Quality improvement in New Zealand pediatric anesthesia: National quality direction, patient experience, equity, and collaboration.

The current priorities of the quality and safety of patient care in New Zealand at a central government level are described, with a focus on equity and patient experience. Priorities between stakeholders differ. We report the current quality activities of New Zealand pediatric anesthetists in relation to these governance aims, seeking gaps and suggesting future directions to align governance priorities and local activities. International relevance is also outlined. New Zealand Māori experience health inequity. Complex systemic factors including those of systemic racism and prejudice contribute to the inequity. The specific contributions to health inequity from pediatric anesthetists are unknown but could include aspects of cultural safety, delays in treatment and treatment deficits. Patient experience is correlated positively with other quality domains. Peri-operative patient experience tools require outcomes of interest that matter to patients, including relevant cultural safety domains. Risk identification and critical event review contribute to local learnings in departments and institutions, and more widely to national and binational (with Australia) learnings. Several collaborative projects in Australia and New Zealand, whilst not primarily quality improvement projects, may improve pediatric anesthesia. These collaborations include a pediatric anesthesia professional network, a curriculum for a pediatric anesthetic fellowship, contributions to a document on standards for pediatric anesthesia, and a national quality group researching key performance indicators across New Zealand.