Board member Dr Malcolm Macpherson said he was concerned quality was associated with managing risk and compliance requirements, rather than a "cohesive view or a brand" everyone could identify with, which was about improving performance.
Recent Otago Daily Times newspaper coverage of Dunedin Hospital's performance on the national target for reducing stays in emergency departments indicated the organisation was "all over the place", with "half a dozen different messages".
People needed to be "lined up" behind a single identifying principle that made it clear to everyone "what we're talking about".
Committee chairman Paul Menzies also referred to there being several "good projects" that were proceeding in an isolated way rather than being under a quality "umbrella".
He asked whether there was an "over-arching quality programme" that involved everyone in the organisation from the board down.
He likened the situation to a rowing eight. The team might be pulling in the same direction, but if some oars were not hitting the water at the same time, some rowers could get thrown out of the boat.
Otago chief operating officer Vivian Blake agreed there needed to be a whole-of-systems approach.
Projects needed to be pulled together and the "dots need to be joined".
Senior staff were grappling with how to achieve that and what quality would look like in the next three to five years.
They knew inherently what it was they wanted to achieve, but "how do you formulate it, package it and sell it, getting to the hearts and minds of all?"
Southland chief operating officer Lexie O'Shea said that while service providers in both regions shared the same view of quality, "in an operational sense, we have different modus operandi".
Quality improvement was "still alive and well" in both of the provider arms.
Chief nursing and midwifery officer Leanne Samuel said staff were actively involved in finding ways to improve quality of care, and risk management formed part of that.
She said she shared quality and risk manager Catherine Rae's frustrations, but the two provider arms had such different philosophies and backgrounds that to find agreed language and a common commitment would be "no mean feat".
Mr Menzies said commitment to it had to start from the board and go right through the organisation, something that would not be an easy process.
Member Susie Johnstone suggested that the matter form part of the board committees' workshops to be held next month, in order to give the matter some momentum.
