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MAY 2017 1

From the CEO


Guest editor| Stephen McBride


Everyday Excellence


Taking a mindful break


Working together a top priority this winter


5,6 Brace yourselves: winter is coming! 7

Minister Dunne visits Middlemore Hospital


Middlemore Foundation | Jammies in June


Did you know?


Making a difference in the lives of women and whaanau in Counties Manukau


Local students benefit from hospital kitchen training


Behind the scenes

With the colder months approaching, winter planning gets into full swing with a focus on staying well and healthy. That’s the theme for May’s Connect+ and who better to be ‘guest editor’ than Dr Stephen McBride, infectious diseases consultant, who knows that the cold weather brings more chills, ailments and respiratory problems, all of which significantly increase demand for the services we provide. As we brace ourselves for the next few months, there’s a real emphasis on working together to share the winter load. The key messages this year are to stay warm and dry, eat well and see your GP early if you start to feel unwell. This winter we also encourage staff to look after themselves and their whaanau – take regular leave if you can and make sure you get some rest and relaxation. By putting yourself first, you are more able to look after others. And don’t forget to get your free flu vaccination this year, which is available at one of the pop up clinics across CM Health. I’ve had flu once in my lifetime and believe me you don’t want to get it. I spent five miserable days in bed!

COVER PHOTO: Michelle Farr and Gillian Davies completed their Nursing training together and now find themselves working as #FluFighter peer vaccinators at Middlemore Hospital.

On a side note this will be my final contribution to Connect+ before I head to Te Papa. While I will no longer be your CEO I take a big piece of CM Health with me. I will miss the amazing culture and spirit that permeates throughout our organisation and want to thank all of you for an amazing 11 years. I’ll look forward to reading about the wonderful things you are doing in the future issues of Connect+. Take care and look after one another.

Connect+ is produced by Counties Manukau Health. If you have something to share or would like Connect + delivered straight to your inbox please contact Sign up to our eUpdate at EDITOR IN CHIEF: Janet Haley | EDITOR: Stacy Superfine

Geraint Martin Chief Executive

Guest Editor

Hi, I’m Dr Stephen McBride, the head of Infectious Diseases at Counties Manukau Health.

Every year, influenza directly or indirectly causes the death of hundreds of New Zealanders, thousands of presentations to GP’s and emergency departments, and likely tens of thousands of sick days. Influenza regularly sweeps the globe, and as healthcare workers we need to grab every advantage we can against it – especially regular hand hygiene, staying away from work when ill, and vaccination. Like all vaccines, the influenza vaccine is not 100% effective at preventing influenza. Seatbelts don’t prevent 100% of road crash deaths either, which is no reason not to wear them! In my family, and my workplace, there are people who are at increased risk from severe consequences of influenza – older people and children, those with chronic illness. I get vaccinated against influenza to protect them, my patients, and myself. Join me: be a #flufighter this (and every) year.


k c a b feed “We were most impressed with the way different medical teams and specialists collaborated. It was encouraging to hear these open discussions between different specialists, including pharmacists, on the best treatment including medication.

“Staff were always on hand to assist. If you had to push your buzzer for assistance, there was never a long period of time before it was answered; and I was always greeted by a smile.”

"I think the hospital is excellent and the teaching side of the hospital is great. The younger staff were very well treated and would have learnt very well".




For as long as he can remember David wanted to be a nurse. Inspired by his mother’s nursing stories and the way she helped her patients, David knew that one day he would follow in her footsteps. Now a Registered Nurse on a renal ward at Middlemore hospital, David cares for patients who are facing a chronic illness. Every day is a new challenge and David enjoys empowering his patients to understand their health conditions and better manage their care at home. There are also times when you need to follow your intuition. This was the case when David noticed something was wrong with a patient’s family member. She was dizzy, sweating profusely and had a headache. Unfortunately the family member, who was a diabetic had mistakenly given herself too much insulin resulting in a hypoglycaemic episode. After checking her blood sugar David gave her a drink with sugar and something to eat. She felt instantly better. David’s quick thinking resulted in a great outcome and saved the person a trip to ED. Thanks for doing such a great job David and living our values of excellence and kindness.

Recently, on a particularly disquieting afternoon, I stumbled into a mindfulness drop-in session at Ko Awatea and left significantly less frazzled. The half hour sessions led by Clinical health Psychologist Dr Jo Soldan and colleague Diane May are designed for staff who have completed the Mindfulness Based Resilience @ Work course.

Registered Nurse at the renal ward at Middlemore Hospital

We began by walking mindfully around the room. It felt bizarre but calming to be so deliberate with my steps. Pairing with another walker, we then took turns leading and following. A seated exercise followed, in which were encouraged, eyes closed, to notice our breathing, the sensation of our hands, and the contact our feet made with the floor.

Mindfulness Based Compassion @ Work will be held in May as a follow-on from Mindfulness Based Resilience @ Work (apply through learning and development).

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Eventually a bell sounded - a gentle jolt back into the room. My fellow attendees and I dispersed to our respective places of work – for my part with a renewed optimism. Jo describes mindfulness as exercise for the mind, and says that in future we will consider it as fundamental to well-being as physical exercise. Soon, she will host Mindfulness Based Compassion @ Work sessions...

Mindfulness drop-in sessions are held weekly (see the electronic display board at Ko Awatea)


Winter often brings an increase in people presenting to ED with a range of winter related conditions such as respiratory illnesses, coughs and colds. While we plan for the extra demand, there are times when the hospital is full and a ‘Dot Day’ email goes out to all staff. This triggers a chain reaction activating people across the hospital and primary care into action. The main aim of a ‘Dot Day’ is to help reduce the grid lock in ED and free up some beds so patients can be admitted. It’s quite a slick operation and requires clinicians to review potential discharges early, follow-up referrals to other health care providers and transfer any patients waiting to go home to the Discharge Lounge. Additional orderlies are rostered on to help with transfers and our colleagues in primary care are called upon to look at their referrals to hospital services to help ease some of the pressure. It’s like a well-oiled machine, designed to get everyone working together to make sure our patients continue to get the best care and experience. So even when our Hospital isn’t full, how can we embed this approach to help reduce demand on a day-to-day basis? A few years ago we launched our ‘6 Hours Can Be Ours’ campaign, which had the audacious goal of admitting, discharging or transferring 95% of patients from Emergency Care within 6 hours. While many people initially saw this as an ED initiative, its success was due to a whole of system approach.

From our cleaners to our doctors, people across the organisation could see how they made a difference to the patient experience and how bottlenecks around the hospital could have a huge impact on patient flow and ultimately patient care. As we head into the winter months, it’s important that we use the lessons from the ‘6 Hours Can Be Ours’ campaign to improve patient flow. If you are a clinician and can get down to see your patients earlier so they can go home sooner, that’s a win-win for you and your patients. If you have a discharged patient taking up a bed while waiting for test results, why not send him or her to the Discharge Lounge. Maybe chase up that referral to see if your patient can be seen or transferred sooner.

If we work together we can improve the experience and care our patients receive, while improving our job satisfaction and morale. We can all go home at the end of our shift knowing we put our patients at the core of everything that we do.


Brace yourselves: Dr Stephen McBride, Clinical Head of Infectious Diseases: As an infection specialist, I often get asked about how people can stop themselves from getting sick over the winter, especially when looking after patients with winter viruses. So here are my recommendations for staying healthy this winter:


Be consistent with your hand hygiene. This needs to be regular as clockwork, before and after every patient contact, every procedure or body fluid exposure, and every contact with the patient’s environment. Remember: gloves don’t matter to hand hygiene – you need to clean your hands before you put on gloves and again after you take them off!


Observe Standard Precautions. Standard Precautions are a suite of precautions designed to protect healthcare workers from acquiring or passing on infections. They include obvious things like hand hygiene, but also the use of appropriate personal protective equipment.


Make sure your vaccinations are up to date. That means getting the influenza vaccination each year, and ensuring that you don’t need an updated pertussis immunisation. Vaccines aren’t perfect, and we shouldn’t pretend they are. But they do reduce your risk of developing and passing on infections, and these infections can be life-threatening for you, your family and your patients.


Take a break. It may be tempting to save up all your leave until summer (so that your holiday can be warm and rainy instead of cold and rainy) but taking time out, even a day or two, is a great way to avoid burning out.


Keep up a healthy lifestyle over winter. Lots of us stop exercising when the weather is cold because it’s rotten outside. But we have built-in, free, climate-controlled gyms in our workplace! They’re called stairs. Use them instead of the lifts, and keep active over winter.


Stay at home if you are sick. If you are one of the unlucky people who do become ill over winter, staying at home is the right thing to do while you’re acutely unwell. You’ll get better, and you’ll be protecting those who are still at work!

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Chicken Noodle


For an easily portable winter lunch, why not try this one dish chicken noodle soup. It’s super quick to prepare, and did we mention easily portable? INGREDIENTS ¼ teaspoon chicken stock powder ¼ teaspoon minced garlic 2-3 slices dried mushrooms, e.g. shitake (optional dash of white pepper 1/3 cup frozen corn kernels ½ carrot, julienned 2 Brussels sprouts, finely sliced ½ cup shredded cooked chicken 175g Singapore noodles ¼ cup chopped fresh parsley INSTRUCTIONS 1. Layer all ingredients except parsley in a 750ml capacity or larger jar in the order listed. Keep parsley in a separate container. 2. When ready to eat, open the jar, fill with boiling water and close and seal the lid. Leave to soak for 2 minutes. 3. Open the jar, stir noodles well and tip into bowl if desired. Top with parsley.


Use ‘shelf-fresh’ noodles, which are precooked and just need to be heated by pouring over boiling water. Break up with a fork before adding to the jar. You could also use noodles you’ve precooked. Run them under cold water before packing in the jar.

Do you have a favourite recipe? Send it to the Communications inbox for a chance to feature in our next issue of Connect+

winter is coming! Get your

free flu vaccine- why wouldn’t you?

Interview with Helen Bretherton, Charge Nurse Manager Ward 34E How did you initially get involved? I was approached to be a peer vaccinator. Ironically I hate needles but I thought why not? I decided to take part and vaccinate my team which led to a role that I thoroughly enjoy. While doing my rounds, I try to change the mind sets of those who haven’t been immunised yet. It’s great to see those who haven’t had the vaccine over the years now lining up to get it. Has there been a highlight for you in being a peer vaccinator? The highlight for me as a peer vaccinator is being acknowledged for being available. It’s great when staff members come by and say, “I’m going to get you to do my flu vaccine again this year!” It’s nice to be sought after and know that people have faith in me to do it.

Why is getting your flu vaccine important? Why not? When I think about it; I’m a mother, a nurse, a sister- we all have responsibilities outside these four walls. It’s about being a role model for the community who look to us to be in the best health and to be fit for purpose. It’s an easy process; it’s funded for staff and you don’t even have to make a booking with a GP. Is there anything in particular that you enjoy about helping your colleagues in this way? I love this role as I can make a difference just by being accessible to anybody to give a simple flu vaccine that takes less than two minutes. It’s about leading by example and busting those myths!

From a healthcare workers perspective, how important is it to be vaccinated during the flu season? Very important; winter is one of our busiest times. In winter our ward becomes a medical ward and we see the flu and other types of illnesses that come through in full swing. We see the sick when they are most vulnerable and if staff aren’t taking care of themselves they can pick up the bug or pass them on to patients through poor hand hygiene. Essentially; why wouldn’t you get your vaccine done? It’s our duty of care.

“It’s about being a role model for the community who look to us to be in the best health.” Get your FREE flu vaccine,

Be a #FluFighter The flu is just a bad cold! The flu is much more severe than a bad cold and hundreds of New Zealanders are hospitalised each year due to the flu.

If I get sick, I’ll stay away from work and so I won’t put my patients at risk You can still transmit the flu without having any symptoms so your best protection is getting the vaccine early.

The flu vaccine gave me the flu! The flu vaccine cannot give you the flu. If you get a fever/muscle aches afterward it means it’s generating an immune response so it’s working!

There are nasty preservatives and mercury in flu vaccines Single dose vials are all we use and they don’t need or have these preservatives/mercury in them

The flu season is here, and FREE flu vaccines are still available for all staff. Keep a look out for the pop up vaccine clinics at key locations across CM Health. The peer vaccinators are roaming across all locations, giving you plenty opportunities to get your flu vaccine. Don’t forget to snap a photo of yourself with our #FluFighter hashtag Once you’ve had your flu vaccine. Upload it to your Instagram and tag a mate to get their flu vaccine. You could be in to win a $100 Westfeild voucher! The competition runs until 8th May.


SANJOY NAND WINS APRIL 2017 OPEN FOR LEADERSHIP AWARD Congratulations to Sanjoy Nand, Pharmacy Service Manager for being the latest recipient of the Health Quality & Safety Commission’s Open for leadership awards.

progressed the projects over an 18-month period and provided leadership in applying quality improvement methodology to deliver the results.

Sanjoy was nominated by CEO Geraint Martin for his leadership in progressing two innovative health quality improvement projects - SMOOTH and SMART at Middlemore Hospital.Associate Health Minister, Peter Dunne, presented the award to Mr Nand and says his exemplary leadership in driving the projects, which are now embedded as business as usual, make him a deserving recipient.

Mr Nand says he feels extremely honoured and grateful for the recognition of his contribution to the work he has led at Counties Manukau Health.

“The Safer Medicines Outcomes on Transfer Home project (SMOOTH) was a safety initiative developed and implemented to reduce medication errors on discharge,” said Mr Dunne. “The process ensures high-risk patients in hospital are educated before they go home about any new medicines or changes.”

“I’m proud of the fact we are making a positive difference to patients by reducing medicine error and harm, and also for the development of leadership capability within the teams I led – knowing that quality improvement and safety is everyone’s business. “I see this award as a celebration of the teamwork and the efforts of everyone involved.”As an award recipient, Mr Nand received a certificate, a trophy and attendance at an upcoming Commission event of his choice.

The Safer Medical Admissions Review Team project (SMART) is an innovative quality improvement initiative to implement a safer and more streamlined admission process. It involves the medical team pharmacist joining admitting doctors on the acute admitting days in emergency care. Mr Dunne said the benefit has been that any errors and medicines issues are intercepted or prevented earlier during the patient journey. “During the testing phase this model demonstrated a significant safety benefit by reducing medicine discrepancies and potential errors by four-fold.”The Open for leadership awards are coordinated by the Health Quality & Safety Commission. They recognise and celebrate health professionals who demonstrate excellent practice, quality improvement and leadership skills. They are part of the Commission’s work to build capability and leadership in the health sector. Sanjoy provided direction and support to the teams to develop and implement the innovative changes. He

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Associate Health Minister Peter Dunne presents Sanjoy with his award.

Did you know Our Orderlies:

Walk 30 km’s per day (that’s each individual orderly) on average


IN JUNE Kidz First Children’s Hospital’s Jammies in June campaign is set to go again, and so successful has the pyjama collection drive been that both Auckland and Waitemata Health have asked to be included. Organised by the Middlemore Foundation, the drive sees individuals, schools, churches, service clubs, and businesses donate cash or pyjamas. The PJs are found homes through Kidz First Children’s Hospital, and its extensive community agencies. The cash is used to fund other winter necessities identified by Kidz First staff. Kidz First Jammies in June began with a simple premise, keeping kids warm in winter might see admission numbers fall in winter, a time when respiratory illness flares. Middlemore Foundation staffer David Kemeys, pictured with Kidz First Jammies in June helper Howard, says education plays a big part.

“Our supporters love it. It’s cheap and it’s fun, and it’s easy to take part. And Kidz First’s people are able to give the PJs out to folk and at the same time engage with them around some other important health messages.”

Deliver 700 x patients per day to their appointments or wards Deliver 6 tonnes of waste to the waste dock per day Deliver 70 x O2 gas bottles per day Deliver 50 units of blood per day Deliver 20 x 240 recycle bins per day

Howard the gorilla has proved a big help, opening doors by visiting many schools around the area. Last year he even made a tour of Kidz First Children’s Hospital, before ending up in a short stay bed himself. Fortunately it was just a case of too many green bananas. Anyone who wants to help or get involved with Kidz First Jammies in June should contact: charlene.colling@ at the Foundation. COUNTIES MANUKAU HEALTH | 8 

Making a difference in the lives of women and whaanau in Counties Manukau

No two days are the same for primary care midwife Katarina Komene. Looking after women and whaanau in the Counties Manukau area for the last five years, Katarina believes being a midwife in the South Auckland area has a lot to offer. “The thing that is really appealing about South Auckland is that you get to work with a diverse range of cultures learning all the different nuances and what’s important to them,” Katarina says.

“I worked with a young girl who was only 15. I had a call from a social worker from Papakura Marae to say that this girl was hapu and would I be her midwife. She had gone through many challenges in her life - referrals done through social workers and a referral done with CYFS [Child, Youth and Family],” she says.

“We have one of the largest birthing populations in New Zealand. There’s such a huge range of cultures and socioeconomic factors in South Auckland.”

“She definitely had some challenges from the perspective of being young and labelled, so I supported her through this process. It was important to gain her and her whaanau’s trust which was challenging, but so rewarding. It’s an awesome feeling knowing you can have such an impact on a young girl’s life.”

A proud South Aucklander, in 2008 Katarina decided to embark upon her journey to become a midwife.

A mother of two with three mokopuna and another moko on the way, Katarina works hard to build a relationship and

“It wasn’t until I got to a point in my life where I wanted a change in career that I started to really think about it. My kids had grown up and were more independent, so in my forties I decided to go back to university and study,” she says. Training at Auckland University of Technology (AUT), Katarina recognised the need for more midwives in South Auckland.

“You want to get to know them because you’re a big part of their life. They never forget you.”

“When I graduated as a midwife, I did the Nga Manukura o Apopo Leadership Training which is a future workforce development programme for Maaori nurses and midwives. Another midwife and I set up a programme called Te Maunga Tapuhi (meaning the Mountain of Midwifery) which helps support Maaori midwifery students at AUT. Our focus is to support our midwifery students during their time at AUT in whatever way they need through to graduation so that they can come out to [South Auckland] and help us,” she says. For Katarina being able to work with women and whaanau during such an intimate time in their lives is a real privilege. She works with an attitude of no judgement, no matter what the whaanau’s background is. “I love working with whaanau in our South Auckland community. They are so grateful for your care and make you feel like you’ve made such a difference in their lives.”

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A love of food, learning and supporting people to succeed are what motivates Middlemore Hospital’s Food Services Manager Karen Reynecke. With a background in food services education, Karen began working for Compass Group New Zealand’s (Compass) in 2015 when she took up the challenge to run one of the country’s busiest hospital kitchens. While Karen’s focus is on the kitchen, the ‘classroom’ beckoned when she was invited to give a motivational lecture to Mangere’s Southern Cross Campus students. “It was a great opportunity to share my personal hospitality and food services experience, while helping them see the many career pathways in both the food services and public healthcare sectors,” says Karen. Karen then invited five freshly inspired students to experience her ‘real’ working kitchen, with more than 142 employees all preparing, cooking and serving up to approximately 3,000 meals every day to Middlemore patients and caregivers. “They’ve learnt about good work ethics, as well as serving patients with many diverse needs. Food services in hospital settings are particularly interesting as every single ingredient on each plate is carefully considered. In healthcare, we need to think about nutritional balance, special meal preparation (such as

pureed food), and allergens, among many other considerations,” she says, adding that they have also been taught about wider topics such as dietitians, supply chain, computer programmes and more. “Our kitchen team has welcomed the students by encouraging them to learn and upskill. The students now want to compete in this year’s national NZ Chefs’ Association National Salon competition, so every Saturday we support them in preparation for their competition dishes. “I’ve also heard they are more engaged in school life and parents have given the school positive feedback about their experience at the hospital – this is a wonderful outcome. “Counties Manukau Health is committed to the communities it serves and Compass supports this. We are privileged to support students from our community to help them to develop and learn, while creating broader awareness around health and nutrition to achieve long-term health and wellness benefits.” Before joining the Middlemore team, Karen taught food services at New Zealand’s NZMA and Cornell Institute of Business and Technology and worked at Auckland Airport, as well as at educational institutions in South Africa.

BEHIND THE SCENES Last month we collaborated with the Counties Manukau Stealers’ men’s and women’s rugby team to help promote the importance of getting the influenza vaccination. The players were filmed getting the vaccination from some of our nurses during one of their training sessions.

Check out these behind the scenes photos, and don’t forget to check out the Healthy Together - Counties Manukau Facebook page to see the videos over the next few weeks. A big thank you to the players and Counties Manukau Stealers’ management team for taking the time to be a part of #FLUFIGHTER videos.

(From left) Teacher, Mahara Honey, is proud of her students, Sianalai Siafausa, Zara Bibi and Bettina Adriano and their commitment to learning new skills with the support of Compass Group Operations Manager Karen Reynecke. (Fellow student Tony Latu is absent).

#I’maflufighter! COUNTIES MANUKAU HEALTH | 10 

Front entrance of the Hospital – late 1940s

Nursing Staff - 1947

usehold staff relaxing in their beautifully appointed ground floor lounge, in the quarters across the railway line – 1950s

Middlemore Site – 1960s

Middlemore Hospital 1970s


Middlemore Hospital 1990s

Front entrance of the Hospital – early 1950s


Esme Montgomery (nee Green) as a young trainee nurse at Middlemore Hospital

Celebrating 70 years

An empty Middlemore Hospital awaits its first patients

2017 May Connect+  

Connect+ produced by Counties Manukau Health. With the colder months approaching, winter planning get into full swing with a focus of stayi...

2017 May Connect+  

Connect+ produced by Counties Manukau Health. With the colder months approaching, winter planning get into full swing with a focus of stayi...