Global talk and local action

1 January 2014

KATHY HOLLOWAY challenges nursing in New Zealand to connect globally including seeking out and learning from the findings of UK’s Francis Report into caring failures at Mid-Staffordshire

The use of information and communication technology (ICT) and the internet are growing in all regions of the world.

As of 30 July 2012, there were nearly 2.5 billion Internet users globally – which represents just over a third of the world’s population (Internet World Stats, 2012). Social media is now well established as an integral part of our information gathering and sharing strategies, as well as revolutionising the way we communicate. This applies to the area of healthcare as with all aspects of society.

High levels of connectivity in healthcare have the potential for both benefit and harm. Often the focus is around the inappropriate use of social media and the lack of professionalism shown by some individuals resulting in harm. Recently, the Nursing Council of New Zealand released guidance for registered nurses on the use of social media

There are great benefits for healthcare consumers also in terms of connectivity between expert patient groups, support for self-management of health and transparency in patient experiences, which have been discussed in previous columns. Being connected as a registered nurse increases your chances of being aware of current professional debates and gaining learnings from across the globe. This is a professional imperative for reflective, evidence-based nursing practice.

As one example, take the crisis in care provision that surfaced in the NHS Mid Staffordshire Trust ospital in the United Kingdom in 2010 – see The ensuing investigations, inquiries, and reports have been studied by health systems around the globe including our own Ministry of Health. The reports and resulting discussions and responses from the NHS are all available online.

In October 2013, the New Zealand Health Quality and Safety Commission hosted a workshop on reflections from the Mid-Staffordshire Trust NHS Foundation Inquiry. The YouTube presentation at this workshop from Robert Francis QC is available on the website and provides a valuable lesson for all of us who work in healthcare.

Professor Don Berwick, an international expert in patient safety, was subsequently asked by the Prime Minister to carry out a review following the publication of the Francis Report into the breakdown of care at Mid-Staffordshire Hospitals. Professor Berwick’s report can be accessed online

Four key guiding principles for change were detailed by Professor Berwick in a letter to NHS clinicians asking them to incorporate these into their daily work the following:

Place the quality and safety of patient care above all other aims for the NHS.

Engage, empower, and hear patients and carers throughout the entire system, and at all times.

Foster wholeheartedly the growth and development of all staff, especially with regard to their ability and opportunity to improve the processes within which they work.

Insist upon, and model in your own work, thorough and unequivocal transparency, in the service of accountability, trust, and the growth of knowledge.

I would invite you to consider these four principles in your own practice environment and discuss with your colleagues the concept of a duty of candour*. More reports and reviews are being published as a wider review of the NHS is undertaken. The most recent on October 28 is a review of the NHS hospital complaints system, which I am sure will also be reviewed by our Health Ministry.

In last month’s Nursing Review, Dr Jo Walton reminded us that we can’t address what we don’t acknowledge. Being aware of and engaging in global conversations can support us to acknowledge issues and identify solutions in relation to our professional responsibility to deliver safe and effective health care to the communities we serve. With awareness comes choice.

Kathy Holloway is dean of the Health Faculty at Whitireia Community Polytechnic

* See Health Foundation ‘duty of candour’ blog at:

Healthcare and Quality: Perspectives from Nursing – Online Issues in Nursing Journal

This edition of the international peer-reviewed publication provides a forum for discussion of the issues for nurses in the healthcare and quality space. The intent of this journal is to present different views on issues that affect nursing research, education, and practice, thus enabling readers to understand the full complexity of a topic. This topic is from September 2013 and very relevant to this month’s column with six articles on various aspects of healthcare quality and patient safety. Of particular interest is an article about new graduate nurses and academic service partnerships (a matter close to my own heart). Follow the journal on Twitter at @ANAOJIN [Site accessed 9 November and last updated November 2013].

Open for Better Care campaign

The New Zealand Health Quality & Safety Commission (HQSC) is undertaking a national patient safety campaign, Open for Better Care to reduce harm and improve quality and safety in health and disability care settings. The campaign website launched in September 2013 and focuses on four priority areas where evidence shows change can reduce patient harm. Those areas are: falls, healthcare associated infections (HAIs) – specifically, surgical site infections (SSIs) – perioperative harm, and medication safety. The website has many free resources and updates in relation to DHB engagement with the four key areas targeted. [Site accessed 9 November and last updated November 2013].