have occurred have made it a major concern (NSW IPART, 2008). Reducing these incidences can go along way into enhancing improved quality and safety of the services. Quality of healthcare forms an important part of the entire system. It helps to improve safety as well as leading to better outcomes. Better outcomes translate to patient satisfaction with the health care services offered. In the NSW system, these aspects have been identified as critical issues for review. A special commission has even been set up to define whether there exist any issues which impact the delivery of acute services in the system. The commission looks at the performance of the system in regard to safety and quality. A good number of entities have been set up to enhance performance standards in an effort to improve safety and quality of health services.
There are two bodies which are charged with the duty of enhancing quality and safety of health care services in NSW. These bodies, namely; Patient’s Safety and Quality branch (PSQB) and the Clinical Excellence Commission (CEC) carry out the assessment of issues pertaining to safety and quality. Formation of the two bodies came out of the necessity to improve safety and quality of the services delivered. Clinical Government units (CGU) also help in offering services.
The PSQB was established in 2004 and since then, it has helped manage the leading components of the service and quality program. It plays the leading role in policy development on quality and safety at state level. It also analyses the critical clinical incidences which have been occurring frequently. Monitoring and implementation of policies regarding safety and quality form the other set of responsibilities of the PSQB.
The CEC, also established in 2004, comes as part of the patient’s safety and quality clinical program. The responsibility of identifying systemic issues affecting quality and safety in has been bestowed upon it. On top of that developing and advising on strategies to help address the issues raised adds to the other duties of the CEC.
The CGUs were also brought into the system in 2004. They are responsible for rolling out the proposed strategies of the program. These CGUs have been strategically positioned in almost all areas of the state for them to execute their duties efficiently.
These establishments have employed several methods, which integrate performance measurement, towards improving service delivery.
Evidence based decision making
This system bases treatment of chest pains on the best available evidence concerning the same. With evidence, for the existence of a condition, hospitals can be able to assess and diagnose a patient in a better way (Paris, 2007). A measurement system has been put in place to help promote clinical practice improvement through evidence based assessments. The CEC in conjunction with several clinical groups has sought to expand the pathways which have evidence based documentation. This works in line with improving of the available information concerning diseases. The information can help clinicians to make a decision in the future based on the effects of previous effects observations made on patients (Nutt et al, 2007). Through the information gathered clinical officers would be able to offer better services in future. Involvement in the evidence based decision making process would equip the clinicians with the desired information and therefore ability to deliver. When the information has been increased, better services shall become a possibility as incidences of guessing shall be reduced. This method has already been accepted by many clinical officers. The method greatly assists those involved as they don’t make decisions based on their own judgments or assumptions. Evidence based decisions are most likely to be true and reduce cases of guessing among the clinical officers (Lippincott & Wilkins 2009).
Collaboration among clinicians
This encourages clinicians to share information regarding practices which have proved to be most effective. This does not only improve the quality of health care services, but also the knowledge of the practitioners (Lorig & Sobel, 1999).. Greater collaboration regarding safety and quality of healthcare shall also ensure standardization of the services offered. NSW healt5h has ensured that all health services posses a clinical services plan outlining networks for sharing information (Wachter & Goldman, 1996.). This approach has led to the development of standardized cardiac monitoring protocols and new models for the care of patients. High level of collaboration as used will ensure creation of many standard operations in different hospitals. This may see the standardization of all the operations in the hospitals under NSW health. Collaboration is managed through the CEC which presents the areas in which require it most. The CEC monitors areas where greatest gaps exist and which collaborative efforts would be of assistance. Breakthroughs which come as a result of collaboration have been easily adopted into the system.
Reporting and monitoring
At this stage, the observations which have been made concerning safety and quality health care provision come under scrutiny. The occurrences of sentinel events need to be reported so that appropriate action can be taken to ensure efficiency in dealing with these events. The NSW health works towards harmonizing the definition of these events with the national data. It has been noted that there exist discrepancies of definition of sentinel events within jurisdictions (Kolehamainen-Aiken, 1997). Harmonization of these definitions can be done through effective reporting and monitoring of the events.
Reporting of the less server incidences should also be carried out. These incidences form the precursor to major incidents and if not well reported, the incidents will increase. Minimization of the incidents shall lead to improved safety and quality in health care services. This method can be termed as one of the effective initiatives to safety and quality. As long as the appropriate information reaches the right people, improvement of safety and quality can be achieved (Saltman & Von Otter, 1995). Once clinical incidences have been reported, there arises a necessity for reviews to be conducted. These review further help in identifying the critical points brought about by the incident. An electronic incidence information management system has been put in place to keep an up to date report of all clinical incidences that have been reported. At this point the CEC analyses the data and goes ahead to make recommendations on the right courses of actions to be taken.
Clinical process and outcome indicators include the measurable aspects of the implemented processes. Many limitations hinder the process of measuring these out come indicators (Todd et al, 2005). Experts argue that reporting at this stage can only be viable if it comes from the public. The information received from the public can be used as a measure of extend to which the public is satisfied with the services of a system. The negative issues raised would help implement corrective measures. Theses measures would in turn improve the safety and quality of health care services.
Clinical registries can also form an important part of the monitoring process. Ensuring that the registry captures details of a patient correctly is essential. These details can be used elsewhere to analyze what the patient may be suffering from. They might also help a doctor identify other associated problems which may arise from the condition of the patient.
Conclusion
There are many challenges which NSW health faces in its quest to offer improved health care. Critical analyses of different aspects that are integrated within it have been considered in implementing the system. A comprehensive health care can be achieved if performance measures are employed to assess the progress the system (Antai-Otong, 2008). In health care, patient care comes at the core of implementing performance measures. The safety and quality of health care should not be compromised in the effort of taking care of the patient. NSW health aims to provide quality health care to the public. Through the use of these measures, it has been able to improve the safety and quality aspects of the health care services it renders to the public. Organized reporting and recording have made it possible to improve healthcare in all parts of the state. Through the annual reports, NSW health has been able to monitor its progress in implementing improvements regarding safety and quality. These reports also provide the necessary information to help CEC come up with policies on the improvements that required. The report has further aimed at establishing the use of performance measurement can be of help in improving the safety and quality of healthcare services. The system faces many problems in trying to improve the safety and quality of patient care.
This report has highlighted majority of those issues and the response NSW health have put to try and improve safety and quality in service delivery. Through the adoption of innovative measures, NSW health has been able to considerably improve the safety and quality of its services. Increased information sharing has led to identification of the numerous gaps which exist in the safety and quality aspects of health care (WHO, 2006).
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