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Issue

Vol 127 No 1405: 07 Nov 2014

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Issue Summary

SUMMARY

Can patient safety indicators monitor medical and surgical care at New Zealand public hospitals?

Phil Hider, Karl Parker, Martin von Randow, Barry Milne, Roy Lay-Yee, Peter Davis

Safety of hospital care is important. The AusPSIs are a set of indicators developed from Australian administrative data to reliably identify adverse events in hospital patients. The main aim of this study was to explore the application of the AHRQ/AusPSIs to New Zealand administrative hospital data related to medical and surgical care. Variation over time and across hospitals was explored using rates adjusted for differences in patient variables including age, sex, ethnicity, rurality of residence, NZDep score (degree of poverty) and comorbidities (additional illnesses). Over the study period considerable variation in the rate of positive events was evident for the six most common indicators. Likewise there was substantial variation between hospitals in relation to risk- adjusted positive event rates. In conclusion patient safety indicators can be applied to New Zealand administrative hospital data and are now available to promote ongoing quality improvement activities in New Zealand hospitals.

SUMMARY

Who wants to be a surgeon? Patterns of medical student career choice

Otis C Shirley, Ben Addison, Phillippa Poole

This study provides a longitudinal view of medical student interest in a surgical career. It showed female and older students are less likely to want a surgical career, but that there is currently enough interest to fill training positions. Work hours and flexibility were reasons students wanted careers other than surgery, whereas the influence of consultants/mentors can encourage a student to pursue surgery.

SUMMARY

Patient engagement with primary health care following discharge from community mental health services

Ryan Stangroom, Molly Morriss, Ian Soosay

Increasing pressure is being placed on specialist outpatient mental health services to facilitate patients discharge to general practitioners (GP). An audit was conducted to measure the level of engagement following discharge, as this is an under-researched area. 72% of GPs reported the discharged patients visited at least three to four times a year. However, 8% of the sample did not visit their GP at all. This research suggests individuals generally engage well with their GP following discharge, supporting current policy regarding discharge of patients.

SUMMARY

The impact of the 6-month waiting target for elective surgery: a patient record study

James Blackett, Alex Carslaw, David Lees, Sophie Fargher, Sudhindra Rao, Margy Pohl

Patients with arthritis who presented to their local specialist for hip or knee replacement at Hawke's Bay and Northland District Health Boards were reviewed. 36% of these patients who were able to have surgery could not have surgery performed in time for the new 6-month Ministry of Health waiting time target. Those patients who received surgery generally had more severe arthritis then those who did not. A prioritisation score was used at both hospitals with Hawke's Bay patients tending to score higher than patients from Northland.

SUMMARY

Fitness to practice of medical graduates: one programme’s approach

Claire Braatvedt, Phillippa Poole, Alan Merry, Des Gorman, Papaarangi Reid, Warwick Bagg

The University of Auckland introduced a Fitness to Practice (FtP) policy to the medical programme in 2005. The goal of the policy was to identify and, wherever possible, remediate students at risk of being unfit to practise after graduation. Over nearly a decade, 5.5% of students who entered the programme received FtP notifications. Most of these were isolated non-critical incidents of a professional nature, with no long-term consequences. A very small subset of students had repeated or serious concerns, underscoring the need for a longitudinal process with formal links to the local regulatory body.

ALL ARTICLES
SUMMARY

Ebola, should we be concerned?

Lance C Jennings, Anja Werno

Can patient safety indicators monitor medical and surgical care at New Zealand public hospitals?

Phil Hider, Karl Parker, Martin von Randow, Barry Milne, Roy Lay-Yee, Peter Davis

Who wants to be a surgeon? Patterns of medical student career choice

Otis C Shirley, Ben Addison, Phillippa Poole

Treating recurrent mood disorders seriously

Marie T Crowe

Macrolides a cardiac risk?

Patient engagement with primary health care following discharge from community mental health services

Ryan Stangroom, Molly Morriss, Ian Soosay

Ethics of mitochondrial therapy for deafness

Michael Legge, Ruth P Fitzgerald

The impact of the 6-month waiting target for elective surgery: a patient record study

James Blackett, Alex Carslaw, David Lees, Sophie Fargher, Sudhindra Rao, Margy Pohl

Fitness to practice of medical graduates: one programme’s approach

Claire Braatvedt, Phillippa Poole, Alan Merry, Des Gorman, Papaarangi Reid, Warwick Bagg

Letter: Treatment of the Insane (part 1)

Duplication of inferior vena cava: a rare but clinically significant anatomical variation

Abdel R Lataifeh, Paula Anderson

Children’s participation in society is likely to lead to their improved health and wellbeing

Karen J Hoare

Medical Benevolent Fund

Murray Joseph Angland McDonald

Is delirium sensitive to socioeconomic inequality?

Timothy Ore, Paul Ireland

SUMMARY

Can patient safety indicators monitor medical and surgical care at New Zealand public hospitals?

Phil Hider, Karl Parker, Martin von Randow, Barry Milne, Roy Lay-Yee, Peter Davis

Safety of hospital care is important. The AusPSIs are a set of indicators developed from Australian administrative data to reliably identify adverse events in hospital patients. The main aim of this study was to explore the application of the AHRQ/AusPSIs to New Zealand administrative hospital data related to medical and surgical care. Variation over time and across hospitals was explored using rates adjusted for differences in patient variables including age, sex, ethnicity, rurality of residence, NZDep score (degree of poverty) and comorbidities (additional illnesses). Over the study period considerable variation in the rate of positive events was evident for the six most common indicators. Likewise there was substantial variation between hospitals in relation to risk- adjusted positive event rates. In conclusion patient safety indicators can be applied to New Zealand administrative hospital data and are now available to promote ongoing quality improvement activities in New Zealand hospitals.

SUMMARY

Who wants to be a surgeon? Patterns of medical student career choice

Otis C Shirley, Ben Addison, Phillippa Poole

This study provides a longitudinal view of medical student interest in a surgical career. It showed female and older students are less likely to want a surgical career, but that there is currently enough interest to fill training positions. Work hours and flexibility were reasons students wanted careers other than surgery, whereas the influence of consultants/mentors can encourage a student to pursue surgery.

SUMMARY

Patient engagement with primary health care following discharge from community mental health services

Ryan Stangroom, Molly Morriss, Ian Soosay

Increasing pressure is being placed on specialist outpatient mental health services to facilitate patients discharge to general practitioners (GP). An audit was conducted to measure the level of engagement following discharge, as this is an under-researched area. 72% of GPs reported the discharged patients visited at least three to four times a year. However, 8% of the sample did not visit their GP at all. This research suggests individuals generally engage well with their GP following discharge, supporting current policy regarding discharge of patients.

SUMMARY

The impact of the 6-month waiting target for elective surgery: a patient record study

James Blackett, Alex Carslaw, David Lees, Sophie Fargher, Sudhindra Rao, Margy Pohl

Patients with arthritis who presented to their local specialist for hip or knee replacement at Hawke's Bay and Northland District Health Boards were reviewed. 36% of these patients who were able to have surgery could not have surgery performed in time for the new 6-month Ministry of Health waiting time target. Those patients who received surgery generally had more severe arthritis then those who did not. A prioritisation score was used at both hospitals with Hawke's Bay patients tending to score higher than patients from Northland.

SUMMARY

Fitness to practice of medical graduates: one programme’s approach

Claire Braatvedt, Phillippa Poole, Alan Merry, Des Gorman, Papaarangi Reid, Warwick Bagg

The University of Auckland introduced a Fitness to Practice (FtP) policy to the medical programme in 2005. The goal of the policy was to identify and, wherever possible, remediate students at risk of being unfit to practise after graduation. Over nearly a decade, 5.5% of students who entered the programme received FtP notifications. Most of these were isolated non-critical incidents of a professional nature, with no long-term consequences. A very small subset of students had repeated or serious concerns, underscoring the need for a longitudinal process with formal links to the local regulatory body.

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