There’s No Such Thing As Overnight Success

You may know that I’m a great fan of Jim Collins, particularly his book Good to Great. When he looked at what characterizes successful organisations, he observed that they rarely achieve overnight success. In actual fact, such organisations work hard over a long period of time in order to build up the momentum required for that leap to greatness. People may see an organisation taking off but that belies the huge amount of effort and hard work that has led up to that point.

And so it is with CM Health. I recently wrote to Professor Alan Merry, the Chair of the Healthy Quality and Safety Commission, to outline some of our latest results in terms of patient safety. I directed him towards four publications which highlight the good work happening here:

In passing these on, I was struck by the way in which CM Health appears to have suddenly blossomed. Yet as we all know, that ‘blossoming’ hasn’t happened by accident. The success showcased in these publications is rooted in the can-do attitude and culture of Team Counties. It’s also important to recognize the early pioneering work done by the likes of Mary Seddon, Peter Gow and the Whai Manaaki team, which laid the solid foundation on which we have built more recent successes. I’d also like to acknowledge the role Ko Awatea has played in recent years. The Centre has been pivotal in helping spread and systematize our approach to improvement, as well as giving us all the space to think and reflect. Without a doubt it has helped us build the capability and capacity needed to make these changes and the many more that are yet to come.

I’d encourage you all to have a deeper look at this stunning set of reports. Here are some of the highlights:

  • Our Emergency Department has hit 97% with Six Hours Can Be Ours since 2009
  • Since redesigning how we work, we have  increased productivity in Surgery by 80% in 7 years
  • As in our Quality Accounts, we have an MRO infection rate of 0.1% per 1000 days
  • Harm from falls has reduced to 1 per 1000 days
  • Our Surgical unit has not had a CLAB infection for 3 years
  • We have some of the highest standards of hand hygiene in the country
  • Over 90% of heart attack patients get a Percutaneous Cardiac Intervention in our Emergency Department within 3 hours
  • We have made great inroads with our Patient and Whaanau Centred Care workstream
  • The 20,000 Days Campaign has saved over 23,000 days by redesigning 13 chronic disease pathways, and is now reviewing another 16
  • We remain one of Australasia’s leading hospitals when it comes to hospital standardized mortality rates

Through these achievements, we have begun to show not only that we can work systematically to change patterns of demand on the hospital but also where some of the new battlegrounds are going to be, particularly around addressing poor levels of health literacy among patients (which drives increased demand, high cost and poor quality care).

All of the work is galvanized very simply in the idea that clinical quality is the only game in town. These improvements and achievements aren’t just an overnight blossoming but the result of many years of perseverance, hard work, capability building and relentless execution of excellence in order to be not just the best healthcare system in Australasia, but also the safest. The momentum we have built up is quite considerable and will serve us well as we strive to achieve even greater things in future.

With that in mind, our Chief Medical Officer, Dr Gloria Johnson, Director of Ko Awatea, Jonathon Gray and our Director of Nursing, Denise Kivell, are developing a new patient safety framework to look more deeply at the care we provide. We’ve also broadened our clinical leadership around patient safety through the appointment of four new Clinical Directors:

  • Clinical Director for Patient Safety and Quality Assurance:  Dr David Hughes
  • Clinical Director for Infection Services:  Dr David Holland
  • Clinical Director for Medication Safety:  Dr Chip Gresham
  • Clinical Director for Patient and Whaanau Centred Care:  Dr Peter Gow

Is all of this making the difference we want to see? As ever, the test for me is stopping to consider whether I would want to have a member of my family treated in our hospital. I’m extremely proud to say that the answer is a resounding yes and I thank each and every one of you for all you do to make that happen.

Geraint

PS: My thanks to Dean Conger for his great suggestion to play patient health education videos on the TV screens in patient waiting rooms (in response to last week’s blog). I have asked our new Director Hospital Services, Phillip Balmer, to action this.

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Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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