Introduction: The increased risk of bacteraemia and associated serious complications culminating ... more Introduction: The increased risk of bacteraemia and associated serious complications culminating in poor morbidity and mortality outcomes among injecting drug users (IDU), is well known. Studies have indicated that infection prevention intervention strategies may reduce the risk of bacteraemias in the IDU population. With an estimated 1400 to 2400 IDU within the LHD, we sought to determine the incidence of Staphylococcus aureus bacteraemias (SAB) in this population and use these findings to inform the potential benefit of harm reduction strategies. Methods: The LHD Infection Management and Control Service has an established database of all SABs reported by the in-house microbiology department. The dataset includes the primary and secondary sources of the SAB and associated morbidity and mortality. This database was interrogated to identify community-associated SAB (CA-SAB) reviewed between January 2009 and December 2017 to identify the number of IDU associated cases and compare with data relating to people not identified as IDU. Results: The number of cases identified represented an estimated annual CA-SAB rate within this population of 3%, compared to the estimated rate among the assumed non-IDU population of 0.2%. The rate of serious complications in the IDU group including: epidural abscess, endocarditis and cerebral emboli was near 50%. Conclusion: This review confirms an increased SAB incidence and serious complication rates within the local IDU population. These findings indicate that there is an ethical imperative to identify culturally appropriate and effective intervention strategies to address this significant risk in this vulnerable population group.
AIM To investigate how quality and patient safety domains are being taught in the pre-registratio... more AIM To investigate how quality and patient safety domains are being taught in the pre-registration curricula of health profession education programmes in New Zealand. METHODS All tertiary institutions providing training for medicine, nursing, midwifery, dentistry, pharmacy, physiotherapy, dietetics and 11 other allied health professions in New Zealand were contacted and a person with relevant curriculum knowledge was invited to participate. Interviews were conducted using a semi-structured interview guide to explore nine quality and safety domains; improvement science, patient safety, quality and safety culture, evidence-based practice, patient-centred care, teamwork and communication, leadership for change, systems thinking and use of information technology (IT). Transcribed data were extracted and categorised by discipline and domain. Two researchers independently identified and categorised themes within each domain, using a general inductive approach. RESULTS Forty-nine instituti...
New Zealand has one of the best value health care systems in the world, but as a proportion of GD... more New Zealand has one of the best value health care systems in the world, but as a proportion of GDP our spending on health care has increased every year since 1999. Further, there are issues of quality and safety in our system we must address, including rates of adverse events. The Health Quality and Safety Commission was formed in 2010 as a crown agent to influence, encourage, guide and support improvement in health care practice in New Zealand. The New Zealand Triple Aim has been defined as: improved quality, safety and experience of care; improved health and equity for all populations; and best value for public health system resources. The Commission is pursuing the Triple Aim via two fundamental objectives: doing the right thing by providing care supported by the best evidence available, focused on what matters to each individual patient, and doing the right thing right, first time, by making sure health care is safe and of the highest quality possible. Improvement efforts must b...
To investigate how quality and patient safety domains are being taught in the pre-registration cu... more To investigate how quality and patient safety domains are being taught in the pre-registration curricula of health profession education programmes in New Zealand. All tertiary institutions providing training for medicine, nursing, midwifery, dentistry, pharmacy, physiotherapy, dietetics and 11 other allied health professions in New Zealand were contacted and a person with relevant curriculum knowledge was invited to participate. Interviews were conducted using a semi-structured interview guide to explore nine quality and safety domains; improvement science, patient safety, quality and safety culture, evidence-based practice, patient-centred care, teamwork and communication, leadership for change, systems thinking and use of information technology (IT). Transcribed data were extracted and categorised by discipline and domain. Two researchers independently identified and categorised themes within each domain, using a general inductive approach. Forty-nine institutions were contacted a...
The effective and economical measurement of the quality and safety of health and disability servi... more The effective and economical measurement of the quality and safety of health and disability services in New Zealand is of signal importance. The Health Quality and Safety Commission has overseen the introduction of an architecture of interacting measures. These include quality and safety indicators, or QSIs, which are whole-system measures; quality and safety markers, or QSMs, which are targeted measures of quality and safety interventions comprising process and outcome measures in sets; and the New Zealand Atlas of Healthcare Variation, which illustrates the differences in the health care received in different regions and by different groups of patients within New Zealand.
New Zealand has one of the best value health care systems in the world, but as a proportion of GD... more New Zealand has one of the best value health care systems in the world, but as a proportion of GDP our spending on health care has increased every year since 1999. Further, there are issues of quality and safety in our system we must address, including rates of adverse events. The Health Quality and Safety Commission was formed in 2010 as a crown agent to influence, encourage, guide and support improvement in health care practice in New Zealand. The New Zealand Triple Aim has been defined as: improved quality, safety and experience of care; improved health and equity for all populations; and best value for public health system resources. The Commission is pursuing the Triple Aim via two fundamental objectives: doing the right thing by providing care supported by the best evidence available, focused on what matters to each individual patient, and doing the right thing right, first time, by making sure health care is safe and of the highest quality possible. Improvement efforts must b...
American Journal of Obstetrics and Gynecology, 2011
We sought to describe a new classification system for contributory factors in, and potential avoi... more We sought to describe a new classification system for contributory factors in, and potential avoidability of, maternal deaths and to determine the contributory factors and potential avoidability among 4 years of maternal deaths in New Zealand. STUDY DESIGN: A new classification system for reporting contributory factors in all maternal deaths was developed from previous tools and applied to all maternal deaths in New Zealand from 2006 through 2009.
The effective and economical measurement of the quality and safety of health and disability servi... more The effective and economical measurement of the quality and safety of health and disability services in New Zealand is of signal importance. The Health Quality and Safety Commission has overseen the introduction of an architecture of interacting measures. These include quality and safety indicators, or QSIs, which are whole-system measures; quality and safety markers, or QSMs, which are targeted measures of quality and safety interventions comprising process and outcome measures in sets; and the New Zealand Atlas of Healthcare Variation, which illustrates the differences in the health care received in different regions and by different groups of patients within New Zealand.
Introduction: The increased risk of bacteraemia and associated serious complications culminating ... more Introduction: The increased risk of bacteraemia and associated serious complications culminating in poor morbidity and mortality outcomes among injecting drug users (IDU), is well known. Studies have indicated that infection prevention intervention strategies may reduce the risk of bacteraemias in the IDU population. With an estimated 1400 to 2400 IDU within the LHD, we sought to determine the incidence of Staphylococcus aureus bacteraemias (SAB) in this population and use these findings to inform the potential benefit of harm reduction strategies. Methods: The LHD Infection Management and Control Service has an established database of all SABs reported by the in-house microbiology department. The dataset includes the primary and secondary sources of the SAB and associated morbidity and mortality. This database was interrogated to identify community-associated SAB (CA-SAB) reviewed between January 2009 and December 2017 to identify the number of IDU associated cases and compare with data relating to people not identified as IDU. Results: The number of cases identified represented an estimated annual CA-SAB rate within this population of 3%, compared to the estimated rate among the assumed non-IDU population of 0.2%. The rate of serious complications in the IDU group including: epidural abscess, endocarditis and cerebral emboli was near 50%. Conclusion: This review confirms an increased SAB incidence and serious complication rates within the local IDU population. These findings indicate that there is an ethical imperative to identify culturally appropriate and effective intervention strategies to address this significant risk in this vulnerable population group.
AIM To investigate how quality and patient safety domains are being taught in the pre-registratio... more AIM To investigate how quality and patient safety domains are being taught in the pre-registration curricula of health profession education programmes in New Zealand. METHODS All tertiary institutions providing training for medicine, nursing, midwifery, dentistry, pharmacy, physiotherapy, dietetics and 11 other allied health professions in New Zealand were contacted and a person with relevant curriculum knowledge was invited to participate. Interviews were conducted using a semi-structured interview guide to explore nine quality and safety domains; improvement science, patient safety, quality and safety culture, evidence-based practice, patient-centred care, teamwork and communication, leadership for change, systems thinking and use of information technology (IT). Transcribed data were extracted and categorised by discipline and domain. Two researchers independently identified and categorised themes within each domain, using a general inductive approach. RESULTS Forty-nine instituti...
New Zealand has one of the best value health care systems in the world, but as a proportion of GD... more New Zealand has one of the best value health care systems in the world, but as a proportion of GDP our spending on health care has increased every year since 1999. Further, there are issues of quality and safety in our system we must address, including rates of adverse events. The Health Quality and Safety Commission was formed in 2010 as a crown agent to influence, encourage, guide and support improvement in health care practice in New Zealand. The New Zealand Triple Aim has been defined as: improved quality, safety and experience of care; improved health and equity for all populations; and best value for public health system resources. The Commission is pursuing the Triple Aim via two fundamental objectives: doing the right thing by providing care supported by the best evidence available, focused on what matters to each individual patient, and doing the right thing right, first time, by making sure health care is safe and of the highest quality possible. Improvement efforts must b...
To investigate how quality and patient safety domains are being taught in the pre-registration cu... more To investigate how quality and patient safety domains are being taught in the pre-registration curricula of health profession education programmes in New Zealand. All tertiary institutions providing training for medicine, nursing, midwifery, dentistry, pharmacy, physiotherapy, dietetics and 11 other allied health professions in New Zealand were contacted and a person with relevant curriculum knowledge was invited to participate. Interviews were conducted using a semi-structured interview guide to explore nine quality and safety domains; improvement science, patient safety, quality and safety culture, evidence-based practice, patient-centred care, teamwork and communication, leadership for change, systems thinking and use of information technology (IT). Transcribed data were extracted and categorised by discipline and domain. Two researchers independently identified and categorised themes within each domain, using a general inductive approach. Forty-nine institutions were contacted a...
The effective and economical measurement of the quality and safety of health and disability servi... more The effective and economical measurement of the quality and safety of health and disability services in New Zealand is of signal importance. The Health Quality and Safety Commission has overseen the introduction of an architecture of interacting measures. These include quality and safety indicators, or QSIs, which are whole-system measures; quality and safety markers, or QSMs, which are targeted measures of quality and safety interventions comprising process and outcome measures in sets; and the New Zealand Atlas of Healthcare Variation, which illustrates the differences in the health care received in different regions and by different groups of patients within New Zealand.
New Zealand has one of the best value health care systems in the world, but as a proportion of GD... more New Zealand has one of the best value health care systems in the world, but as a proportion of GDP our spending on health care has increased every year since 1999. Further, there are issues of quality and safety in our system we must address, including rates of adverse events. The Health Quality and Safety Commission was formed in 2010 as a crown agent to influence, encourage, guide and support improvement in health care practice in New Zealand. The New Zealand Triple Aim has been defined as: improved quality, safety and experience of care; improved health and equity for all populations; and best value for public health system resources. The Commission is pursuing the Triple Aim via two fundamental objectives: doing the right thing by providing care supported by the best evidence available, focused on what matters to each individual patient, and doing the right thing right, first time, by making sure health care is safe and of the highest quality possible. Improvement efforts must b...
American Journal of Obstetrics and Gynecology, 2011
We sought to describe a new classification system for contributory factors in, and potential avoi... more We sought to describe a new classification system for contributory factors in, and potential avoidability of, maternal deaths and to determine the contributory factors and potential avoidability among 4 years of maternal deaths in New Zealand. STUDY DESIGN: A new classification system for reporting contributory factors in all maternal deaths was developed from previous tools and applied to all maternal deaths in New Zealand from 2006 through 2009.
The effective and economical measurement of the quality and safety of health and disability servi... more The effective and economical measurement of the quality and safety of health and disability services in New Zealand is of signal importance. The Health Quality and Safety Commission has overseen the introduction of an architecture of interacting measures. These include quality and safety indicators, or QSIs, which are whole-system measures; quality and safety markers, or QSMs, which are targeted measures of quality and safety interventions comprising process and outcome measures in sets; and the New Zealand Atlas of Healthcare Variation, which illustrates the differences in the health care received in different regions and by different groups of patients within New Zealand.
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Papers by Gillian Bohm