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MARCH 2011

Welcome to the March edition of Connect. Firstly, I would like to thank our staff

who helped with settling in of the Christchurch patients who came to us during the last few weeks. I would also like to thank those of you, including our primary care colleagues who have so selflessly volunteered to be available if needed. It really makes me proud to be part of such a strong and caring community.Many of you will have noticed the astounding progress being made in the construction of Ko Awatea. We are well on track for the official opening in mid-June. Ko Awatea will bring together a wide range of people to share ideas and knowledge. But more than this, it’s your place – a place where you can come to brainstorm ideas and to solve problems. Even just to have lunch and some good coffee! The lecture theatre holds 210 people and is fully partitionable to allow smaller groups who will have full access to state-of-the-art computer technology.

The teaching rooms allow for clinical and non-clinical CMDHB staff to have ongoing education and to learn new skills. Ko Awatea will also be a hub for research and innovation, working with our partners, MIT, University of Auckland and Auckland University of Technology. We will be having staff and colleague open days soon – we will advise as soon as possible when you can come in and have a look around.

Some of you may have noticed the release

of the National Health Targets last week. This is where every New Zealand DHB is compared with our peers to see how we are doing in six target areas. Counties Manukau DHB continues to improve in almost every health target and in comparison with the rest of the health sector. The only area where CMDHB did not improve significantly was in improved access to elective surgery, where we were down by around 2.6% to 97.4% of contract, compared with last quarter.

This is for several reasons; the main reasons being the impact of ongoing industrial action and the higher than usual demand for acute services. We are confident that the elective targets will be reached by the end of the year.

The good news however is that all of the other health targets have improved on the last quarter’s performance. We still lead the country as a large DHB for shorter stays in emergency departments (97.25% of our patients waited fewer than 6 hours), our fully immunised children at 2 years of age has improved by 7% from the same time last year. Of special note are the Maaori and Pacific figures which have improved by 8% and 11% respectively from the same time last year.

CMDHB’s hospitalised smokers given

advice to quit has risen by 1% on the previous quarter but is an improvement of 11% from the same period last year. Better diabetes and cardiovascular services has risen by 5% to a total of 73%. This is comprised of 81% of our diabetics having annual health checks which is 19% over our target set by the Ministry of Health. We are especially pleased to note that we are also surpassing our get checked total for Maaori and Pacific peoples, which is a major at-risk group. We achieved 58% of our target of 60% for the diabetes management indicator which is a measure of the number of diabetics who were checked and display satisfactory condition control but this is an improvement of 2% on the previous year and means that more people diagnosed with diabetes are managing their condition appropriately

Our cardiovascular disease risk assessment is over our target by 1%. This means that 80% of the eligible population have had blood testing to assess their disease risk with in the last 5 years.

These results reflect the very hard work being undertaken by you all to continually strive for better results for our community and I would like to take this opportunity to thank you all for the hard work in achieving these results.

Geraint Martin CEO CMDHB

From the CEO

Ko Awatea landscaping underway.

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Meet the board

2011 will be the year to swap pen and paper for the mouse and keyboard to manage referrals in the Auckland Super City.

The three Auckland District Health Boards are working together with Orion Health and Healthlink to implement an electronic referrals solution for the transfer of referrals from GPs to all six hospitals in the region.

The eReferrals initiative is aligned with the sector priorities of the National Health IT strategy in achieving an integrated healthcare model and better sooner more convenient care for patients.

The solution will improve the transfer of information between primary and secondary care providers by reducing the duplication of effort and minimising errors that occur through incomplete information or lost referrals. Only referrals which are currently sent to elective services through the central referral offices are included in this first phase.

Over 100 clinicians representing 29 services from across the Auckland region have contributed to the datasets used to create the forms to be launched in the first phase of the eReferrals implementation. A clinical panel has worked with the team from the outset advising and signing off on the datasets and the forms.

Jeffrey Garrett represents secondary clinicians on the panel for CMDHB and Dr Harley Aish is the GP liaison.

Forms are now being developed ready for implementation in the first half of 2011.

Northland DHB implemented an eReferrals solution last year which has been welcomed by the GP work force. Many referrals are now done with the patient present at the time of the consultation or at least on the day of the consultation which has obvious benefits to the patient.

The version being implemented in Auckland by Orion Health and Healthlink builds on the benefits of the Northland and earlier Hutt Valley DHB systems and will provide hospital clinicians with visibility of referrals via the clinical desktop (Concerto).

The Clinical Panel has also kept the project informed about the progress of the Clinical Pathways project being developed under the regional ‘Better Sooner More Convenient’ work programme.

As a result, the eReferrals team has reviewed some forms in the context of Clinical Pathways in this first phase of the eReferrals project with the intent to incorporate the clinical pathway model where possible without compromising the primary purpose of a referral.

The Referral Revolution GP Liaisons are working across both initiatives.

Dr Kim Bannister, GP Liaison, WDHB, says working on both the e-referral and pathway projects has highlighted the synergies between the two work streams. “What we have found is that the Pathway work often includes a referral component which is enabled and supported by an eReferral process - when it is aligned with the Pathway.”

“The clinical networks which have been formed for the pathway working groups are an efficient and useful way to agree on the components and design of the e-referral service-specific templates in part because they include representatives of both GP and hospital based clinicians. It is possible to include specific help in the eReferral template for referring GPs to easily follow an agreed pathway when making a referral, so that it becomes an educational process for the GP, as well as improving the quality and appropriateness of referrals.”

“We can see a lot more scope for development of this work in many other pathways requiring referral between the sectors involved in managing a patient.”

A change advisory panel has also been developed to advise the project of internal processes which may be impacted. Kathie Smith, Facilities Manager Inpatient & Outpatient Services and Janet Gibson, Service Manger, Patient Information Services are the CMDHB representatives on this panel

The project team are now also developing an approach for Phase 2 of the eReferrals project which will enable clinicians in hospitals to grade and triage referrals and generate new referrals online removing the need for hard copies of referrals. The team will be approaching managers of services currently not processed by the central referral offices to include them in this phase such as Mental Health and Sexual Health.

Further down the track, phase 3 of the solution will introduce decision support aligned to clinical pathways and enable certain activities to be automated or alerted to clinicians.

For more information and to sign up to eNewsletters go to www.ereferrals.co.nz .

The EReF team (L to R): Clare Dill, Communications; Chris Dawson (back) Business Analyst; Cheryl Singh Testing Lead; Deborah Ross (back) Training Lead; Himani Mehta, Business Analyst; Daniela Harder (back) Business Analyst; Edmund Cheng (back), Infrastructure lead and Grant Ramsay, Project Manager

In each issue of Connect we will pro-file two board members so that you can get to know them better.

Professor Gregor Coster (Chairman)Professor Gregor Coster was appointed Chair of CMDHB in 2007. He was Chair of the Community and Public Health Advisory Committee for CMDHB from 2000-01. He was until recently Deputy Chair of PHAR-MAC and was a member of the Health Funding Authority Board in 2000.

In 1995 he was appointed Head of Depart-ment of General Practice and Primary Health Care at The University of Auckland where he was the Elaine Gurr Professor of General Practice.

Gregor’s early career was in general practice in central, south and west Auckland and in-cluded four years at the University’s Trust Health Care general practice in Manurewa.

He holds a PhD in public policy and was awarded the Companion of the New Zealand Order of Merit for services to public health in the Queen’s Birthday Honours in 2007. His vision for CMDHB is that it should provide excellent health services for all, and particularly for those with the greatest health needs.

Jan Dawson (Deputy Chairman)Jan has held the position of Chair and Chief Executive of KPMG New Zealand since 2005, and became a partner of the firm in 1986. With over 30 years of audit experience she is lead relationship partner for a number of KPMG’s significant New Zealand issuer clients. Jan’s work encompasses a wide range of services including accounting advice, due diligence and risk, governance and litigation support. She has particular expertise relative to financial institutions, registered banks, software/IP and forestry organisations.

Jan has been a Member of the Capital Investment Committee of the National Health Board, is Chair of the Audit Committee of the International Sailing Federation, President of Yachting NZ and is a Member of the Massey University Auckland Regional Advisory Board.

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What’s it all about?A survey was conducted in 2009 which

found that non-clinical information is not being managed properly within CMDHB (source: ECM Strategy Report). We are wasting too much time searching for information, trying to get access to it and/or making sure it is the correct version, which can be frustrating.

In order to solve these problems, CMDHB has decided to implement the Objective system across the organisation. This is the focus of the Corporate Information Programme (CIP), which will ensure that the corporate (non-patient) information of every CMDHB business unit is migrated into Objective over the next 3 to 5 years.

With the support and commitment of CMDHB Management, the CIP Programme Team, which includes representatives from CMDHB, Objective and healthAlliance, wants to achieve the following benefits:• Thereisonesearchablerepositoryfor

documents and records so we don’t need to go to different places to find the information;

• Thereisoneversionofthetruthsowecanalways find the latest / correct version of the document;

• Somebusinessprocesseswillbeautomated

so we can reduce the amount of time we spend on administration;

• Informationisstoredinasecureenvironmentso there is a reduced risk of non compliance or legal implications.The programme has been split into waves

or ‘tides’. Each TIDE is a project in itself and involves a grouping of CMDHB services for which the Objective system will be implemented. Each TIDE project will take 4 to 6 months and involves close cooperation with the groups to gather their requirements and design the Objective solution to their needs.

TIDE01 is currently under way and consists of Service Integration, Planning and Performance, and the Executive team including Finance and Legal. TIDE02 is scheduled to start in May 2011 and will involve Laboratories, CCRep, Facilities, the Spinal Unit, Human Resources, Recruitment, Occupational Health and Safety, and Learning and Development.

Because we want to make the transition process as easy and smooth as possible, a lot of time and effort is also being spent on communication, planning, training and support. An application is for instance being developed to help move the non-clinical information across from the network drives into Objective, and a

training plan will be developed for each TIDE to cater for their specific needs. This training will not only focus on the use of Objective, but also explain the new folder structure and provide an understanding of what needs to be stored in Objective and why. After each Go Live, the Corporate Records Team will also be walking around to lend a helping hand to the new users.

Jai Prasad (Objective System Administrator) and Sandhya Prasad (Document Controller) have recently joined the Corporate Records Team to build up the capacity that is needed to assist in the CIP and support the ‘business as usual’ (BAU). In a separate project from the CIP, the BAU team is also embarking on a journey to optimise the current Objective setup for the management and use of policies, procedures, guidelines and other documents that were migrated from NetIT. Jane Farris, on a six month secondment from Pharmacy Services, will help define key information standards around processes, roles and responsibilities in the management of this information in Objective.

If you would like to know more about the CIP, please contact your manager, have a look at our intranet site http://southnet/CorporateRecords/Pages/CIP.htm or contact Jyoti Chopra, the Corporate Records Manager.

Corporate Information Programme

Waitangi Day at CMDHBOn 4th February 2011 Te Kaahui Ora hosted celebrations for Waitangi Day at CMDHB. The theme was based on the Maaori Core Value, Whanaungatanga ‘Celebrating Relationships’.

It was a successful day with great support and attendance from staff and an overwhelming response from those who took part in the Waitangi Day Quiz.

The buzz around the quiz was very thought provoking and challenging for some of our colleagues. Others were there simply to support their friends.

There were lots of laughs and it generated a lot of conversation and interest in Tikanga Best Practice and the Tikanga In Practice training programmes.

Thank you to those who participated in the activities on the day. Congratulations to those who won prizes.

We look forward to seeing you at our next promotion;Celebrating Matariki (the Maaori New Year)Friday, 3 June 2011Middlemore Hospital Information Foyer

L-R: Professor Iain Martin, Dean of Faculty of Medical and Health Sciences, the University of Auckland, Dr Gregor Coster, Chairman, Counties Manukau DHB and Professor John E Wennberg, Dartmouth Medical School.

February this year saw the announcement of the NZ Health Atlas, a collaboration between a number of health sector partners. Initiated by CMDHB and the University of Auckland, the NZ Health Atlas will compare and map clinical activities and the utilisation of health care services across all DHBs, looking at variations both regionally and nationally. Clinicians will be involved in the review process to help interpret and understand variations - to help inform where and why patients receive different care than people in another area. It will be a useful tool for frontline service improvement and will also identify areas of opportunity for academic study and research. Professor John E “Jack” Wennberg, the founding editor of the Dartmouth Health Atlas in the USA travelled to New Zealand for the launch.

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CMDHBScience Fest

2011 Science Fest is a mini conference celebrating innovation and effective practice, featuring prizes for oral papers and poster presentations, followed by dinner during which the winners are announced.

ORAL PRESENTATIONS start at 4:30pm. They are open for all to attend free of charge.

DINNER FROM 8:00PMIf you wish to attend the dinner tickets can be purchased for $35 per head from:Staff Centre Reception Desk MMH, Reception Desk at MSC, Support Building Reception Desk, DHB Reception Desk.

TelstraClear Pacific Events Centre, Manukau

Tickets on Sale from

March 28th

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2011

Science Fest 2011 Workforce Development Award Shortlist Announced

Presenter (s) Role Entry Time (approx) Caroline Tichbon Programme Manager – Grow Our Own Workforce High School Health & Science Academies 12.10pm Tanya Maloney General Manager - Mental Health Services Champions of Recovery 12.30pm Cassandra Laskey Professional Leader, Peer Support Specialists Dr. Tane Taylor Consultant - East Tamaki Healthcare Learning Environments 12.50pm Debra Fenton Service Manager - Primary Maternity, Women’s Health Increasing Support for Breastfeeding Mothers 1.30pm Through the Introduction of Breastfeeding Advocates on Maternity Ward Vicky Harris Maori Arthritis Educator - Maori Gout Action Group Dr. Peter Gow Clinical Director, Adult Rehabilitation and Mā te mahi ngātahi, Ka putā atu tātou i te Mate Kāute. 2.10pm Health of Older People “Together we can out Gouty Arthritis”

CMDHB’s annual Science Fest awards are just around the corner (14 April 2011) and this year’s new category is workforce development. Prize money is $2000 for the oral section and $1000 for the poster section. Entries closed on 10 February and we had a high number of strong workforce entries, from across the sector (hospital, primary care, mental health, NGOs). After much deliberation the judging panel has narrowed down a shortlist for the orals (presentations). The presentations for workforce development are taking place at Middlemore Hospital, Academic Lecture Theatre, on Monday 4 April. All are welcome. Details of the shortlisted presentation entries are below. Congratulations on those who have made it onto the shortlist and for all entrants taking the time and effort to submit an abstract.

NB: Presentations are 15 mins including time for questions and answers.

The winner will be announced on the night of Science Fest (14 April).

Poster entries will be displayed in the main foyer at Middlemore Hospital from Monday March 28 to Thursday 7 April, and we welcome staff and the community to come and have a look at the great work that’s being done.

There will also be an update to the Counties Manukau DHB Organisational Workforce Initiatives report. The current report can be found at http://www.cmdhb.org.nz/About_CMDHB/Planning/Planning-documents.htm#WorkforceDocs

Please contact Elizabeth Ryan (Workforce Consultant) (Elizabeth.ryan@middlemore.co.nz or 276 0044 ext 6079) if you would like to know more about the workforce awards or are interested in contributing to the innovations report.

Elizabeth Ryan, Workforce Consultant, CMDHB

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The pilot for the Shared Patient record went live Monday 28th Feburary. This is a limited pilot for Emergency Care clinicians that allows Primary Care information to be viewed by Secondary Care Clinicians. Once the pilot has been successfully completed, the system will be available to the wider CMDHB user community.

This is a significant achievement as CMDHB and Total Healthcare will be the first DHB and PHO in New Zealand to provide a shared patient record between primary and secondary care.

A number of other DHBs have already expressed interest in deploying the system once the pilot program has successfully completed.

The project has been a collaborative effort between a number of parties:• ThePHOTotalHealthCare(representing

East Tamaki Healthcare) have made selected clinical information available for viewing by EC clinicians

• Medtech’s‘ManageMyHealth’portalstoresthe patient information in a central location that is accessible by patients and other authorised providers

• healthAllianceIShasbeenresponsiblefor the overall system design, project management and implementation of the components within the hospital.The information that is available to EC

clinicians includes:• Currentmedications• Currentproblemlist• Allergies&Alerts• Immunisations• RecentConsultations

A significant effort has been placed on the security and privacy aspects of this

interaction, which offers secure, real-time access to the ManageMyHealth repository. An audit log stores the name of the clinician viewing the data, and the date that the access occurred. Significantly, the patient is able to view a list of all clinicians who have accessed their information through an option on the ManageMyHealth portal. Should they chose, a patient is able to prevent their information being made available in this way (opt-off).

This project is only the first step in enabling improved communication between primary and secondary care, Further enhancements are planned, allowing the hospital doctor access to an ever increasing range of information such as the Shared Care repository also currently in pilot.

Our thanks to all parties involved - East Tamaki Healthcare (ETHC), Total HealthCare (TH), CMDHB, Medtech and healthAlliance IS.

New Zealand first for Total Healthcare

Dianne Crowley who works for CMDHB Mental Health Services returned victorious from the 2011 New Zealand Masters Games in February. This year’s event took place in Wanganui and catered this year for a total of 64 sports.

It took us some effort to coax her into showing us the medals she’d won this year. What a stash!

Di won Gold in 50m Freestyle; Silver in 100m Freestyle and 100m Breaststroke; and Bronze in 50m Breaststroke and 50m Backstroke. We were so impressed with her success and when we asked her what it felt like to do so well, Di said: “I was blown away. To win the 50m freestyle which is my favourite event, was amazing!”

She joined the New Zealand Masters in her mid thirties in 1982 and was a founder member of the Napier Masters. She hadn’t really swum competitively since her schooldays until she joined and is now a life member of the club. After moving up to Auckland she had a 5 year break from swimming, and found she was out of her depth so to speak. She is currently in training for the Long course North Island Champs to the outdoor pool at Papatoetoe which is a 50 metre pool. She reckons she’s a big sook and so doesn’t like to do early mornings there, but prefers to go down during the day when the weather has warmed up a bit. It is more difficult to fit this in during work hours and consequently feels she doesn’t do the quality training she thinks she should be doing. This will be tested on the 19th when she

Leading the way in the pool

competes in a fun meet in Cambridge at an outdoor 50 metre pool.

Di is normally in the pool three times a week, but with an event coming up, this can increase up to five times a week. She had been advised to get back into swimming by her doctor because of health issues and she has seen the results of the training in more ways

than just the swimming. She has lost weight and found her breathing is more controlled and she is more toned. It is a sport that will allow you to keep going back for as long as you want to. Many competitors are entering in their 80’s and still break NZ records, so there is hope for us yet!

When asked: What do you find swimming does for you? (Apart from keep you in amazing shape!) Di responded: “It clears my mind, and swimming in the morning sets up the energy levels for the rest of the day. My health has improved, the doctor is pleased with me and I’m making contact again with old friends.” The motto of Masters swimming is Fun, Friendship, and Fitness.

Through Masters Di has competed at the Games in Brisbane, Perth, Morocco, Munich, and Christchurch. For these events there are qualifying times and she has only usually competed in the 50m freestyle event.

Di would see it as her ultimate goal to hold the NZ record for that event – though she has doubts that she would achieve this with some wonderful swimmers out there.

Di would like to go back next year – the Masters will be held in Dunedin, so she’s not sure if she will make it. Her target for next year is the World Masters Swimming Games which are going to be held in Italy – so finances may dictate whether she gets to go. Either way she’s an inspiration to us all and we’ll be cheering her on.

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Astounding detail achieved with the latest technology that at Middlemore Hospital is making a big impact with pregnant women.State-of-the-art ultrasound equipment that delivers three-dimensional colour images of unborn babies gives medical consultants clear detail of tiny beating hearts and possible congenital abnormalities.

It also shows mothers-to-be and their family and friends stunning images of their unborn babies.

The ultrasound was recently demonstrated to Mayor Len Brown, and The Lion Foundation CEO Phil Holden and general manager of grants and marketing Jonny Gritt.

The VIPs saw the outcome of the Mayoress’ Charity Gala Ball held in May 2010 which raised $170,000 to help fund the ultrasound equipment.

Middlemore Hospital’s clinical director for women’s health, Dr Keith Allenby says it is much faster to capture an image with the new ultrasound.

“The images are more accurate – particularly when you’re making a complex diagnosis of something like a heart,” says Dr Allenby.

“If it takes a long time to capture the image of a moving heart you can get a blur, so you need equipment that works quickly to achieve accurate detail.”

When accessing if a baby is developing normally consultants look for details such as the way the baby holds its hands.

Older ultrasound technology only produces ‘slice’ images but the new three-dimensional technology gives a clearer picture and consultants are more confident in their diagnoses.

“The way the technology is advancing makes a huge difference to what we can offer to patients in Counties Manukau,” says Dr Allenby.

The increasing incidence of women with high body mass indices (BMI) has made it difficult for consultants to accurately scan foetuses but the matrix probe with 3D/4D/colour doppler addresses this issue.

Inside view of unborn babies

The high speed probe was developed in the United States to overcome growing problems presented by the obesity epidemic.

Patients are often reassured when the ultrasound identifies that an abnormality, such as a cleft lip, is quite small and can be easily repaired when the baby is born.

Medical staff can prepare in advance for more

serious conditions, ensuring mothers and babies receive optimum care throughout pregnancy and after birth.

Mayor Len Brown was intrigued by the detailed images displayed.

“When you see the outcome of having a great night’s fun – the Mayoress’ Charity Gala Ball – this is brilliant for our community,” says Mr Brown.

Len Brown and Phil Holden, CEO The Lion Foundation watch Dr Yvonne Lake demonstrate the new ultrasound machine.

Robyn Murtagh has been knitting soft toys for children coming into Emergency Care for the last 10 years. At Christmas she makes up to 100 toys which are given as Christmas gifts to children…there must be hundreds of these toys in homes all over the city. Robyn is a delight to work with and generosity is appreciated by all of us.

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Months of fundraising by supermar-ket and retail staff throughout the nation has delivered life-changing treatment for children with severe burn scars and birth marks.The annual Fresh Future campaign run by mega retailer Progressive Enterprises Limited resulted in a whopping $120,000 being donated to the National Burn Centre at Middlemore Hospital.

Clinical leader of the burn service, Dr Richard Wong She, was thrilled to receive the giant cheque which will enable the purchase of a pulsed dye laser.

“We need this laser to give children a better future,” says Dr Wong She. “People can be assured patients get the best care in the world at the National Burn Centre.”

At the presentation ceremony Dr Wong She told staff from Countdown, Foodtown and Progressive management that Maori and Pacific

people are five times more likely to suffer a burn.However, European burn patients are twice as

likely to require skin grafts and surgery.Children and adults from throughout New

Zealand are admitted to the specialist National Burn Centre when they have severe burns.

Scarring is almost an inevitable result although good medical and surgical care can minimise the degree of scarring. For optimal results, additional intervention is nearly always required.

While there are many interventions aimed at reducing the amount of scarring forming, there are few options to reduce the amount scar which has already formed.

Lasers represent an important new technique which can improve not only scar development, but also reduce the bulk of scar once formed.

Progressive managing director Peter Smith says staff members fundraise over and above their regular work.

“They do it because they care,” says Mr Smith.

Supermarkets buy hi-tech laser

Motivating people to dig deep into their pockets and make generous donations takes special talent, especially during a sluggish economy.The Mad Butcher and Suburban Newspapers Community Trust can work that magic that makes everyday Kiwis want to support the cause.

The success of the high profile Operation Heal campaign in 2010 raised more than $200, 000 for new surgical equipment for the National Burn Centre at Middlemore Hospital.

Clinical leader of the burn service Dr Richard

Wong She and his team will soon have a surgical microscope that allows the specialists to take a block of tissue, transpose it and connect it to arter-ies and veins at the new site.

The success of Operation Heal can be attributed to numerous factors.

The Mad Butcher, Sir Peter Leitch is a high profile man who is recognised for his integrity and enthu-siasm. Get a good mate behind a campaign and it’s more likely to succeed.

Media saturation throughout print forums ensured the community was well informed about Operation Heal.

Access to patients’ heart wrenching stories com-municated the impact the new equipment will have on the lives of many.

Some donors wrote letters expressing their empathy with Operation Heal, having suffered burns or lived with a family member who was burnt.

The newspaper coverage culminated in a great night out – glitz and glamour with Kerre Woodham, Ewen Gilmour and Prime Minister John Key enter-taining the crowd.

A charity auction also helped reach the fundrais-ing target.

Thanks to the The Mad Butcher and Suburban Newspapers Community Trust for their outstanding effort.

The microscope will be at the National Burn Centre soon and will be eagerly shown- off to the matesthatmadethecampaignasuccess.•

SUCCESS: Sir Peter Leitch hands South Auckland Health Foundation chairman John Maasland a monster cheque for Operation Heal. DRESSY: Prime Minister John Key joins the fun to raise more money. Photography Suburban Newspapers/Fairfax Media

Operation Heal a blazing success

SUCCESS: Fresh Future helps the National Burn Centre, from left, Peter Smith -Progressive Enterprises, Dr Richard Wong She and Ruth Krippner – Fresh Future appeal com-mittee chairperson.

“If we can save one life – then it’s worth it.”All Progressive retailers are involved in the

appeal, including, Countdown, Foodtown, Woolworths, Fresh Choice, SuperValue, support offices and Dick Smith.

Last year was challenging for the nation and the Fresh Future appeal was put on hold to raise funds for the Christchurch earthquake appeal and Pike River Mine appeal.

The national Fresh Future appeal reached an impressive total of $759,600.

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Set your alarm, have your walking shoes ready, get your girlfriends together and set off on the Sunrise Walk for Hospice™, Sunday 3 April at 6:30am with Ambassador Valerie Adams. This is the second year for this all-women event at the Auckland Botanic Gardens & Totara Park to raise awareness and funds for Hospice South Auckland.

Registrations have opened (www.sunrisewalk.co.nz) and places are limited to 1500 women. The inaugural Sunrise Walk for Hospice™ raised over $97,000, this year’s target is $150,000.

Ambassador Valerie Adams, Olympic Gold Medalist, knows first hand the importance of the services and support provided by Hospice South Auckland. Valerie will be attending the event to start the walk and set the pace.

“I want to thank you all for your support. It really means a lot to me. I’m asking for your support again. Not for me, but for Hospice South Auckland. They did an awesome job caring for my mother and I am proud to be their Ambassador.

Last year around 800 women had an amazing time at the inaugural Sunrise Walk. This year we are expecting around 1500 entrants so I look forward to meeting even more of you this year! So come on girls, get out those walking or running shoes on and get moving!” Valerie Adams

Teams and individuals registered for Sunrise Walk for Hospice™ are encouraged to fundraise by seeking sponsorship from friends, family and work mates, with great prizes up for grabs.

Hospice South Auckland Chief Executive, Gary Sturgess said “This year’s walk marks the end of Daylight Saving, so participants will be able to get an extra hour of sleep with the 6:30am start! We are so grateful for the support we received

Sunrise Walk For Hospice™in 2010 and look forward to seeing even more women participate on the third of April.”

We are delighted to announce our Principal Sponsors without whom the event would not be possible. They are Coverstaff Recruitment, Hawkins Construction & Holcim New Zealand Ltd. Thank you to the Auckland Council for making their glorious venues available, the Auckland Botanic Gardens and Totara Park. Special thanks also to Hirepool, EmbroidMe Manukau and many more generous sponsors.

About Hospice South AucklandHospice South Auckland (HSA) provides care, compassion and support for people who are facing a life limiting. We believe no- one should have to face a life-limiting illness alone-

A walk in the park at last year’s Sunrise Walk for Hospice. From L to R: Sarai Latu, Jan Deadman, Sailau Sulusi and Kay Sillis raising much needed funds for Hospice South Auckland. Register now for the Sunday 3 April event at www.sunrisewalk.co.nz

unsupported or uncared for.We provide specialist palliative care to a

population of approximately 440,000 within the South/South East Auckland area and at any time we will be providing care to approximately 370 patients.

The care of our patients and their families is free of charge but comes at a cost to provide. In addition to funding from the District Health Board, HSA still needs to raise approximately $2.68 million to provide a full range of services.

Totara Lodge, our 9 bed In-Patient Unit, provides 24 hour medical and nursing care. Our community palliative care nurses make close to 10,000 community visits each year. Our Family Support Services team provides counselling, social work and spiritual support.

Are you a smokefree trainer or a registered health professional who offers patients smokefree support?

The Counties Manukau District Health Board (CMDHB), with the Hawkes Bay District Health Board, is now offering a smokefree train-the-trainer course nationwide.

Funded by the Ministry of Health, STEPS (Sustainable Trainer Education to Promote Smokefree) came about after the introduction of the national Smokefree targets which specify that 90% of in-patients over the age of 15 years who smoke should be provided with support and help to quit by July this year and 95% by 2012. STEPS teaches health professionals how to train their colleagues to offer this smokefree support so that more of the health workforce feels confident when addressing this important issue with patients.

The one-day workshop covers smokefree

Taking STEPS to Promote Smokefreebest practice, interactive activities, adult learning strategies, training information and a training tool kit. Ongoing mentoring is also provided.

Ingrid Minett, Smokefree Programme Manager at CMDHB, says the workshop aims to build confidence so participants leave feeling capable of training their colleagues.

“Asking a patient about their smokefree status and then following this up with the appropriate support or advice can be daunting,” she says.

“By becoming a STEPS-certified trainer, health professionals learn how to teach their colleagues to do this and are also provided with a variety of resources and support. With more skilled and resourced smokefree trainers, we hope to achieve a strong workforce that confidently assesses every patient’s smoking status and routinely provides brief advice and support to quit to everyone that smokes. The potential impact that this simple intervention can have in reducing the smoking prevalence in our communities is huge.”

STEPS is supported by CMDHB’s Creating a Better Future strategy. It is open to all registered health professionals and people employed as smokefree trainers. Participants need to complete the ABC e-learning tool beforehand. For more information, contact Karyn Borman, National Smokefree ABC Trainer, on karyn.borman@middlemore.co.nz or 021 571 719.

CONNECT I PAGE 9

Stay warm this winterAfter a long summer it‘s easy to forget the cold and damp of winter. To be better prepared for next winter this is the time to consider whether or not you or the families you work with are eligible for the free retrofitting insulation programme offered by the Counties Manukau District Health Board.

Warm Up and Snug Homes Counties Manukau are two free retrofitting insulation programmes operating in our community.

This is the perfect time to have home insulation installed as it is not raining, the ground under your house is dry and the ceiling space is not damp.

Check your eligibility for the free home insulation programmes:

To be eligible for the programmes applicants must:• liveintheCountiesManukau,Papakura,

or Franklin area; • resideinaprivatehomebuiltpriorto1st

January 2000 (i.e. NOT Housing New Zealand);

• theowneroccupierortenantMUSThavea Community Services Card;

• CountiesManukauDistrictHealthBoardare prioritising households that have children (under 14 years of age) or older adults (aged over 65) with housing related

health conditions such as respiratory disease (we recommend that a letter of support is obtained from a health professional to assist with the application).By insulating your home you will improve

the health of your family and you will reduce your power bills through having a more energy efficient house.

The District Health Board supports these initiatives because our population has a high rate of hospitalisations resulting from respiratory disease.

Our hospital admissions in Counties Manukau for respiratory infections are 27% higher than the national average for children (aged 0-14 years) and 42% higher for adults.

Hospital admissions for adults with asthma are 40% higher than the national average.

Living in cold damp homes is impacting on the health of our community. We want to reach out to families who meet the eligibility criteria and who have the most to benefit from having their homes insulated by the programmes.

This year we have helped 750 families have their homes insulated for free- if you meet the criteria we want to hear from you – please contact Kerry on (09) 262 9583.

It gives us great pleasure to report that since our last article in Connect (August 2009), introducing the Middlemore Tissue Bank, we collected samples from our first donor on Thursday, 16 December 2010. Our first donor has multiple myeloma. As of Friday, 25 February we have banked a total of 322 samples from 17 donors across the spectrum of haematological malignancies.

Samples are taken from donors only after they give written consent and are collected during procedures that are part of their normal care, e.g. surgical removal of tumours, bone marrow biopsies and blood tests. Samples for the tissue bank are only available after all diagnostic tests have been carried out. These are processed, labelled with a coded number and stored in a locked -80°C freezer in the tissue bank.

Located at the basement of the Edmund Hillary block, the Middlemore Tissue Bank is to become a comprehensive tumour tissue bank.

Getting to this point has been a long journey for the staff of the Middlemore Tissue Bank. • CuratorwasappointedinJuly2009.• EthicsapprovalreceivedfromNorthernCross

Ethics Committee on 22 April, 2010.• CMDHBapprovalofasubstantialgrantin

May, 2010 to allow the new facility to be built. It was completed on 28 October, 2010 and includes a Class II biohazard cabinet and refrigerated centrifuge kindly donated by the Leukaemia and Blood Foundation (LBF).

• Cresalys®tissuebankingdatabasesoftwarewas installed on 1 November, 2010. The purchase of this software was made possible by an additional grant from the Freemason Roskill Foundation.

• ThefacilitywasblessedbylocalKaumaatuaat Middlemore Hospital on 22 November, 2010. It was an important milestone and attended by many from the local community both within and outside Middlemore Hospital.Many different groups of people have

contributed to the achievement of these milestones and we are grateful for their support. In particular the Towards 20/20 team who coordinated the construction of the new facility.Also, the collaboration of researchers, clinicians, academics and groups like the LBF are crucial to the success of the Middlemore Tissue Bank.

Once a sufficient number of samples are collected they will be released for ethically-approved research that has been authorised by the tissue bank’s Scientific Advisory Committee.

In the future the Middlemore Tissue Bank will become a regional collection centre for human tumour-related biospecimens for research.

Made possible by a generous 3-year

First Sample for Tissue Bankestablishment grant from the Freemasons Roskill Foundation (FRF) in 2009 and with additional financial support from the LBF, Counties Manukau District Health Board the vision of a number of individuals has progressed to now being a reality.

Tissue banks are an integral part of all state-of-the-art hospitals and cancer centres worldwide. They allow the establishment of databases with clinical, histological, genetic, therapeutic and follow-up information on cancer patients. These are important tools for increasing our knowledge about tumours and will eventually translate to developing better treatments and cures.

Daphne MasonCurator Middlemore Tissue bank

CONNECT I PAGE 10

“OTC, smokefree, the way to be” were the resounding words of young people, community organisations and volunteers as they marched around the Otara Town Centre (OTC) in 2009 declaring their desire for the town centre to become smokefree.

The Smokefree Otara Town Centre project has been led by Otara Health Charitable Trust for the past three years. The project has given rise to community volunteers, organisations and businesses working together to support their town centre to be smokefree. Other stakeholders, including Counties Manukau District Health Board, Otara Business

Association, the National Heart Foundation, Auckland City Council and Otara community leaders have actively supported the project.

In the early stages, the project focused on raising awareness of the harm caused by tobacco along with the potential power of a collective effort to reduce that harm. ‘Everybody doing their bit’ has been one of the key messages promoted throughout the project. Because the Otara Town Centre mall is not an enclosed area and therefore is not subject to the smoking ban under the Smokefree Environments Act, an educative rather than an enforcement approach to reducing smoking in public areas

has been taken. Smokefree ‘Auahi Kore’ signs have been put up in the designated smokefree areas in the town centre and are prominently displayed on walls, buildings, seats and through the use of large flying banners. Three designated smokefree areas were chosen by the community because of their high usage by children, families and young people. They include the community courtyard, outside the library, the stage area and the children’s playground. Smokefree promotion and awareness-raising activities are centred around these areas.

Otara Health co-ordinates smokefree promotion activities and delivers smokefree training for the public, community volunteers and staff of organisations operating in the town centre. We have also worked with the Otara Business Association to develop a smokefree stage hireage policy. Once formalised, this policy will mean that

Smokefree Otara Town Centre

The first worldwide Spirometry Day was held towards the end of last year and Counties Manukau participated with an event at Middlemore Hospital.

Spirometry is the most common of the Pulmonary Function Tests, specifically measuring the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is an important assessment tool and is helpful in assessing conditions such as COPD, asthma, bronchiectasis, pulmonary fibrosis, and cystic fibrosis.

World Spirometry Day at Middlemore was very successful with many people from the respiratory and physiotherapy department helping out on the spirometry stand. Thanks to those staff members that volunteered their

time to help out and those who came to have a go! We had a total of 140 people come and have their lung function tested, including staff, patients, visitors and onsite contractors.

It was a good opportunity for increasing awareness on lung health. We had great success in raising smoking cessation awareness and perhaps being the catalyst for change for some current smokers with sub optimal spirometry results. Information packs were offered regarding COPD, smoking cessation, optimising lung health and spirometry. Quit cards and nicotine replacement therapy samples were also prescribed to people who were ready to give up smoking with some additional help.

The European Respiratory Society (ERS)

and the European Lung Foundation (ELF) coordinated the worldwide organisation of the event. Worldwide there were a total of 89,768 tests performed from 355 different events. For more information on other events that took place you can look online at www.2010yearofthelung.org.

Spirometry Day

all groups using the outdoor stage area in the town centre for events will need to promote their event as being smokefree. They will also be required to act as smokefree role models by not smoking themselves while performing in the area. The implementation of the policy will be monitored by the town centre’s Ambassadors.

Forty two people from the community have so far received the training from Otara Health to support the project. These include Otara Wardens, Ambassadors, staff from community organisations and community leaders. Following the training, their role is to be smokefree champions in the community and to educate the public on the designated smokefree areas. Smokefree messages and updates on the project are also provided regularly by Otara Health in the Otara Network, Otara Network Action Committee and Otara Maori Forum monthly meetings.

Although the Otara community agrees on the designated smokefree areas and as a community they agree they have a role to play in the success of the project, there are ongoing challenges. It’s not easy for smokefree champions, ordinary people who have volunteered to take on a role, to confidently approach smokers and to politely ask them not to smoke in the designated areas. This is where the ‘everybody doing their bit’ approach and the provision of ongoing training and support can help to keep up the momentum. Ultimately, we hope that this will lead to many local voices proudly staing that “OTC, smokefree” is the way to be.Adele Hamilton Ph 09 274-8355 adele@otarahealth.org.nz Ambassadors put signs up in the centre and by childrens play area

CONNECT I PAGE 11

Eighty Maaori and Pacific school students spent an action-packed day at Middlemore recently. These students are part of the first-ever high school health academies in New Zealand, run by Tangaroa College, James Cook High School and Otahuhu College. These young students have already expressed a desire and commitment to be part of tomorrow’s health workforce in Counties Manukau and for one exciting day they were given a glimpse into their futures.

Students enjoyed guest speakers in the academic lecture theatre and guided and interactive tours through the hospital, including Emergency Care, Laboratory, Dialysis Clinic and the Clinical Training & Education Centre (CTEC). Throughout the day students met a range of dedicated health professionals with one feature being a role play and demonstration from a team of physiotherapists. The students enjoyed the real life experiences and hands on learning.

The day was organised as part of CMDHB’s ongoing Health Could B 4 U school-based programme which supports all three academies plus eight other South Auckland schools. Both the academies and Health Could B 4 U aim to recruit more Maaori and Pacific people into the health workforce.

Student and teacher feedback from the day was overwhelmingly positive with the majority of the students disappointed only that they weren’t able to see everything. “I enjoyed how welcoming everyone was and how they gave us a chance to look inside their departments...I enjoyed everything about Middlemore hospital…I’ve learnt today that health is for me and I am going to do health as a job..” – Student

“The most important thing I learnt today is that we’re in this to help our own people...” – Student, Otahuhu College

“Today I’ve learnt that HEALTH COULD B 4 ME if I work hard I can achieve my goals. I’m going to achieve my goals!” – Student, Tangaroa College

Health Could B 4 U is delivered into 11 schools across Counties Manukau from Years 9 to 13 offering exposure to health tertiary providers,

In its 3rd year through Learning & Development, Managerial Excellence (MEX) is a customised management development programme designed in consultation with CMDHB and delivered by the New Zealand Institute of Management (NZIM). The programme involves course participants in 14 face to face contact days, work-based assessments, a major quality improvement project and presentation and a reflective journal. As an applied action learning process the emphasis of this programme is as a work-based developmental opportunity. The 6 modules credit towards the 8 modules required to be awarded a Diploma in Management (Advanced) Level 6. The programme focuses on generic skills for professional managers and serves a link between management theory and practical application. Programme participants are drawn from management roles in both secondary and primary care.

Diana Dowdle, service manager NASC and Home Health Care, says the Managerial Excellence programme has proved very successful. “We’re very supportive of it. Although it does take a lot of time it has huge benefits.” Richard Small, operations manager, Home

Health Care Orakau, completed the Managerial Excellence programme last year. His project looked at the allied health workforce’s capacity and resourcing.

“I developed the Allied Health Workloads Standards Project firstly because some of my clinical staff were saying there wasn’t enough time to do what they needed to, there were backlogs in terms of client waiting lists, and a sense that things weren’t on the right track. The other reason was in response to the current economic and political environment, and needing to be accountable for our time and our resource. We needed a clear set of guidelines for the workload expectations and capacity of each discipline and clinician in terms of the volume of clients they should manage.”

“Richard did very good work collecting data on what the teams are actually doing and breaking it down into how much was clinical and what was non-clinical, such as meetings, training, admin, supervision and travel,” says Diana Dowdle. “He worked with them to establish whether the data was correct and what we want them to be doing, which is to spend about 80% of their time on clinical work. That’s actually what they want to do

too, but a lot of meetings and project work were taking them away from their clinical work. It was all about making sure that they were supported, to ring fence their clinical work. His project is a first for allied health, to be looking at work load, capacity, how to match resources to the workload and how to measure it.”

Communication and building understanding and support for the project amongst all stakeholders was vital, says Richard, and he applied many of the principles directly from the change management module in particular, trying to ensure there were no misconceptions and that everyone was moving forward together.

The result was tremendous buy-in from the staff, says Diana Dowdle.

“The content was bang on the money for any manager or leader in any organisation, not just health. The other thing that particularly appealed was the type of content - all things that can be difficult to find in a quality course pulled together in one place. I was able to apply what we were learning absolutely from Day 1.”

Anne Marinelli-Poole Organisational Learning & Development Manager

CMDHB Managerial Excellence Programme

hospital tours, work experience, engagement with health professionals, health scholarship opportunities and more. If you would like more information on the Health Could B 4 U programme or want to know how you can get involved, contact Alexandra Nicholas, Workforce Development Coordinator at alexandra.nicholas@middlemore.co.nz or ext 9176.

Special thanks to all those departments and staff who participated in this hospital visit and for your continual commitment to the future workforce.

Future Health Hopefuls Descend on Middlemore

CONNECT I PAGE 12

Here at Counties Manukau, we’re leading the way when it comes to developing our people. Two significant programmes are making a difference to the way we operate as an organisation, and both have a unique flavour – while one focuses on leadership, the other develops applied managerial skills.

Leading Excellence in Health Care recently celebrated the success of its participants at a graduation ceremony held at MIT’s marae, Nga Kete Wananga (Baskets of Knowledge). Ninety seven people - from across primary and secondary health, including Funding & Planning – took part in this learning journey, which explored different ways of thinking and working, and established a common language. Developed in collaboration with the University of Auckland New Zealand

Leadership Institute (NZLI), the programme exposed participants to new perspectives on leadership and built a strong sense of inquiry. For CMDHB, leadership complexity and the individual, professional and collective identity of leadership and partnership were key drivers for the programme.

One of the strengths of the programme was the ability for people to reflect on new concepts during interactive workshops, where expert facilitators and guest speakers challenged their existing paradigms around leadership. These workshops, along with extensive readings, peer conversations, and leadership projects, are developing leadership capability in our organisation with people who are now better equipped to face complex issues in a dynamic health environment.

Graduands from the Leading Excellence in Health Care gather outside the marae after the ceremony.

Leading the Way

Pacific Return to Nursing Update The journey to NCNZ registration continues for 14 additional Pacific trained and registered nurses. Following on from the success of the 14 that attained NZ registration during the 2009/2010 year under the CMDHB Pacific Return to Nursing Pilot a select subgroup from the pilot are working extremely hard to complete a pass in the one IELTS (International English Language Test) module they are missing. Students selected had scored a 6 or 6.5 in previous tests to make selection for this subgroup which started tutorials in November of 2010.

One student passed IELTS just before Christmas and is awaiting a CAPS programme start date in April. Two students sat IELTS last Saturday and three are scheduled to take the test March 12. The pilot has allowed the team to unpack the barriers to Pacific students’ success in IELTS. The key learnings and success we are seeing is from intense specialist teaching that deconstructs the elements of reading and writing

Regional Clinical Pathways ProjectThe Regional Clinical Pathways project started in July last year and is one of the key ‘Better Sooner More Convenient’ workstreams. The purpose is to define and standardise best practice for common conditions across the Auckland region.

A clinical pathway is a standardised, evidence-based multidisciplinary management plan, which identifies the appropriate sequence of clinical interventions, timeframes, milestones and expected outcomes for a homogenous patient group. Variance is defined as any deviation from the proposed standard of care listed within the Clinical Pathway.

(Dalton, Macintosh, Pearson 2000, Queensland Clinical Pathways Board 2002.)

The first six pathways to be developed are;· Dyspepsia · Iron Deficiency Anaemia· DVT · COPD · Community Acquired Pneumonia · TIA

Following completion of these pathways further condition groups that will have maximum impact on demand, overall population health, and health inequality will be selected. All will be developed as Integrated Pathways delivering the right care, at the right place, at the right time.

After consulting with GP’s and hospital clinicians we have been told that a big part of success in using pathways will be the ease of access and ‘usability’ of the pathways. In other words if they’re not at your finger tips when you need them they won’t be used.

As a result we are developing an electronic solution that will enable clinicians to access the pathway they need within two or three mouse clicks, from their desktop.

Each pathway development workgroup is composed of 8-10 primary and secondary care clinicians. The development process takes place over five meetings.

The development team will be presenting to the DHB’s, PHO’s and GP peer groups and cell groups as the project progresses.

If you have an interest in pathway development and would like to contribute please email the project manager, Kris Vette (vettek@middlemore.co.nz)

that continue to pose barriers to them achieving the mark of academic level 7. This along with small group classes of 6-7 students is the best way to minimise costs, impacts of failure on self esteem, maintain momentum and achieve ultimate success. Students must achieve a score of 8 consecutively across three sample tests before they are allowed to take an IELTS test.

This pilot is scheduled to conclude by 30 June 2011.

The first graduates of the Pacific Return to Nursing Programme.