Clinical Governance News

With the formation of a Clinical Practice Committee and Mortality Review Committee, and a revamped Clinical Council, clinicians, managers and other staff now have more pathways to work together to help improve the provision of safe patient care and our patients’ experience and outcomes.

This month we’re introducing the Clinical Practice Committee - find out about the Committee from the Chair, and read the inspiring story of how a successful application is making a difference to the lives of cardiac patients in our district.

Five minutes with Jo Krysa

A year and a half on since a Southern DHB Clinical Practice Committee was formed we spent five minutes with the Committee Chair, Dr Jo Krysa, General Surgery Specialist to find out more about the committee and its role.

Committee Chair, Dr Jo Krysa, General Surgery Specialist

Why was the committee set up?

The Committee was set up as part of the DHB’s quality framework to improve the provision of safe patient care and our patients’ experience and outcomes.

What does it do?

Its main function is to support SDHB staff by providing a pathway to consider new procedures, techniques and technologies. We ensure the implications of a ‘new way of doing things’ have been evaluated. A second potential function of the committee is to develop a tool to prioritise ‘new ways of doing things.’

Do you report to another Committee?

Yes – we report to the Clinical Council. Some applications need the Clinical Council to discuss them and make recommendations.

Why is a Clinical Practice Committee so important?

The Committee offers governance to oversee applications for the whole hospital.  It allows transparency of process and clinical oversight. We are able to consider applications and give feedback with clear rationale as to why we approve them with ‘no bias’ decision making. Ultimately we look at what is best for our patients and for the DHB.

How often do you meet?

We meet monthly.

How has the first year and a half been?

The committee has been on a journey to find out how to best support people and streamline processes for the benefit of the DHB and our patients. It’s been a privilege to look at systems and processes outside of what I normally do.

Can you tell us about some of the proposals you’ve endorsed?

The committee has endorsed a number of proposals. One of the proposals was to administer azacitadine, a chemotherapy drug at home. Patients now have the convenience of treatment at home, especially if they live out of town.

We have also received a request for a drug bin in theatres. When the request came into the committee we felt a SDHB solution should be considered as it was such a good idea, not just in theatres, but also on the wards and in clinics. Since then a working group has been set up to consider options and identify best solutions for the DHB. It’s great when someone comes up with a good idea for one department that can be utilised across the whole system.

If a member of staff has a proposal how do they apply?

All the information you need to can be found on MIDAS:

Policy: MIDAS 101751

Procedure for submitting a proposal: MIDAS 101752

Flowchart: MIDAS 101753

Application Form: MIDAS 101754

Meet the Committee

Feedback and expressions of interest

The committee would welcome feedback, and if you’re a member of staff interested in being a part of shaping our clinical practice please email: ClinicalPracticeCommittee@southerndhb.govt.nz

Less travel for cardiac patients

A successful application to the Clinical Practice Committee means that Southern DHB cardiac patients can now have an Implantable Cardioverter/Defibrillator (ICDs) fitted in Dunedin rather than having to travel to Christchurch for the procedure.

An ICD is a type of pacemaker that helps keep the heart beating at a steady rate and can reduce the risk of a person dying from dangerous heart rhythms.

“ICDs are implanted in patients for a number of clinical reasons,” says Dr James Pemberton, Consultant Cardiologist who made the application to the committee.

“These are usually when there's a high risk that the patient’s heart could stop beating – a cardiac arrest. This may be because they've already had a cardiac arrest, or because their heart condition means they’re at high risk of having one.”

Derek McKinnel during his recovery at Wakari Hospital with his wife Helen

A recent patient who benefited from having this procedure in Dunedin is Derek McKinnel.  Derek’s heart stopped while he was driving, fortunately his wife was with him and CPR was started promptly. After spending three weeks in Southland Hospital with complications he was transferred to Dunedin Hospital and fitted with an ICD. He completed his recovery in the ISIS rehabilitation ward at Wakari Hospital.

Mr McKinnel’s wife Helen says having the procedure in Dunedin made a huge difference. “It was brilliant news that the procedure could be done in Dunedin and we didn’t have to go to Christchurch. It was really stressful with Derek being so unwell and I really don’t think I could have coped with driving that far – it would have been too traumatic.

 “Being in Dunedin also gave me the opportunity to ask questions and discuss the procedure and implications fully with Dr Pemberton.  It was another bonus that I knew the Doctor who was caring for Derek.”

Consultant Cardiologist Dr John Edmond who performed the procedure says thanks to the successful application to the Clinical Practice Committee the SDHB cardiology department can now provide a full range of pacemaker implant procedures.

“This provides a better service for patients, it’s more cost effective, staff have been able to upskill, and having the ability to fit ICDs is a positive factor for the future recruitment of new staff members to the team.”