ACHSE 48th Residential Conference

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ACHSE48th Residential Conference Future
Directions for Quality Improvement
Patricia FaulknerSecretaryDepartment of Human
ServicesFriday 15 March 2002
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Outline

• Health system challenges
• Assuring system performance quality
• DHS role promoting quality improvement across
  the continuum of care
• What will success entail?
• How do we promote clinician engagement
  leadership?

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Health System Challenges

• Rising public expectation
• Ageing population
• Assessing new health technologies
• ICT information management
• Workforce education training
• Assuring system performance quality

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What is quality of care?

• Degree to which health services meet professional
  standards
• Degree to which actions taken/not taken maximise
  probability of beneficial health outcomes,
  minimise risk and other outcomes
• Quality frequently described as having 3
  dimensions

Input Resources (certification and/or training
of providers)
Service Delivery (appropriate procedures for
given conditions)
Outcome of Service (improvement in condition or
reduction of harmful effects)
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Assuring System Performance Quality

• Importance of system performance quality in the
  health sector is intensifying
• Performance needs to be compared against other
  health systems variation analysed
• Policy makers need to defend against alternatives

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Assuring System Performance Quality (cont)

• For patients
• Improvements less variation in performance
• Greater openness
• For professionals
• Systems to measure own colleagues performance
• More evidence based treatment
• Improved international benchmarks
• Better systems for strategic planning, management
  evaluation

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DHS Role Promoting Quality Improvement Across
the Continuum of Care
Effectiveness
Accessibility
Appropriateness
Organisational capability
Safety
Continuity
Acceptability

• Victorian Quality Framework
• Suite of performance indicators
• Data feedback to health services
• Quality fund supports improvement initiatives

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DHS Role Promoting Quality Improvement Across
the Continuum of Care (cont)

• Legislation to support quality
• Clinical governance enhanced hospital board
  accountability for quality of health services
• Consultative councils
• Reporting to the community about quality
  improvement
• Quality of Care Reports to consumers
• Promoting quality at international, national and
  state levels

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What will success look like?

• What do health service executives need to ensure?

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Success IndicatorPatient Centred Safety
Quality Values are Paramount

• Key role for health service leaders to
  provide continuous leadership high level
  support for safety and quality
• Clinician engagement collaboration to
• Align clinician and management priorities on a
  hospital wide basis to improve patient safety
  quality across the care continuum
• Clinician/management focus on performance drivers
  
• Drive evidence based decisions strategies to
  maximise take up system learning

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Success IndicatorLeaders are identified

• Characteristics
• Optimism / energy / enthusiasm
• The team comes first
• Adaptability able to refocus goals quickly
• Commitment to task
• Bold in vision, careful in planning
• Willingness to change, seize new opportunities
  learn new skills
• Bruce Barraclough, Chair Australian Council for
  Safety and Quality in Health Care, Feb 2002

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Success Indicator .. and leaders are
nurtured

• Give consistent feedback on performance. Most
  feel they dont get enough words of praise and
  encouragement
• Sir Ernest Shackleton, 1874 - 1922

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Success Indicators

• Systems are continuously redesigned for
  improvement
• Tools to make necessary changes are available
• Measurable safety quality improvement

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Future direction

• Develop support clinician leadership
• Continuing support for innovation to create the
  highest level of clinical practice

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• The intelligent leader leaves things different
  not just relationships but the whole situation
• Charles Mant Intelligent Leadership 1997

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New DHS Structure
Secretary
Regional Rural Health Aged Care
Metro Health Aged Care
Policy Strategic Projects
Inter- Governmental Relations Policy
Projects Nurse Policy Workforce Service
Planning Strategic Projects
Funding Finance Policy Ambulance Quality
Care Continuity Mental Health Service
Development ARMC Business Support
Public Health Primary Community Health Rural
Regional Health Aged Care Planning
Resources
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ACHSE48th Residential Conference Future
Directions for Quality Improvement
Patricia FaulknerSecretaryDepartment of Human
ServicesFriday 15 March 2002