Counties Manukau Health (CM Health) is involving consumer representatives in service credentialing as part of its commitment to patient and family engagement across all levels of the organisation.
The service credentialing process is part of the quality and risk management system CM Health uses to protect patients and whānau.
“CM Health aims to credential each service every five years to understand the skill mix of its staff, whether it meets clinical needs, and to identify any risks and opportunities for improvement,” says Renee Greaves, patient and whānau care advisor.
During the credentialing process, a panel interviews the service manager, senior medical officers, and charge nurse managers of a service. Key health professionals who interact with the service may also be interviewed. The panel consists of a discipline-specific external assessor from outside the organisation, a representative from another service which works closely with the service being credentialed, and a consumer or community representative* (CCR). Interviews are based on background information about the service, such as its patient population, staffing levels and service plan; and on self-assessment forms completed by each clinician about their competencies, practice and aspirations.
Once the interviews are complete, the panel produces a report with its recommendations. This goes to the general manager of the department and the chief medical officer to ensure the service is accountable for addressing the recommendations.
A CCR was made a compulsory member of these panels in 2013. Since then, CCRs have participated in credentialing 14 CM Health services.
CM Health has three CCRs who share responsibility for credentialing. Ms Greaves coordinates selection of an appropriate representative for each credentialing process depending on the knowledge, experience and availability of the three CCRs.
“To give meaningful and helpful input to the panel, the representative needs to have the confidence to speak up and enough understanding of the service being credentialed not to feel overwhelmed. If you’re acting as a community representative, you need a strong healthcare consumer focus and experience. It’s also important to be involved with the community and understand its demographic profile and the local issues,” says Sandy Birkenhead, one of the three CM Health CCRs.
Since the CCR was added to these panels, clinicians have noticed a much stronger focus on patient experience, improving access, communication and patient education resources during service credentialing.
“Having a consumer representative on the panel brings a different perspective. As clinicians, we can get caught up in a particular mindset, make assumptions or overlook something that could be important from a patient’s perspective. The consumer representative brings us back down to earth and reminds us to think about the people we’re there to help,” says Linda Huggins, Palliative Care consultant.
“For example, the consumer representative we worked with for the Palliative Care service credentialing raised some very helpful points. Her husband had been a patient and she was able to explain how difficult it was to navigate support services for terminal cancer. We’re now working to improve how we coordinate our care and our transfers of care.”
In addition to their perspective as a consumer or member of the community, CCRs can bring their own professional skills to bear for the benefit of services. In one instance, a CCR with people management experience alerted an overstretched service to the fact that its staff were on the point of burnout. The Executive Leadership Team was informed of the risk and additional resources were allocated to support the service.
As a process that happens only once every five years, CCRs in service credentialing are only part of the answer to engaging with patients and their families. Nonetheless, it is one way CM Health is working with consumer representatives at the governance level of our organisation to shape better services for our people.
* A consumer representative is a person with direct experience as a patient of the target service. A community representative does not have direct personal experience as a patient of the service, but represents the voice of community in general.