Managing the Quality of Health Services

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A Framework
for

Managing the Quality
of Health Services
in
N e w S o u t h Wa l e s

“Improving safety and quality of
care should be a central concern for
all those in the healthcare system:
policy makers, managers and health
practitioners alike.”
Taskforce on quality in
Australian Healthcare
June 1996

QUALITY AND BUDGET

equal partners in health
Quality Framework
for NSW Health
Steering Committee
January 1999

NSWHEALTH

1

foreword
With the increasing recognition that a cogent means of evaluating and improving the quality of health services being provided to consumers was needed across the health system in NSW, a committee was formed which was to provide the NSW Minister for Health with advice on the most effective way of achieving this goal. In response to this challenge, The NSW Ministerial Advisory Committee on Quality in Health Care and The State Continuous Improvement Steering Committee, in collaboration with NSW Health, has developed The Framework for Managing the Quality of Health Services in NSW. It is the result of broad consultation with key stakeholders in health, both locally and nationally which will continue into the future. This document is the first step in the development of a co-ordinated approach to monitoring and managing the quality of health care in NSW. This initiative provides the foundation for achieving many of the goals for NSW Health which have been identified in Strategic Directions for Health 1998-2003.

The Framework for Managing the Quality of Health Services in NSW is a practical, wellfounded approach by which effective clinical governance can be implemented in NSW. This is aimed at achieving a balance between the emerging focus on corporate governance and the corporate responsibility for the quality of clinical care. It identifies a new focus for health care delivery which views accountability for quality and for budget control as equal performance indicators in health management. The framework recognises the important role that all those in the health system have for improving the quality of health care in NSW: health consumers, health care practitioners, managers, the Area Health Service Boards and, of course, the Health Department Executive.

The implementation of this framework is a major milestone along the quality improvement continuum for the NSW health system. The Framework for Managing the Quality of Health Services in NSW is a living document, the benefits of which will become manifest over time. The framework itself and its implementation will be evaluated continually in order that improvements can be made. Your comments and suggestions will be welcomed. The success of the framework will require a commitment to the quality of care from all who work in and connect with the health system.

I commend this Framework for Managing the Quality of Health Services in NSW to you. A most significant step in achieving our purpose; Better Health Good Health Care.

Michael Reid
Director General

NSWHEALTH

Table of contents.
executive summary

1

1.

introduction

7

2.

the framework

10

3.

the principles

14

4.

the performance frame

16

4.1.

PERFORMANCE AREAS

17

4.1.1. safety

17

4.1.2. effectiveness

18

4.1.3. appropriateness

19

4.1.4. consumer participation

20

4.1.5. efficiency

22

4.1.6. access

23

CROSS DIMENSIONAL ISSUES

23

4.2.1. competence

23

4.2.2. information management

27

4.2.3

28

4.2.

continuity of care

4.2.4. education and training for quality
4.2.5. accreditation

4.3.

5.

29
30

PERFORMANCE INDICATORS:

31

the committee structure

32

5.1.

purpose

33

5.2.

objectives

33

5.3.

activities of the council

34

5.4.

organisational structure

36

5.5.

evaluation

39

6.

the reporting frame

41

7.

governance

44

NSWHEALTH

8.

culture change

appendices...
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