Date: Wednesday 6 November 2013
Time: 09:00-10:30
Location: Teleconference, Jane O’Malley’s office
Chair: Jane O’Malley
Attendees: Don Mackie, Arthur Morris, Deborah Williamson, Chris Mckenna, Margaret Wilsher,
Sally Roberts, Hasan Bhally, Ruth Barratt, Noeline Whitehead, Grant Storey (MOH secretariat),
Ryan McLane (MOH secretariat), Geoffrey Roche (MoH secretariat); HQSC members attending:
Adrienne Morgan, Arthur Morris, Deborah Jowitt, Diane Callinicos (Chair), Geoff Cardwell,
Gillian Bohm, Jane Pryer, Joshua Freeman, Mo Neville, Sally Roberts, Shawn Sturland.
Apologies: Bob Buckham
Item Notes
1 Welcome and Apologies
The chair welcomed members to the meeting. Apologies were noted.
2
3
Confirmation of the Minutes
Minutes from the September meeting were discussed. It was agreed that the minutes and an updated list of action points would be circulated at the HAIGG meeting in December.
Progress on actions from September 2013 meeting.

College of GPs liaison
Don will have a conversation with Murray Tilliard, GPNZ and the College of GPs concerning the rapid diagnosis of norovirus before the December HAIGG meeting.

CDI document review: The Infection Prevention & Control Measures for the Prevention & Control of Clostridium difficile Infection (CDI) document has been reviewed by Noeline Whitehead, and Ryan has prepared a final version. The final version is awaiting internal Ministry signoff before being published online on the Ministry’s website.

Single v Double Bed review: A survey and report back requested for the February 2014 HAIGG meeting for work on single v multi-bed approaches in Auckland and Canterbury: it was noted that this report would be useful description for a peer review process and means of incorporating expert advice.
It was also suggested that the principles of this review could be incorporated into the HAIGG schema diagram illustrating HAI management in New Zealand. The report could also advise best practice infection control guidelines for future the building of new facilities.

4
5

Enforcement of standards and attainments
It was noted that there are problems with compliance with standards; provider agreements, section 88 and direct funding arrangements were suggested means of addressing this.
Ryan will circulate a document on standards enforcement at the December HAIGG meeting, which will present two breakdowns: one on general standards attainments and the second specifically on attainments related directly to patient safety.

ESR surveillance
Hasan Bhally has provided feedback regarding the current ESR surveillance programme from a customer perspective to Grant Storey.

Anti-Microbial Resistance workshop
At the last HAIGG meeting it was decided that the Anti-Microbial Resistance workshop will expand its invitee list to create a multi-disciplinary makeup. To date there has been no date or time to arrange this.
It was noted that the Minister has been updated on AMR and wants regular updates. Since the last workshop day Grant Storey has been fleshing out some target areas, and the Ministry is working with
ESR on this. This work will be done in time for the next AMR workshop, when the AMR membership will have been fleshed out also.
Further discussion prior to the December HAIGG meeting will be offline.

Letter to DHBs concerning lab standards
This letter is still being drafted.

Victoria Cleaning Standards
A consultation with Infection Prevention and Control (IPC) nurses and Directors of Nursing (DON)
around the adoption of the Victoria cleaning standards for hospitals is being progressed.

HAIGG involvement with evaluation/redrafting of the IP&C Health and Disability Standards:
This has yet to take place: Ryan is to meet Hannah Kerr to find out how the process works.
HAIGG coordinator FTE.
An advertisement will be posted today for a full time equivalent staff member, a senior advisor, to provide support for HAIGG work.
HQSC patch-in into teleconference
HQSC representatives were welcomed to the teleconference. Chairs were asked by HQSC representatives on their thoughts on how the common vision of the HAIGG and HQSC was to be integrated, and how best to enhance efficiencies and avoid duplications of effort.
 It was noted that HAIGG’s role is the national overview of all related to HAI control, whereas the HQSC’s role was specifically concerned with quality improvement.

It was suggested that annual plans be exchanged, and roles and responsibilities be clarified.

It was noted that the HAIGG had emerged out of the DG’s concerns over hospitals and healthcare acquired infections and their management. If there was confidence that the HQSC could address this task single-handedly, the HAIGG could disband. In response it was noted that the purview of the HAIGG was the entire system, not just hospitals.

The importance of having a single voice in the residential care sector was noted, given the number of potentially conflicting entities. Also noted was the work of April Ferrino, who has recently published a report on quality improvement in age- related residential care through the regulatory process.
1
1
http://www.fulbright.org.nz/wp-content/uploads/2013/08/axford2013_ferrino.pdf

8
6
7
Work allocation between HQSC and HAIGG
To avoid duplication and enhance efficiencies, the following steps were recommended:

A list of actions or areas of concern, to be divided up between HQSC and HAIGG, to ensure that no work falls between the cracks

Work produced by one of the two entities could be signed off by the other; combined signoff could create greater credibility in the sector

Sharing of strategic plans

A combined face to face meetings.

Antimicrobial stewardship and resistance: it was suggested that antimicrobial stewardship remain with HAIGG

Surveillance: it was suggested that this rest with the HQSC or the ESR because of existing work allocation, and because it was more a case of ‘business as usual’ than a strategic issue

Workforce: it was suggested that this remain with the Ministry.
Agreed: To reach committee agreement without full committee involvement, a combined HQSC and HAIGG working group is to meet and look at focus, terms of reference, scope and strategic plans . This work will be facilitated with the strategic plans of both the HQSC and HAIGG in hand, and the schema diagram, which will be used to put things in place.
Next steps:
Don Mackie and Jane O’Malley, together with other Ministry members, to meet with the HQSC to write up a paper; Arthur Morris and Sally Roberts will also attend. This face to face meeting will be held before the next HAIGG meeting.
Schema and Strategic Plan
It was noted that the 5 year strategic plan developed at the last HAIGG meeting was revised into a 2 year strategic plan.

It was noted that the strategic plan appears to imply considerable overlap between HQSC and ESR surveillance, and that it would be helpful, to avoid overlap, to know what other IT systems are being set up. ESR expressed concerns.

In response ESR was invited by Jane to co-author a discussion paper.

In the name of transparency, the need was noted to clearly chart on the schema diagram who is accountable for what, in particular regarding surveillance activity. A diagram that clearly charts accountabilities would be useful not only for the HAIGG but for the HQSC and the wider sector.
Agreed: the phased approach of the strategic plan to be discussed at the next HAIGG meeting
HealthCert data circulated to Directors of Nursing
It was noted that aggregate data had been circulated to directors of nursing around the country, so as to assess whether CMOs are in touch with their own infectious disease teams. It was noted that this communication may have been misunderstood as there was no background information included in the communication.
Agreed: steps to be taken to ensure that HAIGG is better informed of national conversations relating to HAI.
Meeting closed