Embed Size (px)
DESCRIPTION
Counties Manukau Health staff publication
Citation preview
CONNECT I PAGE 1
Welcome to the Spring edition of Connect. Although it is officially Spring, we are still experiencing big numbers of presentations and admissions, putting pressure on all front-line staff. I want to thank all of you for such a sterling effort and for the fact that our 6 hour EC target has still been maintained despite the pressures.
Our 20,000 Days campaign’s importance is highlighted in these figures. We absolutely must change our strategy to reflect the importance of primary and community care in helping to prevent avoidable admissions and to care for more patients where they should be treated. Hospital is not the best place to treat many patients and we have to make changes so that we can not only survive, we can also thrive. This means partnerships with primary care, patients and their whanaau and our communities. We must no longer think in silos but about how what we are doing links with primary care.
This is where whaanau Ora and such thinking has such an important part to play in how we embrace our future and the pressures that await us. It’s not just about being more efficient but about changing how we think about our patients and how we partner with them. Research shows that if a patient has 3 or more co-morbidities that the cost of caring for them rises exponentially. We need to think about the best way of empowering that patient to take better care of themselves and to also be able to access the care they need where they need it, in the community
A couple of weeks ago saw the first big step towards our patients being able to access the care the need in their own community with the launch of our first
Locality Clinical Partnership (LCP) in Franklin. LCPs are about working with our colleagues in primary care to deliver more healthcare closer to patients’ homes. Franklin LCP has been created in partnership with primary and community carers in Franklin and has a slant towards the needs of the community, many of whom are older in terms of the services that will be offered.
So many people in our community now have say diabetes that if we do not get a good handle on the treatment of this epidemic, we will be overwhelmed in the future by increased hospital demand. One way of doing this is by having an ‘informed’ patient. Diabetes UK reckons that 80% of treatments can be wasted if the patient does not fully understand what the treatments are for and what we are attempting to achieve. Each of us has a part to play in creating the informed patient – and this applies to any chronic condition.
On a very positive note I would like to mention the success of the APAC Conference held in Auckland recently and co-hosted by Ko Awatea with the prestigious Institute for Healthcare Improvement from Boston. The meeting drew over 900 healthcare professionals from 16 countries and delegates heard from such luminaries as Dr Don Berwick, Sir Muir Gray and Maureen Bisognano, CEO of IHI. Feedback I have had has been overwhelmingly positive and I know that patient safety and experience will be lifted several notches because of the conference. Thanks also to all the CM Health staff who attended.
Best Wishes,Geraint A Martin, CEO, CM Health
From the CEO
OCTOBER 2012
Brand NewCounties Manukau District Health Board has a new name and new logo - but rest assured we will still provide the same excellent services and care our patients have come to expect.It’s been a challenging process. Firstly our brand and values needed to be aligned with our commitment to the Triple Aim of keeping people well, improving patient experience, and affordability. Secondly it needed to define who we are and what we stand for.Our strategic objective is to become the best health care system in Australasia by 2015 and to achieve a balance between excellence and sus-tainability. The realignment of our brand reflects this journey and our surroundings, our history of Maaori settlement and our aspirations.
Blue: The blue colour reflects the waters which bound our district and relates to the special sig-nificance of the Waikato river to Tainui Maaori.
Wings: Fan shape reflects a birds open wings. Wings reflect freedom from illness and flight to a new future.
Partnership: The interwoven wings establish the importance of partnership – wings are interde-pendent and must work together to function properly, this reflects our focus on integrated services and working closely with our partners and communities.
Weaving pattern: Lines when crossed, reference Maaori weaving and have strong architectural cues. The three lines at the tip represent the three main cultures of Counties Manukau district - Maaori / Polynesian; Asian /Indian; and European.
Manukau: The full name of the Manukau har-bour is “Te Maanukanuka o Hoturoa” meaning, “the compelling paddling of Hoturoa” recognis-ing the anticipation experienced as the Tainui canoe was paddled into the Manukau Harbour for the first time, and a possible reason as to why it was carried across the Tamaki isthmus to the Waitemata Harbour.
CONNECT I PAGE 2
Meet the board
In each issue of Connect we will profile board members so that you can get to know them better.
Lyn MurphyLyn Murphy was elected onto the Counties
Manukau Health in 2010. Prior to this she
was a Member of the Howick Community
Board. Lyn originally trained as an
Occupational Therapist. She has worked in
general and psychiatric hospitals, as well
as providing community-based care. She
has been active in supporting a healthy
community, including membership of
CCS, Arthritis Foundation, and Paraplegics
Association committees and Advisory
Trustee for the Arohaina Trust for the
Elderly.
Lyn is a senior lecturer in management
at the Manukau Institute of Technology.
She has qualifications in psychology and
management. She is currently completing
a PhD in accounting and finance. Her
doctorate thesis investigates the costs
and benefits of medical research at CM
Health .
Lyn is active in promoting New Zealand
as a good place to do health research.
She is a member of the Australian and
New Zealand Academy of Management
(ANZAM), Health Management SIG and
the New Zealand Association of Clinical
Research (NZACRes). She is facilitating
the development of a New Zealand
chapter of the International Society of
Pharmaco-economics and Outcomes
Research (ISPOR). She is a recipient of the
internationally prestigious ISPOR student
award.
Significant and far reaching changes are included in
the new Community Pharmacy Services Agreement
which took effect from 1 July 2012.
District Health Boards (DHBs) have been working
with pharmacy representatives for some time on
a new service model for community pharmacy.
The aim of the new model is to strengthen the
Pharmacist’s role in the modern health environment,
and use their clinical skills and expertise as part of
a multi-disciplinary health team to provide a high
quality patient-centred service.
The fundamental change in the model is a shift
away from payment for each item dispensed to a
system which incentivises the provision of clinical
pharmacy services for patients.
The new model was developed against the
backdrop of increasing dispensing fees and a tight
economic climate. In particular dispensing via
weekly close control has been increasing at an
unsustainable rate.
The Long Term Conditions Service has been
introduced to help the five percent of New
Zealanders with multiple long term conditions
who have difficulty managing their medicines.
Patients who don’t adhere to their treatment
regime don’t get the best health benefit from the
medicines prescribed for them. This is a particular
area where pharmacists can help by synchronising
and reconciling medicines and working closely with
patients to identify barriers to compliance with
medicines.
Some pharmacists are already providing these
services – the new model will encourage all
pharmacists to do so, working with GPs and other
prescribers to assist patients with their medicines.
In the new service model, core dispensing services
remain the same for the majority of people who
receive pharmaceuticals. ■
A new service model for community pharmacy
Could you live on $2.25 a day? That’s exactly
what healthAlliance’s Information Services
Training team did recently.
The team of six took part in the Live below the
Line charity challenge from September 24-28th,
raising more than $1000 for the P3 Foundation,
which empowers young people to take a stand
against extreme poverty in the Asia Pacific
region.
Team member, Christina Duthil, said it was a
challenge to get by living on a tiny budget.
“We really missed the variety of food and
coffee! Resisting all the yummy food in our
pantry was excruciating. We can’t even begin to
imagine how unbearable it must be
for people that can’t afford food to
watch other people eat what they
want. We just feel very blessed to
be able to have whatever food we
like.”
The team pooled resources as
much as possible and shared basic
foods like oats and rice over the
week-long challenge.
“Buying the food for only $11.25
for 5 days got us creative with our
menu and made us realise how
hard it is to live on such a small
budget and how much we waste.
healthAlliance staff ‘Live below the Line’
We had a ball cooking
vegetarian food for each
other,” Christina said.
On the team’s delicious
‘a la carte’ menu was:
dahl, potato curry,
parata, roti, fried rice and
porridge with water for
breakfast.
P3 Foundation’s
mission is to provide young people with the
opportunity to be active volunteers in tackling
extreme poverty. You find out more about them
at www.p3foundation.org. ■
Back Row: Najla Hassou, Christina Duthil, Jayasree Vijayakumar, Elaine Lorimer. Front Row: Jane Shand, Avneet Sharma
CONNECT I PAGE 3
fantastic laboratory for what needs to happen in
the rest of New Zealand.”
ProCare CEO Ron Hooton said the new part-
nership has enabled greater understanding for all
involved of the challenges each other faces.
“We’re 110% committed to making this work,”
he said. “There really is one ultimate measure of
success for me: that there’ll be no more emails
telling me that Middlemore Hospital is full and
can’t take our patients.”
Franklin was the first of four LCPs to be
launched in Counties Manukau, with East (includ-
ing Howick, Beachlands/Maraetai, Clevedon and
Kawakawa/Orere), Otara/Mangere (including
Northern Papatoetoe) and Manukau (including
Southern Papatoetoe, Manurewa, Takanini and
Papakura) to follow in the coming months. Geoff
Smith, who has extensive involvement in the
Franklin community and works at ProCare, has
The launch of the Franklin Locality Clinical Part-
nership (LCP) is a landmark change for primary
and secondary care throughout New Zealand, ac-
cording to National MP for Hunua Paul Hutchison.
The Franklin LCP, the first of four LCPs to be
introduced in Counties Manukau, was launched
in Pukekohe in September.
“It’s taken quite some time to get [the integra-
tion of primary and secondary care] firmly and
squarely on the agenda, but we have here… This
is truly a landmark opportunity in New Zealand,”
Dr Hutchison told the assembled guests.
Counties Manukau Health (CM Health) has di-
vided Counties Manukau district into four locali-
ties to improve the way healthcare is organised
and delivered. LCPs, which partner CM Health
alongside our other colleagues in the health
sector (particularly Primary Health Organisations
and GPs/family doctors) will be developed for
each of the four localities.
The Franklin LCP, a joint venture led by CM
Health and ProCare, encompasses a network
of health services providers and the Franklin
community with the fundamental purpose
of providing excellent health services for the
people of Franklin. Dr Hutchison congratulated
the founding members of the new partnership,
which includes all of Franklin’s general practices
(Waiuku Health Plus Medical Centre, Pukekohe
Family Health Care, Pukekohe Medical Services,
Seddon Street Medical Centre and Tuakau
Health) and ProCare’s Franklin locality team
alongside CM Health.
LCPs are about working with CM Health’s
colleagues in primary care to deliver more
healthcare services closer to patients’ homes.
For patients, this will reduce the inconvenience
and expense of visiting Middlemore Hospital
while enabling CM Health to shift demand for
some services away from the hospital into the
community, where some patients can be better
looked after. In Franklin, the initial emphasis is on
improving the experiences and health outcomes
for patients, particularly in the areas of aged
care, palliative care, COPD, CVD and diabetes.
“People don’t say ‘I live in Counties Manukau
DHB, they say, I live in Pukekohe.’ They relate to
their community, so let’s build our services around
the communities our patients relate to,” said CEO
Geraint Martin at the Franklin LCP launch. “We
need to work differently in different places, where
the people are – not the lines on a map.
“We’re beginning to describe the future of
healthcare in New Zealand,” he said. “It sounds
bold and dramatic, but it really is. Franklin is a
Franklin Locality Clinical Partnership Applauded for national significance
Dr Paul Hutchinson at the Franklin LCP launch
Each year the Faculty of Medical and Health
Sciences honours the best of our clinical
teachers in the form of the Dennis Pickup
Clinical Teaching Awards. These are made
to clinical teachers who are judged by staff
and students to have made an outstanding
contribution to medicine, nursing or pharmacy
by virtue of their qualities as role models and
their contribution to the relationship between
the health professions and the Faculty of
Medical & Health Sciences.
Our second 2012 Dennis Pickup Award
recipient from the School of Medicine is Dr Paul
Jarrett a Dermatologist at Counties Manukau
Health.
Paul Jarrett has only been at Middlemore
for three years but already his contribution to
the academic mission of the South Auckland
Clinical School is outstanding.
Paul has worked tirelessly to develop
teaching in dermatology not only at
Middlemore but also across the city. Currently
he is working towards redesigning the
dermatology contribution to Phase 2 formal
learning. He has also mentored cohorted 5th
years at Middlemore as part of a pastoral care
programme. He is a regular examiner and
contributor to the clinical methods programme.
He has also volunteered to serve on the Faculty
elective supervising committee. He is also
a member and contributor to the Medical
Education Research Group at the South
Dennis Pickup AwardAuckland Clinical School (SACS).
In addition Paul has enrolled in a Doctorate
of Medicine MD programme and is
collaboratively working across departments
and across Universities to investigate the role
of Vitamin D in Psoriasis. He has supervised
a student in a dermatology research project
and is a vital part of the postgraduate research
group at SACS.
Paul’s contribution as a ‘clinical academic’
outside of the normal full-time university
model is a truly outstanding contribution to
the work of SACS. In addition to the above
contribution to the academic environment at
SACS Paul is a highly respected clinician. He
is fully deserving of a Dennis Pickup Clinical
Educator Award. ■
Award recipient Paul Jarrett (right) with Mr Dennis Pickup at the ceremony.
been seconded as the General Manager of the
Franklin Clinical Partnership.
More information is available at www.cmhdb.
org.nz. ■
CONNECT I PAGE 4
Adversity often brings out
the best in people and when
Christchurch was dealt a
destructive blow it was co-
operation and collaboration
that rescued the city’s most
vulnerable older citizens.
Workers at Christchurch’s
rest homes and private
hospitals initially thought they
could cope with the aftermath
of the big quake that hit on
Tuesday February 22, 2011.
However, without power,
water and sewage systems
it was soon evident that
the residents needed to be
relocated to somewhere
safer that could provide for
their needs.
People throughout New Zealand wanted to
know how they could help Cantabrians and staff
members at Counties Manukau Health (CM
Health ) were keen to do their bit.
When other regions were asked to provide
accommodation and support CM Health, Health
of Older People Programme Manager Berta
Nicoll, was asked to coordinate the Auckland
region response and put in place plans to assist
the residential aged care facilities.
“Rest home residents were transferred around
the South Island first, within land transport,” says
Berta.
Air transport transferred people to more
distant locations such as Nelson and Invercargill
but it became logistically easier to transport
people to Auckland where there were more
vacant beds.
Within a day Berta was co-ordinating the
Auckland region and by Thursday private
hospitals and rest homes were on stand-by.
There were three new facilities in Auckland,
and Berta and Jenni Coles knew there was
potential capacity at Ambridge Rose Manor
Private Hospital and Rest Home in CM Health
region, although the new rooms weren’t
completed.
Collaboration and a well-established
relationship with the CM Health and the
residential sector proved invaluable in the
emergency situation and the Pakuranga facility
was asked if they could help out.
Allan Sargeant co-owner of Ambridge Rose
Manor says the building was only a carpeted
shell and the finishing fit-out was immediately
launched, including everything from making beds
to supplying hand gels.
Allan knew he would need all the compliance
approvals off to be completed for these new
beds to be available.
A planned Ministry of Health sign-off went
smoothly, Auckland Council promptly issued a
certificate of public use for the ground floor only
and NZ Fire Service signed off for fire evacuation.
“By three o’clock on
Friday afternoon I had all
of the approvals. There
were no curtains, beds
weren’t made and there
were no hand cleansers,
paper towels or toilet tissue
dispensers,” Allan says.
He contractually ‘seized
the building’ from the
builders and then it was all
hands on deck to clean and
set up everything ready for
the Christchurch evacuees
by 8pm on Friday.
Jenni says Auckland’s
three DHBs planned
together and the goal
was to keep the expected
60 Christchurch people
together.
“The psychological risk and stress of being
moved would be significant and we could put
in good support packages from CM Health .
This would be more efficient if we had people
grouped together rather than dotted all around
the area,” says Berta.
A triage team was organised to meet the
arrivals at Whenuapai at 8pm on Friday February
25.
“The DHBs had their action teams and facilities
were waiting and ready to go,” Berta says.
“We were phoned at 9pm and told people
weren’t coming that night and we could stand
down until the morning.”
Berta stood the DHB and facility teams down
and headed home, but at about 10pm she was
contacted again and was told the plane was
about to land at Whenuapai.
“I re-started the triage. By this stage staff had
all gone home and people were getting ready
for bed or quietly unwinding. They all came back
again.
“Holding an executive role and being at home
already didn’t let Jenni off the hook and the
acting COO was collected by Berta to assist in the
emergency response.
Allan had his feet up in his office but was
immediately back on duty calling staff to return
to Ambridge Rose Manor.
“I learnt to double check every phone call
that came in to make sure I had the correct
information,” Berta says.
“The original call should have informed us
that only half the number expected was on that
evening’s flight.”
Finding refuge for Christchurch’s elderly
Sealed with a handshakeWhen Jenni Coles needed help to
accommodate older evacuees from
Christchurch she knew she could depend
on the residential aged care providers in
CM Health .
“We have excellent collaborative
relationships with the aged care sector.
“We negotiated with Allan to make
Ambridge Rose Manor available and did it
on a handshake. That’s the trust that was
involved and needed at a time like this,”
says Jenni.
Allan says the logistical process was
amazing and there was great support
from CM Health and his own team, which
included the private hospital’s manager’s
husband and their visitors they had from
overseas.
When asked if he would do it again – he
responded with a resounding ‘no’, followed
with a smile and ‘of course we would’.
Allan Sargeant, Co-owner of Ambridge Rose Manor worked with Berta Nicoll, Health of Older People Programme Manager and Jenni Coles, director Hospital Services to re-home Christchurch earthquake evacuees.
CONNECT I PAGE 5
The Christchurch people started to arrive at
Ambridge Rose Manor from 1.30am where the
CM Health clinical team and private hospital
staff welcomed them and got them settled.
Allan says the situation was a changing
landscape that altered hour-by-hour and it was
planning on the fly.
“Until the Christchurch people arrived we
didn’t know who they were or what level of
care they needed.
“Plans then changed minute by minute and
people they thought could be settled in one
room required a higher level of care and were
placed nearer to the nurse’s station.
“It worked really well. Some people could
walk off – we could give them a cup of tea
and settle them in their room. Other people
needed more care and support,” says Allan.
“Noeline Whitehead and her clinical team
were set up to assess them comprehensively
and to settle people into bed,” Jenni says.
The last people were being settled at about
5am on Saturday. About 10 people arrived at
Ambridge Rose Manor in the early hours of
Saturday morning and at about 10.30pm on
Saturday another five people arrived
Many of the people had prepared to leave
Christchurch at 5am on Friday and they didn’t
arrive at Ambridge Rose Manor until about
1.30am the following day.
As some arrived with nothing other than
the clothes they wore and basic clinical
information, the clinical team and caregivers
assessed the need and provided the care and
support.
“Every action plan for emergencies says
contact the families and they will come in and
assist but you can’t contact families in this sort
of situation,” Berta says.
“Their homes were demolished, they didn’t
have phones or power to recharge mobile
phones and they were dealing with their own
crisis.
“They’re thinking in the back of their minds
‘at least my loved one is safe in a residential
care facility.’ Physically they just couldn’t get to
their relatives.”
Berta was pleased to know the planning for
similar situations really worked when put into
practice.
“We were really pleased that we could
move quickly to meet this need” says Allan.
“When we stopped we felt like we could do
anything. It was a great confidence boost.” ■
Lesley MacLennan and Isabella Smart, Clinical Spe-
cialist Diabetes Midwives working in the community
midwifery service in Woman’s Health presented a
poster at the ADIPS (Australasian Diabetes in Preg-
nancy Society) conference in Australia.
The poster shows the development of a
multidisciplinary care schedule and pathway
for women with diabetes in pregnancy. The
poster illustrates the development of a competency
framework for specialist diabetes midwives at CM
Health and various communication tools devised.
It was very well received and we have had
requests for further information regarding our
developmental processes and communication tools
from health professionals doing similar work in
Australia.
The poster is the culmination of two years
of hard work by the two Diabetes in Pregnancy
midwives focused on improving the Diabetes in
Pregnancy Service at CM Health. The aim is to
enable pregnant women with diabetes to be cared
for in a safe, appropriate and efficient manner –
remaining with their primary care midwife wherever
possible – thus maximising their choice of maternity
carer and continuity of care, even when complicated
by diabetes.
The poster also demonstrates the links between
primary and secondary carers in the care of women
with diabetes in pregnancy and the communication
tools to ensure information flow.
To see the full poster, please call Isabella Smart on
021 784 061. ■
Diabetes in pregnancy
CONNECT I PAGE 6
SuperClinic’s wish list answeredChristmas has come early for Manukau SuperClinic after a new ECG machine and autism toys were donated from Middlemore Foundation for Health Innovation sponsors.
Donna Neal, Clinic Nurse Manager, was presented with a new ECG machine worth $13,000 from Visy Recycling General Manager Andrew Gleason.
Visy’s 350 staff members competed in a six week ‘Biggest Loser’ fundraising challenge and The Pratt Foundation, founded in 1978 by Richard and Jeanne Pratt who own Visy, matched dollar for dollar their fundraising efforts.
Siu Havili, 12, had rheumatic fever and a heart valve replacement when she was seven-years-old. This new ECG machine has made her visits faster. Mrs Neal said, in some cases, if a good heart rhythm was not detected on the old ECG machine patients had to make another appointment.
Connecting families in times of needFirst National Real Estate
has kicked off a new
relationship with the
National Burn Centre
by donating four new
ipads, complete with
Internet connections, to
assist patients to stay in
touch with their family
and friends during their
prolonged hospital stay for
severe burn injuries.
Tracey Perrett, National
Burn Service Coordinator,
says the donation of ipads
will allow patients to use
social media and email to
maintain contact with their
friends and family during their admission to the
centre. iPads are also currently being trailed
in burn centres internationally to provide
distraction during stressful procedures.
“We are delighted to be able to offer this to
our patients in the National Burn Centre,” Mrs
Perrett says.
As well as the ipads, First National is gifting
new home buyers a Home Safe Kit, which
includes a 0.9KG ABE fire extinguisher, a
Doctor Vanessa Thornton, clinical head of
Middlemore Emergency Care, has become a top 30
finalist in the NEXT Woman of the Year 2012 awards.
NEXT magazine’s annual Woman of the Year
awards ‘acknowledge remarkable women who
manage all aspects of their lives while making an
outstanding contribution in the following fields: Arts
and culture, business, community, education, health
and science, and sport’.
The Middlemore Foundation for Health Innovation
nominated Vanessa, not only because she runs one
of the busiest emergency departments in Australasia,
but because she is a wife and busy mum-of-three,
leads health research and projects and is a great
mentor to staff.
Winners will be announced at a glamorous gala
dinner on Thursday, October 11 at Auckland’s leading
venue, The Wharf. ■
Middlemore’s Woman of the Year
Specialists used toys to diagnose Tresahn Wharerau, 2, with autism earlier this year.
On the other hand, the Twinkle Child Foundation, a student run charity, used its links with some of Auckland’s top schools to run bake sales, stalls and a comedy night at the University of Auckland. Proceeds raised bought toys for Manukau SuperClinic, to be used as a tool to help specialists diagnose autism in children.
Louise Porteous, Developmental Paediatrician, explained the toys would be used in play-based assessments to see how patients analyse, problem solve, take directions and seek help.
“We find informal assessment with skilled people is equal to more formal assessments,” Louise said. ■
First National General Manager Colleen Milne, Chairman Bob Brereton and burn survivor Erik Molving with the new Home Safe Kits and ipads.
photoelectric smoke alarm and a fire blanket.
First National office and sale representatives
will give $5 from every Home Safe Kit to the First
National Foundation, which will then donate the
full amount to the National Burn Centre.
First National’s General Manager Colleen
Milne said the partnership was a great way
to give back to the community and support
the lifesaving work the National Burn Centre
does. ■
CONNECT I PAGE 7
Girl power wins kids’ heartsMost New Zealanders will never have the
opportunity to hold an Olympic medal in the palm
of their hands. But lucky patients at Kidz First
Children’s Hospital held and wore two Olympic
bronze medals recently.
Rowers Juliette Haigh and Rebecca Scown
visited Kidz First after winning bronze medals in
the Women’s Coxless Pair event at the London
Olympic Games in August.
The visit arranged by the Middlemore
Foundation for Health Innovation was discussed
two days after Juliette and Rebecca won bronze.
Six weeks later, when the pair walked into the Kidz
First playroom it was hard to tell who was more
excited - the patients or Rebecca and Juliette.
Kilahn Manuera, two, was the hugger of the
day and took a liking to Juliette and wearing her
medal.
Cambridge-based Rebecca told sports-mad
Kenna Richmond, 10, to follow her sporting
dreams and that hard work really does pay off.
Juliette said she was blown away by the excited
patients and the experience of visiting Kidz First.
“Amazing visit thanks, Juliette said. “Gorgeous
kids and loved sharing our medals with them!
We’d love to come again and bring more rowers
too.”
Middlemore Foundation and Kidz First patients
can see Juliette and Rebecca again at the Kidz First
Christmas Party in December. ■
Middlemore Foundation for Health Innovation
is pleased to announce the arrival of Bernie
Mackie, who has been tasked with creating
an alumnus for past and present Counties
Manukau Health and South Auckland Health
staff. Bernie is no stranger to Middlemore,
as a former nurse and now Middlemore
Alumni Coordinator. Alumni members will be
kept updated on CM Health projects, news
and events. To join please call Bernie at the
Foundation on 09 270 8808 or email Bernie.
Communities give backRelationships with two community sponsors
were strengthened when Weymouth
Cosmopolitan and Sports Club and Red Knights
Firefighters Motorcycle Club (Northland) were
presented with Certificates of Appreciation.
Weymouth Cosmopolitan and Sports Club
had just donated $2,000 to Kidz First Children’s
Hospital after its annual Kahawai Fishing
Tournament on the Firth and Manukau Harbours.
Keen anglers come from as far as Whangarei to
take part in the fishing competition.
This is the 12th year children admitted to Kidz
First will benefit from the tournament. Over
the last 11 years, proceeds from the event total
$18,000 and have been used for much-needed
equipment, like hearing aids, eyeglasses, a
paediatric bed space and paediatric cot and vital
signs monitor.
A day after the fishing extravaganza, petrol
heads took to Northland roads and revved into
the 10th annual Ride for Kids run by the Red
Knights International Firefighters Motorcycle
Club (Northland). Two hundred riding enthusiasts
cruised from Kaiwaka Fire Station to Waipu Fire
Station. The event raised $1,500 for children
admitted to hospital with burns. The annual rides
have raised in excess of $10,000. ■
Bernie Mackie is a former Middlemore nurse.
Russell Rawiri, President of the Red Knights Interna-tional Firefighters Motorcycle Club (Northland), and Sandra Penny from Middlemore Foundation shake a collection bucket for Kidz First.
Middlemore alumni kicks off
Tyrone Oti, 10, couldn’t believe Juliette let him wear her bronze medal. Juliette couldn’t believe Tyrone made her a paper oar.
CONNECT I PAGE 8
Counties Manukau (CM) Health faces significant
challenges for future health service delivery
including a global shortage of skilled health
professionals and an ageing health workforce.
Research literature indicates that having a
health workforce that reflects the community
it serves leads to improved health outcomes.
Currently at CM Health there is significant
under-representation of Maaori and Pacific in the
clinical workforce. Growing this workforce is a
key focus.
The Tindall Foundation generously provided
$2.25million to CM Health for 2010 - 2013
to develop opportunities for Maaori and
Pacific people to enter CM Health’s workforce
development pipeline. One of the projects
funded by the Tindal Foundation is the Health
Science Academies which was established in
three secondary schools in 2010: James Cook
High School and Tangaroa College partnered with
CM Health while Otahuhu College partnered with
the Pasifika Medical Association. The schools
work collaboratively to equip selected Maaori
and Pacific students with the prerequisites
for entry into health-related tertiary degree
programmes. The first cohort of Year 11 students
entered the academies in 2011 with the target
of 80% achieving NCEA Level One. 87% achieved
this with many receiving merit and excellence
endorsements. The health science academies were entered
Health science academies
into the Tomorrow’s Workforce category in
this year’s ANZ NZ and Equal Employment
Opportunities (EEO) Trust Work and Life awards
and won ‘by a country mile’ according to the
judges. The entry was then chosen as Supreme
Winner.
These accolades are a tribute to the vision and
hard work put in by all involved. Congratulations
to the Future Workforce team for their
successful implementation of CM Health’s
workforce development vision.
On Tuesday 2 October, there was a Health
Science Fair held at the CM Health Ko Awatea
centre where high school students had the
opportunity to talk with people from various
tertiary institutions that offer undergraduate
programmes in health and also meet a range of
health professionals from CM Health.
For more information about the Health
Science Academies, you can contact Christine
Hanley, Workforce Consultant on 021 226
3293. ■
The Northern Region has achieved
zero CLAB for the months of April, May
and August. In January 2012 the rate
of CLAB was 4.53/1000 line days to a
rate of 0/1000 line days. This is a very
encouraging achievement and the
teams to be congratulated on this great
result. At the commencement of the
project there were at least 4 reported
CLAB per month. The Northern Region
makes up 44% of the total line days
(7760/17666)*100. It should be noted
that the Northern Region has worked
hard to implement the surveillance definition of
CLAB. Implementing the surveillance definition
across all DHBs requires active collaboration
with microbiologists and Infectious Diseases
Physicians. There were a total of 12 CLAB in
the implementation months January to March.
Since March there have been a total of 3 CLABS
over a period of 5 months, at least 12 less
patients diagnosed with a CLAB.
The benefits to the patient are a better
experience, reduced number of days in hospital
and reduced harm. This was best demonstrated
when a patient arrived at Middlemore Hospital
from Auckland DHB with a central venous line
in place. Prior to this National CLAB reduction
programme this central line would have been
removed and a new line inserted. However
ICU staff noted that both the insertion bundle
and maintenance bundle processes had been
followed with the checklists completed by
staff at Auckland DHB. The patient kept
the existing line and avoided the trauma
of having it replaced.
“This is really exciting because its shows
the positive difference the staff make,
most importantly for the patient”. This
could not have achieved so much without
involvement of the Project and Clinical
Leads, the participating Microbiologists
and Infectious Diseases Physicians and
they are to be congratulated without
exception for the focus and collaboration
that has helped achieve the outcomes to date.
Implementing the surveillance definition
across all DHBs requires active collaboration
with microbiologists and Infectious Diseases
Physicians. There were a total of 12 CLAB in
the implementation months January to March.
Since March there have been a total of 3 CLABS
over a period of 5 months, at least 12 less
patients diagnosed with a CLAB. ■
Northern region CLAB highlights
CONNECT I PAGE 9
Hospitals are busy places and when you are a nursing student doing your clinical experience you can simply feel in the way.
Manukau Institute of Technology Bachelor of Nursing graduate Anj Taylor says she felt like a wallflower at times during her student days.
“At handover it was like ‘who wants the student?’ It wasn’t negativity. You could see the nurses were exhausted and they felt the student wasn’t going to facilitate making their job easier. They felt like being with a student was a chore.”
Luckily for Anj she became one of the first MIT students to do her clinical experience in a Dedicated Education Unit (DEU) at Middlemore Hospital.
In a DEU students work shifts alongside registered nurses, but the environment and staff are dedicated to teaching and learning. The
student is not an add-on, but an integral part of patient care.
In 2009 MIT and Counties Manukau Health worked together to trial two pilot DEUs in wards six and 24 of Middlemore Hospital.
It has been a successful pilot. There are now nine DEUs within CM Health , consisting of seven inpatient wards, two in mental health and one recently set up for aged care at Howick Baptist Hospital.
This week [Sep 5] a celebration was held at Middlemore Hospital, with past and current students, hospital and MIT staff attending to mark the success of the DEU model, which has become embedded in clinical education.
Anj, who is now a registered nurse and helps teach students within a DEU, says she can’t imagine working in a different environment.
Celebrating a new way of training nurses
From left: MIT student Dong Dela Cruz, Clinical Liaison Nurse Kusum Narayan and student Anj Taylor working within a Dedicated Education Unit at Middlemore Hospital.
“I think the Dedicated Education Unit really breaks down barriers. It’s a fantastic philosophy and way of going forward. There is no way of failing. You’ve got all these people there to help you.”
The staff and students within a DEU are supported by a Clinical Liaison Nurse (appointed by the hospital) and an Academic Liaison Nurse (appointed by MIT).
Clinical Nurse Liaison Rhonda Thorn says there is no doubt the DEU environment is best for students.
“We didn’t have DEUs when I came through MIT. I didn’t have a bad experience, but I knew there were some things missing. Now I’m able to help the students move through their study with confidence.”
Rhonda says a focus is to introduce students to other disciplines within the hospital, including pharmacy, physiotherapy, occupational therapy, speech therapy and social work.
This prepares students for the collaborative skills they need to give patients the very best care.
One of the most eye-opening experiences for students is spending time with the hospital’s bed managers, Rhonda says. This helps them understand exactly what a patient goes through before they are admitted to a ward.
MIT Dean of Nursing and Health Studies Willem Fourie says MIT and CM Health have presented to the Nursing Council about the success of the DEUs and have also published a how-to guide for other DHBs and tertiary institutions.
The project has received support and funding from Ako Aotearoa, the National Centre for Tertiary Teaching Excellence. Director Peter Coolbear says it has been highly successful and the model could be used by other vocational training disciplines. ■
October is Breast Cancer Action Month, and the
perfect time for health professionals to promote
the benefits of breast screening to their patients.
Mammograms can find very small cancers
before a lump can be felt and women who are
aged 45 to 69 should be encouraged to join
the BreastScreen Aotearoa (BSA) programme,
New Zealand’s free national breast screening
programme that checks women for signs of early
breast cancer.
Women aged between 45 and 69 who are
not already part of BreastScreen Aotearoa
can register to enrol on-line by going to www.
breastscreen.govt.nz, or ringing the freephone
number 0800 270 200. Primary care practices
can refer women who have consented to be on
the programme electronically (Medtech practices
only) or by fax or phone.
As there will be increased publicity around
breast cancer during October, GPs may be
approached more often by women who have
concerns about their breast health. As the
breast screening programme is for asymptomatic
women only, women with symptoms should
be referred to the South Auckland Breast Clinic
(fax 277 1646) and women with a strong family
history of breast cancer can be referred to the
CMDHB Mammography Unit (fax 277 1644).
BreastScreen Counties Manukau has recently
developed a Birthday card to send to women
who are turning 45 to encourage them to enrol in
the programme. Primary care practices wishing
to send these Birthday cards to women, or
wanting to identify women who are not enrolled
or who are overdue for the breast screening
programme can contact Roshina Singh (ph 250
8070). Roshina can arrange a data match with
the BreastScreen Counties Manukau (BSCM) data
base, discuss the birthday card project and assist
with other projects to increase participation in
the BSA programme.
If you would like further information about the
BSA programme or you would like someone to
talk to your practice or a group of your colleagues
about the screening programme or breast cancer,
please contact Roshina or ring the freephone
number 0800 270 200. ■
October is breast cancer action month
CONNECT I PAGE 10
what their medication is for and that is such a
waste. If we are all talking together and sharing
the same information the chances of this
happening are much reduced,” he said.
The DHB briefing was part of a series
of public and community seminars held
around New Zealand to discuss shared health
information. These follow on from a series
of community Future of Health workshops
run in 2010, and the NHITB says there will be
further opportunities for public feedback and
discussion.
Counties Manukau Health staff have had
an opportunity to hear first-hand about
improvements to the way personal health
information will be shared electronically.
By the end of 2014 the Government’s
aim is for all New Zealanders and the health
professionals caring for them to have electronic
access to their core health information.
The Ministry of Health’s National Health IT
Board (NHITB) held a briefing for DHB staff and
providers in Auckland in August, and NHITB
Director Graeme Osborne was pleased with
people’s engagement with the
issues.
“This is going to be a
significant part of health care
delivery in the future so I was
glad of the opportunity to talk
to DHB clinicians and staff, and some of their
providers, about the progress being made.
“Improved electronic sharing of health
information will ensure that everyone involved
in a person’s care will have access to the most
accurate and complete information possible.
That means health professionals have a fuller
picture before making decisions, and result in
better, safer care.”
The Chief Executive of Counties Manukau
Health, Geraint Martin, says that this is one
of his priorities in terms of improving patient
care and the patient experience. “I am aware
of patients who have not understood clearly
these improvements.
‘It means that clinicians caring for us will,
with our consent, have access to all of our
core health information over the course of our
health journey,’ he says.
“We will also be able to access our own
records and take a greater role in managing our
own health and wellness.”
There was widespread support for the
concept of electronic sharing of health
information. Ernie Newman says issues which
will need to be resolved to ensure public
confidence include:
• questions about security
and confidentiality, and who will
have access to information
• the possibility of some
information being ‘sealed’ to protect
privacy and further restrict who can view it
• questions about how long data will be stored
• concern about other services gaining access
to personal information
• issues raised by particular community groups
– eg Pacifica peoples seeking assurances
about citizenship databases and Asian
families concerned about access to an elder’s
health status within the family.
More information about the seminars and
a list of Frequently Asked Questions (FAQs)
can be found at: http://www.health.govt.nz/
yourhealth-topics/health-care-services/sharing-
your-health-information. ■
Shared health information briefing
National melanoma summit
Graeme Osborne has led discussion at the
seminars, supported by representatives from
the National Clinical Information Leadership
Group (NICLG) and the NHITB consumer panel.
Public seminars have now been held in New
Plymouth, Invercargill, Auckland and Nelson.
There have also been seminars for specific
groups – students and Maori, Pacific and Asian
populations, and for DHBs/health sector.
Emerging themes from shared health
information seminars
Ernie Newman, Chair of the NHITB’s
Consumer Panel, says people using health and
disability services will benefit greatly from
Health professionals with an interest in
melanoma will gather in Wellington for the third
National Melanoma Summit on 5 April 2013.
With the theme ‘Connecting melanoma
expertise in New Zealand’ the Summit will
provide a unique and important opportunity for
those working in all areas of melanoma control
to hear about recent developments, identify
priorities for action and work more closely to
reduce melanoma’s incidence and impact.
New Zealand has one of the highest rates of
melanoma incidence in the world.
In addition to hearing from internationally
recognised melanoma experts, the Summit will
include workshops on prevention, diagnosis,
clinical management and research.
One-day courses on common skin lesions
and dermatoscopy will be offered on 4 and 6
April.
Speakers
The Summit programme features New Zealand
experts, including overseas speakers who trained
here and are now recognised internationally for
their contribution to melanoma control: They
include:
• Professor David Elder, Professor of Pathology
and Laboratory Medicine at the Hospital of
the University of Pennsylvania and in the
Department of Pathology and Laboratory
Medicine at the university, who will speak
about melanoma diagnosis and staging criteria.
• Professor John Hawk, Emeritus Professor
and recent Head of the Photobiology Unit, St
John’s Institute of Dermatology, King’s College,
London, who will talk about current trends
in incidence and strategies for prevention of
melanoma.
• Dr Mary Jane Sneyd, medical epidemiologist
and Senior Research Fellow, Hugh Adam
Cancer Epidemiology Unit, University of
Otago, Dunedin, who will speak about how
melanoma epidemiology in New Zealand
differs from that of other countries and
how these differences can give clues about
melanoma risk factors. She will also discuss
her development of a New Zealand-specific
tool to assess an individual’s risk of developing
melanoma.
MelNet is sponsoring early bird registration,
valued at $276, for five delegates working
in the area of melanoma control. Successful
applications will be chosen on the basis of merit
and need.
To register for the Summit, apply for
sponsorship, or for more information, visit
http://www.melanoma.org.nz/MelNet/News/
Melanoma-Summit-2013/ ■
CONNECT I PAGE 11
Date: 28th November 2012
Time: 12.00 – 2.00pm (please bring your lunch)
Location: Ko Awatea Lecture Theatre –
Middlemore Hospital
Long-term conditions account for 70-78% of all
morbidity and mortality in New Zealand and
consume a similar proportion of all healthcare
spending. New models of care are required
to move from acute reactive care to planned,
proactive care with improved health outcomes
and patient experience.
Workshop 101: An introduction to Patient Self-
Management
This is a 2 hour session which introduces some
key concepts and resources for improving
chronic care. These include self-management
support, health literacy and some practical
tools for person-centred care planning. This is
ideally suited for health professional continuing
education sessions for medical, nursing, allied
health or interprofessional forums within
or across DHBs, PHOs, general practice and
community health organisations.
Workshop outcomes
• Know how patient self-management can
improve the management of long-term
conditions.
• Understand how patient self-management
supports integrated care practise models.
• Be familiar with Health Navigator’s resources
– the website and self-management toolkit.
• Have been introduced to the Long Term
Conditions Network –how it connects and
informs health professionals and consumers
across New Zealand.
• Know about the importance of person-
centred care in improving adherence and
health outcomes.
Please RSVP to Yasmien Khan by e-mail
([email protected]) by the
14th of November with your name and the
organisation you work for.
If you have any questions about this
workshop please contact Rochelle Bastion via
Facilitator
The facilitator is Dr Janine Bycroft (Clinical
Director) MBChB, Dip Obs, Dip Paeds, MPH
(Hons), FRNZCGP
Janine is the Founder and Clinical Director for
Health Navigator NZ.
She is also a GP, Flinders Trainer, GP Liaison
for Auckland District Health Board, Researcher
and Self-Management Clinical Advisor for
several DHBs and PHOs. Her areas of interest
include self-management support, quality
improvement, chronic care, e-health, health
literacy and the integration of primary and
secondary care. She is the primary care
clinical lead for the National Shared Care Plan
Programme and a member of the Cardiac
Care Strategic Advisory group for the Heart
Foundation. ■
You are invited Long term conditions workshop
Five New Zealanders awarded Honorary Residency of the Cook Islands for outstanding
service over many years in the arena of health to the people. Photo taken at the Queens
Representatives House: Left to right: Liz Iro (Sec Health), Dr Bob Eason (Physician CM
Health ), Dr John Veale, Lady and Sir Frederick Goodwin (Queens Rep), Andrew MacDiarmid
(Orthopaedic Surgeon, Tauranga), Dr Mike Webber.
Honorary residency
World breastfeeding week was held again
this year as for the past 20 years from
August 1-7.
The theme for this year was
“Understanding the past - Planning the
future” and this year also celebrates 10
years of WHO/UNICEF’s Global Strategy for
infant and young child feeding.
The Global Strategy has identified a clear
need for optimal infant feeding practices in
reducing malnutrition as well as poverty. It
is based on a human rights approach and
calls for the development of comprehensive
national policies on infant and young child
feeding. It provides guidance on how to
protect, promote and support exclusive
breastfeeding for first six months, and
continued breastfeeding for two years
or beyond together with adequate,
appropriate and indigenous complementary
feeding starting from the age of six months.
ILCA (International Lactation Consultants
Association) believe the strategy serves as
their roadmap in developing a framework
for action to protect, promote and support
breastfeeding, hence their logo for this
years World Breastfeeding Week theme,
The Road to Lifelong Health Begins with
Breastfeeding.
The Lactation team at Middlemore chose
to use the “Road to Lifelong Health Begins
with Breastfeeding” as the theme for display
posters in Maternity ward and ALBU.
The Big Latch was held on Friday 3 August
2012. There were seven sites that Mothers
and babies could attend within the CM
Health area, and a total of 101 babies were
counted toward the new national record
of 1571(up from1564 last year). Lactation
Midwife/Nurse Specialists from our team
at Middlemore attended at Manurewa and
Pukekohe to show our support. Globally
there were a total of 626 locations across 23
countries and 8862 breastfeeding children
counted for “The Big Latch”.
Thanks to all those in CM Health area
that are helping mothers and families to
make their journey successful.
References;
http://worldbreastfeedingweek.org/
http://www.womens-health.org.nz ■
World breastfeeding week
The National Depression Initiative’s advertising campaign began in 2006 and achieved a high level of awareness of depression amongst the public. The campaign has continued to evolve and now offers several resources you might find useful to help support patients through their treatment.
Using JK’s experience as a discussion pointDepression can be challenging to discuss
and treat when patients are reluctant to even acknowledge the issue. The John Kirwan advertisements have created a discussion point when talking to patients about the illness. Some doctors have reported patients explaining they have the “full JK”. This has reportedly made it quicker for doctors to get to a point of diagnosis with their patients.
Depression.org.nz as an information resourceThe depression.org.nz website offers people further information and covers several areas:• Warning signs and symptoms• Contributing factors• Treatment options• Managing depression• Advice for family and friends
The site also contains video stories of several people’s experience of recovering from depression. Many people find it comforting and informative to hear from others who have been through a similar experience. JK’s story is also told through the original series of TV commercials.
The Journal online programmeA key component of the latest campaign is The Journal. Designed to teach people self- management skills for mild depression, it also follows much of the process used in a clinical environment. Given the challenges of educating patients on all the techniques within a consultation timeframe, The Journal can assist by allowing the education to take place between consults, freeing up time to focus on discussing progress with their patients.
The Journal is made up of six lessons that
cover the key evidence-based, self-help skills:• Positive thinking• Healthier lifestyle• Problem solving
The lessons are structured in a fixed sequence that is designed to build up the skills in much the same way they would be during consultations.
This has the added benefit of guaranteeing all your patients will follow the same process.
Each lesson features engaging videos of JK and leading mental health professionals explaining the theory behind each skill. To help them implement what they’ve learnt JK assigns practical, real-world tasks for them to complete between
online sessions. Every step of the way they are supported by automated reminders and live services from the depression helpline.
Whilst the structure of the programme is fixed there are several ways it can be customised to reflect each user’s individual situation:
In the healthier lifestyle lesson the user may select from one of four physiological health areas; diet, exercise, sleep or relaxation. Talking with a patient about which to choose gives you an opportunity to align their learning with parallel treatment for other health issues.
Within the 3 three problem solving lessons the user has the ability to select one particular issue they face to work through to a resolution, in order to learn the process. Again, discussing what they might focus on beforehand may help them overcome issues you have identified during consults.
To protect the safety of people using The Journal they are asked to self-assess the severity of their symptoms (using the PHQ9 questionnaire) at the beginning, middle and end of the programme. In cases where their condition appears to deteriorate all users receive prompts to contact their doctor or the depression helpline for assistance. These messages will help patients understand when they need to reconnect with you.
Throughout the programme their activity is
recorded, in order to reflect it back to them and build a sense of achievement. This summary, at the end of the Journal, is an ideal way for patient’s to share their activity (and their self-assessed symptoms) during the programme.
It appears the Journal’s strong link to the advertising campaign is also adding an unexpected benefit. Whilst it was designed as a self-directed intervention, surveys of users indicated that 30% of them discussed or involved a friend or family member in their activities. Getting support from someone was also cited as a key way to improve completion of the full programme. This desire, or willingness, for help presents an opportunity to offer patients follow-up contact from practice staff.
Since launching in June 2010, over 30,000 people have actively used The Journal. It has yet to be clinically trialled, but results from user’s self-assessments indicate an improvement in their condition can be associated with its usage. Dr Lyndy Matthews, from The Royal Australian and New Zealand College of Psychiatrists, says “If people are able to use a programme such as The Journal, it shows that although an individual may be suffering moderate depression, the techniques used in The Journal are practical, manageable and effective," and that it may be time for GPs to consider prescribing it to patients.
The Lowdown for teenage patientsThe Lowdown was created to meet the different attitudinal and media habits of teenagers. Like the main campaign, its objective is to raise awareness of the illness and promote help seeking.
National depression initiative
The key difference is that The Lowdown uses youth celebrities to help normalise the problem and introduced text-based services for the first time in New Zealand.
In a clinical environment The Lowdown may help doctors approach the issue of depression with younger patients. The Lowdown campaign is active in secondary schools, so patients may already be familiar with its messages and services. ■
