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We aim to continuously improve our safety and quality.
The quality and safety markers (QSMs) help us evaluate the success of our patient safety programmes, and determine whether the desired changes in practice and reductions in harm and cost have occurred.
The QSMs are sets of related indicators concentrating on specific areas of harm:
The process measures show whether the desired changes in practice have occurred at a local level (eg giving older patients a falls risk assessment and developing an individualised care plan for them based on the findings of the assessment).
Process markers at the district health board level show the actual level of performance, compared with a threshold for expected performance.
The outcome measures focus on harm and cost that can be avoided.
The QSMs chosen are processes that should be undertaken nearly all the time, so the threshold is set at 90 percent in most cases. The markers set the following thresholds for DHBs' use of interventions and practices known to reduce patient harm:
95 percent of hip and knee replacement patients receiving 1.5g or more of cefazolin, or 1.5g or more cefuroxime.
CM Health has consistently met the threshold for falls, hand hygiene, safe surgery and patient deterioration.
One marker that has been difficult to meet is the timing of antibiotic administration prior to joint replacement surgery. The surgeons and anaesthetists at CM Health are working hard to reliably record the timing of these important medicines.
There has been a significant reduction in the number of hip fractures sustained during stays at Middlemore Hospital. Serious bacterial blood infections have remained lower than the national average.
New QSMs are on the way – opioid safety and consumer engagement measures are being developed.