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About First, Do No Harm

Safer care together

The First, Do No Harm patient safety campaign is one of the primary goals of the Northern Region Health Plan – outlining a set of shared objectives for the major public healthcare providers in the top half of New Zealand’s North Island.

Approved by the Minister of Health, the plan is an agreed strategy for addressing the significant pressures on healthcare in the Northern Region.

These include rapid population growth, ageing population and the rising burden of chronic disease.

Under the plan, the four Northern Region district health boards (Northland, Waitemata, Auckland and Counties Manukau) are collaborating with three health organisations – the National Maori PHO Coalition, Alliance Health+ and Greater Auckland Integrated Health Network.

Implementation of the health plan is being supported by the Northern Regional Alliance (NRA), a shared services agency owned by the Auckland metropolitan DHBs. A Memorandum of Understanding has been formalised between First, Do No Harm and the Health Quality & Safety Commission and resources and expertise are being shared between First, Do No Harm and the National Patient Safety Campaign, Open for better care, which is being coordinated and led by the Health Quality & Safety Commission.

Click here to read the Northern Region Health Plan

First, Do No Harm campaign

There is clear evidence that certain interventions, if systematically applied, will improve patient safety, reduce costs and save patient lives.

A 1998 New Zealand study of hospital discharges found that 12.9 per cent had adverse events, 15 per cent of those were permanent or fatal and 33 per cent were significantly avoidable.

Avoidable serious adverse events translated to around 276,000 bed days. At an average cost of $13,000 per adverse event, the cost of preventable adverse events is estimated to be $573 million per annum.

Whilst these results are not atypical of any OECD country, the New Zealand health sector has not made significant systematic change to improve on these results.

First, Do No Harm has adopted a campaign methodology to create energy and momentum to make patient safety a top priority and to shift the mindset to a focus on achieving no avoidable harm.

Clinically-led, the key areas of this work are:

  • Reducing harm from falls
  • Reducing harm from pressure injuries
  • Reducing harm from healthcare-associated infections
  • Improving medication safety
  • Improving transfer of clinical information, and
  • Reducing peri-operative harm.

Click here to view the First, Do No Harm overview

Click here to find out more about First, Do No Harm strategy

Click here to view the First, Do No Harm timeline poster

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Consumers

Click here for information about First, Do No Harm

Click here for consumer representative presentation (video) December 2013

Click here for some of the presentations delivered at the Health Quality & Safety Commission’s Partners in Care Show and Tell Symposium - June 2014. The goal for the day was to provide a range of services that integrated the views of consumers in different ways.

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Frequently-asked questions

What is First, Do No Harm?

First, Do No Harm is a campaign to minimise preventable harm to patients during clinical care. It is estimated that around 13 per cent of patients suffer ‘adverse events’ during care. The First, Do No Harm campaign aims to improve that rate and has set specific targets for reducing patient falls, pressure injuries and central line infections (CLAB). (See About First, Do No Harm for target details.) It aims to develop a regional patient safety culture underpinning the safest healthcare system in Australasia.


How does it work?

The Northern Region’s four district health boards have committed to work with primary care and age-related residential care to deliver a new, system-wide focus on patient safety. The first step is agreeing on how to measure existing patient harm rates and developing regionally-consistent methodologies for collecting data. The implementation phase is now underway. First, Do No Harm creates an opportunity to share information on successes and challenges across the Northern Region with the aim of improving patient safety by working and learning our way into improvement.


Why are you doing this … what are the key benefits?

The campaign is driven by a clinically-led desire to reduce avoidable harm to patients. There is a recognition that patient harm levels need to be minimised to provide the best possible care. There is clear evidence that certain interventions, if systematically applied, will save lives, prevent harm to patients, save money, free-up capacity and improve productivity. This is best achieved by working together as a region rather than having inconsistent approaches.


Who is involved in the project?

First, Do No Harm is one of the primary goals of the Northern Region Health Plan. The four Northern Region district health boards (Northland, Waitemata, Auckland and Counties Manukau) have committed to the plan, alongside the National Maori PHO Coalition, Alliance Health+ and Greater Auckland Integrated Health Network. The roles of the primary care sector and the age-related residential care sector are considered critical; the campaign is not just about hospital care. Implementation of the health plan is being supported by the Northern District Health Board Support Agency, (NSDA) a shared services agency owned by the Auckland metropolitan DHBs. NDSA has formalised a Memorandum of Understanding with the Health Quality and Safety Commission on the First, Do No Harm campaign.


Is this driven by the need to cut costs?

No. The motivating principle behind First, Do No Harm is delivering improved safety for our patients. Another critical consideration is reducing waste and duplication by working across the region and learning from each other. Money saved is as a result of shorter hospital stays for patients and this, in turn, ensures more patients can receive treatment from the public health budget.


Why hasn’t there been a coordinated patient safety campaign here before?

The strong desire to provide the best possible care for patients has always existed. What has been lacking until now is the commitment to work together across normal DHB boundaries – and across sector boundaries with primary care and age-related residential care – to achieve this. Recognition that maximum benefits could be achieved by working together under the Northern Region Health Plan provided the impetus to launch the region’s first coordinated patient safety campaign.


When will we see improvements?

International evidence suggests there is a lead-time before improvements can be quantified. The process must begin with measuring harm and agreeing on consistent measures to understand the scale of the problem. Only then can solutions be implemented – and these take time to become embedded in normal practice.


Why is it important?

First, Do No Harm matters because it is about providing the best care to those people requiring healthcare services, regardless of the setting. A regional focus on patient safety will ensure patients are spared injury, pain and suffering and that they can get back to their normal lives sooner. This will also have benefits for supporting family members and patients themselves in terms of their mobility, confidence and independence. In extreme cases, the campaign has the potential to save lives.


What’s in it for clinical staff?

The campaign is clinically-led and reflects the strongly-held view within the health workforce that the patient must always come first. First, Do No Harm creates a coordinated framework for clinical staff to learn from each other’s experiences and ultimately achieve their goal of providing the best and safest patient care possible.

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Programme team

Karen O’Keeffe – First, Do No Harm Clinical Leadkaren okeeffe head and shouldersweb

Karen is a healthcare professional with a passion to provide the highest standard of patient care possible.

She completed her nursing training in New Zealand and has extensive experience in critical care nursing and as a nurse manager both in New Zealand and overseas.

Her career includes an 11-year period in California.

Key initiatives Karen has been involved in include the physiological unstable patient project, pre-hospital thrombolysis and medication safety.

Over the last five years, she has developed a special interest in patient safety and quality improvements.

Based at Northland DHB, Karen has recently led a number of quality improvement and patient safety projects.

Karen was appointed to the First, Do No Harm Clinical Lead role in October, 2011.

Contact Karen


Peter Leong – First, Do No Harm Improvement SpecialistPeter-Leong-bio

Finding a way to make things work better has always been a passion for Peter, who specialised in quality improvement in Singapore before moving to New Zealand more than 13 years ago.

In Singapore, Peter worked as a human resources development manager and productivity manager. He also developed a series of creativity training programmes for the Singaporean civil service.

Since arriving in New Zealand, he has held positions at Telecom as a process improvement consultant and for Gen-I as a senior business analyst. More recently, Peter was a kaizen specialist with the Bank of New Zealand, responsible for enterprise-wide process improvement.

His natural love of quality improvement and the chance to be involved in changes that will save lives attracted him to his latest position with the First, Do No Harm patient safety campaign.

Peter is a firm believer in using statistics and data to understand a problem before developing a solution and then measuring improvements.

This is Peter’s first role in the healthcare sector and although he believes some tools may be more applicable to patient safety, he says many methodologies are standard throughout quality improvement.

Peter was appointed to the First, Do No Harm campaign team in June, 2012.

Contact Peter


Gael Panama - First, Do No Harm Communications SpecialistGael-Panama

Gael has extensive experience in communications and marketing, most recently as Marketing & Communications Manager at King’s College in Auckland.

She has also worked in Australia, Papua New Guinea and throughout the Pacific and has a special interest in developing communication strategies using plain language that are easily understood across diverse cultures.

Gael considers that clear communication is the most effective way to develop strong working relationships and foster successful stakeholder partnerships.

Print publications, website development and digital media are communication channels that Gael has a particular interest in and she is looking forward to bringing this knowledge to the First, Do No Harm patient safety campaign.

Gael’s qualifications include a BBus (Management), NZDipBus and a DipMarketing.

Gael was appointed to the First, Do No Harm campaign team in July, 2013.

Contact Gael

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