At Southern Cross Healthcare, the experience and safety of our patients is paramount. The clinical components of patient care at our hospitals are underpinned by good communication, training, and constant monitoring.

We equip our healthcare staff with the skills and tools they need to provide the best quality care to patients. We then monitor performance and share the results to ensure continuous improvement, and so that the wider health sector may benefit from our learnings.

When something unexpected happens

Keeping our patients safe is our utmost priority. When an adverse event occurs at one of our hospitals, we take it very seriously.

Our response to these events is driven by a safety culture, open communication and ongoing learning. Each adverse event is followed up by a full investigation. We use what we learn to improve our services in order to minimise the risk of the event happening again. To facilitate this process, our staff utilise the SafeHub digital reporting platform.

The wellbeing of patients and whānau plays a central part in our review of adverse events.

As a patient or whānau to a patient, we recognise the important role you can play in your own care or that of your family member. We encourage you to be involved, to ask questions, and tell us how you or your family member are doing at any point during your stay with us.

Kōrero mai - Talk to Me

We respect that patients and whānau can often recognise the early signs of physical deterioration in themselves or their family members.

If you are a patient or whānau of a patient, we want you to feel comfortable to speak up if you have a concern. Kōrero Mai – Talk to Me is a process through which you can voice any concerns and expect a timely response.

How the Kōrero Mai escalation process works:

1. Press the call bell and talk to your nurse.
2. If you are still concerned, ask to talk to the Nurse in Charge.
3. If you are still concerned, call the senior nursing team at your hospital.

Recognising and responding to patient deterioration

To assist with the recognition of and response to patients at risk of deterioration, we use the New Zealand Early Warning Score (NZEWS).

This nationally standardised vital signs chart provides clear, objective criteria that prompt our healthcare team members to call for help when they suspect a patient may be deteriorating. These include measures such as heart rate, breathing rate, and level of consciousness.

We also recognise that whānau know their loved ones best, and may notice subtle changes that an objective framework such as NZEWS does not detect. We encourage whānau to use our Kōrero Mai (Talk to me) process to report these concerns (see above).

Hand hygiene compliance

One of the simplest things we can all do to help prevent the spread of infection is to practise good hand hygiene – to wash our hands. While this is just as true at home as it is in healthcare settings, it is particularly important in hospitals because surgical procedures increase the risk of infection.

Hand hygiene is a vital component of our infection prevention and control programme. We require that everyone working in our hospitals comply with our hand hygiene policy. This policy is aligned with the World Health Organisation Five Moments for Hand Hygiene recommendations, and compliance with it is audited regularly in our hospitals.

Good hand hygiene practice requires constant reinforcement, even in hospitals. We're passionate about urging our healthcare employees and medical practitioners to attain even greater levels of compliance with our hand hygiene policy. You may see evidence of this when you're in our hospitals.

We encourage our patients and their whānau to review the following resources before coming to hospital:

Staying safe before and after surgery (video)

Preventing infection after surgery (PDF)

Another way we demonstrate our commitment to good hand hygiene is by participating in the Hand Hygiene New Zealand Programme. This enables us to compare our hand hygiene performance with that of public hospitals.

Surgical site infection

Unfortunately 2-5% of patients who have surgery will subsequently develop a wound infection, also known as a surgical site infection (SSI).

The consequences of a SSI can be significant. For this reason, a comprehensive infection prevention programme is in place in every Southern Cross hospital.

Our SSI surveillance programme was first established in 2002, making it one of the longest running in New Zealand. It utilises a standardised system of monitoring and checking for SSIs both during your stay and after your discharge.

Surveillance focuses mainly on procedures considered higher risk for post-operative infection, and which can be particularly devastating should an infection develop. This includes hip and knee joint replacement procedures.

Your nurses will let you know if your procedure falls under your hospital’s current SSI surveillance programme. If so, they will give you more information about what that means. Surveillance begins when you are admitted and continues while you are in hospital and after you go home.

Before you come to hospital

If your completed patient admission forms reveal factors that could increase your risk of developing a SSI, we can address these before you come to the hospital.

While you are in hospital

Once in hospital, the risk of developing a SSI cannot be completely eliminated. However, by following stringent practices in our operating theatres and in our pre- and post-operative settings, we aim to reduce it as much as possible.

We closely monitor you for infections during your stay. We review any that do occur and provide feedback to our medical practitioners and nursing teams. This allows them to make changes to practice if needed.

After you go home

As most infections occur after the patient leaves hospital, SSI surveillance post-discharge involves staying in touch with you to monitor your wound as it heals. Any wound infection that occurs is fully investigated in order to ensure we have followed accepted good practice and to identify any potential for quality improvements.

Monitoring the performance of our SSI surveillance programme

We audit surgical site infection rates in our hospitals twice a year. When we share the results, we include DHB rates collected by the Health Quality and Safety Commission (HQSC) in order to provide a basis for comparison.

However, it is important to understand there are some differences in the way this information is collected:

• At Southern Cross Healthcare, we follow up with all patients who have undergone certain procedures and include them in our results, even if they had a superficial infection which did not need readmission for treatment; the HQSC data only includes those who developed infection while in hospitals or those who could not be treated by a GP but needed to be readmitted to hospital.

• The number of patients included in our surveillance is much lower than the number reported by the HQSC.

Despite these differences, this is an area in which Southern Cross Healthcare performs well.

We also perform SSI surveillance on a wide range of other procedures. This helps us monitor infection rates and investigate any deviations.

Surgical Site Infection Improvement Programme overview [video] features an outline of the New Zealand HQSC SSI Improvement Programme by Dr Arthur Morris - Clinical Microbiologist and Chair of the Southern Cross Healthcare National Infection Prevention and Control Committee (NIPCC).