Well Child/Tamariki Ora - MoH Service Agreement and Quality Improvement 2013-2014
Plunket has agreed to provide services to families nationwide to meet this primary objective;
Support family/Whanau in maximising their child’s developmental potential and health status between the ages of 0-5 years, establishing a strong
foundation for ongoing healthy development.
Key principles;
1. Population health and reducing inequalities
Those with highest health needs get the most service based on assessed need
2. Caseload management based on needs assessment and clinical decision making
Parents benefit from positive experiences of additional support resulting from careful and responsive care planning
3. Early engagement and relationship building
Effective pathways of care reduce inequalities when accountable service providers work together for family wellbeing at community level
To support nurses and other workers in local community teams in to improve outcomes compatible with the WCTO Quality Framework, the Severity
Assessment Code framework highlights undesirable outcomes, or, risks to health outcomes specific to the WCTO universal programme.
Clinical quality systems improve
 competency development
 information management, and
 caseload care planning
These important activities are enhanced by nurses recognising when and what to review from practice outcomes as a result of their clinical decision making.
Improvement tools and processes can then prioritise child [population] health, aligned to the three dimensions of the Triple Aim
 to improve safety and quality experience for the child, family/Whanau and community
 to improve health and equity for all child populations
 to achieve best value for health resource
Population response outcome measures (PROMs) is a set of four measures selected to reduce inequity, improve quality, so that we focus on the right things,
and do these right things the right way. This evidence from practice can be a rapid way of achieving desirable results.
10/2013. Refer to Florence Trout, CQI Leader for further information: Florence.trout@plunket.org.nz
WELL CHILD/TAMARIKI ORA SEVERITY ASSESSMENT CODE (SAC)
Consequence Table For Actual And Potential Adverse Events Linked To The Triple Aim
Adverse Events Are Rated On Actual Outcome And Near Misses On Quality Outcomes
severe
Child or other potential
or actual death directly
related to the service
delivery episode
Failure to recognise
severe and acute health
risk with high risk of harm
to caregiver and/or
child/tamariki
Includes child/tamariki
abduction from any
parenting
group/volunteer/clinical
activity
Example:
Unanticipated severe
reaction to immunisation
process requiring
resuscitation
SAC 1 QAims1,2,3
major
moderate
Major permanent loss of
function or temporary
severe disability related
to service delivery
episode
Failure to recognise need
for potential urgent
intervention that may
result in unanticipated
harm to the child/tamariki
and/or caregiver
Moderate permanent or
temporary major loss of
function related to
service delivery episode
Example:
Failure to act when
immediate care is indicated;
acute febrile illness, family
violence, or early intervention
for physiology / development
outside normal range and
requiring prompt diagnosis
Failure to identify
vulnerable
children/tamariki in a
caseload in the
progressive universal
surveillance program,
resulting in
families/whanau missing
out on engaging in timely,
planned care pathway(s)
in early interventions
Example:
Ineffective prioritisation of
child safety interventions
from analysis of need
minor
Temporary moderate
impairment or an
increased level of care
resulting from service
delivery
Failure to recognise
results from child
screening that require
referral for diagnosis
minimal/near miss
No harm or increased
need for health care
from adverse event
Child injury requiring only
first aid during any
planned Plunket activity
(no GP visit, A&E nor
hospitalisation)
Failure to recognise
results from adult
screening that requires
referral for diagnosis
Involvement in but not
entire responsibility for
illness or injury caused
through inaction from, or
omission of, service
Example:
Infant hits head on
measuring board during
length assessment
procedure
Example:
No plan for screen result with
potential for delay/harm
SAC 2 QAim 1
SAC 3 QAim 2
SAC 4 QAim 3
SAC 4 QAim 1
Improved safety and
quality experience
Improved health and
equity
Best value for health
system resources
Improved safety and
quality experience