Counties Manukau Health (CM Health) wants to be the best at getting better.
It’s a bold objective, but a recent report by the University of Otago shows the South Auckland District Health Board (DHB), which serves a population of 500,000, is well on its way to becoming one of the top health systems in Australasia.
Despite an environment of tight financial constraints, the prevalence of chronic conditions and an ageing population, CM Health is leading Australasia in three key areas of healthcare delivery (system level measures or SLMs), and among the top in several others.
The report, Quality Improvement at Counties Manukau Health; A Case Study Evaluation, written from data compiled in May 2015, shows CM Health is achieving success in wait times for elective surgery with all patients eligible for surgery receiving treatment within the New Zealand target of four months.
The organisation is also at the top for long-term condition risk assessments. Within this measure, 91 per cent of patients have had their cardiovascular risk assessed in the last five years. This exceeds the national average of 88 per cent.
In addition, CM Health has more patients enrolled with GP clinics within a month of discharge from hospital than other healthcare organisations.
CM Health is performing ahead of its peers in other measures such as hospital standardised mortality rates and is within the optimum range in other measures, such as childhood immunisation by eight months, and emergency department length of stay, according to the report.
However, there are areas where the organisation needs to improve, including numbers of avoidable (ambulatory sensitive) hospitalisations and life expectancy for Māori at birth.
Addressing health equity by 2020 is the key focus of CM Health’s strategic plan “Healthy Together”.
Authors note CM Health’s success should not be so much measured in terms of its achievement within specific SLMs, but rather as its commitment to developing the measures themselves.
Report co-author and head of department, preventative and social medicine Dunedin School of Medicine Health Sciences Robin Gauld says CM Health has created a culture with a real focus on getting better.
“It’s not what we’ve achieved, but it is the potential for more improvement,” says CM Health chief executive Geraint Martin, of his organisation’s philosophy.
“Improving the health of our population is not something that can happen by simply changing processes. It involves a culture of ambition, a hunger and an appreciation that nothing is good where better is possible,” Mr Martin says.
The 2011 establishment, by Counties Manukau Health, of Ko Awatea as a centre for education and quality improvement is further evidence of the organisation’s commitment to sustainable change, patient safety and health equity, according to the report.
The report was based on the examination of three aspects of quality improvement:
1. System Level Measures (a suite of measures that provide a whole-of-system view of performance)
2. The establishment of gold standards for these measures, and a case study of health care organisations recognised for their work on quality improvement