Waitemata District Health Board, 15 Shea Terrace, Takapuna

Transcription

1 Date: Octber 2015 Jb Title: Quality and Audit Manager Department: Planning, Funding and Outcmes Unit Lcatin: Waitemata District Health Bard, 15 Shea Terrace, Takapuna Reprting t: Directr Funding Direct Reprts: Nil Functinal Relatinships: Internal Lead CEO fr Planning, Funding & Outcmes Directr, Funding ADHB -WDHB Funding & Develpment Managers Senir Prgramme Managers Prgramme Managers Planning, Funding and Outcmes Unit DHB Crprate Finance Teams DHB Prvider Arm Services External Nrthern Reginal Alliance HealthAlliance Other District Health Bards Healthcare Prviders including Primary Care and NGOs Sectr Services / Ministry f Health Audit & Cmpliance / Ministry f Health Audit Prviders Purpse: The fundamental purpse f the rle is t prvide an independent quality review and audit functin. The rle includes the implementatin and maintenance f tw essential cmpnents, namely: i. Review f: cntractual dcumentatin prcurement prcesses the Funder s implementatin f the Health and Safety at Wrk Act. ii. Management f and reprting prcess fr the auditing services cmmissined by WDHB and ADHB and delivered indirectly thrugh its agents (Natinal Health Bard, Audit and Cmpliance and Third Party NGO Auditrs).

2 KEY TASKS FUNCTIONS Quality 1. Implement and maintain a quality review functin fr cntractual dcumentatin and carry ut related reprting. Cntract Dcument Management is achieved via the Electrnic Cntract Management System (CMS); the utilisatin f which must be mnitred, reviewed and reprted n t cnfirm cmpliance with best practice standards. The Quality and Audit Manager will gauge best practice cmpliance by perfrming mnthly reviews f randmly selected cntracts within CMS, against the criteria specified belw: Cnfirmatin f the Electrnic Cntracts Management System (CMS) as the Funder s primary cntracts management tl Availability f signed Cntracts and Variatins Cnfirmatin that Service Specificatins (reviewed n a three-yearly cycle) describe the DHB s minimum requirements fr service delivery, quality and utcmes, fr example: Cnfirmatin that the technical cmpnents cmply with apprved MOH dcumentatin and guidelines. This includes reviewing purchase unit cdes, descriptins f services, reprting requirements, units f measure, payment methdlgy Cnfirmatin that the service specificatin describes measurable perfrmance targets (e.g. inputs / utputs / utcmes) that are linked t the agreed funding and where relevant, are clinically apprpriate Cnfirmatin that all natinal services are linked t the agreed natinal specificatins as detailed n the Natinal Service Framewrk Library Availability f Audit Reprts Evidence f fllw-up fr issues identified during an Audit Evidence f Audits ccurring within the applicable timeframe Availability f Mnitring Reprts Evidence f Mnitring Reprts being read and then being discussed with the Prvider Availability f File Ntes, s and ther evidence f cmmunicatin between the DHB and Prvider. The review criteria, findings and recmmendatins will be presented n an individual basis, using an existing reprt template. All findings will lgged and reprted t the Manager f Finance and Supprt Services, with a summary f the criteria attained and unattained and will include recmmended actins fr reslving identified issues.

3 2. Review the cntent, frmat and intended prcess fr prcurement activity participated in r cnducted by the Planning, Funding and Outcmes Unit. a. Reviewing Prpsals develped by the Funder Prcurement prpsals are develped by the Funder in respnse t anther funding agency s request fr submissins, generally t secure funding t deliver a health service. The Quality and Audit Manager will review prpsal dcumentatin against best practice criteria; specific feedback will be prvided t authr fr the purpse f imprving the dcument s cmpliance with the evaluatin criteria. b. Reviewing Prcurement Prcesses Managed by the Funder Where the DHB is initiating a prcurement prcess fr the purpse f cntracting fr service delivery, the Quality and Audit Manager will where required review the Funder s prcess fr Prvider selectin. 3) Understand and implement the requirements f the Health and Safety at Wrk Act relative t the Funder. In rder t implement the Funder s respnsibilities relative t the new Health and Safety at Wrk Act, the Quality and Audit Manager will: becme familiar with the DHBs respnsibilities under the new legislatin wrk with prviders t cmplete health and safety capability assessments as part f an audit plan, and initiate a prcess fr regularly and systematically reviewing such prvide update reprting t the Senir Management Team n a t-bedetermined basis in this area. 4) Other tasks Cmplete ne-ff, time limited prjects fr the Finance & Supprt Team as required. Audit 1. Implement and maintain a management and reprting prcess fr auditing services cmmissined by WDHB and ADHB and delivered indirectly thrugh ur agents (Natinal Health Bard, Audit and Cmpliance and Third Party NGO Auditrs) The Audit Prgramme requires: The delivery, mnitring and recrding f: DHB funded audits fr NGO Mental Health, Persnal Health and Pharmacy cntracts DHB funded financial / claims based audits fr all NGO cntracts The mnitring and recrding f: Certificatin audits fr Aged Residential Care, Hme Based Supprt, Residential Mental Health services

4 a. Cntractual Audits and Certificatin Audits The cntractual audit prcess invlves: Develping the Persnal Health audit schedule in cnsultatin with Prgramme Managers and the Manager f Finance and Supprt Services. Lgging all Ntificatin dcumentatin relating t an Audit. Reviewing Persnal Health and Mental Health audit tls and prviding feedback t the audit prvider. Disseminating Risk Alerts nted during the audit by the audit prvider t the respective Prgramme Managers. Reviewing Persnal Health and Mental Health audit reprts in cnsultatin with the respective Prgramme Manager. Cmpiling, lgging and frwarding feedback t the audit prvider. Recrding identified audit issues and fllw-up, as carried ut by the Prvider in cnsultatin with the Prgramme Manager as prgress is made. b. Financial / Claims Based Audits The Ministry f Health s Audit and Cmpliance team cnduct this cmpnent f the audit prgramme n behalf f the DHBs. The Quality and Audit Manager will be the DHB s central pint f cntact fr all issues identified internally and externally. A recrd f all issues identified by r sent t A&C must be maintained, and the details f prgress must be disseminated within the DHB t the apprpriate DHB staff as they ccur. Authrisatin letters must be lgged, frwarded t the respective DHB CEO fr sign ff, and sent back t A&C. Audit reprts are lgged, recrded and then disseminated t the respective Grup Manager and Prgramme Manager. All identified financial recveries must be recrded and tracked. Identified recveries must be apprved via the agreed mechanisms. ADHB fund tw Investigatrs emplyed thrugh Audit and Cmpliance. The Quality and Audit Manager may be required t prvide sme infrmatin supprt t the Investigatrs frm time t time. 2. Reprting The Quality and Audit Manager will maintain a recrd f audits cnducted, issues nted, reslutin f issues and, where apprpriate, funding identified fr recvery. Reprting against this database will, at a minimum, ccur: n a mnthly basis, t the Senir Management Team n a quarterly basis, t the Lead CEO n a six mnthly basis, t the Audit and Finance Cmmittee

5 Statutry & Treaty f Waitangi bligatins Ensures the prfessinal and plitical integrity f Auckland and Waitemata DHBs by carrying ut all functins in cmpliance f the Treaty f Waitangi, and by demnstrating a serius cmmitment t keeping the treaty alive Shws sensitivity t cultural cmplexity in the wrkfrce and patient ppulatin T recgnise Individual Respnsibility fr Wrkplace Health and Safety under the Health and Safety in Emplyment Act 1992 (t be replaced by the Health & safety at Wrk Act 2016) Cmpany health and safety plicies are read and understd and relevant prcedures applied t their wn wrk activities Wrkplace hazards are identified and reprted, including self-management f hazards where apprpriate Can identify health and safety representative fr area Qualificatins Minimum Certificate / Diplma level qualificatin in a relevant field Preferred Accredited t NZQA standard 8084; Level 6, Credit 14 Experience Five years experience in a related field Ten years experience within a related field within the health sectr Skills Prcess 1. Quality Prepare and cnduct a review; reprt n; and verify crrective actins Stre, mdify, and extract accurate infrmatin frm a database Prvide reprting as required in a simple and understandable frmat 2. Audit Ensure transparency; the lgical applicatin and timing f prcess steps; and cnsistent and timely cmmunicatin in delivering the audit prcess Develp and / r critique schedules fr audit activity Stre, mdify, and extract accurate infrmatin frm a database Prvide reprting as required in a simple and understandable frmat Cmputer Extensive experience in using Micrsft Wrd and Excel.