On 26 June 2018 Counties Manukau Health (CM Health) primary care improvement initiatives Safety in Practice (SiP) and Enhancing Primary Care (EPC) hosted the Quality and Safety Symposium at Ko Awatea. The event brought CM Health primary care activities together to highlight and celebrate the achievements of participating SiP, EPC, Modified DCIP practices, and CM Health pharmacies (Owning My Gout).
It was also an opportunity to showcase the work to other general practices, present on the next steps in bringing all initiatives under one umbrella and on the future of quality and safety in CM Health.
According to SiP clinical lead, Dr Vikas Sethi, quality improvement (QI) helps equip practices with the knowledge around having stringent policies and systems in place to reduce incidents of avoidable patient harm. Safety is a key element but broadening it out to quality improvement encompasses errors of omission and commission. “QI also helps ensure the safety culture is embraced by practices”, says Dr Sethi.
Dr Michael Clarke, from Beachlands Medical Centre, reflects on the changes that happened in his practice as a result of participating in a safety and quality initiative. “There is now open communication of error, doubt, incidents and concerns; a culture of improvement and safety; teamwork with a common goal; confidence in audit process and results confirming benefits from agreed changes; leadership teams and better communication. We implemented multiple changes that resulted in better safer care”.
For ProCare quality coordinator Nikki Brentnall, SiP was an opportunity to work collaboratively, improve team functionality and look at data differently. “We are starting to design QI methodology in other areas of the practice”, says Nikki.
East Health Trust nursing director, David Harrison, adds that the EPC modules provide clarity around prioritising when gaps in staff competency and confidence are identified. “It enables us to look wider and access examples of best evidence”. The PHO is promoting a series of training programmes where some of the identified gaps are addressed.
Baderdrive Doctors has also implemented many changes. Dr Nua Tupai states that QI is included as a standard agenda item on organisational meetings and there is now a standard process to update patients’ problem list and medication changes from external sources. “We have also implemented shared medical appointments as a novel approach to management of LTC, created an advanced form to support the management of COPD patients to standardise care and have recently implemented a clinic concierge to address waiting room congestion and waiting times’, celebrates Dr Tupai.
“QI in primary care sets a standard to aspire to, creates and supports a patient safety culture and enhances the quality of primary care.”
Dr Nua Tupai
“Safety in Practice will merge with the other primary care initiatives at Counties. The basis of the key primary care initiatives is quality improvement and SiP will form the key quality component of these. I am excited to see how this spans out encompassing SLMs, patient care and PHO involvement.”
Dr Vikas Sethi
“The benefits of quality improvement in primary care are: higher quality care of patients; safer care, less harm; better teamwork , common aim; better team culture; better outcomes; cost effective care.”
“The Symposium was a snapshot of everything going on across all streams and achievements to date. EPC achievements were unique for each Practice, but all presented huge changes and benefits.”
Dr Michael Clarke