Enhancing health and wellbeing in New Zealand children and young people

Quality Improvement cycles

Maintaining the gains with Standards and Quality Assurance

Quality improvement actions

goals

Small steps of

continuous improvement

Plan

Do

Act

Check

Well-child/Tamariki Ora Draft Quality framework

Health Quality and Safety Commission adapted the IHI Triple Aim for NZ.The three dimensions in the New Zealand adapted model are:• improved quality, safety and experience

of care• improved health and equity for all

populations• best value for public health system

resources.

The three sides of the WCTO triangle are: • improved safety and quality experience

of child, family/and community• improved health and equity across

populations • best value for health system resource

Quality initiatives in Child health in New Zealand

Well-child/Tamariki Ora quality framework

• Immunisation coverage target• B4School check quality initiative• Reducing rheumatic fever• Children’s Commissioners Compass• Development of clinical networks• QI for maternal and newborn screening• Maternity quality initiative

Improved health and equity across populations

Improved health and equity across populations

• To improve immunisation coverage at 2 years to 95% by July 2012

• To reduce ethnic and socio-demographic disparities in coverage

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Dep 5-6 %

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Dep Unavailable %

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The 2 year immunisation target

Public reporting

Immunisation Coverage Toolkit

Best value for health system resource

It aims to identify and address any health, behavioural, social, or developmental concerns which could affect a child’s ability to get the most benefit from school.

The B4 School Check is a universal-offer Well-Child check

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The quality letter. • A Quality Improvement

process for the 4 year old check.

• Shared with providers and DHB management

• An opportunity to provide up to date information and share good practice

• Provision of benchmarking information

Quality improvement in action

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Improved safety and quality experience for child, family and community

Improving community involvement and parent satisfaction with the B4School check

Improved safety and quality experience for child, family and community

We developed a relationship with Richard Taylor of Weta workshop to promote the B4School checks using the Wot-Wots.

Improved safety and quality experience for child, family and community

Validation of the Strengths and Difficulties Questionnaire

SDQ validation

• The SDQ is a behavioural and emotional screen used in many countries and translated into over 30 languages

• Parents and early childhood teachers have told us that they were uncertain about he screen because it had not been tested on New Zealand children

• Ministry of Health has contracted Auckland University of Technology to validate the SDQ on New Zealand children

Conclusion

• Reframing difficult problems within a QI perspective can lead to rapid gains

• A Quality Framework will ensure that all aspects of quality are considered and addressed

• Once you have had success, your learning is generalisable to other areas

• Improving quality doesn’t always save money, but it can increase efficiency