Download - NURSING WORKSHOP Wellington 29 November 2013 The Changing Nature of Healthcare Chai Chuah
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NURSING WORKSHOPWellington 29 November 2013
The Changing Nature of Healthcare
Chai Chuah
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Context• A Health system that has served New Zealanders
well
• Small country punching above our weight globally
• Adventurous, bold and creative
• Can do better for some – equity of access and quality
• Facing similar challenges to other developed countries
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International Perspectives
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Challenges
500,000. 2. 648, 4,000p, 6,000dg, 13,000diag
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Direction of travel for the NZ Health system
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Shifting the focus of healthcare
Prevention Detection Treatment
A health system that works with you, for you
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The Health system - more than the science …
it’s relational
Partnerships Communication
Listening and Equality hearing
Respect and trust Involvement
Patient experience
Families/whanau
Clinicians
Frontline staffCommunities
Carers
GPsNurses
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Health with Other Determinants
Well BeingHealth
services
Education
Housing &Transport
Employment
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Framework for change
Health Services
Policy/reg/funding/
incentives
Businessmodels
Enablers
Models of care
Where everything comes together
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Enablers
Enablers
IT
Capital
Workforce
Devices
Perfect alignment- biggest impact on outcome
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Quality – remains the driver for change
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Mid-Staffordshire – a valuable lesson Meeting the targets but missing the point …
Financial reporting came top of the agenda – safety issues came down the list
Uncaring behaviours became the norm
Clashes of egos and ethos were part of the culture
On the flip side …
Simple and easy to understand standards of care
Openness, transparency, candour and patient voice
Accountability – where everyone knows what ‘good looks like’
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Quality – must be predictable and measurable
• Strong financial reporting is one measure of a well-functioning system – but it is not the only measure
• Real, sustainable, active improvement depends far more on learning and growth than on rules and regulations
• A culture of continual learning helps everyone to grow. In such a culture, measurement is not a threat
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Quality driving disruptive innovations
• Motor vehicles – US, Japanese, Korean
• Retail industry – Department stores, Warehouse
• Health - cardiac surgery/intervention cardiology, POCT
Incentives Process
Structure
Resourcesallocation
Capacity & capability
Success criteria & threshold
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What stands in the way• Innovations often collide with walls of
professional and organisational resistance … Reinforced by outdated protocols, practices, beliefs, and traditional roles that may have served us well in the past but no longer do so.
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Leadership – the Leaders We Need• Those who are motivated to achieve the common
good who have the qualities required to gain willing followers in a particular culture, at a historical moment when leadership becomes essential to meet the challenges of that time and place – Michael Maccoby
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Christensen & Maccoby
Intuitive Empirical Predictive
CraftIndustrialKnowledge
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In summary • Quality improvement is more about patient experience and
behaviours than $. However managing our finances/resources is very much part of the quality agenda.
• Keep the targets in focus but don’t lose sight of the people in front of us
• We are moving beyond the success story to a measurement story – we need to demonstrate the impact on the quality of care
• The door needs to be open – information on impacts, quality and safety will be shared and judged by the New Zealand public
• As leaders we have an important role to play – to invite patients to trust us, talk to us and become co-producers of their care
• We are in the health business – and that makes it personal
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Conclusion
Our collective responsibility
To ensure continued quality improvement and equitable access to services. As leaders and influencers, we need to know that what we do collectively has measurable impact on the quality of care for patients and their experience of the health system.
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Keep talking, keep listening, keep the door open
The science of health is incomplete without the compassion of care. He aha te mea nui He tangata, He tangata, He tangata