1. 1 ACHSE 48 th Residential Conference Future Directions for Quality Improvement Patricia Faulkner Secretary Department of Human Services Friday 15 March 2002

2. 2 Outline Health system challenges –Assuring system performance & quality DHS role: promoting quality improvement across the continuum of care What will success entail? How do we promote clinician engagement & leadership?

3. 3 Health System Challenges Rising public expectation Ageing population Assessing new health technologies ICT & information management Workforce education & training Assuring system performance & quality

4. 4 Degree to which health services meet professional standardsDegree to which health services meet professional standards Degree to which actions taken/not taken maximise probability of beneficial health outcomes, minimise risk and other outcomesDegree to which actions taken/not taken maximise probability of beneficial health outcomes, minimise risk and other outcomes Quality frequently described as having 3 dimensions:Quality frequently described as having 3 dimensions: Input Resources (certification and/or training of providers) Service Delivery (appropriate procedures for given conditions) What is quality of care? Outcome of Service (improvement in condition or reduction of harmful effects)

5. 5 Assuring System Performance & Quality Importance of system performance & quality in the health sector is intensifying Performance needs to be compared against other health systems & variation analysed Policy makers need to defend against alternatives

6. 6 Assuring System Performance & Quality (cont) For patients: –Improvements & less variation in performance –Greater openness For professionals: –Systems to measure own & colleagues’ performance –More evidence based treatment Improved international benchmarks Better systems for strategic planning, management & evaluation

7. 7 DHS Role: Promoting Quality Improvement Across the Continuum of Care Victorian Quality FrameworkVictorian Quality Framework –Suite of performance indicators –Data feedback to health services –Quality fund supports improvement initiatives Continuity Effectiveness Appropriateness Accessibility Organisational capability Safety Acceptability QUALITY

8. 8 DHS Role: Promoting Quality Improvement Across the Continuum of Care (cont…) Legislation to support quality –Clinical governance: enhanced hospital board accountability for quality of health services –Consultative councils Reporting to the community about quality improvement –Quality of Care Reports to consumers Promoting quality at international, national and state levels

9. 9 What will success look like? What do health service executives need to ensure?

10. 10 Success Indicator: Patient Centred Safety & Quality Values are Paramount Key role for health service leaders to provide continuous leadership & high level support for safety and quality Clinician engagement & collaboration to: Align clinician and management priorities on a hospital wide basis to improve patient safety & quality across the care continuum Clinician/management focus on performance drivers Drive evidence based decisions & strategies to maximise take up & system learning

11. 11 Success Indicator: Leaders are identified Characteristics: Optimism / energy / enthusiasm The team comes first Adaptability – able to refocus goals quickly Commitment to task Bold in vision, careful in planning Willingness to change, seize new opportunities & learn new skills Bruce Barraclough, Chair Australian Council for Safety and Quality in Health Care, Feb 2002

12. 12 Success Indicator: ….. and leaders are nurtured “Give consistent feedback on performance. Most feel they don’t get enough words of praise and encouragement” “Give consistent feedback on performance. Most feel they don’t get enough words of praise and encouragement” Sir Ernest Shackleton, 1874 - 1922

13. 13 Success Indicators: Systems are continuously redesigned for improvement Tools to make necessary changes are available Measurable safety & quality improvement

14. 14 Future direction Develop & support clinician leadership Continuing support for innovation to create the highest level of clinical practice

15. 15 ‘The intelligent leader leaves things different – not just relationships but the whole situation’ Charles Mant Intelligent Leadership 1997

16. 16 Secretary Regional & Rural Health & Aged Care Metro Health & Aged Care Policy & Strategic Projects Inter- Governmental Relations Policy Projects Nurse Policy Workforce & Service Planning Strategic Projects Funding & Finance Policy Ambulance Quality & Care Continuity Mental Health Service Development ARMC Business Support Public Health Primary & Community Health Rural & Regional Health Aged Care Planning & Resources New DHS Structure

17. 17 Patricia Faulkner Secretary Department of Human Services Friday 15 March 2002 ACHSE 48 th Residential Conference Future Directions for Quality Improvement