August 2013

Connect +A Counties MAnukAu HeAltH publiCAtion

Pasifika Week Our first Pasifika Week a success!

Patient safety A spotlight on our initiatives

Dental healthBrowns Road Clinic opens

Counties MAnukAu DistRiCt HeAltH boARD

CONNECT+ I PAGE 2

Contents New Emergency Care entrance page 3

20,000 Days achieves goals page 3

District Alliance Agreement signed page 4

Health Passport page 4

Matariki celebrati on page 4

First ever Pasifi ka Week a success page 5

New partnership launched page 5

When Westi n turned up page 5

Spotlight on pati ent safety initi ati ves pages 6 & 7

Infl uenza vaccine uptake improves page 8

New data helps improvements to pati ent safety page 8

Art for a cause page 9

Jammie army makes impact page 9

Law fi rm shows its mett le page 9

Pope honours chaplain page 10

Parenti ng programme inspires royalty page 10

Shared Care Plans for Franklin page 10

Protecti ng our environment page 11

Browns Road dental clinic opens page 11

System integrati on page 11

APAC countdown page 12

Kumara, carrot & cashew nut soup page 12

Trent Silbery is a man on a mission page 12

Broken Wings by Laura Donald page 12

Counti es Manukau Health produces Connect+ three ti mes a year. If you have something to share, or would like to receive a copy of this publicati on please contact the Communicati ons Team via email communicati ons@middlemore.co.nz.

From the CEOWelcome to another editi on of Connect+.

For some months the term ‘fi nancial sustainability’ has been very prominent in our organisati on, and indeed every DHB in the country. Some DHBs are achieving their objecti ves ahead of others. I am pleased to say that we are one of them, having ended 2012/2013 very strongly in June. Further, we provided more and bett er and safer pati ent services than ever before. I thank you for your eff orts towards this.

There is no denying however, that the next year is going to be very tough for us to conti nue to break even. The Christchurch earthquakes hospital rebuild has taken a large chunk of the health dollars available and everybody is being asked to save wherever they can. However, I have every faith that this great organisati on can rise to the challenge with our usual alacrity.

This month the 20,000 Days campaign celebrates the achievement of the saving of 20,000 bed days. Now, we move into the second phase and are launching another 16 initi ati ves and collaborati ves so we can conti nue to build on the results achieved. It is really inspiring for me to see so many of our people moti vated and enthused by the prospect of improvements that they can make across the system.

I urge any of you to send me ideas about how we can improve what we do. I am oft en based in the atrium of Ko Awatea and invite you all to come and say hello. Taking the ti me to engage with staff , I feel, is one of the most important things I can do. It is the human connecti on that makes our work worthwhile, either with each other or with our pati ents. I am pleased to report that Counti es Manukau Health is the best organisati on I have ever had the pleasure to work for. A recent sti nt in our ED only confi rmed that. I know I am not the average pati ent, however, what I saw and heard around me convinced me that our ‘granny test’ is taken very seriously – and it is based on general caring for our pati ents.

I hope this winter is not too diffi cult for you and I am also hoping that the much improved uptake of the infl uenza vaccine will prove of benefi t. Keep warm and keep in touch.

Regards

Geraint A Marti n, CEO, Counti es Manukau Health

On 15 July the new Clinical Services Building (CSB) Plaza was unveiled – much to the delight of staff , pati ents and visitors.

The new plaza is modern, spacious and welcoming and features the new Spiritual Centre which will open in November 2013.

CONNECT+ I PAGE 3

Health systems around the world are struggling with rising pati ent demand and Middlemore Hospital, which services a growing and ageing populati on, is no excepti on.

Building bigger hospitals is not an aff ordable or sustainable soluti on so Counti es Manukau Health has been working with health professionals across the sector to reduce the demand on hospital services through the 20,000 Days campaign.

The aim of the campaign was to give back 20,000 well and healthy days to the community by anti cipati ng and

preventi ng acute health problems, responding quickly and

eff ecti vely in the community, and providing ti mely and safe care to people admitt ed

to hospital.

In June 2013 Emergency Care (EC) opened its new front entrance and triage area, which on an average day can see up to 280 pati ents through its doors.

From day one the new walk in entrance has been a hit – with no more triaging in the corridor for ambulance pati ents, improved privacy and bett er fl ow through the department. “With such a bright and modern space to work in the staff and pati ents love it,” says Alex Boersma, EC Service Manager.

Changes also include a dedicated clinical write-up area, a nurses' stati on,

drug room with pyxis, procedure room and good lighti ng in each of the

individual cubicles. There are fi ve consulti ng rooms (two with doors) and a

procedure room.

“I began working in Emergency Care in 2000 and over the past 13 years have

experienced an enti re shift in the way we work,” says Vanessa Thornton,

Clinical Director EC. “The new front of house faciliti es will enhance the work

we do and enable us to provide even higher quality pati ent care.”

New Emergency Care entrance

Did you know that

Emergency Care

had 65,000 people

through its doors in

2006, compared to

101,000 in 2012?

20,000 Days achieves goalsOn 2 July 2013, campaign team members, pati ents and their families gathered at Ko Awatea to celebrate their achievement of giving back 22,940 healthy and well days for the people served by Counti es Manukau Health.

A number of initi ati ves, such as the Healthy Hearts Programme, Bett er Breathing Programme, VHIU (Very High Intensity User) and SMOOTH (Safer Medicines Outcomes on Transfer Home) are helping people to improve their conditi ons.

Parti cipants have reported having more energy, fewer visits to hospital, fewer sick days and more moti vati on to make healthier choices.

The 20,000 Days Campaign is now entering phase two: Beyond 20,000 Days with 16 new collaborati ve teams working across the sector to give back well and healthy days to the community. For more informati on, visit www.koawatea.co.nz >Campaigns>Beyond 20,000 Days.

Emergency care staff celebrate the opening of their new entrance.

Since joining the Bett er Breathing Programme, Keniseli has a new lease on life.

Enrol with a local

doctor (which helps

reduce costs) and

see them early

if you are feeling

unwell.

CONNECT+ I PAGE 4

Health PassportPati ents with disabiliti es can now use a ‘Health Passport’ to help them communicate bett er with healthcare providers.

The Health Passport is an A4 purple booklet that pati ents own and carry with them when att ending hospital appointments or inpati ent stays. It’s designed to assist communicati on with hospital and health providers and improve the care and support of people with disabiliti es by making important informati on readily available.

The Health Passport has been around for a while and the Health and Disability Commissioner is working with community agencies to make them available nati onwide. Health providers should ensure their staff know what to do when pati ents present with their Health Passports.

Pati ents, or caregivers, should make hospital staff aware they have a Health Passport when they go to hospital and it should be kept at the bedside and be taken home with pati ents. You can request a copy by emailing healthpassport@hdc.org.nz or download a copy from www.hdc.org.nz.

Trust and transparency are at the heart of a new alliance between Counti es Manukau Health and the district’s fi ve Primary Health Organisati ons .

The District Alliance Agreement, which outlines the partnership between Counti es Manukau Health and ProCare, Nati onal Hauora Coaliti on, East Health Trust, Total Healthcare and Alliance Health + was signed last month at a ceremony att ended by most of the Chairs and Chief Execu-ti ves of the organisati ons involved.

Counti es Manukau Health CEO Geraint Marti n acknowledged that the alliance is “uncharted territory” but said that brings with it great potenti al to engineer the future and redesign the health system.

The alliance puts individual perspecti ves to the side in favour of planning that benefi ts the district as a whole. This is already demonstrated through Counti es Manukau’s four localiti es, each of which has a general manager jointly appointed by Counti es Manukau Health and the area’s relevant Primary Health Organisati ons.

The agreement also outlines principles under which all parti es will operate, including with transparency and trust, and specifi c commitments to data sharing, shared accountability and accountability indicators. Primary Health Organisati ons and localiti es will be rewarded or penalised for factors such as Emergency Department presentati ons and admissions to hospital which are deemed to be clinically avoidable.

District Alliance Agreement Signing Ceremony. Front (L to R): Alliance Health + Acti ng CEO Rachel Enosa-Saseve, Alliance Health + Deputy Chair Uluomatootua Aiono, East Health Trust Chair Dr Denis Lee, Nati onal Hauora Coaliti on Chair Dr Cindy Kiro, CMDHB Chair Prof Gregor Coster, ProCare Chair Dr Peter Didsbury. Back: Counti es Manukau Health Kuia Hilda Thompson, Counti es Manukau Health Director of Primary Health and Community Services Benedict Heff ord, East Health Trust CEO Lorett a Hansen, Nati onal Hauora Coaliti on CEO Simon Royal, Counti es Manukau Health CEO Geraint Marti n, Total Healthcare CEO Mark Vella, ProCare CEO Steve Boomert, Counti es Manukau Health Kaumatua Whiti ora Cooper.

District Alliance Agreement signed

‘Litt le Eyes’ (mata riki) or ‘Eyes of God’ (mata ariki)Matariki, also known as the Pleiades, is a constellati on of stars that appear during winter and mark the Maaori New Year. In the past Maaori came together at Matariki to endure the winter months, to gather and fi ll storage houses and pits with food, to remember the past, and to plan and prepare for the future. Present day Matariki celebrates language, people, culture, history and spirituality and reminds us to respect and protect nature in order to provide a good quality of life for future generati ons.

To celebrate Matariki 2013, Te Kaahui Ora, Maaori Health held fun acti viti es and quizzes to raise awareness with staff , pati ents and their families. Parti cipati on grows every year and we look forward to future celebrati ons! Congratulati ons to prize winners Valerie Riordan, and Sandra van Lill and to our hangi competi ti on winners; Heidi Hall and Rushi Penumarthy.

Matariki A Counti es Manukau Health staff member

builds a hangi for Matariki

CONNECT+ I PAGE 5

Marti ne Abel is a Consumer Representati ve on a number of District Health Board forums, including the Pati ent and Whaanau Centred Care Programme Board. Westi n is her guide dog. A recent inpati ent stay at Middlemore Hospital highlighted to her the value of the Partners in Care philosophy which has been embraced by the hospital. This is Marti ne's story.

On a visit to Yangon, Myanmar recently, I ended up in hospital in Kuala Lumpur, Malaysia, with a serious case of food poisoning, which led to acute kidney failure. Aft er four days, I returned home and spent a week in Middlemore Hospital. That was when I experienced the benefi ts and fl exibility of the most recent changes with regards to visiti ng hours for partners in care, or in my case, my husband, mum and Westi n...

Westi n’s been with me for seven months now, so he’s sti ll a fairly new additi on to the family, and wasn’t he excited to visit me nearly every day

while I was in the ward! Guide dogs are allowed to reside in nearly all parts of the hospital, but I felt that Westi n would have been very bored and deprived of exercise, so he stayed at home, being spoiled by my husband.

He was extremely happy and boisterous when he saw me; I had to remind him that we couldn't have play ti me as

I was in a hospital bed, connected to an IV fl uid stand. I think he thought that all the lovely goodies people brought me to snack on could be enjoyed by our partners in care (meaning himself) as well.

He did receive a lot of att enti on from ward staff too, so it wasn’t as if he missed out, really.

People living in Counti es Manukau’s Eastern suburbs can look forward to more integrated healthcare provided closer to home.

The Eastern Locality Clinical Partnership, which partners Counti es Manukau Health with East Health Trust and ProCare, was launched earlier this year at East Health Trust.

“These are really exciti ng ti mes of change,” Eastern Locality General Manager, Linda Bryant, said. “It’s a partnership between these three organisati ons, alongside the community and providers. It’s going to be a great ti me of innovati on which will see the delivery of even more effi cient healthcare services.”

Key initi ati ves for the Eastern Locality include locality-based outpati ent clinics, a care coordinator to help people receive the services they require, bett er informati on management and a proposed Health Hub to provide some intermediate services in the community.

Counti es Manukau has been divided into four localiti es to help organise the way healthcare is delivered with primary care in the community. For pati ents, this will reduce the inconvenience of visiti ng Middlemore Hospital.

The Eastern Locality, home to about 140,000 people, encompasses Howick, Beachlands/Maraetai, Clevedon and Kawakawa/Orere Point. The Franklin Locality Clinical Partnership was launched late last year. Mangere/Otara and Manukau will follow in coming months.

Vibrant and energeti c Pacifi c performers capti vated crowds around Mid-dlemore Hospital recently as Counti es Manukau Health celebrated its fi rst ever Pasifi ka Week (June 24 – 28). Organised by Counti es Manukau Health’s Pacifi c Health Development Unit, Pasifi ka Week connected the many Pacifi c communiti es in Counti es Manukau and launched Fanau Ola, the organisati on’s Pacifi c Annual Plan. Fanau Ola acknowledges the spirit, heart, mana and dignity of Pacifi c fanau and aims to empower them with the capacity, skills and support to plan and pursue healthy futures. Pasifi ka Week brought together Counti es Manukau Health staff with partner organisati ons and Pacifi c communiti es. A diff erent Pacifi c nati on was cele-brated each day through a programme of engaging acti viti es, which included

First ever Pasifi ka Week a success

L-R Counti es Manukau Health CEO Geraint Marti n, East Health Trust CEO Lorett a Hansen and ProCare CEO Steve Boomert plant a kowhai tree to symbolize shared growth in the new Eastern locality.

Understand your

health issues & medications.

Ask about them

if you are

unsure.

talanoa sessions (to profi le and debate key issues for Pacifi c communiti es), talks from guest speakers, Pasifi tness and hot hula sessions, a ward decorat-ing competi ti on, dancing and music performances and opportuniti es to learn Pacifi c languages. Pasifi ka Week billboards were also displayed on Hospital Road. As well as celebrati ng the district’s Pacifi c cultures and communiti es, the week was also an opportunity to showcase the Pacifi c Health services and programmes available in Counti es Manukau. Many local providers from health, educati on and social services were able to promote their services to staff and visitors within Middlemore Hospital, helping to foster a sense of con-necti on focused on the health and wellbeing of our Pacifi c communiti es. Thank you to all the members of our Counti es Manukau Pacifi c communiti es, and to our partner organizati ons, who contributed to this hugely successful

celebrati on. The Pacifi c Health Develop-ment Unit and Counti es Manukau Health staff look forward to seeing you again next year to cel-ebrate another Pasifi ka Week.

Students from Holy Cross Catholic School, Year 7 and 8 Samoan Group perform at Pasifi ka Week.

k fforwarrdgaain

When Westin turned up

New partnership launched

Marti ne and her guide dog Westi n.

CONNECT+ I PAGE 6

Improving pati ent safety and reducing harm and suff ering to pati ents is a common goal for health providers. Counti es Manukau Health has a commendable track record in successfully implementi ng pati ent safety programmes and is now collaborati ng with regional and nati onal initi ati ves which share common goals, including the regional First Do No Harm and the nati onal Open For Bett er Care programmes, to ensure the people of Counti es Manukau receive the best possible outcomes.

The Open For Bett er Care campaign was launched in May. It challenges healthcare workers to be open to acknowledging mistakes and learning

from them, to be open to working closely with pati ents and consumers, and to be open to change, improvement and innovati on.

It focuses on reducing pati ent harm in four key areas – falls, surgery, healthcare associated infecti ons and medicati on safety and will be aligned with regional First Do No Harm initi ati ves focussed on similar outcomes. Other First Do No Harm initi ati ves include reducing pressure injuries, improving the transfer of clinical informati on and medicati on safety. For more informati on go to: www.open.hqsc.govt.nz.

Venous thromboembolism (VTE) Every year over 100 of our pati ents at Counti es Manukau Health develop a signifi cant hospital-associated VTE in the form of deep vein thrombosis (DVT) or pulmonary embolism (PE).

DVT occurs when a blood clot forms in a vein, commonly in the leg, thigh, or pelvis. If the blood clot travels to the lungs it can result in a blockage in the arteries of the lung (PE) which can cause serious harm. Medicati ons which prevent clotti ng of the blood, including heparin and warfarin, are used to treat and prevent VTE.

Middlemore Hospital hosted the Nati onal VTE Preventi on meeti ng recently with 65 att endees from around the country. Acti viti es included teaching sessions, case studies, and several presentati ons by Professor Alexander Gallus, an overseas expert on the diagnosis, preventi on and management of VTE. Other recent developments at Counti es Manukau Health include approval of a new VTE Preventi on Policy and development of a VTE Preventi on eModule for clinical staff educati on.

Spotlight on patient saf

Patient records and medications transitionThe Green Bag (pati ents own medicati on storage system) “The Green Bag” project uses a simple green plasti c bag to keep medicines that pati ents bring into hospital together and stored safely during their stay. This assists medical staff to understand the pati ent's medicati on history.

It also keeps the pati ent’s own medicines separate and helps prevent the risk of ‘double dosing’, i.e. taking their own medicines in additi on to the medicati on prescribed and administered in the hospital. It also ensures the pati ent’s own medicines are returned at discharge and supports self administrati on of some medicati on where appropriate.

Medicati ons can include tablets and other oral medicati ons; creams and ointments; inhalers; medicines purchased over the counter (pain killers, anti histamines) and even herbal medicines and vitamins. Individual pati ent Green Bags are stored securely on the ward, the tear off tag is used to communicate to the whole health care team that the pati ent brought in their own medicines.

Yellow envelopeEnsuring pati ents' clinical informati on accompanies them when transferring between residenti al aged care faciliti es and hospital can improve care and minimise delays.

The yellow envelope is now being used by residenti al aged care, hospital and St John staff involved in the transfer of care. It contains a check list which is completed on every resident who is transferred to hospital for evaluati on and treatment from a residenti al aged care facility and again on discharge from hospital.

It has been a very good example of acute and residenti al aged care sectors working together to spread eff ecti ve interventi ons that will improve safety.

ed care,aff involved It contains mpleted is for

entd on l.

Northern Region DHBs

rch 2013

FIRST DO NO HARM

safer care together www.firstdonoharm.org.nz

Northern Region DHBs

FDNH0001 02/13 P84208 Version 0.1 March 2013

FIRSTDO NO HARM

safer caret o g e t h e rwww.firstdonoharm.org.nz

Transfer from Residential Aged Care to Hospital Envelope Facility:

Contact person: Phone & fax no:

Level of care: Rest Home

Hospital

Dementia Unit

Psycho GeriatricCheck list: Completed transfer document

Copy of the resident’s current medication chart with drug

administration form

Copy of documentation of most recent GP visit

Copy of resuscitation documents if available

Copy of Advance Care Planning (ACP) documentation if available

Copy of Enduring Power of Attorney documentation if available

Family / whanau informed Yes

Unable to contact

Discharge nDept / Ward e

Transferring to:

Check list:

Co

Copy

Copy Family / whanau informed

AFFIX PATIENT LABEL HERE

Name NHI

AddressDOB

CONNECT+ I PAGE 6

SMOOTH (Safer Medicines Outcomes On Transfer To Home)The SMOOTH project is focussed on improving communicati on, discharge processes and pati ent educati on relati ng to medicati ons during the transiti on period when they are leaving hospital.

It encourages bett er communicati on about medicati ons between the pati ent and pharmacies within the hospital setti ng, as well as with community based pharmacies and GPs once they are discharged.

Ensuring accurate medicati on records, communicati ng the changes to primary care providers and explaining medicati on changes to pati ents before they leave is very important for safety. Pati ent educati on includes how to take their medicati on; why they need to take it; and how/where they can get more help regarding issues with their medicines.

Spotlight

Unless your condition is serious, visit your family doctor before

coming to the Emergency Department.

The team at Ward 11 have embraced the green bag project.

CONNECT+ I PAGE 7

April falls month Initi ati ves aimed at reducing falls were highlighted during April Falls Month along with a focus on staff educati on, informati on and displays.

Middlemore Hospital’s annual award for falls preventi on was presented to Ward 33 East for their progress in reducing falls. This reducti on has been att ributed in part to the focus on hourly rounds, known as intenti onal rounding.

Wards use MORSE, a risk assessment tool, to determine which pati ents are more at risk of falls and can factor this in when developing the pati ent’s care plan. There are a number of ways to try and reduce falls including the use of lowering beds to stop falls out of bed, electronic devices such as the invisi beam, bett er lighti ng and reducti on of clutt er on the wards. Providing pati ents with “sti cky socks” which grip the fl oor can reduce falls from slipping. We also have special hip padding for our elderly pati ents which can reduce the impact of falls.

We are acti vely supporti ng more pati ent focussed care as a way to help prevent falls. Having relati ves near at hand, parti cularly for very ill or confused pati ents, can help reduce injuries and keep loved ones safe.

Target CLAB Zero – a national celebrationStaff involved in the nati onal Target CLAB Zero programme have been congratulated for their success in reducing Central Line Associated Bacteraemia infecti ons and improving safe care for pati ents requiring intensive care.

The eff ort began in September 2012 with 18 DHBs and 23 Intensive Care Units across the country implementi ng the programme aimed at improving inserti on and maintenance of central lines to prevent infecti ons. The results speak for themselves. For the post set up period from April 2012 to March 2013 there have been a total of 15 CLABs. Had no correcti ve acti on been taken the number of CLAB infecti ons could have been as high as 105, a potenti al saving of up to 90 (105 minus 15) infecti ons and NZ$1.8 million.

Counti es Manukau Health is the fi rst to complete a hospital-wide roll-out.

ety initiatives

Ward 33 East won Middlemore Hospital’s annual award for falls preventi on.

Preventing pressure injuriesA pressure injury is an area of damaged skin and fl esh caused by staying in one positi on for too long, e.g. prolonged sitti ng or lying, and can occur at home, in the community and in hospital. Someti mes known as bed sores or ulcers, they can develop in a matt er of hours and can range from a blister to a deep open wound. If not prevented, or treated early enough, pressure injuries may ulti mately require surgery and skin graft s, requiring extended periods of hospital care and treatment.

Pressure injuries predominantly develop on parts of the body that take your weight and where the bone is close to the surface. The risk is higher for the frail or elderly and those who have poor blood fl ow, loss of feeling or damp skin. Medical staff can help people at risk to put a preventi on plan together which can include changing positi on regularly or using aids, like pillows, to relieve pressure areas.

Wound Care Coaches help educate and inform staff and pati ents on preventi on methods and annual Pressure Injury Audits help to identi fy what is working well in the hospital setti ng and areas that need further educati on.

Reducing hospital acquired infections10% of all pati ents admitt ed to hospitals are aff ected by hospital-acquired infecti ons. These include surgical wound infecti ons, pneumonias, urinary infecti ons and drip-site infecti ons.

Staff are constantly working to reduce infecti ons, by improving hand hygiene and hospital cleaning, and by running intensive programmes for preventi ng infecti ons of central lines.

Clean hands save lives and cleansing hands before and aft er: contact with pati ents; procedures; and contact with the pati ent’s environment is essenti al for preventi ng infecti ons so we are very proud to be one of the seven nati onal DHBs to exceed the nati onal target of 70% hand hygiene compliance.

Staff are to be congratulated, in parti cular the Hand Hygiene and the Infecti on Preventi on and Control Teams whose ongoing commitment has been instrumental in getti ng the hand hygiene message across. The teams are now aiming to achieve 80% compliance by June 2014 and to sustain this level of practi ce.

It is also important that pati ents, visitors and family/whaanau practi ce good hand hygiene. There are hand hygiene stalls and hand gel dispensers

in key points throughout all hospital sites, ward rooms, toilets and lift s. Cleansing

hands when entering the hospital to protect vulnerable

pati ents, and cleansing again

on the way out, will

help prevent infecti on.

CONNECT+ I PAGE 7

y p gward rooms, toilets and lift

hands whethe hospprotect

pati enclea

o

Good hygiene is the key to staying healthy.

CONNECT+ I PAGE 8

Counti es Manukau – the whole country in fact – has seen record uptake for this year’s infl uenza vaccine. It is the highest year on record, with around 25% of our populati on receiving the vaccine. However, we sti ll want to keep encouraging those unimmunised to get the vaccine.

The free vaccine for eligible pati ents ended 31st July, however, the vaccine is sti ll available and we recommend that if people have not yet had it done, it is not too late for it to be of benefi t.

Right: Clearly some other District Health Boards are well ahead of us in their vaccine uptake. Let's see if we can signifi cantly lift our percentage immunised next month.

The publicati on of new health data will encourage district health boards to consistently put in place steps to improve pati ent safety, says Professor Alan Merry, Chair of the Health Quality & Safety Commission.

The quality and safety markers show the extent to which DHBs take simple acti ons to reduce the risk of harm to pati ents from falls, healthcare associated infecti ons and perioperati ve harm (harm during or aft er surgery). No DHBs performed at the highest level in all areas, or performed badly in all areas.

The Commission evaluated DHBs’ progress in reducing pati ent harm in the following ways.

• Preventi ng harm from falls is evaluated by the percentage of older hospital pati ents assessed for their risk of having a fall. - The desired level is having at least 90 percent of older hospital pati ents

assessed for their risk of having a fall.

• Reducing harm from healthcare associated infecti ons is evaluated by the number of staff following good hand hygiene practi ces, and by compliance

with agreed protocols for preventi ng a bloodstream infecti on called central line associated bacteraemia (CLAB). - For hand hygiene, the desired level is 70 percent compliance with best

practi ce hand hygiene measures.- For CLAB, the desired level is 90 percent compliance with the procedures

for inserti ng catheters into blood vessels near the heart to prevent CLAB.

• Perioperati ve harm is evaluated by the number of operati ons performed using the World Health Organizati on’s surgical safety checklist. A simple tool for avoiding mistakes, the checklist promotes bett er communicati on and planning for things that might go wrong. - The desired level is using all three parts of the surgical safety checklist in

90 percent of operati ons.With the excepti on of CLAB, which has been the subject of a successful nati onal project to reduce the number of these infecti ons, about one quarter to one third of DHBs reached the agreed level in all areas.

Here is how we sit in the DHB performance table.

New data will help patient safety

Regional roundup

Infl uenza vaccine uptake improves

Perioperative harm. Percentage of operations using all three parts of the checklist (2013).Falls. Percentage of older patients assessed for falling (2013).

Hand hygiene. Percentage of compliant moments (Q1 2013).CLAB. Percentage of occasions insertion bundle used (Q4 2012).

30%

40%

50%

60%

70%

80%

90%

100%

Capital & Coast

Mid Central Bay of Plenty Taranaki SouthCanterbury

Nelson Marlborough

West Coast Lakes Waitemata Whanganui Tairawhiti Wairarapa Northland Auckland Hutt Valley Canterbury Hawke’s Bay Waikato SouthernCounties Manukau

34%

28%

42%

34%

24%

29% 29%

24% 26%

30%

25%

33%

28%

23%

27% 27%

31%

24% 25%

28%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Percentage

District Health Board

Infl uenza vaccine distributi on percentage. District health board comparison to 5 July 2013.

CONNECT+ I PAGE 9

Law fi rm shows its mettleBuddle Findlay is going above and beyond with its corporate conscience and Kidz First Children’s Hospital is benefi tti ng.

The prominent commercial and public law fi rm, with offi ces in Auckland, Wellington and Christchurch, established the Buddle Findlay Child Health Foundati on in 2005. The Foundati on was a way the fi rm could give something back.

“Buddle Findlay had previously supported a very wide variety of charitable causes,” explains Buddle Findlay Partner Frank Porter. “However, we felt that the ti me was right to commit to a single cause, child health, in a more structured way.”

Since then, the Buddle Findlay Child Health Foundati on has donated over $372,800 to Kidz First. The money has been used to purchase many essenti al pieces of equipment, including an ear microscope, infant warmer, portable venti lator, apnoea monitors, syringe pumps and phototherapy lamps for the neonatal unit.

“Over the last eight years we have developed an excellent relati onship with Kidz First as part of our grants programme,” says Mr Porter.

“What has been important to us is being part of the wider community support for Kidz First and parti cipati ng in the wonderful work Kidz First does. We also very much appreciate being part of the wider Middlemore community and being involved in exciti ng developments such as Ko Awatea.”

Pam Tregonning says the long-standing support received from Buddle Findlay and its Foundati on over the years has been invaluable and is extremely appreciated.

Paint a bett er picture for children was the purpose of this year’s Original Art Sale annual charity evening.

Thanks to those who bought ti ckets to the gala, over $9,000 was raised for Kidz First Children’s Hospital.

Four-year-old Elliott Crimp, with the help of prominent Maaori arti st Marcus Winter, created three artworks that were aucti oned off on the night raising a fantasti c $1,150.

Elliott is recovering from the eff ects of meningococcal B disease at Kidz First.

“This is the sixth year this fantasti c event has partnered with Middlemore Foundati on to make Kidz First its gala benefi ciary,” says Joanne Hand, Middlemore Foundati on’s Community Relati ons and Fundraising Offi cer.

“Thank you Vodafone Events Centre Team, Counti es Manukau Pacifi c Trust, Marcus and Elliott and Kushla Crimp for making the gala possible and a fun night.”

There was artwork for all tastes and

budgets.

Jammie army makes impactWe asked the country to rally their troops and send us pyjamas or donati ons to help keep sick children in need warm this winter.

The nati on mobilised to make Jammies in June a remarkable achievement for Kidz First Children’s Hospital and Community Health.

Middlemore Foundati on launched its month-long campaign with a donati on of 960 pairs of pyjamas and onesies from Farmers.

For the 30 days of June the hospital mailroom, recepti ons and Foundati on offi ce was inundated with new fl annelett e jammies, singlets, robes, even slippers for children aged from birth to 15 from kind-hearted people – even Kiwis living abroad in Scotland and Australia.

“We are thrilled and immensely grateful with the response and kindness shown towards the Jammies in June campaign,” says Pam Tregonning, Executi ve Director of the Middlemore Foundati on.

“Individuals, families, businesses and schools from all over New Zealand have contributed to make a huge combined impact. People have joined the jammie army from as far and wide as Whakatane, Christchurch, Upper Hutt , Patea, Tauranga and Oamaru.

“It’s been humbling to watch the donati ons fl ood in complete with touching messages of support.”

The response has been “absolutely amazing”, adds Marlene Stratt on, Kidz First Inpati ent Service Manager.

“We have been totally overwhelmed by everyone’s generosity, with so many children in South Auckland able to benefi t from the kindness displayed. Hopefully winter will not be such a cold reality for many youngsters who will now be able to go to bed snuggled up in their warm ‘jammies’.”

The aim of the appeal was to help lessen the high rates of preventable illness, such as respiratory illnesses, Rotavirus and streptococcus throat infecti ons (which can lead to rheumati c fever) by keeping litt le chests toasty during chilly winter nights.

Shortland Street’s Amelia Reid with Faith Hohua for Jammies in June.

Art for a cause

CONNECT+ I PAGE 10

Pope honours chaplain

Sister Mary Keane’s lifeti me of dedicati on to the Catholic Church has been recognised by the Vati can.

Former Pope Benedict XVI awarded her the Pro Ecclesia et Ponti fi ce medal for 60 years’ work, including 17 as Middlemore Hospital’s chaplain.

The award is also known as the Cross of Honour and was established in 1888. It is the highest honour a layperson can receive from the church.

The gold medal was presented by Auckland Bishop Patrick Dunn in a special mass at the Mary MacKillop Centre in Mission Bay on June 5.

Sister Mary, who reti red from Middlemore in December aged 78, says getti ng it was a wonderful surprise.

“It’s hard coming to terms with it but it’s a wonderful honour and just from the old Pope before he reti red which makes it special,” she says.

The papal tribute follows a formal request to the Vati can from Bishop Dunn, who was approached by priests of the South Auckland Deanery.

Bishop Dunn says the dedicati on to her work at Middlemore and as a Sister of St Joseph both factored in her award.

“An example of this dedicati on was that in the course of a week just before her reti rement she had requests on 92

occasions from pati ents asking that she visit them.”

Middlemore Hospital Services Director Jenni Coles says Sister Mary’s cheerful

personality and solid contributi on made her a favourite with pati ents and staff .

A longer version of this arti cle was published in the Manukau Courier on 21 June 2013.

Parenting programme inspires royaltyTongan royalty visited Auckland recently to fi nd out more about a parenti ng programme that is already available for Counti es Manukau families.

ProCare manages the delivery of Triple P (Positi ve Parenti ng Programme) in Counti es Manukau. Her Royal Highness Princess Siu’ilikutapu of Tonga visited the Primary Health Organisati on to fi nd out about Triple P for her home country.

“As a grandmother I have the ti me, I can help the next generati on coming up,” she said. “We were bought up so diff erently. You never stop learning and if you put love at the centre of everything, you can get around mountains.”

Triple P is designed to give parents of three to seven year old children the skills they need to raise confi dent, healthy individuals and build strong family relati onships. The informati on is relevant for children up to the age of 12.

The programme is free for families who live in Counti es Manukau. Parents and caregivers can att end one-on-one parenti ng sessions to help them gain skills to bett er manage their children’s challenging behaviours, or att end discussion groups.

For more informati on, talk to your family doctor or contact ProCare’s Project Administrator, Linda Cooper, by emailing confi denti al@procare.co.nz or phoning (09) 375 7761.

Pati ents in the Franklin Locality are the fi rst to benefi t from an E-Shared Care Plan pilot.

Developed by health professionals and pati ents, an e-shared care plan enables both a pati ent and his/her health professional to have access to the pati ent’s electronic record. This record includes a summary of the individual’s health informati on, a list of the medicines they take, their health goals and details of their treatment and care.

For pati ents, an e-shared care plan reduces the need to tell diff erent people the same thing multi ple ti mes. It also off ers pati ents with long-term conditi ons, and their families, a user-friendly way to keep track of their health and healthcare. It includes ways to identi fy and track

goals, and informati on to help pati ents self-manage more eff ecti vely.

For health professionals, it means that they have access to their pati ent’s current plan (not the full medical record). They can send the pati ent acti ons to complete and, with a pati ent’s permission, can consult other specialists about the individual’s care.

The pati ent can see who has accessed their plan and any changes made.

The plans assist in increasing access to care, even from multi ple professionals; decreasing waiti ng ti mes; pati ent educati on and health promoti on; and disease/injury preventi on.

Sister Mary Keane wearing her medal and pin from the Pope that she received in recogniti on of 17 years as Middlemore Hospital’s Catholic chaplain.

Accredited Tongan Triple P practi ti oners share their experiences. Front: L-R Orla Tava (Plunket), HRH Princess Siu’ilikutapu, Sesi Pongi (ProCare). Middle: Seini Falafata (Plunket), Vaisiliva Vaha’akolo, Soana Muimuiheata (ProCare), Anamafi Paletua (East Tamaki Health Care). Back: Kim Wi and Sarah Tailby (Waipereira Trust). Photo: ProCare

Shared Care Plans for Franklin

Get immunised to protect

against illness.

general waste, increasing revenue for the organisati on and saving cleaners’ ti me – that the cubes are now permanent features in the Executi ve Management Suite and Criti cal Care Complex, and are being rolled out elsewhere, including at the Auckland Spinal Rehabilitati on Unit (ASRU) and Manukau SuperClinic (MSC).

Meanwhile, MSC and ASRU are trialling worm farms to help dispose of food waste. Bins at each site will be able to process about 120 people’s food waste each day, potenti ally reducing the organisati on’s waste volume by 7000kg per year as well as the costs associated with disposing of it.

Other initi ati ves include introducing an overnight sleep system for non-criti cal computers and paper shredders, to reduce secure document removal and increase revenue from paper recycling.

Worm farms, desk top cubes and paper shredders will soon be a routi ne part of healthcare delivery at Counti es Manukau Health.

In December last year, Counti es Manukau Health signed up to the Certi fi ed Emissions Measurement and Reducti on Scheme (CEMARS®), operated by carboNZero, a subsidiary of Landcare Research. It is the fi rst Australasian DHB/hospital to measure, and start reducing, its carbon footprint through CEMARS.

Environmental Sustainability Project Offi cer, Debbie Wilson, has since been developing an Environmental Sustainability Strategy and working to introduce environmentally friendly initi ati ves across the organisati on.

In April, staff in Middlemore Hospital’s Executi ve Management Suite started using desk top cubes, a small box which replaces the general rubbish bin. They were also given a paper recycling box and access to a recycling bin, encouraging them to think about how they disposed of their rubbish.

The trial was so successful – in reducing

Browns Road dental clinic opens On Friday 5 July Geraint Marti n, CEO Counti es Manukau Health opened the new Browns Road Child and Adolescent dental clinic – an important milestone for the Manukau Health Park.

The Browns Road dental clinic is number 16 of 19 new clinics to open in the region and is supported by a new state-of-the-art mobile dental service. The dental clinic will serve approximately 6,000 children from the district aged 0 to year 8 of school (12/13 years), and adolescents who are unable to access private denti sts. “This clinic is very special and will off er 3 surgeries during university ti me as training chairs to AUT Dental Therapist students to complete their practi cal experience with South Auckland children,” says Christi ne McKay, Portf olio Manager Oral Health. “By building potenti al training faciliti es into our planning we also hope to support an increase of local people into the oral health workforce and training, starti ng with dental assistants and dental therapists.”

Dental Manager – South, Lynett e Wilkie and Angeline Pawa discuss oral health in the new Browns Rd dental clinic. Angeline (11 years) has type 1 diabetes and good oral health is very important to help manage her diabetes.

Protecting our environment

System integrationCounti es Manukau Health’s System Integrati on Programme is strengthening our healthcare system through a more local and integrated pati ent experience.

Due to our growing, aging and changing demographic, hospital demand is growing at a rapid rate. As more hospital admissions occur due to preventable causes, we need to examine what could be improved in how we deliver our services.

We’re putti ng in place Locality Clinical Partnerships (LCPs). These are four networks between hospital and primary care clinicians in Franklin, Manukau, Otara/Mangere and Eastern.

Primary care’s role is expanding. Counti es Manukau Health services are either shift ing to localiti es, aligning with LCPs or providing more support to primary care.

Preventi on and early interventi on are our focus, especially for pati ents with chronic illness or long-term conditi ons. We are pulling multi ple programmes into one new, integrated programme. The new LCPs are supported through training, resources, data, self-management and new care pathways.

We are also redesigning services with initi ati ves such as shared pati ent records between healthcare clinicians, changing workforce confi gurati ons (including using non-medical staff more eff ecti vely), telehealth and virtual clinic initi ati ves.

A more local and integrated pati ent experience will relieve unnecessary pressure on our hospitals and be bett er for our pati ents.

Watch a short video at www.counti esmanukau.health.nz/systemintegrati on.

Consider an

insulation grant

if you live in a

cold, damp

house.

CONNECT+ I PAGE 11

CONNECT+ I PAGE 12

Kumara, carrot & cashew nut soup (serves 6… or 4 hungry people!)4 medium size kumara2 carrots1L vegetable stock25g butt er1 onion1tsp chopped garlic1tsp chopped ginger1tsp chopped red chillies (or more if you dare!)Soy sauce2 handfuls of cashew nuts150ml coconut milkCoriander leaves (opti onal)

Peel and chop the kumara and carrots and simmer in a pot with the vegetable stock unti l soft .Pop the butt er in a separate pan and add in the garlic, ginger, chillies and chopped onion and cook unti l soft .Add them both to the same pot with the kumara and carrots and blend with an electric blender.Put the cashew nuts on a tray with a glug of soy sauce and roast in the oven at 180 degrees Celsius unti l slightly brown. (Keep an eye on them in case they burn!)Add the coconut milk to the pot and sti r on a medium heat.Add a tablespoon of soy sauce to the soup and sti r.Serve the soup to family and friends with a few cashew nuts sprinkled on top and decorate with a pinch of coriander leaves.

APAC countdownThe APAC Forum on Quality Improvement in Healthcare is only a few weeks away and fi nal planning and preparati on is in full swing.

This is your conference and a great opportunity to hear and learn from some of the best healthcare leaders from New Zealand and around the world, as well as share your own learning and experience with the internati onal community.

We hope you are able to join us for this inspiring event.

To register go to htt p://apac-forum.com.

Broken Wings Laura Donald, Physiotherapist, Counti es Manukau HealthLaura Donald recounts her experiences from the other side of the health system when a serious accident hospitalised her and takes her on a journey of recovery through her workplace, Middlemore Hospital.

They say that you don’t know what you’ve got ‘ti l it’s gone. It’s true, trust me! Falling head fi rst down a fl ight of concrete steps and fracturing both elbows was never in my plan for 2013. I wasn’t supposed to become completely dependent on others to eat, drink, wash, dress and scratch my head at the age of 32. Ninety-two maybe, but not 32.

Being picked up from the ground was terrifying (and I’m the sort of person who goes skydiving and white water raft ing for fun)! I needed the help of some strong paramedics (and some strong analgesia). The St John’s paramedics were amazing - professional, with a sense of humour and polite, with the desired need for urgency. I was visited later on in Middlemore’s Emergency Department (ED) by each one of them to make sure I was in good hands, which I was. I have to compliment the ED staff for their professionalism, compassion and tolerance to pati ents who are on morphine (a drug I have since discovered can lower inhibiti ons and provide hours of verbal entertainment)…

Read more of this arti cle at: htt p://teamcounti es.wordpress.com/ 2013/04/10/from-a-pati ents-perspecti ve-broken-wings-laura-donald/.

Trent Silbery is a man on a mission Not only does the healthAlliance Inwards Goods Clerk at Middlemore Hospital juggle a busy job and family life, he’s also a big contributor to his local community as a volunteer junior rugby league coach with the Mangere East club. “It does take a lot of ti me but it’s my passion and I really love it,” Trent says.

And the sport loves him too, judging by some of the recent successes he’s had, including being selected from a group of 20 up-and-coming young coaches around the country for an exclusive coach mentoring programme run by Vodafone Warriors head coach Matt Elliot. “It’s great to be recognised like that and I’m really enjoying being exposed to the

Warriors’ coaching philosophy and techniques.”

Trent has also been involved in securing a development contract for one of the Mangere East boys with Australian NRL club Melbourne Storm and has now secured a contract with the Vodafone Warriors.

“It’s great that local kids can now see a pathway to professional league and a brighter future, and I’m glad to play a small part in that.”

Stay at home if you are

unwell. Keep sick children

at home.

Please email communicati ons@middlemore.co.nz if you have any enquiries regarding this publicati on.

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