Quality improvement in mental health at Canterbury DHB

Vicki Dent of Canterbury DHB

Vicki Dent, acting quality manager, Specialist Mental Health Services at Canterbury District Health Board, explains what she hopes to achieve in her role working in quality improvement.

Explain what you understand about the national mental health and addiction quality improvement programme and its related projects, and how your role supports it?

The mental health and addiction (MHA) quality improvement programme (QIP) is a five-year programme co-ordinated by the Health Quality & Safety Commission (the Commission), delivered through the health system by district health boards (DHBs) and partner organisations.

Following discussion with key stakeholders, the Commission identified five priority areas, which informed the focus of the MHA QIP. Three of those priority areas are now live. Specialist Mental Health Services (SMHS) at Canterbury DHB is participating in all three of the live programmes – Safer for all (zero seclusion), Connecting care and Learning from adverse events and consumer, family and whānau experience.

My role is to support, guide and oversee SMHS involvement in the MHA QIP, alongside the project sponsors and other members of the divisional leadership team. SMHS is fortunate to have a team of skilled, experienced clinicians working in quality improvement and several of them are actively engaged in the three programmes, as either project leads, project support or informatics support.

I am the project sponsor for the Learning from adverse events and consumer, family and whānau experience project and I am keen to see the direction that this piece of work will take us in. SMHS has a robust adverse events review process, although we can see opportunities for improving processes, stakeholder engagement and achieving meaningful learning that brings improved care journeys for consumers and their families and whānau.

What does your MHA quality role involve?

I am currently the acting quality manager for SMHS at Canterbury DHB. In partnership with the other members of the divisional leadership team, I lead and co-ordinate the strategic development and maintenance of quality management, risk and patient safety systems and programmes across our service.

I lead two teams that have key roles in quality improvement – the learning and development team and the quality and patient safety team. These teams work with and support clinical areas to:

• build capability
• support workforce development
• identify, develop and embed quality improvement activities
• ensure quality, safe and effective service provision.

When did you complete your quality improvement course? What prompted you to put yourself forward for the course?

The director of quality and patient safety at Canterbury DHB completed the improvement advisor course and supported the DHB to endorse other participants. I was fortunate to be selected to participate in the improvement advisor course that commenced in 2016.

At the time I was working as a project manager for SMHS and my role was all about quality improvement. The improvement advisor course presented a unique opportunity to gain knowledge about the application of the Model for Improvement and improvement science as it applied to the New Zealand health context, as well as networking with other quality improvement professionals from across the health system.

What did you learn? How are you applying your learning? Is the quality improvement course something you would encourage other people to do?

The improvement advisor course was hosted by Ko Awatea at Counties Manukau Health and was led by a trio of expert advisors from within the field of quality improvement. We had access to international expertise and local knowledge that provided a framework for quality improvement. The framework is based in science and makes sense of the complexity of quality improvement and change management. The programme gave a balance of theoretical knowledge and practical application tools, which could be immediately embedded in practice through completion of a quality improvement project. There were challenges in applying pure principles – particularly in mental health, but the expert advisors were well placed to contextualise and support the learning process.

Since completing the improvement advisor course, I have been able to apply the learning through further quality improvement work, as well as building awareness, understanding and capability within the quality improvement team here at SMHS.

This learning has been extended by mentoring other team members who have gone on to complete the quality improvement facilitator (QIF) course, co-ordinated by the MHA QIP. I was delighted that the QIF course was offered as a mental health-specific programme. I think there are unique challenges in undertaking improvement within the mental health context and having a course firmly embedded in the sector has allowed the participants to tackle those particular challenges and see how the framework can be applied. SMHS has been fortunate to have participants supported on all three cohorts of the QIF course and I would encourage others to engage if the opportunity continues to be made available.