South Island Well Child Tamariki Ora Quality Improvement Project

Abstract

The Well Child Tamariki Ora (WCTO) Quality Improvement project is a national two year project that has been funded by the Ministry of Health. The aim of this project is to improve the quality of the WCTO programme and health outcomes for children aged 0-5 years. The Model for Improvement and the WCTO quality improvement framework have been used as tools to support each level of the sector to achieve family-centred, high quality, equitable and effective child health services that deliver the best possible health outcomes for all New Zealand children and their families/whanau. Childhood health care services in New Zealand, primary maternity services, the WCTO programme and primary health services are all interrelated and require an integrative approach to service provision, Strengthening the connections/links between Lead Maternity Carer’s, WCTO provider, B4School Check nurses, Oral Health services, hearing screening, breastfeeding services, primary health organisations and immunisation services has been achieved through quality improvement training and education, establishing multi-agency advisory/strategic groups to oversee facilitate the improved integration, coverage and coordination of WCTO services. The desired outcomes of the WCTO project is based upon the WCTO quality improvement triple aim framework which includes • All children living in New Zealand aged 0-5 years of age have equitable access to the WCTO programme • Best value for the health system resource is achieved • All WCTO service providers have access to high quality and effective quality improvement tools and training Initiatives that aligned with either an access, outcome or quality child health indicator focus were selected. These included quality Improvement workshops offered to the wider Child health and Maternity sector. Establishing District Health Board WCTO forums across the region to provide a more collaborative and integrated approach to achieving child health outcomes.Developing referral pathways to improve enrolment into all universal child health services. Distribution of newsletters and webpage to share learning and provide quality improvement resources. Enabling equity and access: Quality improvement indicator dashboards have been developed as a tool to plan and design services and to underpin the culture of continuous service improvement. The WCTO quality indicator dashboards enable the impact of the project to be measured against the desired outcomes. The South Island region has demonstrated an overall improvement in children receiving core contacts in the first 12 months and greater number of children being referred from their Lead Maternity Carer into the WCTO programme. Engaging children, families and communities: The journey of navigating and staying connected with health services from consumers’ perspectives has been explored. Families were invited to share their experience of the Well Child service as well as suggest ideas for improvement through a group or individual discussion session. Stories were filmed to inform practice and training/ education sessions. All improvement requires change but not all change will result in improvement. Thus, the Model for Improvement methodology has ensured all change ideas are sustainable, measureable and result in beneficial change in the provision of health care for all children living in New Zealand.