Work has begun on a quality plan for the Southern District Health Board, but it will take some time as the newly-merged board is still "trying to find itself as one organisation", quality and risk manager Catherine Rae says.
One of the issues would be reaching agreement on what should be included in the plan.
It is expected to sit with the organisation's strategic plan, with a focus on "putting the patient first" and "pull together" everything which was already being done to improve quality.
This included work to maintain quality accreditation of services, initiatives to encourage no-blame incident reporting, ongoing projects to reduce falls and improve hand hygiene and the use of such things as the World Health Organisation surgical checklist to reduce operating errors.
It also involved culture change and how to move the organisation forward.
Agreeing on principles was relatively easy, but the details would take time.
Because the plan would have to be implemented across both Otago and Southland it would take longer, but just how long was hard to estimate at this stage, Ms Rae said.
There were differences between the two areas which needed to be acknowledged, but they also had a common direction.
It would be necessary to work out what resources could be committed to it, including ongoing staff training.
If that was not done, staff would end up "trying to do stuff in their lunch breaks", she said.
Emergency specialist Dr Tim Kerruish, who led a 2008 project in the emergency department looking at lean thinking, had been leading discussions on this in other areas.
Ms Rae said she supported recent suggestions that discussions on quality should be an important part of board discussions, but she was not sure "really good information" about quality aspects of the organisation in an appropriate form was yet available to members which would support this.
She was confident, however, that staff reporting of incidents had improved considerably.
They could see that when incidents were reported and reviewed that "robust recommendations" were coming out of those reviews which were being followed through.
It was important that when public reporting of sentinel and serious event statistics occurred, people did not jump to the conclusion that because there had been an increase in reports, hospitals were providing poorer patient care.
Increased incidents could reflect the greater emphasis on reporting and some places would be better at reporting than others, Ms Rae said.
