About The Clinical Excellence Commission

Desired Outcomes for 2008

By 2008, the CEC will have delivered the following specific outcomes:-

• Evidence of improvement in relation to specific targets can be demonstrated
• CEC reports are widely used by decision makers and the community to shape healthcare improvement
• Self-assessment using the CEC quality systems assessment framework is in place in all NSW Public Health Organisations
• Decision makers at all levels are using robust data to identify and implement improvements
• NSW Health has a cohort of clinical leaders skilled in the leadership of quality improvement initiatives and
• There is evidence that the workforce is engaged with the principles and practices of a safe culture.

Broad Measures of Performance

As it moves forward, CEC will be able to evaluate its success by high levels of:-

• Uptake

  The extent to which its reports, data and methodologies are used and implemented.

• Demand

  The extent to which the demand for participation in CEC leadership and clinical improvement programs increases over time.

• Satisfaction

  The level of perceived satisfaction and respect for the CEC and its services by clinical leaders and key decision makers in NSW and elsewhere.

• Influence

  The extent to which CEC's influence extends across the continuum of care and it is a primary point of reference on healthcare improvement.

Stakeholders

In planning for 2008, the CEC must take account of the interests and needs of its key stakeholders:

• The Minister(s)

  The NSW Minister for Health is the CEC's sole shareholder and expects the CEC to address issues of access in addition to issues of safety and quality in healthcare in NSW. The CEC will need to provide assistance in solving problems in the health system and pro-actively manage issues.

• Consumers

  Patients and their families expect that the CEC will evaluate the quality and safety of the system with honesty, fairness and transparency. The CEC will not only identify areas for improvement but will facilitate system wide solutions.

• Clinical Leaders

  Clinicians expect the CEC to demonstrate that its requirements and programs are not yet another imposition on their workload, but will help them to help their patients and help them to acquire additional resources and tools to do their work.

• Health Decision Makers including Area Health Service Chief Executives

  The Chief Executives of the eight Area Health Services expect the CEC to assist with achieving better outcomes in relation to appropriateness, effectiveness and accessibility. They will be expecting economic benefits to be delivered by the quality agenda.

• Clinical Governance Units (CGUs)

  The CGUs will be the CEC's primary interface with Area Health Services and expect the CEC to assist them in undertaking their role and in achieving results for patients.

Values

The CEC places a significant emphasis on four key values which underpin and guide its strategic direction and actions. These values are:

• Effectiveness

  The CEC will be recognised for its capacity to make a difference in healthcare by improving the safety and quality of healthcare in NSW. To achieve this, the CEC will need to focus on achieving results.

• Courage

  The work of the CEC will necessitate courage to report truthfully, to address difficult issues and to take decisive action.

• Integrity

  The actions of the CEC will be characterised by the integrity of its approach: its agenda and priorities will be clear, its methods and processes will be practical and it will follow through on its commitments.

• Honesty

  The CEC will be honest in its dealings with stakeholders and will demonstrate that it is trustworthy. It will ensure that its actions are based on sound evidence, its processes are transparent and accountable, and it will be open in its communication with stakeholders.

Distinctive role and Contribution

The CEC has been established to be a catalyst for change and improvement in healthcare service delivery in NSW. It is uniquely placed to do this as a result of its:

• Focus on both health system processes and engagement with the community Independence and honesty enabling it to identify the best way forward, based on evidence
• Authority arising from its mandate and linkages to governance of the health system
• Capacity to apply an integrated and disciplined approach to coordination within the health system
• Experience and a knowledge base in relation to clinical quality improvement and system change
• Ability to challenge the status quo.

Key drivers and imperatives

Workforce

• Health workforce shortages and changing work expectations and participation rates are placing increased pressure on the system and this will increase expectations on the CEC to provide solutions to these issues.
• Related workforce issues are the changing skills mix and career expectations of staff, which will have implications for the CEC's initiatives. In particular there are significant shifts in expectations about working conditions and work practices that will require new approaches.

Consumers

• Socio-demographic changes in the patient population are resulting in significant pressures on the delivery of healthcare, particularly in relation to population relocation and ageing.
• Widespread use of electronic sources of healthcare information has created a better informed and more articulate consumer population which expects the healthcare system to operate at an optimal level in terms of safety and quality; which wants to have confidence in that system; and which expects open disclosure practices to be practised across all health disciplines when there is an adverse event.

Resources

• These pressures will impact on resource allocation and models of healthcare. They will require a focus on the management of chronic disease in ambulatory/community care settings, multi-disciplinary care, and an increased focus on primary/preventative care.
• Finally, the current national discourse on Commonwealth/State arrangements for funding healthcare needs to be monitored on an ongoing basis.

From this analysis the following strategic imperatives emerge as key to the CEC's success in achieving its mission in the next three years:

• Strengthen the CEC's profile and influence
• Build skills and capacity within the CEC and across the health system, including leadership capacity
• Develop and implement targets based on available data
• Build partnerships with stakeholders
• Get some 'runs on the board', including the first CEC annual report on NSW Health System Safety and Quality.

Strategic directions/key result areas: 2005-2008

• Provide assurance through credible public reporting

  The CEC will provide annual public reports on safety and quality and on adverse events in NSW healthcare. The reporting will identify areas to address and, over time, demonstrate improvements.

• Facilitate the uptake of clinical improvement programs

  Clinical Governance Units will be a critical link in the overall system of improvement. They will work in partnership with the CEC and clinicians to implement improvement programs and methodologies.

• Implement a system of quality assessments

  The CEC will ensure that Public Health Organisations have the capacity to self- assess against processes, indicators and targets established by the CEC, whose role is to provide an assurance that the self-assessment process is in place.

• Develop and manage information and reporting systems

  A robust and integrated information base regarding key areas of risk that are of public interest is critical to provide the basis for improvement. Working in partnership with the CEC, clinicians will have feedback reporting systems that support clinical improvement initiatives.

• Build leadership capacity

  The CEC will ensure that effective professional development opportunities in safety and quality leadership are available and utilised. In addition, the CEC will be a high performing organisation, demonstrating excellence in its own management and business practices.

• Influence culture through communication and advocacy

  The capacity of the CEC to communicate the need for change, influence, uptake and advocate publicly and with decision makers will be critical to its success.