THE OFFICIAL MAGAZINE FOR AUCKLAND DHB

OCT/NOV 2017

InsideHealthy Homes Initiative Auckland City Hospital’s Level 5 refurbishmentCelebrating the Starship simulation programme Improving safety in mental health services

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Celebrating Te Wiki o te Reo Māori Māori Language Week

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CEO Column

Staying connectedAilsa ClaireChief Executive

We’ve had some record numbers of patients coming to our hospital throughout 2017. Almost every department has experienced increased workload, both those that are directly patient focused and those which support the organisation.

This is a direct result of the population increasing at a rate we have not experienced before, people are getting older, and standards are always improving and services developing. We also provide care for the Northern Region and New Zealand’s most complex patients. The volume and acuity of these patients is also increasing, placing further pressure on our services.

We are working with our regional partners to look at our long-term plan to deliver services differently in the future. We’re also looking at what we need to do in the short-term to continue to care for our patients safely and ensure the wellbeing of our employees.

You can hear more about this at my Staying Connected Sessions, see page 3 for the dates.

I continue to be overwhelmed by the determination of our people in all areas to do the best we possibly can for our patients.

Despite the increase in demand there are so many improvements and innovations taking place. I’ve been delighted to read about many of these in the applications received for the Health Excellence Awards this year. I look forward to celebrating with our winners and finalists at the Awards evening in November.

I’ve also been impressed with the proud moments our people have been sharing on Hippo (our intranet site). I encourage you to take a look at these as well as to take a minute to reflect on the great things you have done within your role, and add these to our proud moments.

I am proud to be part of a team where so many people are leading and embracing change to help us continue to deliver world-class healthcare.

On the cover: Ailsa Claire celebrates Māori Language Week with the AkoAko girls.

“I left a message with the sleep clinic, and the employee who called me back was very empathetic about my situation and despite my hesitation, she suggested that I try a different piece of equipment. She offered to send it through and when I received it I knew that she knew about these things and the item turned about to be exactly what I needed. Thank you very much for caring for me and the other patients relying on your service for their health and wellbeing.”

– L.

“I recently had a few months in the Fraser Macdonald Unit, and would like to express my sincere thanks for the excellent care I received from ALL staff including doctors, nurses and ancillary personnel. I think the Auckland DHB is to be congratulated on having such a fine facility with its background on to the domain and its pleasant garden. Please pass on my grateful thanks.”

– P.

“Lovely staff of ward 63: Thanks for your kind cooperation while my dad was under your treatment. He is fine now and settled back after my mother’s death. Our blessings are always with you. ”

V family.

news in brief news in brief news in brief

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Long Service AwardsOur Long Service Awards recognise and celebrate 20, 30 and 40-plus years’ service by our people. It’s our way of thanking our employees and showing we value their dedicated service. The awards are made possible thanks to the generous support of A+ Trust.Long service doesn’t have to be consecutive. If your total time with Auckland DHB adds up to 20 years or more, we would like to celebrate your service. Our next long service celebration events will take place in November 2017. If you haven’t received your invitation yet and believe you’re eligible for recognition, please contact AskHR@adhb.govt.nz. Sometimes HR records may not pick up the service before a break.

Staying Connected Come along to one of the Chief Executive road shows where you can hear Ailsa talk about the budget, patient demand and our plans going forward, as well as other key organisational news. The sessions are for everyone in the Auckland DHB team:

Wednesday 25 October: 1.30 – 2.30pm, Henley Room, CEC, Level 5, ACHWednesday 15 November: 12 – 1pm, Auditorium, CEC, Level 5, ACHTuesday 5 December: 8 – 9am, Liggins Theatre, Level 1, Building 16, GCC

Staying Connected is also an opportunity for you to ask questions – so put one of the dates in your diary and join in the conversation.If you have any questions please email communication@adhb.govt.nz

Patient Safety WeekThis year Patient Safety Week focuses on medication safety, to avoid harm resulting from people taking the wrong medicines.‘Let’s talk medicines’ is about encouraging conversations between health professionals and consumers.Auckland DHB will be joining the Health Quality and Safety Commission, and the other DHBs in encouraging patients to ask three important questions:

What is my medicine called?What is it for?When and how should I take it?

These questions act as prompts for wider conversations about things like side effects, the impact of stopping medicines, or taking several medicines.Patient Safety Week runs from 5 to 11 November 2017. Look out for how you can get involved on Hippo and in Our News.

Teddy returned to rightful owner thanks to Starship FoundationSocial media followers of the Starship Foundation jumped into action when an album was posted in August featuring a cute gang of special soft toys who were seeking their rightful owners. Each of them arrived at Starship with a patient or family but got separated while at hospital, eventually finding their way to the Starship Foundation team who put the word out on Facebook and Instagram in the hope that they could be reunited.

The Starship Foundation’s Facebook post was shared 450 times, reaching close to 60,000 people. But best of all, the album cover teddy was quickly recognised and returned to young Georgia. Her Mum Aimee says: “She is delighted to have him home, and would like to say a big thank you for helping to spread the word.”

Follow the Starship Foundation at facebook.com/starshipfoundation

local heroes is kindly supported by A+ Trust4 / NOVA / OCTOBER/NOVEMBER

localheroesOur Congratulations to our August and September local heroes: Rachel Gatland, Cardiac Sonographer and Renee Rangi, HR Coordinator. Rachel was nominated by a colleague who said: “Rachel always goes the extra mile to fit patients onto cardiology outpatient lists to ensure patients receive an echo – which is often the most important diagnostic tool in cardiovascular disease. Recently, she worked really hard to ensure a young patient with significant valve disease had an urgent echo. This ensured the patient was referred in a timely manner for valve replacement surgery which will enhance her quality of life. Her ‘can do’ attitude is an example of how our Allied Health workers are an integral part of our patients’ pathway and experience. Her display of our Auckland DHB values about working together for our patients and aiming high to provide excellent care is a credit to her profession.”

Here is what two colleagues said when they nominated Renee: “I hear Renee on the phone – she is always courteous and polite, without being over the top. She’s very conscientious, I hear her discussing tricky questions with her manager, her communication skills are awesome and she is often the last one left in the office at the end of the day. She is such an asset to the Ask HR team. Renee’s customer service stands out! Whether it’s her great telephone manner or follow up on customer requests to ensure they get a timely response. She is also able to respond to and deliver high volumes of recruitment documentation and her knowledge of our recruitment processes, and willingness to share that as a mentor, with her colleagues, is greatly appreciated and often acknowledged by the team. Renee is one of those people who enables others so that together we’re achieving much more than we would as individuals.”

Please keep your stories about our local heroes

coming in. To nominate go to: www.adhb.health.nz.

Well done to everyone nominated as a local hero – thank you for living our values!

Aneesh SukumaranCecille VillaluzElizabeth WaiariHeather SimsJade CowleyJohn AndersonKaren Beckett

Local Hero Award winners Rachel Gatland (left) and Renee Rangi (right) receive their awards from Chief Executive Ailsa Claire.

Karen HodsonLapasi (Pasi) UilavaiLeota Te NgaioLinda ChalmersMegan Tennant HumphreysNeal Driver

Paul MooreRichard DooceyRichard WatkinsonRoslind DeviRuby LoweSara Tipi-RopetiShanti Devi

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Healthy Homes InitiativeKainga Ora is a free service, run by Auckland and Waitemata DHBs, which supports low income families to have warmer, drier and healthier homes through a mixture of social work and interagency collaboration.Healthy Homes may be able to assist with the following interventions: Education on keeping homes warm and dry, social work, insulation, ventilation, curtains, carpets, heating, bedding, budget services, Full and Correct Entitlement Assessments (FACE), support with social housing applications, and minor repairs (window repairs, draught stopping, and installation of smoke alarms).Eligibility and referralsWhānau that fit the criteria are eligible for our healthy homes service. Referrals can come from health professionals, or whānau can self-refer. We are happy to take calls regarding eligibility. Once a referral for whānau is received and accepted, initial contact is made by a member of the Healthy Homes team. They

Partnering with parents and caregivers to be food allergy smart

We are encouraging parents and caregivers of Starship inpatients to partner with us in being food allergy smart by checking their child has the right meal for them before they start eating.Starship has worked with the Auckland DHB Communications team to create posters, admission pack inserts and food tray cards to deliver this important message to caregivers. Distribution of the posters, admission pack inserts and tray cards began in mid-August and will continue on an ongoing basis. This is just one of the many ways Starship partners with parents and caregivers to ensure the safety of their children while in our care.

will make an appointment to do a home assessment with the family.Referral forms and more information can be found on the service’s Healthpoint page.

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Celebrating Te Wiki o te Reo Māori | Māori Language Week

September events at Auckland DHB

In September, Te Toka Tumai Auckland DHB celebrated te Reo Māori with the rest of Aotearoa New Zealand. This year’s theme was Kia ora te reo Māori, which not only plays on our national greeting kia ora but means literally, ‘Let the Māori Language live’. Proudly greeting people with kia ora is a special part of our Chief Advisor Tikanga, Naida Glavish’s story. Te Reo pronunciation and waiata workshops, nga kaikōrero (guest speakers) and a daily competition with the AkoAko girls were some of the highlights of the week. The competition saw employees using the kupu (word) of the day in videos shared on social media. Congratulations to our Urology team for their winning video.

The kia ora storyFrom the 1970s, Māori words began being increasingly heard on radio and television, and read in newspapers. The first Māori television programme, Koha, was broadcasting from 1980. Some announcers began radio shows or news bulletins by saying kia ora. But there was some controversy... In 1984 national telephone tolls operator Naida Glavish (of Ngāti Whātua) began greeting callers with kia ora. When her supervisor insisted that she use only formal English greetings, Naida refused and was demoted.The issue sparked widespread public debate. Not everyone was keen to hear kia ora used commonly, but many others came out in support of Māori greetings. People called the tolls exchange to speak to ‘the kia ora lady’, and airline pilots began to use the term to greet passengers. After Prime Minister Robert Muldoon intervened, Naida returned to her old job. Eventually, she was promoted to the international tolls exchange, where she greeted New Zealand and overseas callers alike with kia ora.We are proud to have Whaea Naida working with us as Chief Advisor Tikanga for Auckland and Waitemata DHBs.

Naida Glavish, Chief Advisor Tikanga with Riki Nia Nia, GM Māori Health with guest speakers Atawhai Tibble (second left) and Mahana Toka and Glenda Taituha (first left and first right).

Clockwise from top left: : Dietitians’ Day, International Translation Day with our Interpreter Service, World Pharmacy Day, Speech Language Therapy Awareness Week, talking about early identification on World Sepsis Day, World Physiotherapy Day, Social Workers’ Day.’

Leevonia Meredith, Shelley Sebastian, Cyndy Brown, Michael Rice, Ian Mundy and Sum Sum Lo from Urology and Orthopaedics celebrating their winning video at a morning tea with Surgical Services colleagues, and Naida Glavish, Chief Advisor Tikanga, Auckland and Waitemata DHBs.

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Auckland City Hospital’s Level 5 refurbishmentIn 2014 we talked to over a thousand patients, visitors, family, employees and neighbouring communities about what they would like to see when entering Auckland City Hospital on Level 5. The aim was to use the feedback to create a space that would make people feel welcomed when they arrived, that would be easy to navigate and to provide a range of useful services and eating options. Following the opening of Carpark A, the majority of patients and visitors arriving at the hospital do so through Level 5 and the retail area. This route was often difficult to navigate with many patients and visitors needing frequent directions from employees. With the feedback we received from our survey and engagement activity, the area was reviewed from a functional and cognitive impairment perspective where several issues were identified that needed addressing. In general, the area was both visually and acoustically too busy. For example, high colour contrast flooring and overly reflective flooring can appear like a step to the visually or cognitively impaired, and light reflecting off the floor can look like a pool of water. Both represent a barrier and potential hazard. Additionally, most of the retail outlets couldn’t accommodate a wheelchair or pram.In order to address these issues and simplify the entry point so that people coming in with complex needs or who may be stressed or anxious can easily make their way through the retail area, a group of both internal teams and external organisations worked together to create solutions. With patients at the centre of the redesign, this group looked at ways in which this space could be improved. Multiple programmes such as our values, Security for Safety and the transfer of food services to Compass needed to be taken into consideration.

So what’s changed on Level 5?The Muffin Break was refurbished and replaced with Jamaica Blue at both Grafton and GreenlanePlanet Espresso moved to a larger and lighter location which is more accessible and will enable a direct route from Carpark A through the retail area

Retail outlet opening hours were extended into the evenings to better meet the needs of patients and visitors The retail pharmacy was reconfigured to make it more accessibleNew flooring has been put down in the level 5 area to remove the reflective and inconsistent surface which was in placeThe Paper Plus pop-up shop has opened with improved natural light and accessible layoutWheelchair bays are now at the main entry points

Going forward, there is still some work to be done as we fix flooring, paint walls and make other minor changes. A big thank you to those who have contributed with feedback or as part of the process, and to all of you for your patience throughout the refurbishment!

The new Planet Espresso coffee bar on Level 5.

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What’s small, square, fits on your desk and is helping to save the planet?At Auckland DHB we are committed to reducing our carbon footprint.

Our vision for the future is to reduce greenhouse gas emissions, energy use and waste. By reducing emissions, we will have a positive impact on our environment, and the health and wellbeing of communities in which we all live and work.The rollout of desk cubes and tri-bins at Auckland City Hospital and Greenlane Clinical Centre is yet another initiative aligned to our commitment to environmental sustainability.

In August, over 3000 desk cubes and an additional 155 tri-bins were rolled out by our Waste Management team at both sites. As part of the rollout our waste orderlies and cleaners went through training on the correct use of the desk cube and tri-bins. The desk cubes are designed to be the perfect size for landfill waste such as tissues, food scraps and lunch wrappers. Once the desk cube is full it is then emptied into the landfill section of the tri-bin.

Red section goes to landfill; the following items should be placed here: • Anything that is dirty or contaminated by food i.e. coffee cups, pizza boxes • Paper towels• Polystyrene lunch boxes• Plastic wrappers and bags• Paper cups and lids• Plastic cups• Straws• Take out containers

Yellow section is for hard recyclable items such as: • Tins and aluminium cans• Plastic bottles• Glass bottles• Jars• Milk cartons• Plastic tubs• Juice cartons• Aluminium foilBefore you recycle please make sure the items are clean and empty

Blue section is for soft recyclable items such as:• Scrap paper• Notebook paper• Newspapers• Magazines• Envelopes• Junk mail• Soft cardboard• Soft boxes

What rubbish goes where?

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A visit to the PopeThere are many amazing people doing amazing things every day at Auckland DHB. One of these people is Jo Dysart, Huntington’s Disease Nurse Specialist. Jo has worked with families affected by Huntington’s since 1993 both here in New Zealand and the UK. But it is more than a job for her. “It is a passion to advocate for people with the disease and make sure they get the very best outcomes,” says Jo, who is also the General Manager of the Huntington’s Disease Association (Auckland). “We have a great health system in New Zealand but because Huntington’s Disease is genetic, confidentiality is a huge issue (with disclosure) so it’s a disease that keeps people in the shadows. If one of your parents has the disease there is a 50 per cent chance you will get the disease,” said Jo. To help break down the stigma the disease carries, an international coalition of Huntington’s patient advocates and organisations were invited to a meeting with Pope Francis I in May this year. Jo wanted Auckland DHB Huntington’s families to be part of the meeting.Thanks to generous donations from the Neurological Foundation and The Hugh Green Trust, five families were able to make the trip to Rome.“It meant so much to the families who went to Rome,” said Jo. “It was a privilege to be part of the trip with so many courageous families. I met an amazing South American women whose husband and five of her children had all died from Huntington’s Disease and she was caring for four other children with the disease.” The hardest thing was leaving some of the families behind.” To make the families who couldn’t go on the trip feel a part of it, Jo invited the Huntington’s community to a presentation at Auckland City Hospital. It was an opportunity to share the message of hope and to see the screening of Pope Francis’ special audience with the Huntington’s Disease Community.In solidarity with South America, Jo also brought back rosary beads blessed by the Pope for all the Huntington’s families. Distinguished Professor Richard Faull, the Patron of the Huntington’s Disease Association, said “When Jo told me she wanted to take Auckland DHB people to meet the Pope I knew they would be going. Jo is a person who makes things happen! There were people there from many cultures and religions. Religion didn’t come into the experience it was about humanity and the care the Pope showed for the people who have been touched by the disease. This trip has been transformational and has changed the lives of the people who went. Jo is an angel for making this possible.”Steve was one of the carers who went to meet the Pope. Steve looked after his wife for 20 years as she battled Huntington’s Disease and he now cares for his two sons both in their fifties who have the disease. “I was shocked when Jo rang me to say we are going to see the Pope, it was a dream to meet him – one of the highlights of my life,” says Steve. I’m nearly 80 and caring gets harder as you get older, I’m faced with lots of challenges every day. The help I get from Jo and the team makes it easier. Visiting the Pope has recharged me, it was a great privilege that will stay with me forever.”The main symptoms of the disease are a change of normal personality, this can be one of the hardest thing for families and loved ones to cope with. Memory and cognitive function starts to be lost and a terrible movement disorder develops which gradually worsens until coordinated movement

becomes difficult and the person is unable to talk. The specific symptoms can vary between people. Talking about the future for Huntington’s Jo said, “There is no cure for the disease but some of the symptoms can be managed with medication and through lifestyle choices. We’re now getting to second generation Huntington’s Disease sufferers so we work with the genetics service on predictive testing so people can make informed choices about their future. If people are gene-positive we will work with them and provide support.”

The Huntington’s Disease Association works to improve the quality of life for each family affected by Huntington’s Disease. While there is no cure, the charity aims to help sufferers reach their maximum potential at each stage of the disease and provides support for their carers.

Richard Faull, the Patron of the Huntington’s Disease Association.

A Huntington’s family from Auckland DHB.

Jo Dysart, Huntington’s Disease Nurse Specialist meets Pope Francis I.

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Thank you for your care this winter

Dr Lester LevyBoard Chair

This winter season has been a very busy period for our hospitals across Metro Auckland. We have seen record numbers of presentations at our EDs and intense demand for healthcare services, exceeding forecasts by a significant margin.While we always expect winter to be busy, there is no question that the surge in patient numbers this year has placed a real strain on our hospital-based teams. I want to acknowledge all of you for giving your all to provide very high-quality services for our community during a particularly challenging period. This includes working extra hours to help out and demonstrating flexibility to allow us to meet this sustained need for care. Your commitment is recognised and very much appreciated.

I know a great amount of effort and thought went into how best to manage fast-emerging scenarios, with an overriding priority of protecting patient safety at all times. I also want to pay tribute to all those staff who played a role in the discharging process to ensure the flow through our hospitals was expertly managed according to what was best for individual patients.The reality is that while we do our best to forecast demand, the pressure on the front doors of our hospitals is famously difficult to predict. One thing is clear, however: the population of Auckland is growing rapidly and the need for care continues to grow year-round, not just in winter. The same growth pressure and demand is contributing significantly to housing affordability and the challenge of commuting right across the city.The high demand we have seen this winter reinforces the need for the three Auckland-based DHBs to work closely together on sustainable planning for future patient needs. I was very pleased to see the level of collaboration and joined-up decision-making to consider the overall picture in the Auckland region. This will continue to be increasingly necessary if we are to rise to the challenge of a larger, older and more multicultural population.Once again, thank you – the work you do and your commitment is recognised and appreciated.

Spreading some cheer on Christmas DayFor the last 14 years, members of the Auckland DHB team have been spreading some Christmas cheer at the Auckland City Mission. Organised by Jo McDermott, from Lab Plus, a small group of volunteers have spent their Christmas morning entertaining some of Auckland’s homeless and families in need at a Christmas lunch put on by Auckland City Mission.Entertainers have included, Margaret Wilsher, Sarah Parry, Trevor Anderson and David Rowbotham.This year Joe is looking for more entertainers to join him. “It’s

an opportunity to be part of a bigger team and really give something back,” says Joe. “We’ve had some great people involved with this over the last 14 years but it’s always good to get new faces involved. It means giving up a few hours of your Christmas Day but when you see the people in the room it really feels worthwhile,” says Joe.If you can sing, dance, mime and are willing to give up a few hours on Christmas Day contact Joe McDermott to find out more.

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Improving safety in mental health services

More than 200 Auckland DHB mental health workers have taken part in Safe Practice Effective Communication (SPEC), a national training programme to improve service user and employee safety in acute inpatient mental health services. The training teaches techniques to de-escalate and intervene and is based around a philosophy of knowing the person’s history so you can understand them as a person. “The four day training was a big investment for Auckland DHB with more than 200 people taking part,” says Mike Butcher, Allied Health Director for Mental Health and Addictions. “The content draws on local scenarios, making it relevant for the people taking part. The groups were really engaged in the learning and the feedback has been excellent, with people consistently rating the training as good or very good. Lots of people made comments about how energised and enthused the trainers were.”The programme uses a ‘train the trainer’ approach – 10 of our Mental Health registered nurses were trained by Master Trainers Kathy Moore and Richard Webber from Counties Manukau DHB.Anna Schofield, Mental Health and Addictions Director says: “We have rolled the training out to more than 200 employees

Richard Webber, Emal Saba, Cullum Millar, Michael Sethna, Andrew Tang, Katie Lowe, Rebecca Turner, Vicki Johnson, Pauline McKay.

Some quotes from those who undertook the training programme“When we first talked about this we talked about the potential challenges. The training went far better than I was expecting and none of those challenges eventuated. It was a well-built course.” – Rebecca Turner, Nurse Educator and trainer.

“People liked the group work, it really changed the dynamic of the course. People were really energised by the posters they created and have taken them back to their workplaces.” – Pauline McKay, Nurse Unit Manager and trainer.

“The master trainer system was really helpful. I felt more confident as a trainer and that sets the tone for a good course.” – Cullum Millar, Registered Nurse.

“It was great to see the confidence of the trainers grow. Finding their own stories or drawing stories from the participant makes it most interesting and relevant.” – Richard Webber, Master Trainer, Counties Manukau Health.

in 14 weeks. This is all down to our trainers and their commitment. The feedback from the people who have been trained has been phenomenal. In particular, people liked how the training was delivered and the inclusion of local stories. This is a huge step in continuing to deliver safe practices.”The training is being rolled out nationally, which means that if employees transfer between DHBs, they are ready to hit the ground running. The training is based on evidence-based practice on what works best. The training can change as new evidence or experiences come to light, but with a national governance group in place, any changes will be made consistently and on a nationwide scale. “It’s no mean feat rolling out a national programme and if we can do this training nationally we can do anything,” says Kathy Moore, Master Trainer.What next?While training a high number of staff has been a major accomplishment for the trainers, the employees, and the services involved, the next step on the journey is to ensure the skills and techniques learned are put into practice, as part of a cultural shift to reduce the use of coercive practices in mental health care.

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Values of ‘Respect’ and ‘Together’ evident in trauma careBack in 2003, Ian Civil introduced the DSTC (Definitive Surgical Trauma Care) course for surgical registrars and qualified surgeons. The course teaches time-critical decision-making and techniques to manage patients who have suffered major trauma through clinical scenarios and simulated practice. Trauma care is changing all the time, and the course also updates knowledge and information in the field of trauma care.“The training was always done alongside operating room nurses and we had really good outcomes practicing shared decision-making,” said Ian Civil, Head of Trauma and lead facilitator of the course. “However, we didn’t include anaesthetists and as key members of the Operating Room Team and we realised there was a gap.”“I heard about the DSATC (Definitive Surgical and Anaesthetic Trauma Care) course running in the Netherlands, so I went over there to participate. I was captivated by the relevance of having all the team involved and set about planning the first DSATC course in New Zealand,” said Ian.The course was held over three days at the Marion Davis Library and the University of Auckland medical school, with surgeons, anaesthetists and OR nurses from around the country taking part. The course is primarily about decision-making and relevant intervention in trauma, but it’s also about teamwork and communication. “Getting the teams to talk together as they are managing the injured patient in the lab is amazing to watch and represents best practice in professional care,” said Ian. Talking about his career choices Ian said, “I chose to work in trauma because it was seen to be a hard area to work in and that appealed to me. Trauma is complex and time critical. So, if I could be confident in trauma care then I know I could manage many other conditions. I’ve been a trauma teacher for more than 30 years,

I take most satisfaction from empowering surgical teams to use their skills and knowledge.”“Courses like DSTC and DSATC do save lives. One example is a DSTC participant based in Rotorua who was faced with a child who had a huge bleed on the brain. After speaking to the neurosurgeon he was able to perform the craniotomy. The procedure almost certainly saved the child’s life. I’m not sure he would have felt empowered to do that before the course.”Ian is planning the next iteration of the course which will include anaesthetic technicians, another important part of the Operating Room team.

About Professor Ian CivilIan is a Professor with the University of Auckland, a General and Vascular surgeon, and Clinical Director for Trauma Services at Auckland DHB.Ian joined Auckland DHB as a registrar in 1981, and then went on to work in vascular surgery and trauma in the USA for three years before returning to New Zealand. In 1990 he led the NZ Army Medical Team to the first Gulf War. Ian was also President of the International Association for the Surgery of Trauma and Intensive Care.

Prof Ian Civil with Anaesthetist Dr Kerry Gunn, who was one of the facilitators at the DSATC course.

Participants of the first DSATC course in New Zealand.

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A career in health and a passion to reduce inequitiesInterview with Riki Nia Nia, General Manager for Māori Health at Auckland and Waitemata DHBs. What has been your career pathway?I graduated with an honours degree in social work, social policy and sociology from Massey in 1994 and then went on to work at Child Youth and Family (now Oranga Tamariki). After one year, I moved on to Tairawhiti Healthcare and have worked in health boards for the last 20 years. In that time I’ve been the General Manager for Māori Health across all three Wellington DHBs and at the three Auckland DHBs. I also spent four years as the Manager of Public Health services in Whanganui DHB.

Who has been most influential in your career?Academically, it would be Prof Sir Mason Durie, who was my Masters supervisor at Massey University. He has also been a role model and set a gold standard in terms of contribution that I’ve aspired to achieve. I’ve also been fortunate to work for some really good Chief Executives, Joel George has been a great mentor. However, my approach to life has been mostly influenced by my upbringing, observing the many hours of community work my parents contributed to the people of the Tairawhiti.

What have been your career highlights?I have enjoyed watching the people I have worked with grow both in confidence and capability and seeing the important contribution they are making now. I’ve also been heartened by the change in the appetite of the health workforce to have more challenging conversations which surface bias and prejudice in our system, and more importantly allow us to collectively address these.

Why is it important to you to increase and develop the Māori workforce?Currently 4-5 per cent of our workforce at Auckland DHB identifies as Māori. That increases slightly to 7 per cent across all DHBs in New Zealand. Research shows that if our workforce is representative of our communities we will increase cultural intelligence and greater connectivity to our communities, and be better able to care for our population.We need to recruit people with the beliefs and standards that align with our values. While the right skills, experience and knowledge are essential we also need people who care about each other, care about the work they do and care about patients and whānau.

What are we doing to increase the Māori and Pacific workforce?In partnership with Waitemata DHB the recently formed Māori Alliance Leadership Team is working towards having a workforce that reflects our working age population. We are working with our communities to get young people interested in health so that they choose health as a career. We work with schools through the Rangitahi Programme and offer a number of cadetships and scholarship opportunities. Once they have joined us, we continue to help them grow and develop in their careers, just as we would with all our employees.We have also signed Auckland Council’s Youth Pledge which

We need to recruit people with the beliefs and standards that align with Auckland DHB’s values.

commits us to, increase youth awareness about roles in health, employ more youth, and become more youth ready and youth friendly.

What are we doing to reduce health inequities?More systematic reporting of our performance by ethnicity will continue to surface the inequities We must continue to innovate and try new things. What we generally find when we do that is access to health care improves for everyone. Where there is persistent and historical inequity we must become more deliberate and intentional to ensure we are working in a way that is effective for all our population groups – one size doesn’t fit all. Every small step we take to eliminate health inequities is an important one.

Riki Nia Nia, General Manager for Māori Health.

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Aucklanders urged to dispose of unwanted medicines safelyPeople with expired or unwanted medicines at home are urged to dispose of them through the Dispose of Unwanted Medicine Properly (DUMP) initiative.All pharmacies across Auckland, in collaboration with Auckland, Waitemata, and Counties Manukau District Health Boards, offer a free, safe collection and disposal service for unwanted and out-of-date medicines through the DUMP project. This includes over-the-counter and prescription medicines, sharp items such as needles and cytotoxic (chemotherapy) drugs.Auckland and Waitemata DHB Funding and Development Manager for Primary Care Tim Wood says the DUMP project is part of Auckland and Waitemata DHB’s commitment to improving patient safety in hospitals and in the community.“Providing this service means patients and those living in their homes will be safer by reducing any risk of incorrectly

Checking Auckland DHB’S blood pressureDo you know what your blood pressure is? Auckland DHB got involved in the annual Stroke Foundation Big Blood Pressure Check this year. We welcomed everyone and anyone around the level 5 atrium at Auckland City Hospital, to come get their blood pressure checked for free. A huge thank you to the amazing Ward 63 Stroke Services nursing team for running the stand! They helped around one hundred of our employees, patient whānau, and visitors, to get to know their blood pressure, all in the name of stroke awareness.Blood pressure is the most important indicator of your risk of having a stroke. The higher your blood pressure, the higher your risk of stroke. Someone with high blood pressure is up to seven times more likely to have a stroke than someone with normal or low blood pressure*. High blood pressure puts stress on the walls of blood vessels and increases the risk of both haemorrhages and blood clots.You may not know if you have high blood pressure, as there are usually no symptoms… So it’s important to get yourself checked regularly, and take steps to control your blood pressure if it’s high. The good news is blood pressure can be managed with a combination of diet, exercise and medication.For more information, see the Stroke Foundation website stroke.org.nz*Source: Stroke Foundation NZ

Remember the signs of a stroke FAST and you could save a life!

FACE - Is their face drooping on one side? Can they smile?ARM - Is one arm weak? Can they raise both arms?SPEECH - Is their speech jumbled or slurred? Can they speak at all?TIME - Time is critical. Call 111.

Learn the signs of a stroke FAST and you could save a life! Stroke is always a medical emergency - Act FAST

using medicines,” Mr Wood says “People should tell their doctor or pharmacist if they are no longer taking a particular medicine and should only ask for the medicines they need when collecting them from the pharmacy.”People are urged to remember the following rules when disposing of medicine:

Don’t flush medicines down the toilet – sewerage plants are unable to treat all chemicals in waste water and this could result in waterway contamination.Don’t pour medicines down the sink – highly soluble medicines could harm aquatic life.Don’t throw medicines in the rubbish or recycling bin – medical waste in landfills is prohibited under the Auckland Council Solid Waste Bylaw because it can harm the environment. The DUMP project is also supported by International Waste Ltd and Auckland Council.

Right: Ready to check Auckland DHB’S Blood Pressure – Asha Karimbabachalil, RN; Kamlesh Nand, Charge Nurse Manager; Rajani Fazly, Clinical Coach, from the Ward 63 Stroke Uni.

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Celebrating the Starship Simulation ProgrammeThe Starship Simulation Programme was initiated in 2010 and has been built with support from within Starship, the Starship Foundation and through collaboration with Boston Children’s Hospital.The Starship Simulation Programme aims to deliver world class education, training and systems improvement through simulation with broader objectives of improving patient safety and outcomes and developing staff. The programme delivers a range of simulation education from skills training and scenarios to human factors training using high fidelity simulators. The Starship Foundation has enabled us to purchase and use a range of manikins across the paediatric spectrum, including our newest and youngest simulator, a 28 week gestation neonate.With the support of the Starship Foundation, the programme now has a team which is directed by Drs Michael Shepherd and Gabrielle Nuthall and includes Trish Wood, Programme Manager and Nurse Educator; Wendy Sullivan, Nurse Educator; Denish Kumar, Simulation Technician and Usha McCrae, Team Support Administrator. The simulation

team also includes a multidisciplinary group of experts in a range of clinical areas who are critical to the programme’s success, including NICU, PICU, Oncology, Operating Theatres, Children’s Emergency Department and Cardiology.The Simulation Programme focuses on in-situ, ‘native’ team training for expert teams in Starship Child Health, and is also involved in a wide range of other simulation activity within Starship.There has been a strong focus on building simulation capacity, with training of over 100 simulation faculty members, within Starship, around Auckland DHB and in other centres.Simulation activity is now part of the quality and safety structure of Starship and is recognised internationally for its high quality programme. The programme continues to grow in its quality and safety improvement role, with plans for further innovation and research, and to further develop outreach activity in partnership with other DHBs.If you’d like to know more about the team and the training they provide, contact Trish Wood, TrishW@adhb.govt.nz or see the Starship website: www.starship.org.nz

Care closer to home even if it’s under a bridgeThe Calder Health Centre, based alongside the Auckland City Mission, provides much of the primary care for people with ‘no fixed abode’. Without the Calder Centre, many of these patients would not otherwise have regular access to a GP.As part of our growing relationship with Auckland City Mission, Auckland DHB has been working closely with the Calder Centre, particularly around complex wound care. Nurse Educator Robyn Patterson has been providing advice, support and training to the Calder Centre nurses for a number of years. “The Calder Centre only has a small number of nurses and they don’t have access to a nurse educator,” says Robyn. “We have started to build up a really good relationship with the Centre. We provide them with additional expertise. If a patient walks in with a wound they’re not sure how to treat, they can call me or the triage nurse and we can provide support over the phone – it works really well; a bit like a virtual clinic, I suppose.“Some of the Auckland DHB nurses will also see patients at the Calder Centre and do a joint consultation. Auckland DHB

doesn’t have a central city location and this means we can provide care closer to where our patients sleep and eat.”Robyn’s work has recently extended right into the community. “One of the Social Workers at the Calder Centre asked if I could go out with her to visit a man who lived under a bridge” she says. “She was concerned about a wound on his leg and wanted me to take a look. I went to visit him but he was adamant he was fine and wouldn’t let me look at his leg. I left him with some dressings and promised to come back the following week. After a few visits he would chat away to me and we started to build a relationship. Eventually he did show me his leg but only quickly; not long enough for me to treat it. I am still visiting each month. “What keeps me going back? At the moment I can make sure he is medically safe, but as a nurse I really want to heal people, so I’m hoping that one day he will trust me enough to let me treat his leg.”The collaboration with the Calder Centre is one of the many ways we are continuing to build our relationship with Auckland City Mission.

If you have a story to share with the Auckland DHB Team please contact the Communication Team on ext 26556 or email communication@adhb.govt.nz.ISSN 1178-5373 (print) ISSN 1178-5381 (online)

150gramgift

As told by the daughter of a kidney donor, and friend of a transplant recipient, Emma MacDonald.For most people 150 grams isn’t very much - it’s a cup of blueberries, 15 $2 coins or a large apple. Recently, I discovered the true value of 150 grams – a future, quality of life and one of the greatest gifts one person can give to another.150 grams was the weight of my Mother’s kidney. It is now the weight of Dean’s only functional kidney. Dean was in end-stage kidney failure, dialysing almost daily, struggling to get through every day, battling constant pain, nausea and exhaustion and facing the fact that without a kidney transplant he would die. My mother and I had no hesitation in being tested to see if we were a match – almost as soon as Dean told us what he was dealing with, the conversation and testing process started. Unfortunately, our reaction is uncommon – many people we told were flabbergasted, they couldn’t believe that we would consider donating a kidney - especially “just to a friend”. As we looked at it – we had two and only need one to live a full and healthy life. It was a no brainer.We both went through the testing cycle, the blood and urine tests, the x-rays, the lung function testing, the thorough questioning, history gathering, the psychiatric screening and the cross matching. We passed – not only were we a match, we were both deemed healthy enough to be donors. We made the decision that Mum would donate.We got the call, unexpectedly early – we had a date and if Mum was happy, the transplant was going to go ahead the following week! We all got together, processing the enormity of what was about to happen, Mum and Dean were understandably nervous, a little tearful and above all relieved that the transplant would go ahead.Both Mum and Dean are now in perfect health!I decided to photograph this process to raise awareness for organ donation, to celebrate both the truly selfless gift that was given, and the start of the rest of Dean’s life!Talk to your families, talk to your friends. Whether you simply tick donor on your licence and reiterate your wishes to your family or look further into the donation process for someone you know, (or someone you don’t – a truly altruistic gift) you have the power to save lives. For more information on donation in New Zealand, two brilliant websites filled with information are donor.co.nz and kidneydonor.org.nz.

The series of photos showing the donation journey, for which Emma won a silver documentary award in the New Zealand Institute of Professional Photographers Iris awards. Emma is donating one of her award winning photos to our Renal Transplant team at Auckland City Hospital.