Harkness Project Title: Impact of Health Care Delivery Systems on the Quality of Ambulatory Care for Patients After Myocardial Infarction

Mentors: John Ayanian, M.D. and Barbara J. McNeil, M.D., Ph.D.

Placement: Harvard Medical School

Biography at time of Harkness Fellowship: Mary Seddon, a 1998-99 Commonwealth Fund Harkness Fellow in Health Care Policy, is a physician and fellow of the Royal Australasian College of Physicians. Prior to accepting her Harkness Fellowship, Dr. Seddon was a research fellow at New Zealand’s National Heart Foundation (NHF). Her work for the NHF involved a critical appraisal of the evidence for the NHF national nutritional guidelines, as well as assisting in the development and dissemination of guidelines for the management of heart failure. She recently completed her master's of public health degree. The thesis for this degree, included an overview of the rationing of health care, the various approaches to rationing, and the ethical implications of these. The focus was on the recently introduced priority scoring system for Coronary Artery Bypass Graft (CABG) surgery that is used in New Zealand to ration access. Her current research interest focuses on methods of measuring quality of care, and ensuring quality in the face of funding constraints. She received a medical degree from Otago Medical School, Otago University. She is also currently completing a Masters of Public Health.

Career Activity Since Fellowship

• Clinical Director Quality Improvement Unit, Counties Manukau District Health Board, 2007
• Head of Quality Improvement, Medicine and Acute Care, Middlemore Hospital, 2001
• Senior Lecturer in Quality Improvement, School of Population Health, Auckland University, 2001
• Ken Newell Prize in Public Health (top examination candidate), 2001
• Director, Clinical Quality Improvement Program, Middlemore Hospital, Auckland, New Zealand, 2000

E-Mail: MZSeddon@middlemore.co.nz

Harkness-Related Publications

Willcox S, Seddon M, Dunn S, Edwards RT, Pearse J, Tu JV. “Measuring and Reducing Waiting Times: Cross-National Comparison Of Strategies,” Health Affairs 2007 26(4): 1078-1087.

Seddon, M.E., Marshall, M.N., Campbell, S.M., Roland, M.O. “Systematic review of studies of quality of clinical care in general practice in the United Kingdom, Australia and New Zealand.” Quality in Health Care. 2001; 10(3):152-158.

Seddon ME, Ayanian JZ, Landrum MB, Cleary PD, Peterson EA, Gahart MT, McNeil BJ. “Quality of Ambulatory Care after Myocardial Infarction for Medicare Patients by Type of Insurance and Region” American Journal of Medicine July 2001; 3: 24-32.

Seddon ME.  “Managed Care in America:  Lessons for New Zealand” New Zealand Medical Journal 2000; 113(1114):318-21.