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Welcome to the autumn issue of Connect

For some time I have been talking about the need for us as a DHB to be prepared for a future which includes an aging and increasing population, inequalities in health, variation in quality and more limited resources, whereby new hospital facilities may not be available to us. We are all aware of the increasing pressures on hospitals all around the world. This does not mean however that we cannot provide our population with excellence in healthcare that is sustainable in the long term. Between now and December 2013 we need to put in place some important strategic programmes so that we are ready to implement the changes that are needed for us to be able to deliver the best healthcare.

It is very clear to me that marginal efficiencies will not deliver the system changes needed for us to meet all the pressures that we face. We have to work differently in the future. Knowing this is to be the case and that it has to be planned, we have, over time been building the capacity in the DHB and wider system to ensure

From the CEO

MARCH 2012

we have in place the means and relationships to make rapid, radical but very positive change. Ko Awatea, our continuing focus on quality improvement and worker smarter and safer, increasing the number of frontline staff, building Middlemore so it is physically a 21st Century Hospital and developing strong links with Primary Care are just some examples of the preparatory work we have been doing.

I want you to keep in mind two dates – December 2013 and December 2015. Between now and December 2013 we will be implementing a range of programmes which will address some of the wicked issues facing us – like reducing demand for hospital care through the 20000 bed days campaign. But it is vital for you to understand how it all fits together and where you are playing your role in shaping the healthcare of the future. So over the past few weeks we have been stocktaking on all of our work, projects and initiatives and organising them into a simple diagram which links the work that you do with the initiatives and outcomes we are focussing on. We can then be clear to prioritise those initiatives that add most value and to reduce that that doesn’t.

The successful implementation of these programmes will reshape how the health system works for the better, and will set the foundation for a better performing, fit for purpose sustainable and excellent health system where

you can feel you have the skills, workplace and most important of all time to care

There are so many examples of fantastic excellent care at Counties - wouldn’t it be great to see that excellence spread and acknowledged? So we have set the goal of being the leading health system in Australasia by 2015. I do not mean this to be an empty boast or pious hope – I genuinely believe we have the great people at CMDHB and beyond who can make this happen – World class in New Zealand, not just world famous or world champions. So over the next few months I will be leading a project that will identify in a measurable way what that means, how it can be shown and how we can go about delivering it. In doing so I want staff to be part of mapping the journey and able to feed into setting those goals up.

As we enter this year with this crucial programme, informing you and getting your help, support and in-put is vital. A detailed communication plan is being finalised and we will keep all staff updated on how each of you can contribute your part. Apart from my blog and staff forums, there will be group and team briefings that will keep you and your managers up-to-date.

I look forward to an exciting, positive as well as challenging time ahead.

As ever thank you for all that you do.Geraint A. Martin

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Meet the board

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

Lyn Murphy Lyn Murphy was elected on to the CMDHB in 2010. Prior to this she was a Member of the Howick Community Board. Lyn originally trained as an Occupational Therapist and has been active in supporting a healthy community, including membership of CCS, Arthritis Foundation, and Paraplegics Assn committees and Advisory Trustee for the Arohaina Trust for the Elderly.

Lyn is a senior lecturer in management at the Manukau Institute of Technology and is currently completing a PhD in accounting and finance. Her doctorate thesis investigates the costs and benefits of medical research at CMDHB.

Lyn is active in promoting New Zealand as a good place to do health research. She is a member of the Australian and New Zealand Academy of Management (ANZAM), Health Management SIG and the New Zealand Association of Clinical Research (NZACRes). She is facilitating the development of a New Zealand chapter of the International Society of Pharmaco-economics and Outcomes Research (ISPOR). She is a recipient of the internationally prestigious ISPOR student award.

Paul CressyA Counties Manukau resident all his life Paul was elected to the Counties Manukau District Health Board in 2001 and has served as Deputy Chairman of the Board, Chairman of the Community and Public Health Advisory Committee and is currently Chairman of the Hospital Advisory Committee, and a member of the Finance and Audit Committee and the Community and Public Health Advisory Committee. He also serves on the Maori Health Committee Pou. A pharmacist who has owned two pharmacies, Paul was Managing Director of East Health Services and a Trustee of the EastHealth PHO.

Chairman of the Child Cancer Foundation from 1981 to 1992, Chairman of the Ronald McDonald House Auckland Trust from 1982 to 2006, a past President of the Rotary Club of Howick and the Rotary Club Half Moon Bay, he is currently Chairman of the South East Auckland Life Education Trust.

In 2007 he was appointed an Officer of the New Zealand Order of Merit for his services to child cancer. Paul is committed to the expansion of quality health services to the population of Counties Manukau that are truly integrated between Community and Hospital care.

Who would have thought that gauze dressings, casts and other wound care products held the key to saving hundreds of thousands of dollars a year?

That is what a successful procurement programme at the Counties Manukau and Waitemata DHBs has shown – so it is now being used as the basis of a national programme. Just over three years ago Counties Manukau and Waitemata DHBs standardised the prices they pay for a wide range of tapes, bandages, wound care and casting products. Their work in negotiating set prices is now being used as the basis of a national programme. “They did a fabulous job,” says healthAlliance procurement specialist Chris Biltcliff. When the contracts were signed in 2008, Counties Manukau DHB spent more than $2.5m per annum on these products, and expected to save around $364,000 a year, or 16%. Nationally, the long-term goal is for DHBs to do the same.

Across the country DHBs use more than 400 different types of wound care products, and until recently the prices they paid varied a lot. Now healthAlliance has negotiated national prices for all those products. “If you are buying a gauze square in Northland, it will be the same price as if you are

buying a gauze square in Otago,” says Chris.Contracts are in place with the five man

suppliers, and Chris says the national savings across just two of them will be around $750,000 a year. “The suppliers have provided some really sharp prices.” The next step for Counties Manukau DHB, which buys around 350 different types of wound care products, will be to rationalise what it buys. Clinical input is crucial at every step, Chris says, and she is working with DHB staff on that.

“DHBs need to save money,” says Chris. “One of the ways we can do that is to rationalise and standardise the products they purchase. It won’t mean any change to the process new products go through before a DHB decides to buy them, but it does mean DHBs will know exactly what they will cost if they buy them.”

First published in Waitemata DHB’s Healthlines magazine

Savings more than just a band-aid

Mental Health Graduates start with CMDHBMental Health services are delighted to welcome 17 graduates to their workforce. Occupational Therapists, Social Workers and Nurses all commenced their orientation with a Whakatua at the Tiaho Mai marae, Nga Whetu Marama on 23rd January 2012. These new staff will work across all MH services including community, speciality services and inpatient services.

It is always exciting to greet new staff and even more so, those who are just starting their

journey. A truly multi disciplinary approach has been taken to support them with the view to building close and effective working relationships with colleagues as is reflected in the model of care provided in MH. The enthusiasm displayed by the graduates’ augers well for their busy and challenging roles.

We wish them a very successful year as graduates and a great career in mental health at CMDHB.

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On 31st October this year, Women’s Health was privileged to host two midwives from the Solomon Islands for a four week clinical placement as part of the Brian Spurrett Fellowship Program coordinated by the Royal Australian & NZ College of Obstetricians & Gynaecologists (RANZCOG) and the Pacific Society for Reproductive Health Trust (PSRH).

The programme is established for the promotion of clinical leadership in women’s health in the Pacific Islands. It aims to equip and empower visiting midwives with information, observations of best practice and clinical skills to make an informed contribution to their own hospital role and regional activities aimed at reducing pregnancy-related morbidity and mortality as promoted in MDG 5. The Program is consistent with WHO, UNFPA and UNICEF strategies to escalate progress towards Millennium Development Goal (MDG) 5 by 2015, and the national health plans in use in the various Pacific island countries.

For four weeks, Glence Faka (from Good Samaritan Hospital in Gaudalcanal Province) and Ellery Hivu Nagu (from National Referral Hospital in Honiara) attended a variety of clinical placements in Women’s Health at Counties Manukau District Health Board. They spent time in Maternity Ward, Assessment, Labour and Birthing Unit, Community Midwifery, the Diabetes and Obstetrics Medical Clinics, as well as the Early Pregnancy Assessment Clinic, Neonatal Unit, Colcoscopy Clinic and the Acute Pain Service. In addition they attended the Perinatal Mortality Meeting and various education sessions, including a Practical Obstetric Multi-Professional Training (PROMPT) day. “We were

Solomon Islandsmidwives visit

Director of Midwifery Practice Thelma Thompson, Ellery Hivu Nagu, Glence Faka & Sanne Wesseling

impressed with how nice the midwives talked to patients and how much information the women were given as this is not always the case back in our islands” said Glence on her feedback of the attachment. It was a pleasure to build relationships with these two midwives, to become more aware of the clinical and professional challenges they face and to look at our own practices from a different point of view. The RANZCOG and PSRH are grateful to

the leadership and midwifery team at CMDHB for the opportunity and sharing with their Pacific Island colleagues.

Dr Alec Ekeroma, President PSRH and Councillor of RANZCOG, Pacific Womens Health Research & Development Unit, Middlemore Hospital Sanne Wesseling, Midwife Coordinator Women’s Health, CMDHB

Counties Manukau District Health Board (CMDHB) has received its fourth consecutive ‘outstanding’ rating for exceeding the national health target around elective surgery.

During quarter two of 2011/2012, CMDHB performed 7904 elective surgeries, exceeding the national target by 612 discharges. This resulted in an ‘outstanding’ rating from the Ministry of Health – the fourth quarter in a row in which CMDHB’s performance has been recognised in this way.

“This continued success is fantastic and a great credit to our staff who have worked hard over the last year to ensure that an increasing number of patients are receiving their elective surgery,” says CMDHB CEO, Geraint Martin.

The rating comes with the release of district health boards’ performance against the quarter two national health targets from the Ministry of Health.

CMDHB also continued to meet the national

targets around shorter stays in emergency departments (97% up from 96% in quarter one) and shorter waits for cancer treatment (100%, unchanged).

Our performance against the immunisation target substantially improved to 91% (up from 89% in quarter one) thanks to an outreach vaccination programme, which is run through Well Child providers, resuming. The target for Pacific immunisation (95%) has now been met and Maaori immunisation rates have also increased.

CMDHB is also making significant inroads into the smoking target, with a result of 92% (up from 89% in quarter one). Of the 4069 smokers hospitalised during quarter two, 3745 received advice and support to quit. This significant improvement demonstrates the way in which smokefree interventions have become embedded into staff’s routine practice. A daily reporting system is also monitored to identify

wards that need ongoing support in this area. The result for the smokefree target for

Primary Care, which was introduced in quarter one, was 16.97%. While this is well short of the target, it is an improvement on the previous quarter (15.79%). The Ministry of Health, CMDHB and primary health organisations (PHOs) are continuing to work on the issues with data collation. PHOs are also receiving support from CMDHB to offer smokefree interventions and improve their performance.

Finally, CMDHB also recorded improvements for cardiovascular risk assessments (84%, up from 83% in quarter one) and diabetes management (59%, up from 56% in quarter one). The result for diabetes annual checks was 77%.

For more information, visit the Ministry of Health website (www.health.govt.nz) or contact External Communications Manager, Lauren Young, on 021 823 590.

National Health Targets Quarter 2 2011/2012 Performance

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We invite all PHOs, DHBs and health providers join the blood pressure awareness campaign – Saturday, 12 May 2012The Stroke Foundation and St John, together with Rotary NZ and Foodstuffs are delivering a Blood Pressure Awareness Campaign across New Zealand on Saturday, 12 May 2012. The aim of the campaign is to raise awareness about the relationship between high blood pressure and stroke and ways to reduce risks from stroke.

How will the campaign be delivered? “Blood pressure sites” will be set up across the country, mostly in participating Foodstuffs supermarkets (ie, Pak N Save and New World stores). These sites, staffed mainly by St John and Rotary, will hand out information on blood pressure, stroke and stroke risk factors, and offer free blood pressure checks to the general public. Those who have a blood pressure check will receive a print-out containing their result and a general explanation about readings. Those with concerning results will be advised to have a further check with their GP or nurse. (Health providers may experience an increase in requests for blood pressure checks as a result of the campaign.)

How can you support the campaign?All health providers including clinics, PHOs, DHBs, hospitals etc are warmly invited to participate in the campaign. They may wish to:•setupasiteintheirclinic,hospitalfoyeror

elsewhere (eg, mall,) offering information and free blood pressure checks . We can send you a carton of resources for this.

•setupabloodpressuredisplayintheirpremises; or join with their local Stroke Foundation or St John to participate in some other way. Community groups can support the

Campaign by encouraging people to visit the sites and learn more about stroke and reducing their risks for stroke.

Registration to participate closes on 15 March 2012. A carton of print resources and data-collecting forms is available to providers participating in the Campaign. If you are interested, and for all enquiries please contact:

Heather KizitoHealth Promotion Manager Stroke Foundation of New Zealand Phone (04) 8158123Email: Heather_kizito@stroke.org.nz

An invitation

Staff at Middlemore Hospital will soon see clearly thanks to the generosity of their colleagues.

Mid-way through last year, the Learning and Development team at Counties Manukau District Health Board (CMDHB) launched an organisation-wide appeal to collect used reading glasses for staff in its StepUP literacy and numeracy programme.

CMDHB staff soon got behind the request and more than 70 pairs of glasses flooded in.

“It really shows the character of CMDHB staff – that they’re people with good hearts who are happy to make a difference to others,” says Learning and Development consultant Sandy Millar.

“Staff rallied around and got their colleagues to donate too so all sorts of spectacles just kept rolling in. Many pairs had been lurking at the back of people’s drawers for years. We got everything from slimline specs to Dame Edna masterpieces.”

As well as reading glasses, many of pairs of prescription glasses were also donated. These will now be redistributed through the Manukau SuperClinic while the reading glasses will be used by staff participating in the literacy and numeracy programme. By the end of this year, about 180 staff will have completed the StepUP programme which is offered by CMDHB in partnership with

the Tertiary Education Commission.“Literacy and numeracy are important for us

in Counties Manukau, especially amongst staff who speak English as a second language. Our cleaners, orderlies and health care assistants often need extra help with language and benefit enormously from the training that is offered. Improved literacy and numeracy helps people do their jobs better, and they are more engaged and patient-focussed. They have the confidence to continue studying so they can take the next step in lifelong learning. Literacy becomes a platform to further education, which can only be good for our community.”

Sandy says the glasses will greatly benefit these staff by making it easier for them to read, which in turns takes away a barrier to participation at work and in the community.

“People are often surprised that something as simple as a pair of reading glasses can make such a big difference to their lives.”

A 2011 study found that 478,900 Auckland adults have low numeracy while 410,000 have low literacy. In Counties Manukau alone, 65% of adults have low numeracy skills.

For more information, please contact Katie Wylie, Senior Communications Advisor, on 021 784 610

Gifted glasses help staff see clearly

Learning and Development consultant Sandy Millar was thrilled with the response to her request for used glasses.

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highlight of the evening and presentations by Dr Colin Tukuitonga, Chief Executive of the Ministry of Pacific Island Affairs, and Dr David Galler, Clinical Director Ko Awatea CMDHB, completed a memorable night for all. Seven of the award recipients also went on to successfully receive a CMDHB Ko Awatea Health scholarship after undergoing a rigorous selection and assessment centre process in January, which will help support their health tertiary studies this year.

The Health Could B 4 U programme forms part of a range of workforce development activity operating to grow the health workforce in Counties Manukau. The programme is delivered in 8 schools across South Auckland including kura kaupapa. It

is a partnership with tertiary providers, health professionals and health services to support, engage and expose selected Maaori and Pacific students to health career pathways. If you would like more information on the programme and how to get involved please email Alexandra

Butterfly creek came to life with the vibrant colours and flavours of the Pacific at the annual Health Could B 4 U secondary school leadership dinners. The events capped off the 2011 academic year for selected students in Health Could B 4 U, a workforce development programme at Counties Manukau District Health Board (CMDHB) which is aimed at encouraging and supporting local Maaori and Pacific students into health career pathways. A heart-stopping powhiri performed by students from Te Kura Kaupapa a Te Rohe O Mangere opened the fourth annual Maaori Leadership Dinner celebrations on December 5, followed by the first ever Pacific equivalent on December 7. The decision to pursue a career in health and holistic student success was celebrated at both dinners in a combination of academic, social, spiritual and cultural achievements.

Bernard Te Paa, General Manager Maaori Health CMDHB, welcomed students and whaanau to the Maaori dinner followed by special guest speakers Alf Filipaina, Auckland City Councillor, and the hilarious TV personality Te Hamua Nikora from Maaori television’s ‘Homai Te Pakipaki’. Both speakers shared their inspiring story of success and challenged students not to give up in their pursuit for a career in health. 21 Year 13 Pacific students were acknowledged at the Pacific dinner, many hoping to begin health tertiary study this year in Physiotherapy, Midwifery, Nursing, Medicine and Optometry with a desire to give back to their family and community. A beautiful tau’olunga (traditional Tongan dance) performed by three of the award recipients from Aorere College was a

Bright future for Maaori and Pacific students

Te Hamua Nikora from Maaori television’s ‘Homai Te Pakipaki’. Left: Tau’olunga performed by Aorere College award recipients L-R: Meliame Fatai, Catherine Tupou (Deputy Head Girl, 2011) and Frances Vehikite (Head Girl, 2011).

Above: Dr Colin Tukuitonga presents an award to O’Charlette Mougavalu from Tangaroa College at the Pacific Leadership Dinner.

Nicholas, Workforce Development Coordinator at alexandra.nicholas@middlemore.co.nz or Taura Te Whata, Maaori Workforce Development Coordinator at taura.tewhata@middlemore.co.nz

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TACKLING teens on their terms is no easy task for health workers but thanks to a new venture with Youthline – young adults are rocking up to impor-tant appointments.

Last year the old Papatoetoe fire station was converted into a Youth and Community Develop-ment Centre and Counties Manukau District Health Board joined Youthline in the purpose-designed facility.

For the past few years charge nurse manager Cate Fleckney and paediatric consultant Rachel Johnson have delivered healthcare services to young people from a variety of clinics.

But now they have a permanent location where young adults feel right at home and can hang out with other people their age.

“We see young people with their families who present with a variety of conditions, including diabetes, asthma, kidney problems or any chronic health condition,” says Rachel.

“Teenagers with any physical health problem can be referred to us but we don’t just focus on physi-cal health – it’s important to look at all aspects of a young person’s life. What’s happening at home, in school or with friends – all impact on overall health and wellbeing for young people.”

Children with chronic conditions can face chal-lenges as they progress towards adolescence and adulthood.

Cate says changing priorities are an important part of normal youth development and it’s about getting the balance right.

“In early adolescence it’s all about fitting in at school and being the same as your friends,” says Rachel. “It’s not about injecting yourself with insulin before you can eat.”

tive sport can be devastating,” explains Rachel.The youth-friendly location increases young

people’s motivation to turn up for appointments.Funding from the Mayoress’ Charity Gala Ball

will be used to purchase furniture and help equip clinical rooms.

With youth-focussed staff and surroundings the long-term prognosis for youth health in Counties Manukau looks good.

Community Café The centre reflects the history of the old Papatoe-toe fire station and the old engine bay is a prime space for the community café and training facility.

It will also be the home to a restored ‘little flick’ provided by the Papatoetoe Community Ex-Fire Fighters Charitable Trust.

Nestle’s funding of equipment and furnishings for the Community Café gives young people a place where they can socialise, develop practical skills and have ownership of a working project.

Hospitality Skills Development The hospitality sector continues to show strong growth in jobs and this project – using the employ-ment model of social enterprise – would lead young people towards an employment pathway.

The social enterprise model project would leverage existing and developing relationships with training providers and employment brokerage services to provide a fully integrated pathway of training and learning opportunities.

Healthy hangout for youth

Specialists working with teenagers look at the whole picture because young adults can become less engaged in their health and more focussed on what is going on in their life.

“For example, being diagnosed with a heart con-dition that suddenly means they can’t do competi-

NEW HOME: Charge nurse manager Cate Fleckney and paediatric consultant Rachel Johnson are happy in the new Youth and Community Development Centre.

INSPIRATION: Words of wisdom gifted by the South Auck-land Poets Collective.

KAI TIME: The Community Café is a place to chill out and re-fuel.

Community Healthy Eating One of the key roles for the Community Café space is the provision of information about healthy eating, practical classes on how to prepare quality meals within the financial constraints common to the area and how to grow your own produce.

The project would use the catering facilities, staff and students to up-skill their communities and to support them to cascade that knowledge through-out their families/whanau and social networks.

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to a recent team building day.They contacted South Auckland Health

Foundation with a proposal to make something cool for Kidz First.

Assembling children’s bicycles met everyone’s needs – providing Baxter staff with a challenge

and producing items that would be wonderful gifts for deserving children.

Not only did the Baxter team deliver four wicked bikes to Kidz First – they also had them checked by a bike mechanic to ensure they were safe and provided helmets.

Some lucky whanau will be thrilled to receive the sparkling new bikes.

Manukau Bunnings Warehouse also did their bit to help mums with their newborn babies.

Botany Downs Primary Birthing Unit has large grounds where mums can relax outdoors.

However there was limited shade until Bunnings donated an umbrella where whanau can shelter from hot

CREATIVE companies looking for ways to help the community have come up with some original ideas to improve the lives of others.

Conferences can often be long-winded affairs listening to monotone speakers but the team at Baxter Healthcare took a more hands-on approach

THE first tiny gasps of air a newborn baby takes are so exciting for parents but occasionally

struggling infants need assistance to breathe easy.Midwives at Botany Downs Primary Birthing

Help for first breaths

THANKS: A new Neopuff donated to Botany Downs Primary Birthing Unit by Somerville Howick Rotary is a welcome arrival. Clockwise from left: Philly Karani, Alex Garden, Vinod Sareen, David Hawke, service manager primary maternity care Debra Fenton and independent midwife Debbie Ritz.

Unit had one Neopuff to resuscitate newborn babies and neonatal Ambu-bags were relied on for back-up.

The staff at the birthing facility were concerned that when babies were transferred by ambulance to Middlemore Hospital the Neopuff went with them.

The Neopuff is recognised as best practice and it was top of the wish-list for the maternity staff.

The call went out for a second Neopuff and the Rotary Club of Somerville Howick came to the rescue.

President Dave Hawke says the Rotary club immediately approved funding for the equipment because members could see the urgent need for the back-up unit.

Botany Whare Tapu is also used by many families in the region and Somerville Howick Rotary members consider it a valuable local facility.

The Neopuff proved potentially lifesaving on New Year’s Eve when two babies needed resuscitation.

The Neopuff is designed to provide breaths at a set flow with consistent Peak Inspiratory Pressure (PIP) and Positive End Expiratory Pressure (PEEP) to infants.

It is easy to use and designed to provide safe, consistent and optimal resuscitation for infants.

Original ideas for philanthropy

SHELTER: Bunnings staff chill out the new home for a new sun umbrella they donated. Sue Karekare (front) and Sarah Holland.

sun but still enjoy being outside.Thanks to these kind corporates for making a

difference to others.

COOL FUN: (left) The team from Baxter Healthcare assembled bicycles and donated them to Kidz First. From left, Vi Nguyen, Cheryl Foster, Robyn Maria from Kidz First and Brett Smith.

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Finding a solution to heavy luggage generated a project that will have an immediate impact on the health of tiny vulnerable babies.

When Jan Cooper from Manurewa travelled with her Freemason Grand Master husband, Selwyn she enjoyed taking numerous books along for the journey.

However, the items were heavy and the avid reader needed a substitute to keep her busy during their travels.

Knitting was a perfect solution and when Jan heard of friends knitting for premature babies she was inspired to develop a project for other keen knitters within the Freemasons’ fraternity.

“It has grown beyond my expectations,” says Jan. “There are wives and partners, widows and men throughout New Zealand knitting for babies.”

Support from The Wool Company in Taihape and The Freemasons Charity covered the cost of wool when Jan launched the knitting initiative early in 2011.

“To date we have been provided with 2,740 100gm balls of wool – just over quarter of a tonne of wool.”

Garments presented to four Auckland hospitals were lovingly created by knitters throughout Auckland – stretching from Tuakau and Pukekohe to Waiheke Island, the North Shore and Waitakere.

The aim of the project was to make garments small enough for premature babies to wear when taken home by their parents.

Nationwide more than 11,400 tiny booties, beanies, singlets and jackets have been crafted and donated to neonatal units throughout New Zealand.

CARING: Wives of Freemasons Robyn Stephen and Jan Cooper with Diane McEntee, Janis Stockman, Susan Law and Debbie Read for Kidz First Neonatal Unit, Waitakere Hospital, North Shore Hospital and Auckland Hospital, respectively.

Most of these wee garments were made into sets and wrapped as gift packs.

There is an ongoing need for new clothing for full-term babies in Counties Manukau.

About 30 per cent of the children admitted to Kidz First Children’s Hospital in Counties Manukau live in homes with no heating.

Cold and damp housing frequently transforms minor sniffles into severe respiratory illnesses

Knitting for the nation

PILED HIGH: Kidz First Neonatal Unit nurse manager Niccy Brougham with boxes of bundles of knitting for premature babies.

PERFECT: Winter woollies kindly crafted by Freemasons and their wives, widows and partners.

requiring hospital care.“The South Auckland Health Foundation’s

knitting programme has captured the imagination of Freemason men and women throughout New Zealand,” says Jan.

“There will be positive spin-offs for Kidz First and now we are much more aware of the huge need.”

Go to www.sahf.org.nz for more information about South Auckland Health Foundation wool programme.

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GET UP &RUNNINGGET UP &RUNNINGGET UP &

PORTS OFAUCKLANDROUNDTHE BAYS2012

SUNDAY 18TH MARCHSTART TIME 9.30AM

REGISTER ONLINE NOW ATwww.roundthebays.co.nz

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Dr Denholm Crone was born in Oxford, schooled in Northern Ireland and attended medical school in Liverpool. After emigrating to New Zealand in mid seventies he joined the Auckland Hospitals Anaesthetic Training scheme. He came to NZ because “at the time it seemed a good thing to do”. His first consultant job was at Tauranga hospital where he practiced Intensive care and Anaesthetics. In 1985 he returned to Auckland to take up a Full time Intensive Care job at Middlemore hospital. His interest in Intensive care and pre-hospital care landed him an appointment as medical director for the St. John Ambulance Service. He later rejoined the Middlemore Anaesthetic Department and rose to become its Head. His passion was education and as well as organising the anaesthetic education days he was instrumental in founding the Anaesthetic Simulation Centre within CTEC. His always questioning mind lead to many improvements in patient flow thru the hospital.

The hospital farewelled Denholm on Wednesday 15th February wishing him well for his next challenge. He is building a new house in Kati Kati, Bay of Plenty and

Farewell to Dr Denholm

Retired from CMDHB Service – Dr Denholm Crone, Specialist Anaesthetist.

The annual Serious and Sentinel Events Report released today by the Health Quality and Safety Commission states that thirty five patients suffered serious or sentinel events in CMDHB facilities in the last year. Two of the 35 events were defined as sentinel (life threatening, or led to an unanticipated death or major loss of function).

The vast majority of serious events at Middlemore involved serious injury from falls. The next two largest groups (3 in each) were people being incorrectly identified and given the wrong procedure or treatment, and patients with allergies not being recognised.

National results

According to the national figures, 195 falls were reported as serious and sentinel events in 2010/11. A total of 25 medication errors were reported, along with 108 clinical management incidents which included:

• delaysinrespondingtoapatient’schangingor deteriorating condition

• poorcommunicationbetweenhealthprofessionals

• delayeddiagnosesduetofailingsinreferralprocesses and the reporting of results.

A full copy of the report is available on the Commission’s website at www.hqsc.govt.nz

AIMING FOR ZERO PATIENT HARM

The Aiming for Zero Patient Harm programme has been running for over a year now with a number of working groups. Three are focussed on the most common SSE cases in this year’s release:

1 Reducing serious harm from falls This group is working on 3 areas: patient factors contributing to falls, the role of staff, and the environment.

We now have a standardised, validated risk assessment and most patients are assessed for their risk of falling within 6 hours of admission;

Fall reduction strategies aligned with the patient’s risk such as lower beds, clear instructions to the patient on calling for assistance, supplying non-slip socks, staff awareness of the patient needs and reducing clutter in wards have seen our serious falls decrease.

We are now part of the regional collaborative work to reduce harm from falls.

2 Patient mis-identification. This can be due to face-to-face mis-ID, or

Serious and Sentinel Events

from using the wrong sticky label.

To address the first problem, the (AI2DET) programme focuses on standardised patient/healthcare worker engagement (including identification). So far 496 staff have received this training (all senior nurses, all first year house surgeons, moving onto orderlies and cleaners).

The 5-step AIDET programme teaches staff to: Acknowledge those in the room; Introduce themselves; Identify the patient – ask them full name and DOB; Duration of intervention; Explanation of what is happening and why; and ending with a thank you.

Work is also being done on electronic

requests of procedures to reduce the need for sticky labels.

3 Medications

The patients who receive medications despite being allergic to them are the focus of an Allergies Working Group, which is working towards getting staff to look for locally and nationally validated alerts which are clearly signalled on electronic patient records.

Over the coming year the group will be focussing on decreasing Healthcare Associated Infections, Venous Thrombo-embolism and Medication Safety. Contact person, Mary Seddon ext 7879.

becoming more involved with his family’s kiwifruit and avocado business there. He says his next project is to get fit and learn the electric guitar.

Tony Mark, Colleague, Department of Anaesthesia.

CONNECT I PAGE 11

Trust Joint Effort Walk New Zealand Orthopaedic Association & Wishbone Trust Joint Effort Walk 10am Sunday 25th March 2012, Manukau Superclinic

Although Project Leader Michele Naish is moving on to another position within CMDHB, she is leaving the Advance Care Planning (ACP) project in good heart to continue to roll out within the hospital and the community. Pukekohe Family Health Centre as well as wards 7 and 11 and the Very High Intensive User service are implementing the programme and ACP is planned to roll out in AT&R in March and Pukekohe and Franklin Memorial Hospitals are due to begin this May. Advance Care Planning involves health teams to take a person who probably has a long-term condition through a series of steps designed to inform carers – and family – of what the person’s true wishes are for care and treatment as their illness progresses. Advance Care Planning is intended to sensitively explore what sort of treatment, be it palliative or aggressive the patient actually wants and to document this in an advance care plan.

Michele Naish says that it has been difficult for health professionals to find the time to carry out ACP with patients. However, Meg Goodman has taken up the role of ACP Facilitator to

mentor and support staff to engage in ACP. This will enable ACP to become standard practice in due course. “One of the biggest satisfactions that I have had is meeting and working along side people at the DHB - people have been more than helpful and have taken my ideas and made them happen such as the electronic pathway which enables advance care plans to reach our Patient Information service”, says Michele.

Robust methods have been developed to record ACP conversations, including an audit code in the form of a sticker which will go on patient files which will say whether an ACP conversation has been initiated or was unable to take place. When an advance care plan is entered into Concerto with a National Medical Warning alert is readily accessible to those providing treatment.

The Connect™ UK communication skills training is currently taking place at Ko Awatea with six courses planned, 10 health professionals from across areas where ACP is planned are taking part in the training in March and another 10 in May.

Advance Care Planning

The NZ Orthopaedic Association will be conducting the Joint Effort Walk on Sunday 25th March 2012. This walk is held throughout the country and raises money for research into bone and joint conditions. Over the last decade, these funds have greatly assisted surgeons in improving the quality of care for patients.

The walk will be held at the Manakau Superclinic. Registration is at the main entrance from 10am. Previous patients have been sent forms to obtain sponsorship for a 1km walk.

There will be displays of orthopaedic implants and demonstrations of surgery on plastic bones. After the walk light refreshments will be provided with a sausage sizzle to round out the morning. A series of

spot prizes are up for grabs. Our Orthopaedic staff will be onsite to pace patients around the course.

Donations can be made on the day. For those who would like to make a

contribution, cheques can be sent to: “Joint Effort” PO Box 28912, Remuera, Auckland, orDept of Orthopaedic Surgery, Middlemore Hospital, Private Bag 93311Otahuhu

Please use your name as a reference and email Brendan.Coleman@middlemore.co.nz for a receipt if required.

For more information contact module one, Manukau Superclinic or ext 7666 at Middlemore

For information on the NZOA please visit www.nzoa.org.nz