A COUNTIES MANUKAU HEALTH PUBLICATION | OCTOBER 2015

In this issue WAXING LYRICAL – RUBY WAX TALKS MENTAL HEALTH

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OUR REFRESHED VALUES AND STRATEGY 

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DIVERSITY BALL PHOTOS 

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FROM THE CEO I always enjoy reading Connect+ as it gives me an opportunity to catch-up on the amazing work and achievements taking place across our organisation. This issue is no exception as we celebrate key events such as the Diversity Ball, update you on projects such as SWIFT and Community Integration, and bring you stories of everyday people, doing amazing things at work and in their community. Our special feature on page 5 covers the launch of our refreshed values and strategic plan, which took place on 10 September. This follows months of hard work, with input from over 2000 people, including our patients, whaanau and families. As a result we have put together a strategic plan, which builds on our success and will help guide us into the future. While this plan will evolve over time, it will help us to achieve a balanced health system of people living long and well in the community, but are treated well and with compassion when they come to Hospital. The four values we have chosen help tell a story of how we can provide great care and a great experience at work. They also sit behind the granny test, ensuring we treat everyone we look after as a member of our own family. The values are Kind, Valuing everyone, Together and Excellent. Many thanks for your continuous hard work, particularly through the winter months, when demand tends to rise. Even through this busy period people have continued to perform at the top of their game. This was highlighted in our latest health targets, with CM Health being the only DHB to achive national health targets two years in a row. That’s something to celebrate. To add to the good news, spring is here, with hopefully a return to some warmer weather. We also have APAC and the rugby world cup to look forward to. It’s going to be an exciting few months.

Geraint A Martin CEO, CM HEALTH

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CONTENTS Waxing lyrical – Ruby Wax talks mental health at APAC forum 2015

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Going the extra mile

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Early maternity care cuts the risk

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Environmental Sustainability

 4

Values and Strategy

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Integrated care

 6

SWIFT jigsaw comes together

 7

Middlemore Foundation

 8

Diversity Ball

 9

Clinical research opportunity

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NEHR Phase 2

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Connect+ is proudly produced bi-monthly by the communications team. If you have something to share, or would like to receive a copy, please email communications@middlemore.co.nz

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were d understanding an n io ss pa m co “ The support, d 34 North. The ar W in ay st y s of exceptional in m e all bright star er w ar ul ic rt pa nursing staff in and over the two y th pa em d an e d medical intelligenc all so friendly an e er w ey th e, er th weeks I stayed onships with them ti la re ly ve lo e m so caring I built up their care.” while I was in of the g the praises n si ’t n a c ly “ I honest and how they h g u o n e m a e T entire Burns s showing the y a lw A . e m r looked afte to me and my t c e sp re f o nt sted highest amou enuinely intere g s a w m a te ay to visitors. The re, and my d a lf e w , ry ve o in my rec m became an a e T e h T . te a day mental st my family.” f extension o

esome I ment was aw rt pa de g in I th “ The bir ter care while et b or f ed sk a and couldn’t have sant experience ea pl a s a w feeling so was there. It with our baby t f le I nd a t r my partne and commitmen re ca of el v e le work.” touched at th put into their es rs nu nd a the midwives

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Ruby Wax talks mental health at APAC Forum 2015

Ruby Wax

At the height of her mental illness, Ruby Wax was grateful for the support of ‘angels’ – mental health nurses who would sit and hold her hand. They would walk her to her door, and eventually, one of them walked her through it. Recovery from depression was slow, “It’s like when the sun comes up, it’s so gradual,” she says over the phone from London, where she now lives, ahead of her much anticipated keynote speech at this year’s APAC Forum in Auckland in September. These days Ruby Wax, world-renowned comedian, celebrity interviewer, and script editor of the 1990s classic, Absolutely Fabulous, has an OBE for her services to mental health and a master’s degree in Mindfulness-based Cognitive Behavioural Therapy from Oxford University. She travels frequently, talking frankly about mental illness and the brain and engaging audiences worldwide with her openness and acceptance of mental illness. “I love New Zealand,” she says, enthusiastically, of her upcoming visit. APAC Forum delegates can expect her trademark humour and honesty at the SKYCITY event. Sharing openly, she says, is crucial to the destigmatisation of mental illness – a cause very dear to her heart. These days, Ruby agrees the stigma about having a mental illness is lessening, but she is deeply concerned that this hasn’t trickled down to the workplace. Whether overtly or not, she says, more than half of all employers won’t hire someone who has disclosed a previous mental illness. She says she would like to see the development of professionally moderated drop-in centres within workplaces where people can share experiences. “A place where these people can meet and see people who have what they have.” Being with like-minded people, or one’s “tribe”, as she describes it, is important to recovery. She says of her time in a treatment facility during recovery from depression: “The good thing about being in an institution is that you’re with your people.” Being zz is also essential for people working with the mentally ill she says, noting the most important quality of

an effective mental health worker is that they “try to get into my skin, and understand.” Careful to emphasise difference between sadness and depression, Ruby is similarly clear about the stages of mental illness and she appreciates that sometimes a person is so depressed that treatments such as cognitivebased mindfulness are ineffective; that time when “you can’t move, you’ve lost the essence of you.” But there was a point at which mindfulness became beneficial for Ruby, and it’s a practice she still uses today, regularly connecting with others on social media to encourage its use. In today’s environment, with its invasive technology, burnout has become a pandemic, she says, noting this is being recognised in some organisations. She has recently been asked to train London Transport staff in mindfulness, and although she had to decline due to the demands on her time, the request indicates a willingness from businesses to embrace a new way of approaching stress. Mindfulness has worked for Ruby, and now she’s interested in how it can be used as a form of stress release, thereby preventing people from developing a mental illness. Keeping up the momentum for awareness and understanding requires active participation from those with mental illness.

“I’m trying to build this campaign where people with mental illness recognise that they’re not alone.” Keeping quiet, she says, ultimately encourages discrimination and she has real concerns that it creates a cycle within families. “If you don’t express it, sometimes you imbue it. So I believe if the public are more aware, just like they were with the effects of smoking, they might start to suss that they have to do something now.” Ruth Larsen   apacforum.com

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Going

The Extra Mile I’d like to share this story about the inspiring dedication of the renal staff at CM Health. A few weeks ago I was called by the Auckland Renal Transplant Unit late on a Saturday night. A deceased donor renal transplant had become available for one of our patients. Despite multiple phone calls however, the patient couldn’t be reached on the mobile number we had listed.

Many CM Health patients share phones with family members and cannot always be directly contacted. With this in mind Counties renal doctors always make a special request for a bit of extra time to contact the patient before the kidney is offered to the next person on the list. In this instance we were told the unit couldn’t wait long for a response, and we only had until midnight to find the patient! We checked the new contact details database we lately developed but no luck. We asked the ward clerk to access all databases available just in case we could find a new contact number. Still no luck. The ward clerk’s efforts were so intense that a passing nurse, Jazmine Boyce, noticed and came to investigate. Jazmine remembered the patient and took matters into her own hands. She quickly arranged to take an early break and drove off into the night to bang on the patient’s door, waking up the entire household! The donor recipient was a middle-aged Samoan lady who had been dialysing herself at home for the last eight years. Thanks to Jazmine and, all the others involved, the lady is now off dialysis and enjoying a healthier happier life with a well-functioning kidney. The renal team really did go (more than) the extra mile, making a real difference to one of our patients. Thank you all! Christopher Hood

Early maternity care

CUTS THE RISK First-time mum Talya Wilson wanted the best for her baby Ezekiel. So she signed on with a midwife when she was just seven weeks pregnant for her own peace of mind. "Because Ezekiel (now 1) was my first child, it is quite helpful to know things. You have a midwife that can explain what you're going through," the Weymouth woman says.

"It's quite important in the first trimester because that is when things can go wrong. "So if you're not seeing someone, then it's a risk you are taking for your baby and also yourself. Things can be picked up a lot earlier." Counties Manukau Health is encouraging woman to get early pregnancy care through the national campaign Best for Baby, Best for You. It's aimed at pregnant women and the communities and people around them. Maternity services development manager Amanda Hinks says a high percentage of women in the Counties Manukau 3  |  CONNECT + OCTOBER 2015

area tend not to engage a midwife until they are 14 to 18 weeks pregnant. It needs to be earlier, Hinks says. "Research tells us that pregnant women should be engaging between 10 to 12 weeks so they can receive help and advice about their health and how to optimise the outcome for baby. "In our community our families are larger than the national average so by the time you get to pregnancy number four, five and six you think you know what you're doing and you have trust in your body," Hinks says.   Go to bestforbaby.co.nz for details or to find a midwife. Reproduced with permission from Stuff.co.nz

l a t n e m n o r Envi

Debbie Wilson middlemore.co.nz  debbie.wilson@

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We held a fantastic workshop at Ko Awatea on the 17 June with the Nappy Lady – Kate Meads The workshop provided information about modern cloth nappies and education around other ways you could minimize waste at home with a baby. The best news... each person took home a pack of cloth nappies worth $90 for just $25 – subsidised by Auckland Council. If you missed this workshop, don’t worry, the Nappy Lady will be in your area soon! Workshops are free to attend and you are welcome to bring along your babies. For more info:

  ‘The Nappy Lady’ thenappylady@me.com   (027) 22 11 242

DID YOU KNOW

?

On average walking for 10 minutes can extend your life by up to 20 minutes! If you fit in a 10 minute walk to, and from, work or the bus and you could burn up to 3.5kgs of weight a year!

ROSE PLANTING AT PUKEKOHE HOSPITAL The rose garden at Pukekohe Hospital was once revered and the women who labour there and the elderly who stay there often used to remark on how beautiful they were. In more recent years the rose garden has succumbed to scarce resources have shifted away from supporting the gardens onto meeting more pressing demands. As part of our Environmental Programme we were asked by the team at Pukekohe to help revitalise the rose garden. Working collaboratively with the facilities team and various volunteers from the Auckland and Franklin Rose Societies, a plan was put in place to review the rose beds, repopulating the gardens with new plants and revitalising the beds with compost to give the new and existing plants a chance to flourish. During the planting day, there were over a dozen helpers including staff from the Pukekohe hospital, members of the Environmental Sustainability Board (past and present), Rose Society experts, a group from a local Catholic church in Manurewa who had helped during our previous dig at the Manukau SuperClinic and a eager family members. Whitiora kindly started the session with a blessing, then the digging began. 50 roses were planted, a morning tea served and a very large pile of compost was spread around the roses. Special thanks to Envirofert Tuakau and Fonterra, who donated the compost. COUNTIES MANUKAU HEALTH  | 4 

VALUES AND STRATEGY

Healthy together CM Health launches new values and strategy Thursday 10 September was a day to remember as staff, patients, family and whaanau gathered for the unveiling of CM Health’s refreshed values and strategy. This significant event follows months of planning, numerous conversations and over 63,000 sticky notes with ideas and comments shared by staff and members of our community. It’s been an incredible journey. For those of you unable to make the launch, the values you helped co-design are: Excellent, Valuing Everyone, Kind and Together. These values will help guide us in our work, and measure whether we are providing care to our patients at a level we would be happy for our loved ones to receive. It’s now over to us to embed these values in our day to day work. Are you willing to take up the challenge? Sitting alongside our values is our strategy, and our goal is to achieve health equity for our community. We will achieve this by building on our past and current successes and working in partnership to help provide Healthy Communities, Healthy People Whaanau and

Our strategic objectives strategic r strategicobjectives objectives

Families and Healthy Services. We can’t do one without the other and we can’t be successful without the support of our staff, pateints, whaanau and our partners. The next five years is about how we work together to bring all of the pieces together. Over the coming weeks we will be sharing stories from our staff who live our values. We also encourage you to participate in the Embedding Our Values Week 19-23 October.

If you have any questions about the Strategy and Values Refresh, please contact: Adeline Cumings   adeline.cumings@middlemore.co.nz

Healthy Services

Why it matters People are at the heart of our services and must be well equipped to provide safe, high quality and equitable care. What we will do To help us workthis, together achieveour ouractions strategic work together to achieve we willtoorganise around three Invest strategic in our frontline staff and partner organisations us work together to achieve will organise actions around families, three strategic objectives, we willthis, organise our actions around . Together means collaboration andwe partnership withour people, whaanau, to provide excellent, collaborative, high quality, strategic objectives. Together means whaanau, es. Together means collaboration andHealthy partnership with people, families, and safe healthcare. ties, health three and other providers. compassionate

collaboration and partnership with people, whaanau, nities, health and other providers. families, communities, health and other providers.

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Healthy Communities Why it matters Decisions about personal health and wellbeing are influenced by your whaanau and families and the network of people that matter the most. What we will do Work in partnership with local communities and other sectors to prevent ill health and provide more integrated health care closer to home.

Healthy People, Whaanau & Families Why it matters Decisions about personal health and wellbeing are influenced by your whaanau and families and the network of people that matter the most. What we will do Improve the experience of care every day through health literate services and people. Where patients agree, whaanau and families will be part of our care conversations and decisions.

Healthy Communities Healthy

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Healthy People, Whaanau & Families Healthy People,

INTEGRATED CARE

New approach for care Plus patients in Counties Manukau Reproduced with permission from NZ Doctor

Reynald Castanedaz

A new initiative aimed at preventing some of the 60,000 Counties Manukau residents with long-term conditions from becoming chronic care patients has been launched. The At Risk Individuals programme is expected to be embedded into all general practices in Counties Manukau within the next 12 months, says Benedict Hefford, the DHB’s primary and community care director. It is hoped the new programme will provide early intervention for patients as well as re-establish general practice as the centre of coordinated care. Approximately 30,000 people are at risk of poor health in the region because of their long-term conditions in combination with their low socio-economic status and poor health literacy, he says.

“We need to support these patients to better manage their conditions and keep well.” Mr Hefford says patients registered in the programme will have a patient-centred care plan developed with them. The patient will be assigned to a care coordinator, with an “Summary health record” created, reviewed and made available to everybody involved. Other health providers and social care providers can be included as a part of a patient’s care team. Mr Hefford says these electronic health records will be stored in HSAGlobal’s Connected Care Management System. Medtech head of solutions sales Sanjeewa Samaraweera says connectivity between the management system and Medtech will reach certain milestones this month, with technical plumbing ironed out behind the scenes.

KEY POINTS It’s anticipated every general practice in Counties Manukau will take part in new At Risk Individuals programme in the next 12 months. Registered patients will have a care plan created with them; plans will be stored in HSAGlobal’s Connected Care Management System. Counties Manukau Health has allocated $4.93 million for the initiative and PHOs are contributing CarePlus funding.

Previously, GPs have complained about connectivity issues between the two IT products (New Zealand Doctor, 7 May). But, Mr Samaraweera says, several meetings have been held to fix this and Medtech will be reimbursed for any technical changes at their end. Mr Hefford says the new Counties Manukau initiative will cost the DHB $4.93 million; the PHOs will contribute resources mostly via Care Plus funding. In the first year, 10 per cent of funding is allocated according to how proactive practices are in creating care plans. In the second year, 25 per cent of funding will be awarded according to outcomes, which will be set by a governance group. The clinical leads of the programme are Mangere Health Centre GP Tim Hou and Counties Manukau Health integrated care clinical director Harry Rea. Mr Hefford says practice owners can choose when they will participate. Eligible patients can be identified by various methods including a newly developed guide covering clinical and psychological factors as well as a hospital readmission prediction tool. Mr Hefford says PHOs will provide support to GPs during transition to the new initiative. This will include advice on funding, appointing the care coordinators and IT tools. Practices will be supported in transitioning patients off the chronic care management programme, which the new initiative will replace. Practices can appoint their own care coordinators, who must be registered healthcare professionals already employed in primary care. For more info:   www.countiesmanukau.health.nz/about-us/performanceand-planning/achieving-balance/system-integration/

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implementing a single integrated electronic health record for the whole health sector in the Northern region, including primary care and private hospitals.

SWIFT jigsaw comes together Project SWIFT reaches another critical milestone this month, as more than a year of investigation culminates in recommendations for future investment. During August, senior Counties Manukau Health clinicians and managers will start evaluating possible new tools and systems to recommend to the Board. The process started in June 2014 to understand and document current processes and how our services should work in future. The SWIFT team – CM Health and its strategic change partner IBM – has compiled a range of possible options that look at the functionality of different systems, both new and building on existing ones, and the capabilities they will provide. In the primary care space, the Model of Care team will shortly report back on the results of lean practice consulting work with a small number of practices, and smart tools like the glucometer and smart inhaler that have been trialled with patients. In addition to all this, the Northern Electronic Health Record (NEHR) Implementation Planning Study is underway to explore the feasibility and costs of

CM Health Chief Medical Officer Gloria Johnson says it is critical that all of this work forms a coherent programme.

“The various components need to be fitted together so that they complement one another and collectively help us to move quickly towards the long-term goal of information being available whenever and wherever it is needed to enable efficient, safe healthcare. “Ensuring that our local aspirations can fit in and help accelerate the changes required will be an opportunity to make the SWIFT projects even more relevant. It will involve the most challenging programme of work the DHBs in this region have ever undertaken.” Paula Jackson

TAKE THE STOPTOBER CHALLENGE THIS OCTOBER AND STOP SMOKING FOR 31 DAYS FIND US ON

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atio d n u o F e r Middlemo The Middlemore Foundation’s staff love Countdown. “There is no doubt Countdown are one of our most loyal and committed supporters,” says Foundation Community Relations Officer Joanne Hand. “They have backed us with serious donations from the Countdown Kids Hospital Appeal, with funds going to Emergency Care, the National Burn Centre and to paediatric work in the community.” The company has just launched their 2015 Countdown Kids Hospital Appeal, which since 2007, has contributed almost $1.5 million to Kidz First and Middlemore Hospital. “It would be a mistake to think Countdown just gets money from shoppers,” Joanne said. “Sure they are important, but much of the money comes from the efforts of staff, who do the runs, shave their heads, bake the biscuits, buy the raffles, and a million other things. Just last year almost quarter of a million dollars came the our way for Women’s Health ultrasound equipment. In 2012 and 2013 the appeal contributed towards ventilators for our newborn and premature babies in the Neonatal Intensive Care Unit as well as a centralised monitoring system. This year the foundation has sought assistance for the National Burn Centre, which will mark its 10th anniversary in 2016. Behind the scenes, Countdown also has a hand in many other gestures. Middlemore Foundation Public Relations Officer, David Kemeys, says the company never seeks credit. “Mick Willis and his distribution team who do amazing things for Jammies in June. We also get food, clothing, toys, books, toiletries and all sorts of things that Ruth Krippner sends us. We owe so much to her and her organising committee who run the appeal.” Foundation Deputy Chair, Rob Fisher, summed it up at the launch of the appeal.

“We are blessed to have Countdown as a member of our family, in fact we can only wish we had a few more brothers and sisters like you.”

Poster boy Elliott Crimp parachuted in to lend a hand to the Countdown Kids Hospital Appeal.

This year a familiar Kidz First face in Elliott Crimp will be one of the poster children for the appeal. Elliott has spent more time than any youngster should with us, battling meningococcal meningitis – or “ninja-coccal” as he calls it. Mum Kushla says “We know better than most how vital our hospitals are, so we are delighted to do anything we can to help. And it means we get to come back and see some friendly faces too.”

HELP US RIGHT NOW

Text KIDZ to 5144 to donate $3

David Kemeys   david.kemeys@middlemore.co.nz   more info middlemorefoundation.org.nz

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Y T I S R E

V I D

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BALL

Photos: Nigel King, White Door Event Photography

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NEHR Phase 2 kicks-off to decide on Integrated Health Record for Northern Region

Clinical Research Opportunity

The Northern Electronic Health Programme (NEHR) hosted three ‘kick-off’ sessions this month to launch the second phase of the programme.

FISH OIL CAPSULES

Help us explore a potential way to protect your heart. Middlemore Clinical Trials is seeking volunteers to participate in a clinical research study of an investigational medication at Middlemore Hospital. You may be eligible if you: ƒƒ are 18 years of age or older ƒƒ take a statin medication but still have high triglyceride levels ƒƒ have at least one risk factor for heart disease, such as: ƒƒ a history of heart problems or stroke ƒƒ type 1 or 2 diabetes ƒƒ high blood pressure or taking blood pressure medication ƒƒ being a regular smoker

We deliver this healthcare via a complicated matrix of providers and processes with various sources of funding and in partnership with members of a multicultural community.”

Please note: The study drug and placebo formulations contain a substance that is derived from pork. For additional information and/or to register your interest please phone us   participants@mmclintrials.nz   0800 27 27 84 (0800 2 PARTICIPATE) This study has been approved by the Central Health and Disability Ethics Committee (14/CEN/97).

SuDoKu

Middlemore Clinical Trials is a charitable trust whose key objectives are to undertake, conduct and promote clinical research within the South Auckland region.

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Epic (a global leader in Integrated Electronic Health Records) was selected by a committee comprising stakeholders from the four DHBs, Primary Care, MercyAscot as well as consumer representatives. Epic have attended the sessions to provide a variety of demonstrations on what their systems can do and outline their approach to implementation across the globe. At the sessions, Gloria Johnson, CMO at Counties Manukau Health and programme sponsor, outlined the case for change. “This region faces huge challenges in continuing to deliver high quality, safe, affordable healthcare to a large, ageing and rapidly growing population with pockets of extreme socioeconomic deprivation and chronic disease.

Compensation will be provided for travel.

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The programme was established in July 2014 with the objective of selecting a vendor to assist with an Implementation Planning Study (IPS) which will consider its feasibility for the Northern Region.

A Programme Level Business Case will be developed in parallel to the IPS, which will assess the affordability of the system. Once these documents are complete, early in 2016, the region will pause as part of an agreed stop-gate process. This will give the region time to consider the detailed information and decide whether to make a commitment to continue. The nature and scope of the programme is ambitious. NEHR’s potential scope includes primary care and private providers in addition to the provider functions of the four DHBs. However, all of these groups have made significant contributions to the programme so far and there is a commitment to continue this phase of programme across the region.

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“It is vital that the information systems which enable healthcare are able to operate reliably and seamlessly. They need to include the patient and all those who care for them, so that accurate information is available when and where it's needed,” says Gloria. “This Implementation Planning Study is an important and exciting opportunity for us to discover what might be feasible and affordable for us.” Clare Dill   clare.dill@healthalliance.co.nz