Dr Charles Pain
Director, Health Systems Improvement
Clinical Excellence Commission, NSW
Professor Jeffrey Braithwaite
Public confidence in the safety and reliability of healthcare has declined around the world over the past twenty years. Consequently, governments and healthcare providers are under increasing pressure to improve standards. Several decades of the patient safety movement have had mixed results and have not delivered the transformation in reliability that politicians and the community expect. Public inquiries continue to find the same system weaknesses. Fresh solutions are needed that are effective, sustainable, scalable and affordable.
Healthcare is delivered by teams. They are the basic units of production within healthcare systems. In other words, they are the constituent microsystems of the health care macrosystems, upon which performance reliability depends. Highly functioning healthcare unit teams deliver the best health care and achieve the best outcomes for their patients. Conversely, poorly functioning teams put patients at risk and their system failures are universal root causes of patient safety and quality problems in health systems around the world.
Therefore, building high-reliability patient care teams which are resilient and adaptable, then replicating the essential attributes of these teams across healthcare organizations is a means of building high reliability healthcare systems. A practical means of achieving this will be presented.
Dr Charles Pain is a public health physician and is currently Director for Health Systems Improvement at the Clinical Excellence Commission for NSW.
His first job was as a house officer in the NHS, in 1983, in the days when junior doctors worked up to 120 hours a week. He has since worked in three public health systems, in the United Kingdom, New Zealand and Australia in various clinical roles and then as a public health physician. He has worked in the NSW public health system since 1997 on the executives of a number of health services. The main focus of his career in the past decade has been on improving patient safety and quality of care. Immediately prior to his appointment at the Clinical Excellence Commission, he was the Director of Clinical Governance for Sydney West Area Health Service for three years.
His career has led him on a quest for answers to the reliability problem that affects health care systems around the world. His views and his ideas have been forged by his exposure to some of the most seismic political events in the history of the NSW public health system in 2003 and which have continued to affect the political and cultural conditions clinicians, managers and administrators work under in NSW to this day.
