Summary of meeting March 6th 2006
Pip Rutherford the College of Nurses representative developed a table and asked ACC group members to complete this, so the College of Nurses members could be kept informed of progress on issues that had been tabled at previous meetings.
Rationale:
- Review NLG activities
- Enable NLG representatives to report back to national groups
- Identify which outcomes have been fully or partially achieved
- Identify areas requiring further work/collaboration
- Identify barriers for change
- Develop joint strategies to help us achieve mutually beneficial outcomes
ACC have now responded to this summarized below.
- Community Nursing Service contract review No longer relevant as changes will not be made
- Medical misadventure: New definition "treatment injury" individual cases now only taking 17 days to process.
- Treatment profiles: With College of Nurses waiting for peer review
- Paramedics unable to be registered as ACC provider Legislative issue and part of wider work with Dept of Labour
- Awarding CME for nurses for resources. ACC to discuss this with Nursing Council when resource available
- Rural Nurse scholarships ACC have sponsored 5 nurses to complete Masters
- Nursing costs/fees should be same as GPs. Ongoing review each year involves Dept of Labour, and Treasury and includes paying NPs at higher rate. "Not enough NPs yet for ACC to change now" NPs can approach ACC to make a case to contract, needs to go through proper processes. Next year work will commence when resources available to include assessment of risk to the scheme, future costs and benefits
- EN issues re community nursing contract EN/NA can provide services under supervision
- Review contracting process with MOH and Dept of Labour, re rehabilitation/compensation act. Work underway
- ACC funding for drugs (NP prescription) work progressing Pip Rutherford to invite ACC pharmacy advisor to an NP meeting, will table at meeting in April.
- Propharma issues (consumables, new products). Lower North Island review and monitoring progressing
- NZ Wound Care Society venous ulcer Clinical pathway funding request declined NZWCS asked to resubmit proposal.
- Work certificates not able to be written by nurses, issues in rural areas. Work in progress with inter-agency lead by Ministry of Health to be part of omnibus legislation
- Return to work project, issues for occupational health nurses . Pilot in Hawkes Bay
Agenda items:
Future purchasing strategy
ACC future purchasing strategy is underway with high level discussions going on and work streams will drop out of this project. ACC is not ILO-17 compliant (International Labour Organization) as in NZ ACC clients pay a small fee for ACC related visits. Five key areas are identified by ACC and their new approach will move towards:
Community basis - for example having Pacific Health workers, or PHO case managers
Purchasing and funding that supports an outcomes approach
Reducing fragmentation (health ACC, welfare) e.g. possibly sharing systems.
Incorporate more prevention strategies
Patient Safety Presentation.
Under old system only 30% of claims were accepted as medical misadventure. This is now 60% accepted under "treatment in jury" system. Median time for decision is now only 17 days.
Recent example is quite a few recent cases accepted for ACC following shoulder rotator cuff injury secondary to Menz B injections into joints of children. So far 2 events have gone to Nursing Council.
In 2006 ACC will focus on research, patient safety publications, web site, presentations and data collection and analysis
Clinical Pathways
Pathway issues were identified by Pip Rutherford who noted ACC use terminology re pathways, guidelines, protocols, pilots and standards interchangeably with the result that people are not "all seeing the same picture". Pip did a presentation clarifying different terminology and gave an example of the NZWCS pathway process/documentation. Pathways on backs, knees, shoulders being explored by ACC
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