Click photo to enlarge
Brian Rousseau
The Otago District Health Board does not understand the
role it will need to take in leading from the top to improve
quality of health care if it is to catch up on the rest of the
world, chief executive Brian Rousseau says.
"If I take a look at what is happening in the rest of the
world, we have slipped behind in New Zealand.
"I think quality starts at the governance level.The boards
need to understand their role in quality and I don't think
they do.
"It is not the fault of the boards. That is the kind of
system change we need."
The board had been focused on "chasing our tails on a lot of
initiatives", but improving quality of care had not been one
of them, he said.
Mr Rousseau's comments followed his attendance earlier this
month at an international conference in the United States
about quality improvement in health care, which was attended
by more than 5000 people.
One presentation Mr Rousseau attended, which examined how to
get "boards on board" to improve quality and safety,
suggested boards should have a quality improvement committee,
spend more than 25% of their time on quality issues and
invite patients and families to board meetings to share their
experiences.
Every board member should be asking questions about patient
safety, such as "do we really have an open and fair culture?"
and "are we always open when things go wrong?"
conference-goers were told.
While change was needed at board level, Mr Rousseau was also
critical of his own performance.
As chief executive, it was his role to lead a change of
culture in the organisation to a culture focused on quality,
he said.
"Probably the biggest problem is lack of time. The reality of
a chief executive's job is there are a lot of other things we
deal with.
"It is about finding the time to get out of the office and
spending time walking around the organisation, talking to
people. Finding out more about their roles is a vital step.
"I don't do that enough and it is one of the things I have
got to change."
Mr Rousseau said he had "had his nose to the grindstone" and
had not been to the annual quality improvement conference run
by the Institute for Healthcare Improvement for seven years.
One hospital took quality improvement so seriously it had 25
people at the conference.
The board had made a start on improving quality of care and
patient safety with a "putting the patient first" pilot in
Dunedin Hospital's emergency department, but needed to go
"harder and faster", he said.
Emergency specialist Dr Tim Kerruish, who is leading the
pilot project which aims to reduce waste, increase efficiency
and improve patient flow, has previously told the board the
project could founder in the existing hospital culture.
Mr Rousseau said he would spend his Christmas break
reflecting on the issues and "come back with plans" next
year.
