1. Overview of the E-Quality Group Christchurch Hospital Emergency Department
Anne Esson – Nurse Manager
Polly Grainger – Nurse Coordinator Clinical Projects
History
In 2012 discussion at the national REDS conference about the creation of a national quality framework and suite of quality measures via the MOH sparked a review of our current quality focussed forums . At the time some of the most active were the Floor Group which was established in 2004 as a forum for discussing ED matters among all professional groups working in the ED and Project RED . Project RED (rejuvenating ED) was set up n 2007 as a response to overcrowding in CHCH ED and a great number of improvements were made over a period of 3 years. As time went by Project Red become less active and the floor group was trundling on . The development of the quality framework seemed a good time to farewell the above groups and create something else that would be proactive in setting the direction for the department and bring to life the new the quality framework.
So the Christchurch ED E- Quality group was born .This group has a strong leadership role-helping to direct us to where we need to be and ensuring we get there .It is still in its infancy stage and I don’t think we’re there yet but we’re on the journey.

2. Purpose
Embed the New Zealand Triple Aim Principles for quality improvement for:
The individual – improved, quality safety and clinical care
The population – improved health and equity for all populations
The system – best value for public health system resources
Facilitate the monitoring and compliance to the Shorter Stays in ED Health Target, the Quality Framework and Suite of Quality Measures

3. Scope and objectives Scope:
Provide overview, support and direction towards clinical governance in the ED context through:
Open and transparent communication and decision-making
Implementing best practice
Adherence to policies, procedures and protocols
Robust measurement, accountability and responsibility 
Objectives:
Patient safety; clinical effectiveness; patient experience

4. Participants Clinical Director Nurse Manager Clerical Manager
Quality Facilitator
Service Manager
Visiting subject matter experts as required
Representatives of all ED multidisciplinary professional groups
Note: Consumer and/or community representation to be set up

5. Collaborative functional relationships
Senior Nursing Team (SNT) Group
Senior Medical Officer (SMO) Group
ED Business Meeting
Combined SNT /SMO Group
ED Nurses Rep Group
Hospital Aides Group
Mortality and Morbidity Meetings
Infection Prevention and Control
Process Improvement Groups (PIGs)
Health and Safety Committee
Audit Planning Team
Nursing Roster Governance Group
Evaluation and Audit Working Group
Acquisitions Group
Quality Action Plan Development Team

6. In practice Quarterly reporting:
New business: audit prioritisation, new policies, and invited speakers
Ongoing business: existing projects
Patient H&S and OSH topics and initiatives – staff (patient H&S in all other meetings)
Month 1 – Jan, April, July, Oct
Audits & pathways in progress
Month 2 – Feb, May, Aug, Nov
Patient journey time stamps
Month 3 – March, June, Sept, Dec
Quality processes and patient experiences: Incidents, complaints, compliments, M&M outcomes, SAC outcomes

7. Tools Decision Reporting Suite Signals from Noise (SfN)
Quality Framework and Suite of Quality Measures for ED
HAC key improvements reports
Audit prioritisation template – Hawkes Bay DHB
Individual audit tools
CDHB Audit Reporting Suite
Open-access electronic file of resources from the Quality Office

10. Audits Integrating SMO requirements for FACEM and RN needs for PDRP
Altering the focus: – from what the auditor needs to comply
– to what the department needs
Providing existing tools for repeat audits
Providing similar tools to base new audits on
Raising awareness of audits – enabling collegial assistance
Collating all tools and reports in one open-access electronic file