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Quality and safety superstar: Lorraine Harry

10 Dec 2022

This year’s recipient of the Excellence in Remote and Isolated Health Practice Award is Quality & Safety Officer at Mala’la Aboriginal Health Service, Lorraine Harry. Here, she discusses transitioning from the public system to the Aboriginal Community Controlled Health Sector, quality systems, and the compounding impact of small changes.

The 2022 Excel­lence in Remote and Iso­lat­ed Health Prac­tice Award was spon­sored by James Cook University/​Murtupuni Cen­tre for Rur­al & Remote Health.

After 20 years in pub­lic hos­pi­tals in her home state of New South Wales, RN Lor­raine Har­ry sam­pled remote work with a stint in Mt Isa 12 years ago, before com­menc­ing as a nurse in the Ter­ri­to­ry nine years ago. 

Lor­raine has worked at the Man­ingri­da Pri­ma­ry Health Cen­tre since 2017, ini­tial­ly with NT Health. Then in 2020, she accept­ed a role as Qual­i­ty and Safe­ty Coor­di­na­tor with Mala’la Abo­rig­i­nal Health Ser­vice, short­ly before the ser­vice com­menced its final pro­gram-by-pro­gram tran­si­tion from gov­ern­ment to com­mu­ni­ty control.

Mala’la offered me a posi­tion to look at their gaps with the tran­si­tion based on a NT Health gap analy­sis report,” Lor­raine recalls. 

Even though the organ­i­sa­tion has been around for more than 20 years, tak­ing on the pri­ma­ry health sec­tor tripled the organ­i­sa­tion in size. 

Part of my role was to ensure we had all the qual­i­ty and risk man­age­ment sys­tems, ser­vices and process­es in place to sup­port a safe and qual­i­ty focused pri­ma­ry health service.

” To oper­ate a ser­vice as an Abo­rig­i­nal Com­mu­ni­ty Con­trolled Health Organ­i­sa­tion (ACCHO), it is nec­es­sary for a cor­po­ra­tion to gain mul­ti­ple accreditations. 

The NT Gov­ern­ment hand­ed the last remain­ing pro­grams to Mala’la Health Ser­vice Abo­rig­i­nal Cor­po­ra­tion in Feb­ru­ary 2021, giv­ing them three months to pre­pare for Aus­tralian Gen­er­al Prac­tice Accred­i­ta­tion Lim­it­ed (AGPAL) accred­i­ta­tion sur­vey that May. 

That they gained accred­i­ta­tion on the first attempt reflects the hard work of the team, includ­ing Lor­raine, who – among oth­er achieve­ments – helped imple­ment of Logiqc Qual­i­ty Man­age­ment Sys­tem and Com­mu­ni­care med­ical records system. 

Logiqc has every­thing in one space, acces­si­ble from any plat­form,” Lor­raine explains. It allows us to track staff train­ing; have a repos­i­to­ry for meet­ings, agen­das, min­utes; and gives staff ready access to all doc­u­ments, poli­cies, and pro­ce­dures. It enables trans­paren­cy of inci­dent report­ing, out­comes, and inves­ti­ga­tion… All these func­tions make it easy to man­age a big­ger work­force and staff.” 

Mean­while, the tran­si­tion to a Com­mu­ni­care elec­tron­ic med­ical records sys­tem, a pre­ferred sys­tem among ACCHOs for its cus­tomis­abil­i­ty and data capa­bil­i­ty, required the trans­fer of 4,500 client records across from the old Pri­ma­ry Care Infor­ma­tion Sys­tem (PCIS). It was a pret­ty ambi­tious vision that the Mala’la Health Board had,” Lor­raine says, reflect­ing on the dif­fi­cul­ties oth­er organ­i­sa­tions have encoun­tered tran­si­tion­ing from PCIS.

It was a two-year project, with Tel­stra Health, NT Health and Mala’la, to make that happen.” 

With these sys­tems in place and the health ser­vice under com­mu­ni­ty con­trol, Lor­raine feels vin­di­cat­ed in her move to the ACCHO sector.

The best thing is the lev­el of com­mu­ni­ty engage­ment; how it empow­ers the com­mu­ni­ty, know­ing that now their health ser­vice is run by the com­mu­ni­ty; and how we’ve been able to improve and expand services.

We’ve got a lot more involve­ment now with the Tra­di­tion­al Own­ers, and the 14 dif­fer­ent fam­i­ly groups in Maningrida.”

Lor­raine is quick to point out that you don’t need her job title to be involved in con­tin­u­ous qual­i­ty improve­ment (CQI).

As RNs, that’s part of our role every­day – look­ing for ways we can improve,” she says. A lot of peo­ple look at CQI as extra work, but when it’s done well and done prop­er­ly, it actu­al­ly improves your work sat­is­fac­tion, makes your job eas­i­er and improves outcomes.” 

Even though it’s everybody’s busi­ness, Lor­raine counts her­self as for­tu­nate to have a job with this focus. I’ve always had a pas­sion for main­tain­ing stan­dards and cre­at­ing an envi­ron­ment where excel­lence flourishes.” 

When going out remote, that pas­sion was ignit­ed even fur­ther because some­times there is a sense of com­pla­cen­cy – it’s remote, you can only do so much, you don’t have all the resources or equipment’.

The team at Mala’la Abo­rig­i­nal Health Service

But there is the abil­i­ty to pro­vide excel­lence in ser­vice, and to always look to improve what we do. It can just be the lit­tle things, the one per cent changes. 

A lot of peo­ple don’t see that because there’s a high turnover of staff in remote, but when you look back – even for me, look­ing back over 5 years’ time from when I start­ed at the Man­ingri­da Pri­ma­ry Health Ser­vice – I can see that there’s been quite sig­nif­i­cant change. 

That’s what keeps me moti­vat­ed every day. I use an anal­o­gy with the staff if they feel a bit over­whelmed… A stone is bro­ken by the last stroke of the ham­mer, but that doesn’t mean that the first stroke is useless. 

Suc­cess is a result of con­tin­u­ous and per­sis­tent effort. Even if you may not be around to see that final stroke or out­come, you’re still part of that effort.

While this award was award­ed to me, I think it’s also an acknowl­edg­ment of every sin­gle per­son with a pas­sion and a pur­pose in their work, striv­ing to improve out­comes every day. 

The every­day qui­et achiev­ers often don’t feel like they’re seen or have an impact or influ­ence on what’s hap­pen­ing around them. 

On reflec­tion on receiv­ing this award, I think that’s what it rep­re­sents – and I hope that every oth­er qui­et achiev­er that is chip­ping away at that stone will appre­ci­ate that this award is for all of them as well – and most def­i­nite­ly for my team, and the won­der­ful men­tors and teach­ers I’ve had over my career.”

To hear more from Lor­raine, lis­ten to Episode 12 of CRANAcast: The beau­ty, col­lab­o­ra­tion and gen­eros­i­ty of remote Aus­tralia”.