A COUNTIES MANUKAU HEALTH PUBLICATION | JUNE/JULY 2015
In this issue PRINCE HARRY VISITS AUCKLAND SPINAL REHABILITATION UNIT
LIVING OUR VALUES TOGETHER – VALUE AND STRATEGY REFRESH
JAMMIES IN JUNE APPEAL
CONTENTS CM Health staff set a Smokefree example������������ 2 Environmental Sustainability���������������������� 3
Geraint has asked me to contribute to this month’s Connect, which is great timing as there are so many amazing things happening at Counties Manukau Health. There are three recent events in particular I’d like to highlight here. The organisation is about our people and our community. In early May, I was delighted to attend the Annual Nursing and Midwifery Awards. The evening was an amazing success and reflected the huge potential and capability of our nursing and midwifery staff. To hear the achievements of the nursing team within the hospital and the community was incredibly uplifting and made everyone in the room proud to be part of CM Health. The second wonderful experience was attending with Dr Lee Mathias and some board members, Prince Harry’s visit to the Auckland Rehabilitation Spinal Unit. His visit, attended by four current and past All Blacks, was hugely successful. He met all the VIPs - the Very Injured (Rugby) Players, and spoke to them in a very personal and genuine manner. He then meet with every spinal patient in the Spinal Gym (and many outside), and sat and talked with them and with the staff (with many selfies going on). The third is my involvement in the SWIFT project (System Wide Integration For Transformation). This project focuses on how we challenge the current norm, what will be viable in the future and how to create an environment that focuses on the whole patient journey and illness avoidance. This is leading-edge thinking. On a recent intensive study trip to Europe and North America, Wilbur Farmilo and I looked at how similar challenges were addressed. One of the things we found was how advanced Counties is in its thinking, efficiency and effectiveness and willingness to change to meet future challenges (See page 5 for more details). The final topic concerns our position. We are tracking towards our budgeted operating breakeven for this year-end despite heavy clinical demand, cost challenges and tough national targets. It has involved hard and intensive work by many of you, and I personally wish to take this opportunity to thank you for the great effort. On a positive closing note, we received approval for the much-needed Acute Mental Health facility (Tiaho Mai) replacement. This more than $50m state-of-the-art mental health facility will be built on the existing site and linked to the Clinical Services Block (Harley Gray building). I continue to be unbelievably proud to be part of our organisation and its people.
Ron Pearson CFO AND DEPUTY CEO, CM HEALTH
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Co-design initiative: Meet our Consumer Council ������ 3 Looking to the future with SWIFT������������������� 4 Top Posts�������������������������������������� 4 A Right Royal Welcome for the Prince��������������� 5 About – The Auckland Rehabilitation Spinal Unit������� 6 Values and Strategy������������������������������ 7 Healthy Together�������������������������������� 8 Middlemore Foundation�������������������������� 9 The Rainbow Volunteers������������������������� 10 APAC Forum 2015������������������������������ 10 Annual Nursing & Midwifery Awards��������������� 11 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 firstname.lastname@example.org
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CM Health staff set a
Two Counties Manukau BreastScreen staff are proud to be quitters. Verona Puru and Ren Holmes have both stopped smoking in the past year and are proud to be setting an example for their friends and whaanau. Verona smoked for 40 years and made the final transition to life as a non-smoker during Stoptober.
“I feel really good, really proud of myself. I’m saving money and I can taste my food!” Verona says the support that came from group sessions helped her quit. “Having the support of all the other people was great. Really it was about focusing and keeping to what I wanted to do. I wanted to quit and not fail. Nothing was going to get in my way,” she says. Ren Holmes smoked for 39 years and quit in January 2014. “One day I walked up the driveway and it took me 10 minutes to catch my breath. My mum died of emphysema and I just thought ‘that’s it’.” Like Verona, Ren didn’t tell any friends or family for a few weeks, wanting to feel secure in her success before sharing it with the people she was setting an example for. “It’s a big deal to quit and my family are really proud of me, so it feels good.”
Georgina Pickering, Tony Ormsby and Gloria Onelino out and about in Mangere Bridge
Counties Manukau Living Smokefree Service has a number of campaigns on the go to help smokers quit. The Quit Bus is out and about across Auckland regularly, and CM Health staff can pick up a free Nicorette QuickMist from the Middlemore Pharmacy by presenting their staff ID. The Smokefree Pregnancies programme is celebrating success rates of 65% to 67% of pregnant women referred to the service quitting for four weeks or more. It is currently running in Manurewa, Otara and Mangere and will soon launch in Papakura.
For help to quit smoking phone 0800 569 568, text NOW to 226 or check out the Smokefree Counties Manukau 2025 Facebook page.
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Counties Manukau Health CEO Geraint Martin recently visited the green team in the critical care complex to get a hands-on experience of the interventions the team has set up to minimise waste and reduce costs. One of the waste types being collected is oral care packaging. An estimated 9 million toothbrushes and 16 million toothpaste tubes are used in New Zealand each year. Ordinarily these items end up in the landfill, however,
Left to right: Helen Polley, Geraint Martin, Debbie Minton, Catherine Hocking
they are now collected and sent to TerraCycle, a recycling company that collects difficult-to-recycle packaging and products and repurposes the material into affordable, innovative products. For every oral care item, two cents is donated to an allocated charity. If you would like to get involved and support the Middlemore Hospital Foundation, please visit www.terracycle.co.nz for more information.
CO-DESIGN INITIATIVE: Meet our Consumer Council We are a team of 10 dynamic consumers representing a wide range of different backgrounds, ages, ethnicities and localities. We have all experienced the different health care services CM Health provides, either personally or as whaanau members. Our new Council will focus its support within Middlemore Hospital and outpatient services and will work closely with all of our consumer groups within CM Health’s Localities. The ongoing development of patient and whaanau focused care will ensure we fully incorporate health care services and care across our community. The Council provides a consumer/whaanau perspective and advice for improvement projects, policy formation, service and delivery changes and more. Over the next few months we will be introducing you to our members We look forward to working with you on this co-design initiative. Rosalie Glynn, Chair PATIENT AND WHAANAU CENTRED CARE CONSUMER COUNCIL
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Back row left to right: Jay Keu Keu, Ezekiel Robson, Stella Cattle, Allan Edmondson, John Coffey. Front row: Rosalie Glynn( Chair) Kelly Wright, Barbara Broome, Samantha Barber, Myra Barrett. Absent: Diane Coomber
For any enquiries about the Consumer Council and how we can help with your next project please contact Renee Greaves, Patient and Whaanau Care Advisor. Renee.Greaves@middlemore.co.nz.
Looking to the future with SWIFT More than 300 Counties Manukau Health staff gave their time over the past three months to determine how Counties Manukau Health works and how SWIFT can help deliver the desired “future state”. The SWIFT team held working sessions with staff from acute, outpatient and elective services and shadowed teams in their daily work. They then documented user stories from consumers and key clinical and operational areas of the organisation to pinpoint inefficiencies in current processes and set out how CM Health should work in the future. SWIFT sponsor and Director of Hospital Services Phillip Balmer says the next phase of work in June and July involves assessing options for solving the problems highlighted, which could be new ways of working or new tools.
“We’re grateful to everyone who gave their time and expertise to help us work through this process, and it continues over the next few months.”
CM Health staff and others involved with regional initiatives attended SWIFT sessions in March and April. From left: Sanjoy Nand (seated), Rachael Grey, Austin Walls (IBM), Lara Hopley, Dot McKeen and Tim Alvis
Meanwhile, work to test enhancements to primary care in Counties Manukau has started, with several general practices conducting a range of research and evaluation projects and testing new ways of working and engaging with patients. The work includes eHealth services, process re-design, apps for patients and integrated pharmacy services, with results to be reported in August and a timeline developed for wider implementation. On Mobility, the first implementation of smart devices for community teams has started with members of the Child Development Services, Home Healthcare Orakau and Very High Intensity User teams to test the devices and new forms in the next few weeks. countiesmanukau.health.nz/project-swift
YO U AV RF
IN S O CI A L ME D
TH BIRTHDAY HAPPY 68 E MIDDLEMOR
MAY HOUSE OFFICER OF THE MONTH The May winner Dr Benjamin Liu, currently a General Medical house officer (on Mahoe team), was nominated by senior staff who felt he deserved recognition for his good work. Senior staff describe him as a conscientious and reliable house officer who is a joy to work with.
Don’t miss out on any updates, follow Counties Manukau Health on Facebook, Twitter, LinkedIn, YouTube and Google+.
Middlemore Hospital had its 68th birthday on 3 May. It has come a long way since it was opened! Back then, it was surrounded by farmland and considered on the outskirts of Auckland.
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Prince Harry and Grant Sharman
Prince Harry and Sarah Ellington
A Right Royal Welcome for the Prince Despite the heavy downpour, it was a day that many of our staff and patients will never forget – the day that Prince Harry, fifth in line to the British throne, popped in for a whistle-stop tour of the Auckland Spinal Rehabilitation Unit. 5 | CONNECT + JUNE/JULY 2015
Prince Harry and Willy Ihaka
About – The Auckland Rehabilitation Spinal Unit
The prince with All Blacks Jerome Kaino and Keven Mealamu
Counties Manukau Health, Middlemore Hospital and Auckland Spinal Rehabilitation Unit (ASRU) provide surgical, acute care and rehabilitation services to patients with spinal cord impairment. Around 70 percent of all patients receiving rehabilitation at ASRU require this as a result of trauma, and the remainder as a result of medical issues such as infection, vascular issues or tumour. The length of stay varies according to the level of impairment, pre-existing conditions and complexity. Today, there is a far greater recognition of the need to support people to live rich lives in their own communities. Inpatient stays are now typically around 8 to 12 weeks or less depending on the reason for admission. Inpatient patients receive support from; Rehabilitation Medicine, Nursing, Physiotherapy, Occupational Therapy, Social Work, Psychology and Urology specialist services. Prior to discharge back to local DHBs, links are made to community-based services to ensure necessary supports are in place. Patients who live locally can attend for outpatient Physiotherapy/Occupational Therapy support.
Prince Harry and Ben Clifford
It was a real honour and privilege to meet the prince, says service manager Jude Sprott, who was on hand to personally greet him when his entourage arrived. “I found him to be a down-to-earth young man who appeared genuinely interested in meeting our patients and finding out how we deliver our services.” Jude guided the prince around the facility and introduced him to several patients who were currently undergoing rehabilitation at the unit.
“I might be a bit of a royal fan now, it was lovely to meet a real prince!” After the formal welcome overseen by CM Health Kaumatuas Ronald Miki Apiti and Lewis Moaeau, the prince had a lengthy tour of the gymnasium. All Blacks Jerome Kaino and Keven Mealamu presented the prince with a signed All Black jersey, while patient Grant Sharman, who paints with his mouth, gave Harry a water painting that celebrated the prince's army service. The royal visit was arranged at the request of the New Zealand Rugby Foundation, which actively supports injured amateur and professional rugby players. Last year, the Foundation funded a large deck and is currently fundraising, with support from the Middlemore Foundation, for an O-Arm, which is a multi-dimensional surgical imaging platform that is designed for use in spine, orthopaedic, and trauma-related surgeries.
Follow-up in the community is through team assessments in outreach clinics held in key population bases such as Hamilton, Whangarei, Tauranga, Gisborne, Rotorua, as well as specialist medical and Urology clinics. Patients may return to ASRU for a short readmission to support specific health needs or following surgery such as tendon transfer.
DID YOU KNOW When we’re born, our spines consist of 33 individual vertebrae.
As we age, some of these vertebrae fuse together. The five vertebrae composing our sacrum become one bone and the coccygeal vertebrae – which can vary from three to five bones – fuse together as one. Thus, the tailbone is formed. You have 12 vertebrae in your thoracic area – the middle portion of the back. You have five vertebrae in your lumbar spine area – the lower back. And the cervical area, or the neck, is comprised of seven individual vertebrae. The spinal column has three very important functions – it supports the body’s weight, provides flexibility for movement, protects nerve roots and fibres and forms a protective surrounding for the spinal cord – the main pathway of communication between the brain and the rest of the body.
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Values and Strategy Thank You for Your Participation in Values Week (28 April– 4 May) Thank you to all staff, patients, family, whaanau and carers who took time out of their busy schedules to attend Values Week and make it such a success! More than 1000 staff from throughout the organisation, and more than 100 patients, their families, whaanau and carers attended a variety of In Our Shoes and In Your Shoes feedback sessions held across South Auckland. The purpose of the sessions was to listen to their experiences of what works well and what doesn’t work well at CM Health, so we can continue the good things and respond to things we can improve and change. A number of Leading with Values sessions were also held to assist leaders to recognise and role model behaviours that support our values. A feedback session was held with our PHO colleagues. Here are some of the comments people made regarding the Values Week sessions: “I really enjoyed the “In our Shoes” session I attended. It was powerful, personal, energising and fun! My colleagues who I share an office with were also buzzing with energy after the session.” Mareta Ferguson Clinical Nurse Manager – District Nursing
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“I have just completed the In Your Shoes sessions and wanted to express to you directly what a wonderful experience it was… I came away from the session feeling like I was heard and supported.” Patient “I have just attended all three sessions of values week, staff feedback, leader’s session, and patient listener. I would like to thank all the team that were involved in bringing this fantastic programme to CMDHB.” Judy Scott Theatre MRT, Radiology The feedback from Values Week will be incorporated alongside the 1549 staff survey responses and 338 patient survey responses, then analysed to inform the organisation’s refreshed value statements and our future programme of work. The Executive Leadership Team will consider the proposed values statements at its June meeting before they are presented to the Board for approval in July. Phase Two of the Values Refresh will look at how the new values will be embedded as common behaviours at CM Health, including promoting, embedding and sustaining our values, recruiting and rewarding for our values, and addressing unacceptable behaviours.
Healthy Together CM Health is refreshing its strategic direction before the end of 2015, when it will see out its goal of becoming the “Best Healthcare System in Australasia by December 2015”. This next five years is about building on what we have achieved, joining up all of our strategic activities and plans and evolving our Triple Aim through three Healthy Together missions: Healthy People Whaanau and Families, Healthy Communities and Healthy Services. Since January 2015, the Healthy Together missions have been shared with over 1200 people from across the organisation. The conversations have been engaging, transparent and valuable in helping to paint a picture of what we need to focus on in the next five to 10 years. Strong themes are already emerging from the feedback: Vanu Faasisila, Charge Nurse Ward 23
Healthy People Whaanau and Families: Ensure patients whaanau and families are at the centre of care and decision-making. Remove the barriers to joining up services and teams, advance community health services integration and remove the barriers to health and social services access through primary and community care for everyone. Healthy Communities: Be intolerant of health inequity across our diverse communities. Value and foster partnerships to work more closely with communities, schools, business owners and other social sector agencies to promote healthy choices. Be precise about our role in the big social and health issues such as obesity, smoking and alcohol; ‘walk the talk’ by being active advocates of healthy living and making it easier to be health literate. Healthy Services: Consistency of patient and whaanau centred care, quality and safety improvement, teaching and performance across services within a strong learning culture, workforce and leadership development, focus on whole of system teamwork (removing silos). Joining up of teams and services, enabled by faster progress on information and communication technologies to better support people with complex health and social needs.
Simon Kerr, Professional Leader, Physiotherapy
It’s not too late to add your voice. Your feedback will help shape a health system that is not only the best in Australasia but more importantly that passes the granny test – i.e. a health system that provides the care you would be happy for your family and friends to receive. You can provide your feedback by email: email@example.com or firstname.lastname@example.org All feedback will be collated and analysed in early June as we shape a cohesive story to guide our actions and resources over the next five years. If you have any questions about the values and Strategy Refresh Project, please contact Adeline Cumings on 09 259 9650.
Margie Apa, Director Strategic Development COUNTIES MANUKAU HEALTH | 8
Middlemore Foundation year. It can also help prevent chest infections and children being readmitted.” “The simple nature of Jammies in June seems to have struck a chord with people,” Mr Kemeys said. “But we have to keep working to make sure we help as many people as we can, so it is important to us that hospital people take part too.
The Middlemore Foundation is preparing for Jammies in June, and one of its major targets this year is Middlemore itself! Jammies in June started in 2013 and continued last year when about 5000 pairs of pyjamas were collected and more than $20,000 in cash donated. PJs came in from individuals, kindergartens, schools, businesses and sports clubs, with the Vodafone Warriors playing a big part in a $10,000 donation from the UFC. Now the foundation wants staff and departments to take part too. “We all see the problems associated with child poverty, and we see the children who suffer,” Foundation public relations officer David Kemeys said. “At the Foundation we know Middlemore’s people work hard within the hospital and community, but this is a simple way to something practical. We hope departments will collect pyjamas for us because as fast as they come in, we get them on to our young people, and that means we won’t see them admitted when winter bites,” he says. Jammies in June targets respiratory illnesses, asthma, Rotavirus and streptococcus throat infections, which can lead to rheumatic fever, in a simple way. “Few children have their own jammies, especially if they have been admitted in an emergency,” KidzFirst Children’s Hospital Inpatient Service Manager Marlene Stratton says. “Giving out pyjamas helps normalise a hospital stay and helps parents and families understand the importance of keeping their children warm, especially at this time of
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“All you need do is put a box in your department, and drop new pairs of PJs in it. We’ll even give you a box and collect it if you call us.” Cash collected as part of Jammies in June is used for other winter warmers like vests, singlets, socks and even blankets. Middlemore Foundation executive director Pam Tregonning said people probably did not understand how important their kindness was.
“It would be hard for people to know just how much difference the simple gift of some pyjamas makes, but it’s enormous.” Every year the number of children admitted to KidzFirst doubles over winter In January around 317 children are admitted – in August it’s more than 700 Most admissions are for preventable illnesses in children under five Every winter KidzFirst must open an additional pod with 12 extra beds 25 short-stay beds in Paediatric Emergency Care are often called into use too New flannelette jammies are needed for kids aged from birth to 15
For queries call Ankita Luthra at Middlemore Foundation on 09 270 8808.
The w o Rainbunteers Vol Volunteers at Counties Manukau Health will finally have their own brand and identity with the adoption of the name Rainbow Volunteers for the team. The name was an unanimous choice by the Volunteer Committee Board, and reflects the spirit of the rainbow graphic which has been the main guide through the hospital for many years, and remains a meaningful part of the hospitals architecture. The Rainbow is also representative of the diverse cultures and ethnicities that make up our unique community as the volunteers are our people serving our community. The volunteer uniforms are proudly sponsored by the Hector Trust and will visible across the hospital so that patients, whaanau and staff may easily identify them as helpers in this busy hospital. Did you know that our volunteers will be: Reading to patients/playing board games/card games/ Talking to patients and providing a listening ear Helping at meal times where appropriate under the direction and request of staff e.g. opening juice or yogurt Taking patients down to rehab garden or hospital patient areas for air and sunshine Health literacy promotion and surveys Helping with admin tasks As the rainbow that runs through the hospital has helped people find their way over the years, our Rainbow Volunteers will continue to do the same and so much more! You will soon be seeing volunteers in their new uniforms. Can your ward benefit from using our volunteers? Contact email@example.com
Can be anywhere
APAC Forum 2015 Run by Ko Awatea, our APAC Forum is Asia Pacific’s premier healthcare conference and will take place this year from 23rd to 25th September at SKY City. Promising to be our biggest and best Forum to date, you will have access to over 130 high-profile speakers covering 45 sessions and 16 intensives, together with key note speeches from comedian and mental health advocate Ruby Wax, leading patient safety expert Professor Charles Vincent, and composer and leadership expert Itay Talagam. You will hear from world-renowned presenters, as well as the best NZ has to offer; people who are pioneering change and making a real difference to the lives of patients and communities. As part of APAC’s gala dinner, Ko Awatea will recognise excellence as part of the Ko Awatea International Excellence in Health Improvement Awards. Entering for an award provides you with an opportunity to celebrate your work in health improvement and in delivering high quality care to patients and communities. This is your time to shine! For more information www.apacforum.com
Peer vaccinators and Occupational Health & Safety will continue to offer the Flu vaccinations after the formal programme finishes. Contact OHSS on ext. 8142 for an appointment.
Protect yourself, your colleagues and family. Get immunised. COUNTIES MANUKAU HEALTH | 10
Celebrating our nurses and midwives
Rebecca Le Noels, Puawai, Georgina Hohepa, Irene Tukerangi, Miriata Hohepa, Devi Ann Hall, George Ngatai
On Wednesday 13 May more than 300 guests celebrated the excellence of Counties Manukau Health nurses and midwives at the Nursing & Midwifery Awards 2015. “This is a time where we acknowledge individuals from across our health system who have shown excellence in clinical practice, clinical leadership or both, as well as contributing to quality initiatives that have contributed to improved patient safety and outcomes,” says Denise Kivell, Director of Nursing. In total 39 awards were presented to registered nurses, midwives and support staff, in recognition of their excellent contribution to nursing and midwifery.”
Suzie King and Dianne Dawson
Awards covered General Nursing, Midwifery, Mental Health and Primary Healthcare & Community.
“We are privileged that we have a well-developed collaborative working approach with our tertiary education providers. Awards are also offered and presented by Manukau Institute of Technology, University of Auckland and Auckland University of Technology.” Inspiring guest speakers rounded up the night for all attendees. Riki Nia Nia, (General Manager, Maaori Health) spoke about the values of CM Health staff highlighting that what we value is intrinsic to how we work. “Values are an essential part of providing great care and a great experience at work. Communication, being more caring and where possible being flexible are three values whaanau have signalled are important values that matter to them. Therefore we all need to continue to do or do better in our daily work.” All the images from the event are available on the Counties Manukau Health Facebook page.
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Elizabeth Powell, Lani Ioelu and Leilani Jackson
KEY UPCOMING DATES AND EVENTS Pasifika Week Jammies in June World Hepatitis Day Diversity Ball
29 June - 3 July 2015 June 28 July 8 August