District health boards have pledged to make improvements in response to a report showing varying rates of patient safety in hospitals.
A report by the Health Quality and Safety Commission reveals just a quarter to a third of the 20 DHBs in the country are doing enough to protect patients from falls, infections or harm during or after surgery.
The data in the report reveals patients aged 75 and over have a high risk of falling over in hospital, thus adding on average a month to their hospital stay.
It found that though five DHBs effectively assessed patients at risk of falls, on average every weeks two patients fell and broke their hips, costing the health system at least $2.6 million.
DHBs found to have assessed at least 90% of patients in this age group last year are Counties Manukau, Canterbury, Waikato, Taranaki and South Canterbury.
The commission's chairperson, Alan Merry, said on Thursday that district heath boards need to improve.
"We have chosen levels that are quite high. But at the same time, the fact that a quarter or so of hospitals are already achieving them, it's showing that what we are asking is something that everybody ought to be able to achieve.
"This is a wake-up call that there are some very basic, relatively simple things that we ought to be getting right, and we've just simply got to lift the game on those basic, simple things."
Professor Merry said overlooking what seems like trivial detail, such as using a checklist or washing hands regularly, can have fatal consequences for patients. He said the findings should motivate DHBs to introduce local management safety strategies that work for them.
The Bay of Plenty District Health Board is ranked third on using a comprehensive surgical checklist for operations, which it does 94% of the time. However, it is last for assessing older patients for the risk of falling, which happens just 43% of the time.
Acting director of nursing Ros Jackson said the DHB is looking at ways it can improve.
"There's no way to dress-up forty-three percent - it is what it is. However, we need to reinforce that we are serious about the work that we do with health quality and safety and our patients' safety measures, and we will certainly be looking at revising what we currently do in terms of documentation and seeing what we can do to improve."
The South Canterbury District Health Board was found to be the least compliant for hand hygiene. Chairperson Murray Cleverley said the board is not happy with its ranking and has made changes.
The commission's next report is due out in December this year.