Well Child / Tamariki Ora Quality Improvement Framework

Updated 24 November 2022.

Introduction

The Ministry of Health, in partnership with sector experts, developed the Well Child / Tamariki Ora (WCTO) Quality Improvement Framework in 2013, drawing on New Zealand and international research.

The Framework has three aims: focusing on family/whānau experience; population health and best value for the health system; and setting quality indicators to audit health system performance.

The Framework and quality indicators provide a mechanism to drive improvement in the delivery of WCTO services. Ultimately, they aim to support the WCTO programme to ensure all children and their families/whānau are supported to achieve their health and wellbeing potential.

2016 Review

Under the Framework, the quality indicators are reviewed every three years. The 2016 review included consultation with the sector. The Raising Healthy Kids Health Target, the sector System Level Measures and the New Zealand Health Strategy were considered as part of the review.

The key changes to the indicators are the reduction in the number of indicators from 27 to 18 - indicators were either retired because they had been consistently achieved or removed to streamline the data set - and the inclusion of indicators on screening for family violence and Sudden Unexpected Death in Infancy (SUDI) awareness.

Publication of quality indicators data

The 27 WCTO quality indicator set reports were published every six months between September 2013 and March 2016, for the reporting periods ending respectively 30 June and 31 December and remain available on the Ministry of Health website and the HQSC Atlas of Healthcare Variation.

Available below is the latest quality indicator report (March 2021) and historical reports back to March 2015 for the set of 18 indicators. These reports support WCTO health system partners to maintain their focus on quality improvement and system integration, both within and outside of the WCTO Quality Improvement Framework.

The information within the report has been improved and enhanced for users by incorporating a definition table; a data table with numerators and denominators; and, interactive graphs with results by both DHB and quality indicator, by region, and by ethnicity.

September 2021 - Correction to Indicator 15 and 18 data

In July 2021, the Ministry identified and fixed a programming error which incorrectly set the parameters for Indicator 15 – children are a healthy weight at 4 years.

The error meant previously published reports have incorrectly included children in the overweight BMI category (91st – 98th percentile) in the healthy weight data for this indicator.

Reports published from March 2021, will correctly use the 2nd and 91st percentile parameters for Indicator 15 – children are a healthy weight at 4 years.

The healthy weight data in reports from March 2015 to September 2020 have now also been corrected.

Data in the quarterly Raising Healthy Kids target reports are not affected by this error.

In 2020, the Ministry also identified and fixed a programming error which incorrectly set the parameters for Indicator 18 – children are referred when there is a concern for underling mental health problems.

The error meant previously published reports have incorrectly used PEDS assessment scores and showed the number of children with a concerning PEDS score who have either been referred to a specialist service or been provided with extensive clinical advice.

The Indicator 18 data in all published reports has now been corrected to use SDQ assessment scores and only include the number of children with a high SDQ-P score who have been referred to a specialist service.

WCTO Quality Indicator Report - September 2022 (xlsx, 741KB)

WCTO Quality Indicator Report - March 2022 (xlsx, 250 KB)

WCTO Quality Indicator Report - September 2021 (xlsx, 250.1KB)

WCTO Quality Indicator Report - March 2021 (xlsx, 255.97KB)

WCTO Quality Indicator Report - September 2020 (xlsx, 676.5KB)

WCTO Quality Indicator Report - March 2020 (xlsx, 285.03KB)

WCTO Quality Indicator Report - September 2019 (xlsx, 286.55KB)

WCTO Quality Indicator Report - March 2019 (256.56KB)

WCTO Quality Indicator Report - November 2018 (xlsx, 252.09KB)

WCTO Quality Indicator Report - March 2018 (xlsx, 253.5KB)

WCTO Quality Indicator Report - September 2017 (xlsx, 250.79KB)

WTCO Quality Indicator Report - March 2017 (xlsx, 252.05KB)