How are we really doing?

Recently, we shared with the media the findings of a report on CM Health’s performance.

The report, Quality Improvement at Counties Manukau Health; A Case Study Evaluation, led by Professor Robin Gauld from the University of Otago, showed that while there are definitely areas for improvement, we really are heading in the direction we want to go.  What’s more, we’ve developed a distinctive culture here where everyone is committed to continually doing better.

We’re trying to deliver healthcare services to a population of 500,000 with high levels of socio-economic deprivation and the well-documented corresponding healthcare challenges of which you will all be aware. It’s complex and expensive, and we have to constantly be asking ourselves; how are we really doing?

That’s where System Level Measures (SLMs) come in. Developed by Ko Awatea’s Dr Mataroria Lyndon and team, SLMs are 16 measures which give a whole-of-system dashboard review of our performance.

Based on these SLMs, the report identified we were at the top in three of these, including wait times for elective surgery, with all patients eligible for surgery receiving treatment within the New Zealand target of four months.

We are also ahead in our management of cardiovascular risk. Within this measure, 91 per cent of patients have had their cardiovascular risk assessed in the last five years. This exceeds the national average of 88 per cent.

We are also performing well integrating patients back into primary care, and we have more patients enrolled with GP clinics within a month of being discharged from hospital than other healthcare organisations that were compared.

In other measures, CM Health is performing ahead of its peers such as hospital standardised mortality rates and is exceeding the national target for shorter stays in the emergency department, according to the report.

However, there are areas where the organisation needs to improve, including life expectancy for Maaori at birth. This is 72 years, well under the OECD average of 80.5 years and therefore addressing health equity is the key focus of the strategic plan “Healthy Together”

The report also identified higher numbers of avoidable (ambulatory sensitive) hospitalisations that occur in other healthcare organisations.

But, like any organisation there are areas where we must strive to improve especially for healthy equity. The report identified clear gaps in life expectancy for Maaori and identified higher numbers of avoidable (ambulatory sensitive) hospitalisations for Maaori and Pacific. As you will know, addressing health equity is our key focus of our Healthy Together Strategy. Although achieving health equity will take time, we are committed to the journey.

What I’ve always said, and what this report has identified, is that it is not so much what we’re achieved, as our potential for further achievement and our collective commitment to that process.

To make lasting and significant improvements for the health of our population we need more than merely system-wide change. We also need to nurture a culture of ambition and a restlessness to continually improve.

Last week at the Deloitte IPANZ Public Sector Excellence Awards 2016,  Dr Lyndon was recognised for his work on System Level Measures and health equity.  In fact Mataroria was named Young Professional of the Year, which is an incredible honor and acknowledgement of his hard work.  I couldn’t be more proud.



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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.

One thought on “How are we really doing?”

  1. We have a Wifi that blocks outgoing emails. We have an non integrated IS suite. There is a fragmented IS machinery that prevents us from viewing a patient’s profile in completeness, or tracing their progress. In the light of such glaring deficiencies all your board are producing is slogans and propaganda. Without a coordinated National IT programme we are battling quality and investment targets with one hand tied behind our backs. Wake up and smell the roses. Our chances of a “World Class Service” are on a par with a Welsh Rugby Union Victory in the Southern Hemisphere.

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