First home with the impressive time of 38 minutes 20 seconds was Russal Fredericks, healthAlliance and in second place was Kim Arcus, CMDHB project manager, who ran a time of 42 minutes and 18 seconds. Congratulations to both.

To reward the staff for their participation there was a BBQ at Madill’s Farm park. It was here that staff demolished the hamburgers and sausages prepared by Geraint Martin, Ron Pearson and other DHB staff members.

There was then a presentation of spot prizes including pedometers, movie vouchers, children’s Rainbows End vouchers, a cd player, rebel sport vouchers, a DVD player, beach towels, children’s wallets and finally New Zealand-themed coasters.

Congratulations to all staff who participated in the event and we look forward to seeing you all again next year.

APRIL 2008

Going the DistanceOn Sunday 16 March 265 CMDHB employees put on their running shoes to participate in the 2008 Round the Bays. Round the Bays is a 8.4km run or walk around Auckland’s waterfront. This year there were over 40,000 registered runners.

Left to right: Christine Lockhart, Denise Kivell, Ron Pearson, Jackie Aston, Geraint Martin, Susanne Abel, Justina Corbett

Left to right: Christine Lockhart, Ron Pearson, Geraint Martin

From left to right: Jackie (visitor), Christine Lockhart, Denise Kivell, Ron Pearson, Dot McKeen, Geraint Martin, Justina Corbett

Geraint Martin, CEO and Chief Burger Flipper will serve morning tea to the team or department that can come up with the best caption for this photo. The winning caption and highlights will be announced through the group exchange during May.

Please send your entries to lryoung@middlemore.co.nz with your name, contact number and department/team.

Caption Competition

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As we head into the the cooler months I am acutely aware

that we have had no down-time over summer and staff will be feeling the pressure.

We are all working to ensure that our processes work as smoothly as possible and that staff are free to spend as much time as possible doing what we are here for – caring for our patients. Several initiatives are under way, including ‘releasing time to care’, whereby staff organise their ward or work areas to make doing their job easier and to work smarter by challenging the ‘this is they way it has always been done’ way of thinking. Hospital systems and processes can then be redesigned to focus on the patients’ needs rather than what the system needs.

This can be as simple a thing as having patient files kept in easy reach by the patient or discarding outdated products that clutter storage rooms and stop easy identification of immediate needs. Thank you to the staff who are working to ensure that the patient experience is markedly improved.

This brings me to an issue I wish to discuss with you all.

On 10 December 2007, most DHBs in New Zealand were issued Official Information Act (OIA) requests, from the New Zealand Herald and the Dominion Post, requesting information on each DHB’s serious and sentinel events, dating back to 2003.

It was decided that the national Quality Improvement Committee (QIC) would coordinate the release of this information in a way that did not single out any one DHB, that added context to the numbers and that attempted to direct the debate away from the sensationalist and toward national learning and solutions.

The first problem encountered was the fact that DHBs did not have a standard definition for serious and sentinel events (basically degrees of patient harm due to medical management rather than the natural course of the disease), nor did they have a standardised process for collating this data. Only those Serious or Sentinal Events (SSEs) thought to be preventable were included in the report.

The report was released on 20 February. For the 06/07 year there were 182 SSEs

reported by DHBs. Some DHBs had high numbers and some low, but the figures were not a reliable indicator of organisational safety as high figures were generated by the busier hospitals treating greater numbers of patients (and those with good safety cultures), whilst DHBs like Counties Manukau had a relatively low number partially due to poor processes for collecting such data.

The report was useful as it showed a willingness of DHBs to reveal their data on SSEs, all DHBs participated, and for the first time it was obvious that the same SSEs were occurring at multiple DHBs. These included: wrong site surgery, patient falls, inpatient suicides, and medication errors.

This reporting of data is set to become an annual event and the QIC is coordinating the standardisation of definitions and processes (Waikato is the lead DHB). Here at CMDHB we are working on a system to collate these events. We are also working on supporting staff so that they feel safe to report SSEs and embed a process to investigate these events. In this way we will be contributing to the learning that comes from shared, open discussion of such events.

Geraint Martin, Chief Executive

Board ProfilesEach Connect we will profile two board members so that you have an opportunity to get to know them a bit better.

Michael WilliamsMichael Williams is a Chartered

Accountant with 22 years experience including six years in the Health Sector.

Michael was brought up in Pakuranga, lives in Howick with his wife and four young children and represents Botany/Clevedon as a Manukau City Councillor. He was previously the Chairman of the Botany Community Board.

Michael is passionate about continuous improvement and maximising value for money. He is Chairman of the Finance, Risk and Audit Committee for the Counties Manukau District Health Board.

Anne CandyAnne is of Ngaiterangi, Waikato,

English and Scottish descent and has been a resident of Manurewa for more than 30 years. She is currently a Manukau City Councillor for the Manurewa Ward and was previously the Deputy Mayor of Manukau City from 1998 to 2007.

Her special interests include being a Life Member of the Maaori Women’s Welfare League Inc., Patron Manurewa Returned Services Association, Patron Manukau National Council of Women and Inaugural Recipient of Auckland University Business School’s Mira Szaszy Maaori Alumni Award 2003.

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Are you here to make a difference?

The new-look Influenza Immunisation campaign, which starts in March, adopts a “Kung Fu” martial arts theme and highlights the key message “Improve your Defence - Immunisation helps improve your body’s defence against influenza”.

The new TV ad will appear on screens in mid April 2008.

National Influenza Strategy Group (NISG) chair, Anna-Marie Frost says the new 2008 Healthcare Workers Influenza Resource Kit is expected to be in hospitals later this month (February). The kit, which is sponsored by vaccine-maker sanofi aventis, is designed to assist hospital occupational health and immunisation teams to provide influenza immunisation to staff.

The influenza vaccine composition for New Zealand for 2008 is:• an A/Solomon Islands/3/2006 (H1N1)-like

virus;• an A/Brisbane/10/2007 (H3N2)-like virus;• a B/Florida/4/2006-like virus.

NISG spokesperson and virologist, Dr Lance Jennings says the New Zealand vaccine will provide protection against the viruses currently circulating and those likely to affect us this coming winter.

Healthcare workers are a key focus of this year’s campaign. “We are concerned at the comparatively low levels of influenza immunisation among healthcare workers in New Zealand. Rates reported to NISG from district health boards ( DHBs) have shown coverage rates of only 20 to 40 per cent for healthcare workers, despite the vaccine being free to staff,” she comments.

Dr Jennings said in a New Zealand Medical Journal paper in May 2006 that, “Annual immunisation of healthcare workers is the most efficient way to minimise their (patients’) exposure to a potentially lethal virus. There is research that clearly shows that with the increasing compliance of frontline clinical staff to having the vaccine hospital nosocomial influenza infection rates diminish. Indeed, it

has been suggested that annual immunisation should be a compulsory requirement of every healthcare worker with direct patient contact, unless there is a specific reason otherwise.”

While stopping short of requiring compulsory immunisation many individual DHBs have been actively promoting the need for healthcare workers to have an annual influenza vaccination, says Ms. Frost.

The new healthcare worker kit has been supported by NISG to provide a standardised campaign for all DHBs using the “Kung Fu” imagery which is similar to the main patient influenza campaign. It includes a leaflet to explain Influenza Immunisation Facts for healthcare workers, “I’ve been immunised today” stickers, T-shirts for vaccinators, posters, and other material that DHBs have requested, including the option of lollipops for staff who have been immunised.

”We urge healthcare workers to be immunised against influenza to protect themselves, their patients and their families from this serious disease,” concludes Ms Frost.

Improve your defence against influenza

You have a very powerful role. You are able to influence very important moments in people’s lives when they are at their most vulnerable.

When you are friendly, informative and

genuinely concerned, patients begin to trust you and this organisation. They form their opinions of our organisation based on your performance. If it is a positive one, then we are all winners and the reputation of our organisation grows in stature and we all feel just a little proud. If it is a negative experience then that reflects on us all.

You may have noticed how quickly the media picks up upon poor performance

within the health sector. We all shake our heads and say ‘yes but those people

were really difficult.’ The greatest challenge for us in respect of patient-centred practice is getting it right when things are complicated. It is easy to provide fantastic patient care and service when things

are going well but when the pressure comes on we really sort out the

customer service champions. Be prepared, anticipate challenging situations and have a plan of action. For example, if there is an ‘unavoidable’ issue, how can you make that situation better? One of the most important factors is to keep communicating with the patients. Approach the issue from a number of angles. If you cannot resolve the issue one way, try something or someone else. Don’t give up.

Think of yourself as the face of this organisation and ask yourself, what is my performance really like? Honest evaluation is crucial to good performance. Supporting one another is also vital. How do you treat your fellow CMDHB workers? Are you helpful? Do you encourage those under stress? Do you live the vision and values of this organisation- do you know them?

Care, compassion, courtesy and clinical competency- How do you rate?

Mary Burr, Customer Service OfficerSurgical and Ambulatory Care

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ASB Polyfest is a spectacular community event in which our youth express themselves through the song and dance of their own and other Pacific cultures. 2008 saw a record number of cultural groups enter ASB Polyfest competitions with an increase on each of the five cultural stages – Cook Islands, the Hapai Te Hauora Maori stage, the MIT Niue stage, Pacific Corned Beef Samoan stage and the ACC Tonga stage.

The Counties Manukau District Health Board supported the three day event through the planning and participation of many staff from the Smokefree, Maaori, Pacific, Workforce Development and Let’s Beat Diabetes (LBD) teams.

The ASB Polyfest provides an opportunity for the District Health Board to extend our presence in Counties Manukau to our Pacific and Maaori youth and to pass on positive health messages for education and behaviour change in a celebratory atmosphere.

This year’s festival’s main CMDHB sponsor was Smokefree, encouraging a completely Smokefree environment across the entire event.

Action and Entertainment at the ASB Polyfest

Counties Manukau DHB set up two marquees at the event, one in the Maaori section and one in the Pacific section. The marquees were themed “Counties Manukau invite you to treat yourself” and attracted attention with activities such as basketball, pamper slots and show your-muscle-type competition to engage festival-goers. The three-on-three basketball competition proved a big hit with prizes being basketballs. Hundreds of students were drawn to the basketball court over the three days, regardless of the rain, heat or extreme sun, they still played on.

Health competitions ran with on-the-spot prizes including LBD lanyards, LBD t-shirts and toothpaste and brush sets. iPods were awarded as major prizes for the bench-press competitions and a lucky winner of the survey questionnaire won a ride to their school ball in a Hummerzine.

The Whatcha Gonna Do?, Health Could Be 4 U, Swap2Health, Smokefree and Breastscreening slogans were well displayed on posters and flyers within the tents and on branded t-shirts and caps worn by over 100 volunteers.

More importantly, general discussions were held with school students from all over

Auckland regarding what they are “gonna do” when they leave school and Swap2Win messages focussed on swapping fizzy drink to water and swapping to active sports. The variety of foods available at the Polyfest sparked many conversations about reducing fat in the diet.

CMDHB staff members were superb in helping to promote important messages about taking up health careers particularly to develop our Maaori and Pasifika health workforce, healthy swaps to beat obesity and diabetes, staying active and quitting smoking.

The ASB Polyfest which ran in mid-March is the largest secondary school Maaori and Pacific Islands cultural festival in the world.

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Counties Manukau District Health Board is pleased to announce that training sessions for Antenatal HIV Screening began in March.

The aim of screening is to identify HIV infection in pregnant women. Since 2000, approximately 14 children in New Zealand have contracted HIV because it was undetected during pregnancy in their mothers.

Training sessions are being provided to ensure all health professionals are updated on the need to routinely offer and recommend an HIV test along with the first antenatal bloods with each pregnancy to all women. It is their choice whether to accept or decline the test. Sessions will cover the screening pathway

and guidelines for reactive and positive results and more.

If women are diagnosed and treated in pregnancy, the risk of vertical transmission to the baby can be reduced from (up to) 30% to less than 1%. In fact, no babies born in New Zealand have contracted HIV to identified HIV positive women who have been appropriately treated in pregnancy.

Up coming dates;To find out about training sessions check

your PHO calendar for dates or your coordinator. CMDHB Antenatal HIV screening coordinator: Tracey Senior 021940745 Email seniort@middlemore.co.nz

For further Information see on HIV Screening in Pregnancy see National Screening Unit www.nsu.govt.nz or www.healthpoint.co.nz

Antenatal HIV screening training sessions for health professionals have started

The Incubator programme (www.incubator.net.nz) is now underway in our neighbouring secondary school, Aorere College.

The Incubator programme is a workforce development initiative developed for secondary school students by Hawke’s Bay DHB, to nurture interest in a career in health. Incubator applies innovative experiential learning techniques with health sector employees. The Incubator programme has been short-listed in the category of innovation, for the 2008 Health Innovation Awards.

This is a pilot programme for the DHB and consists of a mix of school-based visits by health professionals, secure internet discussion forums and health sector visits by school students.

Aorere College is a Decile 2 secondary school and has a total roll of 1331 students, with Maaori and Pasifika accounting for

over 70% of the total. Twenty year 12 and twenty year 13 students who have shown an interest in the health field have been selected to participate in this programme.

Without the help of you, our staff, this programme will not succeed.

Staff members who are interested in working with our young people to educate and mentor them about health issues and health career options are encouraged to get involved, whether that be as a volunteer to visit students or as an online mentor.

Please feel free to contact Luke Fleming for further information:

Luke Fleming, Programme Coordinator - Schools’ Health Careers, fleminl@middlemore.co.nz

Rm 413, Support Building (Bldg 30), Middlemore Hospital

Ph: 276 0044 ext. 9176 Mob: 021 806 710

Incubator hits Counties Manukau!

This year was arguably the most successful in recent history. With $10,700 raised on the day and more being mailed in, it was a worthwhile contribution to the Joint Effort and Wishbone Trust’s goals.

More importantly, feedback from the patients has been overwhelmingly positive. Eleven hundred letters had been sent to those with a hip or knee arthroplasty in the last two years. Thanks go to Mary Upton at Middlemore for arranging the mail-out. Around 150 patients were in attendance.

Refreshments and the trade stands passed the time while the donations were collected and patients registered. With a few words from Garnet Tregonning who thanked participants and explained the purpose of the Trust, they were off. Two laps of the Manukau site made for 1.2 kilometres. Our fastest patient completed this in a mere 9 minutes 48 seconds, only limited by strict instructions there was to be no running. The vast majority took things at a more leisurely pace.

Their return was welcomed with food and drink along with a free sausage sizzle prior to the awarding of prizes. This year ‘prizes’ were distributed by a free raffle for those who donated. Our fastest walker happened to pick up a prize through sheer luck of the draw. Prizes were donated by Registrars including a return family pass to Waiheke from Fullers, movie passes from Hoyts, an eleven year old bottle of merlot from Villa Maria, a subscription to House and Garden along with a free current issue for all from the publishers Gordon & Gotch, free coffee vouchers from Ben Café and products from Healtheries. This was in addition to the gift baskets from Stryker and laptop accessory packs from Zimmer.

All in all, the crowd had an excellent day. We look forward to the next and hope they too generate such an enthusiastic response.

Rob OrecArthroplasty FellowMiddlemore Hospital

Joint Effort Hip Walk Manukau Superclinic ‘08

Action and Entertainment at the ASB Polyfest

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Fisher & Paykel Healthcare has had a close relationship with Middlemore Hospital and our staff for over 20 years.

Over this time we have formed strong, mutually beneficial relationships in the research and development of healthcare products and solutions.

We were thrilled to receive a call this week advising us of a $1 million sponsorship for the new Intensive Care Unit, due to open in June.

We welcome this partnership with a New Zealand company that manufactures and supplies innovative healthcare solutions to improve our patient care.

The vision of Fisher & Paykel Healthcare to provide medical devices which can help

improve patient care and outcomes and to support their clinical partners, which is surely endorsed in this generous gesture.

This funding ensures that the brand new ICU, will include all the facilities and equipment needed to provide the highest level of critical care.

News Flash!

Sunday 24th February saw thousands of Aucklanders under the stars at the Auckland Domain, being entertained by our own Dame Kiri Te Kanawa, Will Martin, the Auckland Philharmonic Orchestra and the SKYCITY Massed Choir.

The magical evening had special significance for the South Auckland Health Foundation as benefiting charity for the event. All proceeds from the event are going towards equipping a specialised bed-space for children in the new Intensive Care Unit at Middlemore Hospital.

You will recall our brave hero, Keegan Maley, (from December Newslink), who was a star at the SKYCITY Starlight Symphony. Keegan and his family had the important job of activating the Mercury Energy laser light show.

The evening ended with a breathtaking firework display executed to the sounds of the 1812 Overture.

A huge thank you must go to principal sponsor’s SKYCITY Auckland, and their wonderfully supportive and enthusiastic team whose passion, enthusiasm and dedication made the evening such a success.

The South Auckland Health Foundation is also enormously grateful for the support received from the local community, CMDHB and staff from local businesses who

volunteered to ‘shake the bucket’ for Kidz First. We are also grateful to all supporters who donated a variety of goods and services’ ensuring the Foundation was able to maximise funds raised, whilst keeping our costs to a minimum.

Another thank you to the following organisations and their wonderful staff:

Maxwell & Williams Designer Homeware, Stevens, The New Zealand Herald, The Breeze, RedBalloon, Auckland Philharmonia Orchestra, Auckland Rugby, Mercury Energy, ETSL-EFTPOS, BDM Grange, La Prairie, Progressive Enterprises, OfficeMax, Nice ‘n Natural, Frucor Beverage Group, Prince & Partners and Nestlé New Zealand.

Special mention must go to Maxwell & Williams Designer Homeware and Stevens

who jointly donated a $10,000.00 homeware package that was won by Onehunga resident Shane Miller (pictured with his family).

A beautiful evening in the Domain

Prizewinners Shane & Sheryn Miller with twins Troy & Kaizea surrounded by their prize

SKYCITY Starlight Symphony Success

Fireworks and laser extravaganza

Keegan Maley with MCs Wendy Petrie and Mark Sainsbury

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Our charity: The South Auckland Health Foundation is a registered charitable trust that supports and raises funds for the health services of Counties Manukau District Health Board.

Thanks to the generosity of Lady Marion Davis (Hospital) Foundation administered by New Zealand Guardian Trust, the Middlemore Gastroenterology unit has a brand new Given Pill Cam Endoscopy machine.

The machine is one of only three in the New Zealand public health system – the other machines are in the Waikato and Christchurch Hospitals.

Patients with symptoms of abdominal pain, bleeding or anaemia are given a small pill to swallow that is equipped with a miniature video camera. Bluetooth technology then sends images to a recorder similar to a walkman, which is strapped to the patient’s stomach, over an 8 hour period.

The diagnostic tool can be used to effectively detect diseases in the gastrointestinal tract, - but at a cost of $1100.00 per pill each treatment must meet strict guidelines.

Gastroenterologist consultant, Dr Paul Casey commented, “The Pill Cam is the best test for examining the small intestine as the camera is

able to transmit images of metres and metres of intestine for detection of diseases and bleeding which would not ordinarily be able to be viewed”.

Upon completion the machine is plugged in and images are downloaded. Specialists are then able to review the images and report back to the referring specialist within 1-2 days

As the treatment requires no sedation, it is safe and convenient with an immediate recovery.

The South Auckland Health Foundation would like to gratefully acknowledge the New Zealand Guardian Trust for their generosity.

Generous Westfield Manukau City shoppers have donated nearly $6,500.00 by making a gold coin donation to have their Christmas gifts wrapped at Manukau City in December.

Michelle Kidd, Public Relations Officer from the South Auckland Health Foundation acknowledged the welcome donation from shoppers at Westfield Manukau City.

“We were delighted to learn that the South Auckland Health Foundation was once again, the benefiting charity from this fundraiser. It is particularly meaningful to have local organisations based in our community supporting local projects”.

Westfield Manukau City Marketing Manager Kathryn Heard, saluted the generous support of Manukau City’s shoppers.

“As keen supporters of the communities

we operate in, we are thrilled to be able to provide the venue for this fund raising effort. We were so delighted to learn that the donations received are going to be used to purchase invaluable equipment for the new Intensive Care Unit, under construction at Middlemore Hospital”.

In the three years Westfield has been hosting the Christmas wrapping fundraising programme at Westfield Manukau City shoppers have raised close to $20,000 for the SAHF.

Westfield Shoppers Make a Difference

An ongoing project here at the Foundation is to be able to provide packs of new knitted clothing to some families when they leave Middlemore Hospital with their newborns.

We are so fortunate to have over 300 regular knitters on our database who frequently donate the most welcome parcels of bootees, bonnets, blankets, jackets and toys.

A small group of volunteers then work tirelessly 1-2 days each week, here at the Hospital, making up the gift packs ready for distribution.

If you would like to know more about our wool programme or join this keen team of knitters, please call Nicki Winn on 09-2708808.

(We are also always looking for donations of wool that we can pass on to our knitters).

Wool Programme - Maybe You Can Help…

Pictured is Michelle Kidd from the South Auckland Health Foundation receiving a cheque from Kathryn Heard, Marketing Manager of Westfield Manukau.

Middlemore Hospital Gifted a New Diagnostic Tool

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Over 180 people crowded into the Papatoetoe town hall to hear presentations on exciting new initiatives in the mental health and addictions sector.

Presentations and posters competed for a total of $5000 in awards towards work-related travel, study grants or resources for services. They were judged on the day by two judging panels.

His Worship Len Brown, the Mayor of Manukau City Council presented the awards to the poster winners and Professor Rob Kydd, Department of Psychological Medicine, University of Auckland presented the awards to the oral presentation winners.

The 180 people in the audience could cast a vote for the People’s Choice Awards for the best presentation and best poster. A beautifully carved trophy for the overall People’s Choice award winner was provided by CHAMP (Counties Manukau Mental Health and Addictions Partnership involving NGO and CMDHB services). CHAMP co-sponsored the event along with CMDHB Mental Health and Addictions Services and Manukau City Council.

It was an excellent opportunity to share innovation and excellence across the sector.

Celebrate Innovation and Excellence was the second such event in the CMDHB region and planning is already underway for the next one in 2009.

WINNERS Oral presentations

First: He Kaakano. Flying Differently: Putting community innovation into action. Hinemoa Elder, He Kaakano, Whirinaki Child and Adolescent Services, CMDHB.

Second: South Auckland Youth Stand Up! - Ben Birks, Wayne Fergusson,

Odyssey House and Nicola Woodward, CMDHB

Third: Family Peer Support Volunteer Program - Jade Caulfield, SF Auckland - Supporting Families in Mental Illness

PostersFirst: Mental Health Services Leading the

Way with Consumers on Recruitment Panels - Shirl Corles Davies, Senior Consumer Adviser, CMDHB

Second: Consumer Activities and Events at Tiaho Mai - Alexander Stevens, Tiaho Mai Acute Mental Health Unit, CMDHB

Third: Healthy Mind, Healthy Body: Healthy Lifestyle Programme

- Diane Bartlett and Simon Huges, Challenge Trust

Peoples Choice – Oral Presentation South Auckland Youth Stand Up! - Ben Birks, Wayne Fergusson,

Odyssey House and Nicola Woodward, CMDHB

Peoples Choice – Poster and CHAMP Trophy for Overall People’s Choice Award WinnerThe Adventures of A Cute Service - Bruce Dumper, Fiona Warwood, Johnny

Angel, Carlos Tuiletufuga, Maka Mesui, Daphne James Francis Arts, Shavneel Chand, Densie Newell, Peer Support Specialists, Pathways Trust

Winners of the CHAMP Trophy for People’s Choice for their Pathways Trust poster “Adventures of A Cute Service” Left to Right: Ross Phillips, Sarah Bell, Johnny Angel, Hydie Balle, Bruce Dumper, Daphne James and Andrea Williamson

Mental Health and Addictions Sector in the Counties Manukau Region Celebrate Innovation and Excellence

The 2008 International Diabetes Federation Western Pacific Region Congress ran in Wellington at the beginning of April. Over 1,700 delegates registered for the Congress making it one of the biggest health-related conferences ever held in New Zealand.

The theme of the Congress is Asia Pacific: Working for Solutions and catered to a range of interests from people with diabetes, primary

healthcare workers, researchers and specialists.The Counties Manukau region and the

Let’s Beat Diabetes Programme had a strong presence at the Congress with oral presentations from Dr Brandon Orr-Walker, Let’s Beat Diabetes Medical Director, on Community Intervention to Manage Diabetes and Amanda Dunlop, Let’s Beat Diabetes Food Industry Accord representative on Increasing Fruit & Vegetable Consumption a Multi-Pronged Intervention: The “Fresh For Less” Campaign in Counties Manukau - a Let’s Beat Diabetes initiative. Poster presentations were on display from the CMDHB on Diabetes Care Support Services: GP Quality Improvement Audit

2007-2008 and from Let’s Beat Diabetes on ‘Challenges and Learnings from Implementing the LBD Strategy.’

The Diabetes Projects Trust presented a number of posters including: the Healthy Tuck Shop Model meets Ministry of Health Food & Beverage Guidelines, Otara Healthy Kai Programme, Get Wise to Health Programme, The Diabetes Project Trust also presented their latest DVD resource “Shop for your life”.

Copies of these presentations abstracts and posters will be available for viewing on the Let’s Beat Diabetes website: www.letsbeatdiabetes.org.nz

Local flavour at International Conference

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Local flavour at International Conference

A recent pilot project run out of the Adult Rehab and Health of Older Peoples Service has shown that intensive nutrition support can improve the nutritional status of older people living in our community.

Previous New Zealand studies have shown that Meals on Wheels alone may not provide sufficient nutrients to support older people to maintain their independence. In particular, for those whom are already underweight or are at high risk of malnutrition due to chronic disease.

The six week “Meals for Independence and Rehabilitation Programme” piloted in the CMDHB urban area in 2007 provided home-delivered meals and intensive nutrition education. Twelve older people completed (thirteen participants started and one lost to follow up) the programme which proved to be easy to deliver and well received by older people.

The aim of pilot was to see if it was practical to deliver the 6 week programme, which

included Meals on Wheels and additional chilled and frozen meals. Changes in the participant’s functional ability, nutritional status and quality of life were also measured at the end of the programme.

Home Service and Needs Assessors at Middlemore Hospital identified the majority of participants who could most benefit from the programme. Participants had to be at risk of or suffering from malnutrition, be living independently in the community, have the ability to set and achieve their own goals and be over the age of 65 yrs (over 55 years if Maori or Pacific People).

The meals included standard Meals on Wheels along with a chilled snack meal delivered by the Red Cross Volunteer Drivers. Frozen meals were also provided for the first 2 weekends of the programme. Participants were prescribed nutritional supplements if additional nutrients were required.

A Dietitian specializing in gerontology nutrition provided intensive nutrition education and monitored each participant’s weight over the 6 week programme.

Participants ages ranged from 67 to 98 years with an average age of 79 yrs, the majority

of participants were women (69%) and the most common diagnosis was COPD (45% of participants)

Results from the programme saw an increase in the participants’ functional ability and quality of life and a significant improvement in their nutritional status. Over half of the participants (58%) who were on Meals on Wheels at the start of the programme returned to being independent with their meals after 6 weeks. The programme ran from June to October and it was exciting to see that of the original 13 participants only one was admitted to hospital.

Feedback from participants indicated that at the completion of the programme they had a much better understanding of the nutrition required to maintain their health and indicated they were able to follow through with suggestions for easily prepared meals.

Based on the success of this programme it will now be piloted in the Pukekohe Community over the next 6 months.

If you would like more information on this programme please contact:

Kaye Dennison, Clinical Specialist Dietitian, AT&R Unit Email: DennisK@middlemore.co.nz

Pilot Study - Helps Older People in CMDHB to Maintain their Independence.

With 1 in 10 people world-wide suffering with some form of kidney damage, World Kidney Day is a timely reminder to everyone of the importance of healthy kidneys.

Counties Manukau DHB helped promote World Kidney Day with a stand at Hunters Plaza Mall in Papatoetoe.

With High blood pressure and diabetes being the main causes of chronic kidney disease, free blood pressure checks and health information were being offered by Renal Nurse Specialists Hannah Cattaway, Denise Beechey and Nogi Eiao.

Through the generous support of local

sponsors, shoppers at the mall were enticed over to the World Kidney Day promotion with free bottles of water and goodie bags. This allowed the nurses to be able to promote the importance of healthy kidneys as well as the importance of early detection of Kidney disease.

Both Hannah and Denise estimate they met over 500 people in the mall that day.

“People were lining up for free blood pressure checks, the response was overwhelming”, said Hannah.

People were also encouraged to answer a simple kidney quiz (to win a drink bottle) which allowed the opportunity for more discussion on the importance of good kidney health.

All it takes is a simple blood pressure check or urine test to see if you are at risk of kidney disease. Both of these can be easily arranged at your local GP practice whilst you wait.

Back at the hospital all the renal nurses on the Ward 1 wore World Kidney Day tee shirts in support of the day.

Planning will now begin for World Kidney Day 2009!

“Amazing Kidneys” - World Kidney Day March 2008

Denise Beechey and Hannah Cattaway (white tee shirts) with two Papatoetoe Ambassadors.

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The population of New Zealand has changed a lot in the past decades due to immigrants and refugees arriving from different countries including China, India, Korea, Burma and Laos.

In 2006, the Asian population in New Zealand reached 8.5% of the total population. 66% of the Asian population lives in the Auckland region which makes it the second largest population group in Auckland. The Chinese (45%) are the largest Asian group in Auckland, with 27% of Indian and 9% of Korean respectively. It is expected that further immigrants and refugees will continue contributing to the growth of the Asian population in New Zealand.

In Counties Manukau, 16.1% of its population identified as Asian in 2006. Although Counties Manukau DHB has a high proportion of Asian people in our catchment area, the access of Asian people to mental health and addiction services are the lowest of all populations. In order to address this, one of the actions stated in the Counties Manukau DHB’s Mental Health & Addiction Action Plan for 2006 – 2010 is to develop strategies to improve the responsiveness of mental health and addiction services to the needs of Asian people and to ensure Asian people have equitable access to mental health and addictions services.

The Asian Service Development Coordinator role has been developed to take a lead role in developing the strategies to address this need and to develop an plan to ensure that these strategies are met. Priorities have been

identified and they include: improved access pathway for Asian clients; ensuring that mental heath information is available in different Asian languages to assist with improving access and on how to get help; ensuring that mental health clinicians have the competency to deal with the needs of Asian people and finally enhancing community based support for Asian people with mental health issues.

I am very glad that I can work as the Asian Service Development Coordinator as I have always wanted to help my community and this

is where my passion lies. If you are interested to know more about any further service development of Asian mental health in Counties Manukau DHB, or you would like to receive a copy of Asian mental health newsletter, please feel free to contact me through my email address: kos@middlemore.co.nz or contact me by phone on 09 5380700. I am based at Te Rawhiti Community Mental health Centre in Highland Park.

Asian Mental Health Service Development

Approximately 160 health professionals attended the New Zealand Lactation Consultants Association Conference in Wellington over three days.

The event was a huge success and many thanks must go to the major sponsors Fisher and Paykel and the MOH (HEHA).

Throughout the conference there was a lot of support for the Baby Friendly Hospital Initiative (BFHI) and emphasis

on basic clinical skills. The conference was a wonderful learning opportunity for people new to lactation and those preparing for the IBCLC (International Board of Lactation Consultant Examiners) exam to hear internationally recognized lactation consultants, authors and lactation researchers from Australia, the US and the UK speak about their expertise.

The theme of the NZLCA Conference was “Breastfeeding and Family Wellbeing”. Current breastfeeding initiatives, relevant research, expert clinical practice and differing cultural needs were highlighted

throughout. Presentations acknowledged the positive effects of breastfeeding on mental health, relationships and the health of our indigenous and migrant families.

Our three Primary Maternity Units are BFHI accredited and we are now working towards this status at Middlemore. 62 Maternity facilities in NZ have BFHI accreditation. (See www.babyfriendly.org.nz).

This conference was a great forum to network with lactation professionals from around New Zealand and overseas. It provided an opportunity for all attendees to greet, share questions/answers and enjoy new friends with a common passion.

Angela CarpenterMidwife Clinical Specialist-Lactation CMDHB

Kitty Ko (Asian Service Development Coordinator).

NZ Lactation Consultants Association Conference 2008

CONNECT | PAGE 11

Asian Mental Health Service Development The CMDHB 2008 Wellness Programme Starts With a Bang!

RetirementsHeather Hawthorne the ward clerk for the DOSA (Day of Surgery Admissions) Unit in theatre has retired.

Heather was employed at CMDHB for many years as an ECG technician and then as a ward clerk in orthopaedics (Ward 18) and finally in DOSA from 2001. Heather was always a great contributor to the “fun” or celebratory occasions days the hospital had - funny hats, Americas Cup, Christmas, St Patrick’s Day, etc - she would always dress up and decorate DOSA, often with prize-winning results. Survey Thanks

Thank you to all staff who participated in the Connect survey. Your feedback was much appreciated and changes are being made to the way you are receiving Connect.

If you have any further comments or suggestions please feel free to send an email to lryoung@middlemore.co.nz.

Richard Girling and Michelle Leigh (Smoking Cessation Specialists) have recently joined with CMDHB to establish Smoking Cessation Services across CMDHB’s mental health services, including the Non-governmental Organisation Sector.

The role will entail implementing Smoke Free Systems First Model. The pilot will run over a period of 12 months & is a joint initiative with

CMDHB’s Smoke Free Service, Mental Health Planning & Funding & Counties Manukau Mental health & Addiction Partnership. Our goal – Smokefree Mental Health Services 2010.

Congratulations to Jessie Crawford who has just become a Nurse Practitioner. After an exhaustive interview in Wellington Jessie was told that she would become New Zealands 46th Nurse Practitioner. Jessie says “it has been a very long and sometimes difficult journey but it is so good to have achieved this goal. It is now time to define my role and move into this.” She would like to thank ProCare and CMDHB staff, especially DON Denise Kivell, for their support during this journey.

New Appointments

FunctionalAge™ health checks started in February and will run through until May, or as needed.

It’s a great opportunity to either have your first health check, or check in on your health changes since last time. A health check at least every three years is recommended by best practice guidelines so take advantage of this free to staff offer. Book online by clicking the Wellness Portal link from SouthNet, then select your preferred testing date and location.

We’ve had great feedback from some CMDHB employees making amazing improvements to their lifestyle and benefiting from huge health improvements. If you have a story to share email lisa.reardon@azion.co.nz.

Here’s just one of the success stories:Russell Neal, based at Middlemore

Hospital, has made many small changes to

his lifestyle since July last year adding up to some impressive improvements! At only 36 Russell thought ‘if I don’t lose weight I’m going to be in a wheelchair by the time I’m 50’. It was this, feeling disgusted with himself and finding it hard to find clothes to fit that prompted him to embark on his journey. Since then, Russell has lost 25kg through regular low-impact exercise (walking & a cross trainer) and changing his food choices.

Russell found motivation a constant battle - “one of the hardest things was keeping up my motivation over a long period of time; staying positive and not feeling bad if I had a setback”. Like so many others he hit a plateau after a time; taking up the challenge Russell changed the type and intensity of his workouts and was soon making forward progress again. Part of Russell’s successful strategy involves having two rest days a week from exercise and one day a week where he eats what he wants. He also had a

goal to go on holiday at end of the year.Russell says the best things about his

improved health are getting rid of big clothes, feeling better and happier in himself and having more energy. He has also noticed an increased respect from others as he is now wearing smarter clothes and feels more confident. Others also benefit as Russell now says he’s ‘not so grumpy”!

Tips from Russell:• It’s important to pick a day to start

and stick to it;• Planning is really important - have a

meal plan for week, get in the right groceries and read labels.

• Positive ‘self talk’ is really important, and;

• If you have a setback just get right back into it.

Try changing one thing in your day that will boost your health and energy and see what a big impact repeating one small thing consistently, has by the end of the year!

We wish her good luck and good health in her retirement.

CONNECT | PAGE 1�

We are especially interested in contributions from our community partners.If you have a story you would like to contribute for Connect please email it to the Editor at: lryoung@middlemore.co.nz

If you have ever had the pleasure of being a patient in an emergency department then you’ll appreciate that there are two or three key things that you want to happen while you are there. You probably want to be seen as quickly as possible and you’ll want to be treated safely, to the highest degree of clinical care. These also happen to be the goals that clinicians strive for.

Of course there are also forces at work that compete with those aims, forces that challenge staff on a daily basis. The ever-increasing and variable patient load that comes through the front door of Middlemore, for example, in terms of both numbers and the acuity/complexity mix is one of them. Add to this other factors like inpatient ward work, theatre loads, bed occupancy and staffing numbers and you have quite a complex challenge. Finding a way to match these competing forces and designing smarter ways of working is the aim of the patient flow project.

Over the past 12 months the Quality Improvement Unit, headed by Dr Mary Seddon, Director, and Allan Cumming, General Manager, have been working with staff from the emergency department, medicine, surgical services and mental health to improve delivery of care processes. A fundamental belief of quality improvement is that every system is perfectly designed for the outcomes that it achieves. Over the years clinical and non-clinical staff alike, have strived tirelessly to deliver the best possible care for the patients they look after. Systems have previously been ‘redesigned’. However, whenever the work-loads get stretched too far we need to step

back, review the way that we do things and ask some basic questions.

A key part of this process has been the involvement of the staff in order to get the changes designed and driven by the nurses, doctors, HCA’s and clerical staff that have to make the systems work. They understand it better than anyone else and know what needs to change. Ultimately we are all focussed on the same goal; that is to deliver the right treatment to the right patient at the right time and their input is vital.

By improving both the time taken to see patients (according to their triage category) and the total time that patients spend on their journey through assessment, treatment and discharge, or admission to a ward and onto discharge, we hope to improve outcomes and reduce clinical incidents.

Emergency Care, or EC, is the front end of the system and this is where problems throughout the hospital will often surface, even if the cause is elsewhere. One example of this is ‘access block’. Once a patient requiring admission has been worked up and treatment initiated they then will require access to an inpatient bed. Working on downstream components from EC starts with the linkages into the rest of the hospital, the other specialties like medicine, cardiology, surgery, orthopaedics, plastics, gynaecology and mental health.

By taking a whole systems approach we are able to focus earlier in the process on the likely outcome of the patient. By giving an early ‘heads up’ to Daily Ops, the ward is able to prepare for a likely admission earlier than normal and before the inpatient team have fully worked the patient up. The intention of giving an early indication of likely admission is to avoid last minute rushes and surprises, while trying to smooth the admission and discharge loads more evenly over the course of the day. Staff

are then able to work at a more measured pace. The measure of success in clearance of patients through the ‘front end’ of the hospital is the six hour target for patients to be either admitted or discharged from EC.

Other changes include the development of an early assessment process, nurse-driven protocol care for Chest Pain, Asthma, and Extremity Injuries, extension of Exercise Stress Testing times and the development of an SMO Patient Flow Supervisor role.

Over the past summer we have experienced the highest-ever seasonal patient loads and staff have worked fantastically well to keep up. However, we need to continue our quality improvement work at pace to ensure that we are best set up for the coming winter months and there are many improvements that are being driven through in terms of process and role redesign, bed reconfiguration and additional resourcing.

There is no simple or quick fix and without the high levels of staff commitment and hard work seen already it couldn’t happen. We just need to keep the good work up and the goal in sight.

Kris VetteSenior Quality Improvement Manager

The Quality Improvement Unit and the Patient Flow Project.