Dr. Pay Tuohy: Enhancing the Health & Wellbeing of Children & Young People in New Zealand
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Transcript of Dr. Pay Tuohy: Enhancing the Health & Wellbeing of Children & Young People in New Zealand
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
Jun
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1250%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Coverage at 2 by Socioeconomic quintile
Total %
Dep 1-2 %
Dep 3-4 %
Dep 5-6 %
Dep 7-8 %
Dep 9-10 %
Dep Unavailable %
Co
ve
rag
e (
%)
10% difference
3% difference
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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Extreme Obese that are referred
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100.0%120.0%
% of Abnormal SDQ scores referred
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
01-July-2011 01-January-2012 01-April-2012 01-July-20120.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
Lift the Lip % of 2-6 referred % of BMI>=21 referred
PEDS % of pathway A referred SDQ-P abnormal that were referred
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