New Zealand new quality framework for medical profession

Citation

(2001), "New Zealand new quality framework for medical profession", International Journal of Health Care Quality Assurance, Vol. 14 No. 4. https://doi.org/10.1108/ijhcqa.2001.06214dab.001

New Zealand new quality framework for medical profession

New Zealand new quality framework for medical professionKeywords: Hospitals, Quality management, New Zealand

The New Zealand Ministry of Health is introducing a new quality framework for clinical practice for public hospitals, based on credentialling. This is a relatively new concept to the New Zealand health sector and involves assigning specific clinical responsibilities (scope of practice) to health professionals on the basis of their training, qualifications, experience and current practice, within the facilities and support services available and the service the organisation is funded to provide.

It is part of a wider organisational quality and risk management system designed primarily to protect the patient, its purpose being to protect patients by carefully defining the clinical responsibilities of practitioners. Credentialling also protects District Health Boards (DHBs) which are required to ensure that appropriate systems are in place to manage service quality.

The new framework, "Toward Clinical Excellence: A Framework for the Credentialling of Senior Medical Officers in New Zealand" was released in March as part of the Health Ministry's ongoing quality improvement programme. The Health Ministry expects that it will improve the quality and safety of medical and surgical services on offer in New Zealand's hospitals.

Director-General of Health, Dr Karen Poutasi, said that credentialling applies to all health professionals, and that it will support and protect them as well as patients:

DHBs as employers are responsible for ensuring that their people are competent to do the job they are required to do. Everyone expects a safe service from medical professionals. Credentialling means that patients can be more certain surgeons and physicians have the appropriate training, qualifications, and experience. For example, someone who does knee replacements might not have the credentials to do spinal surgery, or a doctor who is credentialled within a big city hospital may not be credentialled for the environment of a small rural hospital.

It is intended that each of the District Health Boards will develop its own credentialling system based on the national framework. It will build on existing requirements, and involve peer review, clinical audits, and enhance the clinical quality improvement activities which are already in place. Credentialling is more specific than vocational registration; both in terms of the skills and scope of practice that is organisation specific, and in relation to the period between reviews. While information about the credentialled status of a practitioner in one organisation could be made available to another as part of an appointment process, it is an organisation specific finding. Each organisation must make its own decision about the credentialled status of the medical practitioners that they employ.

The framework has been developed by the Medical Credentialling Working Party, jointly sponsored by the Health Funding Authority (HFA) and the Ministry of Health. The Working Party's task was to assist clinical leaders to develop a common approach to the credentialling of senior medical officers, focusing on framework development and implementation issues, and collecting the available "best practice" information.

The implementation of credentialling for senior medical officers within publicly funded provider organisations has been identified as a priority to improve patient safety and public confidence in the health system, and District Health Boards are required to have a credentialling process in place for public hospitals by June 2002.

Other professional groups are expected to develop models over time. For most groups outside the medical profession, development is needed in two areas: the ability to require evidence of practitioner competence as a prerequisite for the issue of practising certificates and the development and formalisation of professional sub-specialisation.

For further information contact: Dr’Robert Logan, Chair, Medical Advisors’Group. Tel: (0064) (0) 4 566 6999, or contact Dr Peter Lesley, Council of Medical Colleges of New Zealand. Tel: (0064) (0) 4 460 8124.