Consumer engagement quality and safety marker framework supplementary information
This page contains supplementary information relating to the consumer engagement quality and safety marker SURE (Supporting, Understanding, Responding and Evaluating) framework . It is relevant when viewed in conjunction with the framework document.
For information about the quality and safety marker, to view the framework document (PDF and MS Word formats) or to submit data, please return to the main consumer engagement quality and safety marker page.
Supplementary information
Domain: Engagement | Te tūhononga
- There is involvement and engagement of consumers and whānau in all areas of the organisation, representing both the population served and over-representing communities who experience poorer health outcomes.
Further information:
- Areas include direct care (if applicable), service delivery, policy and governance.
- Consumer and whānau involvement is openly demonstrated, viewed positively and highly valued by the organisation.
- Consideration of these groups should be demonstrated: Māori, Pacific, disability, rainbow, rural, refugee/ migrant, older people and women's health.
- See also the Te Pae Tata Interim New Zealand Health Plan 2022.
- The centrality and importance of whānau in te ao Māori is valued and recognised. Māori are always provided opportunities to exercise decision-making authority.
Further information:- The collective voice of Māori (whānau voice) is heard and demonstrably acted upon.
- Te Ao Māori Frameworks are considered, and cultural experts have been engaged to ensure an understanding and respect for tikanga. - There is evidence that partnership with consumers and whānau is well established, resourced and highly valued.
Further information:
- Providers should be guided by the health sector principles contained in section 7 of the Pae Ora (Healthy Futures) Act 2022, which states: ‘the health sector should engage with Māori, other population groups, and other people to develop and deliver services and programmes that reflect their needs and aspirations...’
- Consumers and whānau are regularly in attendance, resourced and feel able to actively participate.
- There is Māori representation and linkage to Māori communities, hapū, and/or iwi.
- There are meaningful, ongoing relationships built on trust with Māori communities, hapū and iwi.
- There is a demonstration of tikanga Māori (protocol) and culture, and what is important to Māori.
- Training and support include developing Te Tiriti o Waitangi knowledge, understanding tikanga and mātauranga Māori. This training is offered to consumers and whānau and the workforce at all levels.
- See also the code of expectations implementation guide section on accessibility and resourcing for consumer, whānau and community engagement.
- Consumer and whānau groups are well established and resourced. When a group is established or members recruited to a group, the needs of the population served are reflected.
Further information:
- Feedback gathering and evaluation is undertaken regularly, and acted upon.
- These groups report that they are supported, provided guidance and their input is valued.
- Equity for Māori is an area of focus.
- Individuals in these groups are, where possible, not the sole representative for a population demographic (see section 2.5 of the code of expectations).
See also:
- Middlemore Consumer Engagement Questionnaire
- the code of expectations implementation guide section on accessibility and resourcing for consumer, whānau and community engagement. - Options are made available for consumers and whānau to participate and engage.
Further information:
- Māori are given options, and by this their right to decide the appropriate pathway to improved health outcomes is ensured.
- Consider also the Wai2575 principles:- Tino Rangatiratanga / Self-Determination
- Mana Taurite / Equity
- Whakamarumarutia / Active Protection
- Kōwhiringa / Options
- Pātuitanga / Partnership
- Co-design or a similar method is regularly used by and applied in all parts of the organisation.
Further information:
- Learnings from lived experience inform improvement actions. These have been widely shared in order to improve systems and processes.
- Tikanga and te ao Māori frameworks are considered in co-design.
- Hui and wānanga with Māori are representative of the community served by the organisation.
- Lived experience is documented and used to co-design services.
- See also the e-learning modules, Co-design in health: an introduction. - Cross-sector collaboration is strong, well established and well demonstrated.
Further information:
- This can include collaboration with primary, social services, non-governmental organisations, acute and community care and collaboration among health entities and/or across government sectors.
- See also the code of expectations implementation guide section on improving equity through partnership and collaboration. - Pursuing equity for the population served is a strategic focus in the organisation. Ōritetanga (equity) and whakamaru (active protection) are well understood principles throughout the organisation.
Further information:
- Inequities affecting Māori, Pacific, disabled and other populations groups are identified and discussed with representative consumers and whānau.
- Tino rangatiratanga for Māori is embedded and demonstrable in organisational policy. - The organisation’s recruitment strategy encourages a diverse workforce, driven by the pursuit of equity. Policies exist stating that consumers and whānau are regularly involved in recruitment.
Further information:
- Examples of shared leadership: consumers and whānau are included on a range of panels, recruitment interviews and various evaluations.
- The Māori, Pacific and disabled workforce is over-representative of the population, and pursuing equity is prioritised. - Training and development are available for and offered to staff, consumers and whānau about how staff, consumers and whānau can be engaged.
Further information:
- Consumer engagement training is available for both staff and consumers.
- There is evidence of the increasing number of people who have completed training.
- Provide evidence that consumers and staff have the skills required to make sure consumers and whānau are involved in the development and implementation of services.
- See also the code of expectations implementation guide section on co-designing with consumers, whānau and communities.
Domain: Responsiveness | Te noho urupare
- Pursuing equity for the population served is a strategic focus and this results in demonstrable improvements.
Further information:
- Active participation to counter inequities is evident.
- Power to make decisions at all levels – including governance – is in place. - Systems are established and robust. They involve:
- gathering, understanding and responding to the experiences and views of consumers and whānau relative to the respective organisation
- sharing the results and themes with participants and the wider organisation
- involving consumers and whānau as partners in any resulting improvement activities.
Further information:
- Māori are engaged and their contribution and feedback are responded to with projects and programmes that improve outcomes as identified as important by Māori, for Māori.
- The voices of diverse communities are regularly sought and reported to senior leaders within the organisation and demonstrably acted upon. ‘Closing the loop’.
Further information:
Examples of closing the loop:
- There are regular formal and informal opportunities for leaders to hear the voices of consumers and whānau. Feedback is acted upon with consumer and whānau involvement and these learnings are shared.
- Consumers and whānau have the opportunity to engage with senior leadership to communicate their needs and concerns.
- Senior leadership actively provides feedback and keeps consumers and whānau informed.
- Communication is provided indicating where consumer and whānau input has led to a change.
- Information, resources and engagement opportunities provided by the organisation are varied and accessible to all consumers and whānau. Barriers to any of the above are actively addressed and remedied.
Further information:
- The contribution and input provided by a wide range of consumers and whānau are recorded, actions are progressed and feedback given.
- Māori are represented within consumer and whānau groups. Their contribution is documented and acted upon.
- There are formal mechanisms that ensure the voices of consumer and whānau groups are heard and acted on.
- There is strong evidence of improvement actions resulting from engagement activities. - Māori report experiencing tino rangatiratanga (effective power, decision-making and leadership opportunities). A wide range of resources, determined by Māori, is available to support Māori participation.
Further information:
- This measurement considers the experience of Māori and whether they report feeling that effective power, decision-making and opportunities for leadership were made available.
- See also the code of expectations implementation guide section on resourcing and support for Māori participation. - There is evidence that there are policies and processes in place to support the co-design of health resources and information.
Further information:
- Co-design is an expectation that is woven throughout policies and processes to create resources and information.
- All health education resources and consumer and whānau-facing information are co-designed.
- Māori are engaged in co-design of health education resources information, and te reo Māori in these is applied appropriately and respectfully. - There is evidence that information is accessible for all groups (eg, websites are up to date, signage is clear). Health resources and information meet the needs of different communities and are regularly evaluated by consumers and whānau to ensure they are easy to follow and help build understanding between patients, whānau, and staff.
Further information:
- Opportunities to communicate in te reo Māori are identified, and wayfinding signage, reports and glossaries encourage the use of te reo Māori.
- Evaluations of information are undertaken regularly with a wide range of accessibility requirement. (See also the Accessibility Charter.)
- Consumers and whānau are involved in making changes and providing feedback about the impact of those changes. - The Accessibility Charter informs all aspects of communication with consumers and whānau in the organisation.
Further information:
- the Accessibility Charter
- the code of expectations implementation guide section on accessibility and resourcing for consumer, whānau and community engagement. - Data is actively used to inform improvements in health services and the pursuit of equity particularly for Māori, Pacific peoples and disabled people.
Further information:
- Consumers and whānau have been involved throughout. Evaluation of the changes have been undertaken and the findings disseminated.
- Health equity for Māori is prioritised.
See also:
- the Te Pae Tata Interim New Zealand Health Plan 2022
- the Pae Ora (Health Futures) Act 2022
Domain: Experience | Wheako
- Metrics and systems are in place, well established and regularly reviewed. As a result of monitoring these metrics, actionable changes are made with the guidance of consumers, whānau and staff.
Further information:
- There is evidence that specific metrics and systems are in place to support the monitoring of patient experience, including the extent to which co-design is being used to gather and act upon lived experience data.
- Māori input and contribution is recognised and evidenced.
- Data may be gathered in a range of ways including surveys, focus groups, interviews, and other patient feedback mechanisms. - Metrics are regularly shared with relevant stakeholder groups in an accessible way.
Further information:
- There is evidence that metrics are reported on and shared with relevant stakeholder groups, including consumer and whānau groups.
- Consumers and whānau are involved with the work; reporting is timely; and feedback loops are closed.
- Relationships with Māori are built on trust and ongoing engagement and there is evidence that Māori are kept in feedback loops.
- Changes (improvements) to health outcomes for Māori are reported to Māori.
- Feedback from stakeholder groups is highly valued and influences action. This includes the co-design of solutions. The results are reported back to these groups and a range of others. - There is evidence of a range of accessible options for consumers and whānau to provide feedback.
As a means of ‘closing the loop’, all feedback is acknowledged and responded to. Feedback given leads to demonstrable change as appropriate.
Further information:
- Engagement options appropriate for Māori are considered (eg, forms, surveys, face-to-face interactions, attending meetings and /or sharing their lived experience).
- Consumers and whānau have been involved in identifying a range of ways to provide feedback that allow for the greatest accessibility possible.
- Feedback is highly valued, always acknowledged and leads to demonstrable change that is reported back to consumers and whānau.
- Follow-up feedback is always sought.
