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Waikato District Health Board Māori Health Plan
Ki te Taumata o Pae Ora 2016-2017
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KiteTaumataoPaeOra“TowardsthesummitorpinnacleofPaeOra”
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TABLE OF CONTENTS TABLEOFCONTENTS................................................................................................................3
ACKNOWLEDGEMENTS............................................................................................................4
FORWARDFROMACTINGEXECUTIVEDIRECTORMĀORIHEALTH...........................................5
SUMMARYOFINDICATORS......................................................................................................6
POPULATIONPROFILE..............................................................................................................8
OurPopulation..................................................................................................................8
HealthProfile....................................................................................................................9
MĀORIHEALTHPRIORITIESANDINDICATORS.......................................................................12
TEPUNAORANGAHOLISTICPROJECTS/PROGRAMMESTOACHIEVEHEALTHTARGETS13
NATIONALPRIORITIESANDINDICATORS...............................................................................16
DataQuality....................................................................................................................16
AccesstoCare-PHOEnrolments....................................................................................17
AccesstoCare–AmbulatorySensitiveHospitalisation(ASH)........................................20
ChildHealth(Breastfeeding)...........................................................................................22
CardiovascularDisease....................................................................................................25
CancerScreening(Cervical).............................................................................................26
CancerScreening(Breast)...............................................................................................28
Smoking...........................................................................................................................30
Immunisation(1).............................................................................................................32
Immunisation(2).............................................................................................................34
OralHealth......................................................................................................................37
MentalHealth.................................................................................................................39
RheumaticFever..............................................................................................................41
SuddenUnexpectedDeathinInfancy(SUDI)...................................................................43
LOCALPRIORITIESANDINDICATORS......................................................................................47
1. SupportingWhānauOraProviderCollectivesandWhānauOraCollectivePlan.....47
2. Workforce................................................................................................................54
3. VirtualCare..............................................................................................................54
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ACKNOWLEDGEMENTS
Ka hoki, anoo, ki te timatanga koorero e kiia ana, he honore, he korooria ki te Atua; kia tau, tonu, oona manaakitanga maha ki runga i a Kiingi Tuheitia me toona Whare Ariki, nui tonu. He maungarongo ki te whenua; he whakaaro pai ki ngaa taangata katoa!
Ka whai iho nei he timatanga tuhononga o te mahere rautaki Māori o te Rohe Hauora o Waikato ki raro i te maru o ’Whānau Ora’; me te mihi ki ngaa manukura o teenaa iwi, o teenaa iwi me maataawaka o te rohe nei, kua whakaaengia, ka whakawhanakehia teenei tuhononga; hei tautokona te tirohanga whakamua, te anga whakamua o ’Whānau Ora’.Kia ara poutama, tonu, te kaupapa o ’Whānau Ora’, hei oranga ake mo te iwi nui tonu!
Waikato District Health Board (DHB) wishes to thank and acknowledge the members of our Iwi Māori Council and Kaunihera Kaumātua, our Māori communities, and the Waikato DHB Board who participated in the development of Waikato DHB’s Māori Health Plan 2016-2017. In particular Waikato DHB wish to give special thanks to the people of Hauraki, Ngāti Maniapoto, Ngāti Raukawa, Waikato, Ngāti Tuwharetoa, Whanganui and all other iwi (Ngā Maata Waka) living within the Waikato DHB rohe.
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Ti
FOREWORD FROM ACTING EXECUTIVE DIRECTOR MĀORI HEALTH
TePunaOranga,theMāoriHealthService,oftheWaikatoDistrictHealthBoard,isgoingthroughaperiodofchange.Aspartofthatchange,wearerefreshingthewayweplantoimproveMāorihealthoutcomesintheWaikatoregion.Thenewplanningformatwillbepredicatedonavisionof“happy,healthyandwealthyMāori.”ItwillincludeatwentyyearoutlookstatementbasedonwhereweexpectMāorihealthtobein2026ifwearetobeintentionalaboutachievingourvision.ItwillincludeafiveyearMāoriHealthPlanwhichwillidentifyandarticulatethekeyelementsrequiredtoimproveMāorihealthinthisregion.Finally,itwillincludeatwelvemonthbusinessplanthatwillidentifywhereTePunaOrangawillfocusitsresourcesasittransitionstothenewplanningregime.
ThiswillbeacollaborativearrangementbetweenTePunaOrangaMāoriHealthServiceandtheIwiMāoriCounciloftheWaikatoDHB.
WeexpecttohavethenewplanningformatcompletedandforwardedtoyoubytheendofAugust2016.Inthemeantime,wesubmitthisMāoriHealthPlantosatisfythecompliancerequirementsoftheMinistryofHealth.
MillieBerryman
ActingExecutiveDirectorMāoriHealthTePunaOrangaMāoriHealthServiceWaikatoDistrictHealthBoard
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SUMMARY OF INDICATORS
National
Priorities Indicators
Baseline 2014/2015 unless otherwise stated
Māori Other
Target for Māori
Data Quality 1. Ethnicity data accuracy Primary Care Ethnicity Data Audit Toolkit Implemented
Access to care 2. Percentage of Māori enrolled in PHOs 91.95%1 95% 100%
Access to care
3. Ambulatory sensitive hospitalisation (ASH)
0-4 yrs
45-64 yrs
9,088
7,956
7,956
4,154
7,936 or less
5,650 or less 2
Child health3
4. Exclusive or fully breastfed at LMC discharge
5. Exclusive or fully breastfed at 3 months
6. Receiving breast milk at 6 months
6 weeks 3 months 6 months
60%
43%
50%
Total:
66%
54%
60%
75%
60%
65%
Cardiovascular disease and diabetes
7. Percentage of ‘eligible Māori men in the PHO aged 35-44 years’ who have had a CVD risk recorded within the past five years
84%4 89.3%5 90%
Cancer
8. Breast screening rate
60.1% 68.1% 70%
9. Cervical screening rate
60% 80% 80%
Smoking 10. Percentage of pregnant Māori women who
are smoke free at two weeks postnatal 60% Total population
WDHB-
82%6 95%
Immunisation 11. Percentage of infants fully immunised by 8 months of age 88%
Total population WDHB-
91%7
95%
1DataretrievedfromTrendlyforperiodQ1toQ42015
2ASHdatasourcedfromNSFLwebsiteforperiod12monthstoMarch2016
3MinistryofHealth:2016.IndicatorsfortheWellChildTamarikiOraQualityImprovementFramework:September2015.Wellington:MinistryofHealth
4DataretrievedfromTrendlyforperiodQ1toQ42015
5DataretrievedfromTrendlyforperiodQ1toQ42015
6DatasourcedfromMinistryofHealth.2015.IndicatorsfortheWellChild/TamarikiOraQualityImprovementFrameworkMarch2015.Wellington:MinistryofHealth.Timeperiod:birthsbetween1Januaryand30June2014.
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National
Priorities Indicators
Baseline 2014/2015 unless otherwise stated
Māori Other
Target for Māori
12. 75% of the eligible population (>65 years) are immunised against influenza annually
55.25% 56% 75%
Rheumatic Fever
13. A two-thirds reduction from baseline in the number and rate of hospitalisations for acute rheumatic fever
2013/2014:
4.8 per 100,000
2014/2015:
3.6 per 100, 000
Rate: 1.2 per 100,000
Please note this is a target for the total population
Sudden Unexpected Death in Infancy
14. National SUDI target - 0.4 SUDI deaths per 1,000 live births
2010-2014:
1.48/1,000 live
2010-2014:
.18/1,000 live
0.4 /1,000 live Māori births
Sudden Unexpected Death in Infancy
15. All caregivers of Māori infants are provided with SUDI prevention information at Well Child Tamariki Ora Core Contact 1
2014:
39.2% of Māori
caregivers received
SUDI info at Core
Contact 1
2014:
59.9% of non-Māori
caregivers received
SUDI info at Core Contact
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70% of caregivers of Māori infants are provided
with SUDI prevention
information at WCTO Core
Contact 1
Mental Health
16. Mental Health Act: section 29 community treatment order comparing Māori rates with other (per 100,000)
July 2012 to June 2013:
384
July 2012 to June 2013:
301
N/A
Oral Health
17. Percentage of Māori preschool tamariki are enrolled in the community oral health service
Not able to be reported
Not able to be reported 95%
Local Priorities Supporting Whānau Ora Provider Collectives and Whānau Ora Collective Plan
18. Strengthen the relationship that the Waikato DHB has with its local Whānau Ora collective
Workforce 19. A workforce that is reflective and responsive to
the needs of Māori
Virtual Care 20. Increased delivery of health services to the large
rural population closer to home.
7DatasourcedfromMinistryofHealth.2015.IndicatorsfortheWellChild/TamarikiOraQualityImprovementFrameworkMarch2015.Wellington:MinistryofHealth.Timeperiod:October2014toDecember2014.
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POPULATION PROFILE WaikatoDHBPopulationWaikatoDHBservesapopulationof400,820andcovers21,220squarekilometres.ItstretchesfromnorthernCoromandeltoMtRuapehuinthesouth,RaglanonthewestcoasttoWaihiontheeastcoast.
TheWaikatoDHBdistricttakesinthecityofHamiltonandtownssuchasThames,Huntly,Cambridge,TeAwamutu,Matamata,Morrinsville,Ngaruawahia,TeKuiti,TokoroaandTaumarunui,coveringsixIwigroups.WaikatoDHBpopulationbreakdownispresentedinthefollowingtable.AgeGroup Ethnicity
Māori Pacific Other Total00–24 47,850 5,700 86,950 140,50025–44 21,940 3,200 72,280 97,42045–64 16,680 2,120 80,940 99,74065–74 3,690 500 32,010 36,20075+ 1,640 280 25,040 26,960Total 91,800 11,800 297,220 400,820
Thelargeruralpopulationpresentsdiversechallengesinservicedeliveryandaccessinghealthservices.Significantpointsofinterestinclude:
• ThepopulationisexpectedtoincreaseinWaikatobutataslowerratethantherestofNewZealand
• WearemoreruralthanNewZealandasawhole• Wehaveapopulationthatisgettingproportionatelyolder(the65plusagegroupis
projectedtoincreaseby52percentbetween2011/12and2025/2026)• Thepopulationofchildrenandyoungpeopleispredicatedtodeclineby2026• WehaveaMāoripopulationwhichisgrowingataslightlyfasterratethanother
populationgroupsandisestimatedtobe23.3percentby2026
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• WehaveapopulationofPacificpeoplewhomakeupanestimated2.5percentofourpopulation
• AhigherpercentageofpeopleinourDHBliveinareasoflowsocio-economicstatuscomparedtotheNewZealandaverage(24.10percentliveinareasclassifiedasquintilefiveormostdeprived,comparedtoanationalaverageof20percent)
• Ruapehu,WaitomoandSouthWaikatoterritoriallocalauthoritieshavethehighestproportionofpeoplelivinginareasoflowsocio-economicstatus
• Inequalitiesinhealthtendtobehighestforpeoplelivinginareasidentifiedasquintilefourandfiveandthesepeoplearelikelytoexperiencelowerlifeexpectancyandhigherratesofchronicconditions
• HighnumbersoftheMāoripopulationinourdistrictliveinareasidentifiedasquintilefourandfive
HealthProfileUnderstandingourhealthprofileplaysanimportantpartinourplanninganddecisionmakingprocesses.KeypointsofinterestintermsofthehealthprofileoftheWaikatoDHBpopulationare8:
• In2012–2014,lifeexpectancyatbirthforMāoriintheWaikatoRegionwas76.5yearsforfemales(7.5yearslowerthanfornon-Māorifemales)and72.2yearsformales(8.1yearslowerthanfornon-Māori).
• Theall-causemortalityrateforWaikatoMāoriwastwiceashighasthenon-Māorirateduring2008–2012.
• Injurymortalitywas85%higherforMāorithanfornon-MāoriinWaikato.Maleshadhigherratesofdeathfrominjurythanfemales.
• Potentiallyavoidablemortalityandmortalityamenabletohealthcarewere2.6timesand2.7timesashighforMāoriasfornon-MāoriinWaikatoduring2007–2011.
• Theall-causerateofhospitaladmissionswas16percenthigherforMāorithanfornon-Māoriduring2011–2013.
• Almost5,200Māorihospitaladmissionsperyearwerepotentiallyavoidable,withtherate38percenthigherforMāorithanfornon-Māori.Theambulatorysensitivehospitalisationratewas75percenthigher.
• Therateofhospitalisationduetoinjurywas19%higherforMāorithanfornon-Māori.Maleshadhigherratesofadmissionthanfemales.
• ThemostcommoncausesofinjuryresultinginhospitalisationsamongMāoriwerefalls,exposuretomechanicalforces,andcomplicationsofmedicalandsurgicalcare,transportaccidents,andassault.
8InformationinthissectionhasbeensourcedfromRobsonB,PurdieG,SimmondsS,WaaA,BrownleeG,RamekaR.2015.WaikatoDistrictHealthBoardMāoriHealthProfile2015.Wellington:TeRōpūRangahauHauoraaEruPōmare
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• Ratesofhospitaladmissionforinjurycausedbyassaultwereover5timesashighforMāorifemalesasfornon-Māorifemalesand2.4timesashighforMāorimalesasfornon-Māorimales.Maleshadhigherratesthanfemales.
• Comparedtonon-Māori,cancerincidencewasalmost50%higherforMāorifemaleswhilecancermortalitywasclosetotwiceashigh.ForMāorimales,cancerincidencewassimilartothatofnon-Māori,whilecancermortalitywastwo-thirdshigher.
• BreastscreeningcoverageofMāoriwomenaged45–69yearswas55%comparedto68%ofnon-Māoriwomenattheendof2014
• CervicalscreeningcoverageofMāoriwomenaged25–69yearswas60%over3yearsand75%overfiveyears(comparedto78%and91%ofnon-Māorirespectively).
• Breast,lung,colorectal,uterineandcervicalcancerswerethemostcommonlyregisteredamongWaikatoMāoriwomen.
• Therateoflungcancerwas4timestheratefornon-Māori,aswasthemortalityrate.Breastcancerincidenceandmortalityrateswerebothtwo-thirdshigherforMāorithanfornon-Māori.
• ColorectalregistrationandmortalityratesweresimilarforMāoriandnon-Māori.• Stomachcancerwasthefourthleadingcauseofcancerdeathwith4timesthe
mortalityrateofnon-Māori.• During2011–2013Māoriwithdiabeteswerenearly4timesaslikelyasnon-Māorito
havealowerlimbamputated.• Māoriadultsaged25yearswere82%morelikelythannon-Māoritobehospitalised
forcirculatorysystemdiseases(includingheartdiseaseandstroke)in2011–2013.• WaikatoMāoriwere28%morelikelythannon-Māoritobeadmittedwithacute
coronarysyndrome,43%morelikelytohaveangiography.• Heartfailureadmissionrateswere5timesashighforMāoriasfornon-Māori.• StrokeadmissionratesweretwiceashighforMāoriasfornon-Māori,aswererates
ofadmissionforhypertensivedisease.• Chronicrheumaticheartdiseaseadmissionswerealmost6timesascommonfor
Māoriasfornon-Māori,whileheartvalvereplacementrateswerejustovertwiceashigh.
• BySeptember2014,66%ofMāorigirlsaged17yearsand64%ofthoseaged14yearshadcompletedallthreedosesofthehumanpapillomavirus(HPV)immunisation.CoveragewashigherforMāorithanfornon-Māori.
• Ratesofhospitalisationforseriousinjuryfromself-harmweresimilarforMāoriandnon-Māoriamongthoseaged15–24yearsduring2011–2013butoverathirdhigherforMāorithanfornon-Māoriatages25–44years.
• Māoriaged45yearsandoverwere3.8timesaslikelyasnon-Māoritobeadmittedtohospitalforchronicobstructivepulmonarydisease(COPD).
• Asthmahospitalisationrateswere2to3timesashighforMāorithanfornon-Māoriineachagegroup.
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• Onaverage,2,180Māoriinfantswerebornperyearduring2009–2013,40%ofalllivebirthsintheDHB.SevenpercentofMāoriand6%ofnon-Māoribabieshadlowbirthweight.
• In2013,two-thirdsofWaikatoMāorichildrenaged5yearsandone-thirdofnon-Māorichildrenhadcaries.
• AtYear8ofschool,almostthreeinfiveMāorichildrenandjustovertwoinfivenon-Māorichildrenhadcaries.
• Māorichildrenunder15yearsweretwo-fifthsmorelikelythannon-Māoritobehospitalisedfortoothandgumdisease.
• Māoriwerefour-fifthsmorelikelyasnon-Māoritobeadmittedtohospitalforamentaldisorderduring2011–2013.Schizophreniatypedisorderswerethemostcommondisorders,followedbymooddisorders.
TheIwigroupswithinWaikatoDHBdistrict:
The principal tribal Iwi groups that reside within the Waikato DHB district also affiliate to Tainui waka : • Hauraki • Ngāti Maniapoto • Ngāti Raukawa • Waikato
Ngāti Tuwharetoa and Whanganui iwi groups also reside within Waikato DHB district. A significant proportion of Māori living within the Waikato DHB district affiliate to Iwi outside the district and collectively they are known as Maata Waka.
Figure 2: Map of Te Rohe o Tainui
Mokau ki runga
Tamaki ki raro
Mangatoatoa ki waenganui
Pare Hauraki
Pare Waikato
Te Kaokaoroa o Patetere
Te hokinga mai ki te Nehenehenui
Mokau above
Tamaki below
Mangatoatoa in the middle
The lands of Hauraki
The lands of Waikato
The lands Maniapoto and Raukawa
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MĀORI HEALTH PRIORITIES AND INDICATORS ThefollowingsectionsofKiteTaumataoPaeOra2016-2017detailMāorihealthprioritiesandalignedindicatorsthathavebeenselectedatthenationalandlocallevel.
ThefirstcomponentfocusesonTePunaOrangaspecificactivitiesthataligntomorethanoneindicator;thisistoavoidrepeatsthroughoutthedocument.
Thesecondcomponentfocusesonprioritiesandthealignedindicatorssummarisedwiththefollowingheadings:
• Whyisthisapriority?• Objective• Actionstodeliverimprovedperformance • Measure • Reporting
Monitoring and Reporting
TheindicatorsandperformanceexpectationsidentifiedinKiteTaumataoPaeOra2016-2017aremonitoredregularly.WeprovideasixmonthlynarrativereporttotheSeniorManagementandBoardonourperformanceagainstalltheindicatorsinthisplan.SignificantreportsareprovidedanddiscussedinBoardmeetingsandthereportsareavailabletothepublicaspartoftherelevantBoardagendaavailableonourwebsite.
TheIwiMāoriCouncilandtheKauniheraKaumātuareceivetheannualnarrativereportswithanadditionalannualWaikatoDHBMāoriHealthMeasuresOmnibus.
Ourperformanceagainsttheindicatorsinthisplanisoneofthetoolsusedbytheorganisation(throughtheIwiMāoriCouncil,KauniheraKaumātua,theBoardandSeniorManagement)toidentifyissuesandinformdecision-makingtoimproveperformance.
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TE PUNA ORANGA HOLISTIC PROJECTS/PROGRAMMES TO ACHIEVE HEALTH TARGETS
ThefollowingactivitiesdemonstrateaholisticapproachtomeetingtheNationalIndicators.
AstheyarereferredtooftenthroughouttheWaikatoDHBMāoriHealthPlanasummaryofeachprojectandwhichindicatorstheyaligntoisprovidedbelow.Moredetailonhowtheseactivitieswillimpactonachievingequityisdetailedwithintheplanningdocument.
Whatarewegoingtodo? Measure
1.Attempttocontactcaregiversofallpēpi,tamariki,andrangatahiadmittedintoWaikatohospitalwithrheumaticfever.
Monthlyreports
2. Workwithwhānautopreventreadmissionintohospitalbecauseofrheumaticfever
3. Workwithwhānautopreventotherpēpi,tamarikiandrangatahifromdevelopingrheumaticfever
4.TePunaOrangawillprovidetheMinistryofHealthwithmonthlyreportsontheprogressoftheimplementationofWhareOra
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Whatarewegoingtodo? Measure
1.ThenHartiHauora(HH)TamarikiAssessmenttoolreferralpathwayisevaluatedreviewedandimplementedinWaikatoHospital.
Reportannually
2.ImplementationoftheHartiHauoraTamarikiAssessmenttoolinatleast3othersettingswithinWaikatoandMidlandregion.
Reportannually
3.Developandimplement2xHHassessmenttoolstargetingspecificagesandgender
Developmentandimplementationof2xHHbasedassessmenttools
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Whatarewegoingtodo? Measure
1. ReviewandalignKaitiakiandKaitakawaengaculturalassessmenttooltoalignwithMāoriHealthindicators.
Assessmenttoolrealigned
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NATIONAL PRIORITIES AND INDICATORS
DataQualityWhyisthisapriority?
CollectingaccurateethnicitydatainaccordancewiththeEthnicityDataCollectionProtocolswillimprovethequalityofethnicityhealthdata.
BaselineMeasure
Māori AwaitingbaselinedatafromJune2016resultsofEDAT
Non-Māori AwaitingbaselinedatafromJune2016resultsofEDAT
Objective Actionstodeliverimprovedperformance Measure Reporting
EthnicityDataQuality
IdentifyandcreateasetofKPI’sthatwillbeusedindifferentsettingswithinthehospitaltocollectqualitydataethnicity.
CreateKPI’sthatcanbeauditedthroughouttheyeartoensurequalitydataiscaptured
Annualreporting
WaikatoDHBwillcontinuetoworkwithourlocalPHOsinordertoimproveandmaintainthequalityofethnicitydatasubmittedtonationalcollections
Sixmonthly
TheMidlandHealthNetworks(MHN)willauditagainstitsethnicitydataviaitsqualityassuranceprogramme.TheMHNwillprovideinformationonthecomparisonbetweenPHOenrolmentandCensusfigures(refertoPHOenrolmentsectionofthisplan)
100%ofHaurakiPHO’spracticeswithintheWaikatoDHBdistrictwillunder-taketheMinistryofHealth’sEthnicityDataAudit(by30thofJune2017)
100%ofNationalHauoraCoalitionpracticeswithintheWaikatoDHBdistrictwillunder-taketheMinistryofHealth’sEthnicityDataAudit(by30thJune2017)
Target
Awaitingbaselineinformationbeforeatargetcanbeestablished
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AccesstoCare-PHOEnrolments Whyisthisapriority?
PHOenrolmentisthefirststepinensuringallpopulationgroupshaveequitableaccesstoprimaryhealthcareservicesandisthereforeacriticalenablerfirstpointofcontacthealthcare.Differentialaccesstoandutilisationofhealthcareservicesplaysanimportantroleinhealthinequities,andforthisreasonitisimportanttofocusonenrolmentratesforMāori.
BaselineMeasure
Māori 91.95%
Non-Māori 95%
Objective Actionstodeliverimproved
performanceMeasure Reporting
IncreaseinthepercentageofMāorienrolledinaPHO
HartiHauora(HH)TamarikiAssessmenttoolreferralpathwayisevaluatedreviewedandimplementedinWaikatoHospital,withaspecificaccesstocarereferralpathway.
HHTamarikiAssessmentToolisevaluated,reviewedandimplementedbyDecember2016.
PublishevaluationfindingsinAcademicJournalbyDecember2016.
6monthlyreporting
ImplementationoftheHHTamarikiAssessmenttoolwithaspecificaccesstocarereferralpathwayinatleast3othersettingswithinWaikatoandthewiderMidlandregion,toincreasewhanauenrolmentthatmayhavebeenmissedinothersettings.
HHTamarikiAssessmentToolispilotedinatleast1settingattheendofeachofthefollowingquarters-
Q1-Firstsetting
Q2-Secondsetting
Q3-Thirdsetting
6monthlyreporting
Target
100%
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Objective Actionstodeliverimprovedperformance
Measure Reporting
Design,developandimplementassessmenttoolsbasedontheHHTamarikiAssessmentToolspecificallytargetingKaumatua,Kuia,wāhineandtāne,withaspecificaccesstocarereferralpathway.
ToolspecificallydevelopedtotargetKaumatua,Kuia,wāhineandtānebyDecember2016
6monthlyreport
ReviewandimplementKaitiakiandKaitakawaengaculturalassessmenttoincludeaspecificaccesstocarereferralpathway.
CulturalassessmentreviewedandimplementedbyDecember2016
6monthlyreport
NationalHauoraCoalitionwillcontinuetosupportarangeofPrimaryHealthOrganisationbasedinitiativestoimproveMāoriengagementwithprimarycare,includingcommunityeventsandtheuseofcommunityworkersandnavigatorstosupportMāoritoconnectwithgeneralpractice
WaikatoDHBwillmonitorPHOenrolmentsbyprovidingacomparisonoftheenrolledpopulationwithinourthreelocalPHO’srelativetoCensusdatathatrelatestotheWaikatoDHBdistrictbythefollowingdates-
FirstdatasetbyJune2016
SeconddatasetbyDecember2016
ThirddatasetbyJune2017
WaikatoDHBwillmonitorPHOenrolmentsbyethnicityonaquarterlybasis.
MidlandsHealthNetworkviaitslocalityplanningworkisalwaysactivelycomparingvariousviewsofthepopulationtoensurethatweareachievingthehighestpossiblecoverageaspossible.Inareaswhereitappearstherearegapsthenwewillundertakelocaldrivesandalwaysadviseparentsaccessingcaretoenlistwitharegularprovider
WaikatoDHBwillmonitorPHOenrolmentsbyprovidingacomparisonoftheenrolledpopulationwithinourthreelocalPHO’srelativetoCensusdatathatrelatestotheWaikatoDHBdistrictbythefollowingdates-
FirstdatasetbyJune2016
WaikatoDHBwillmonitorPHOenrolmentsbyethnicityonaquarterlybasis.
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Objective Actionstodeliverimprovedperformance
Measure Reporting
SeconddatasetbyDecember2016
ThirddatasetbyJune2017
HaurakiPHOwillworktoincreaseMāorienrolmentsinitsPHO,viaamediacampaignandmarketing,includingpromotionatcommunityevents,andthroughpromotingenrolmentinprimarycarethroughtheHaurakiWhānauOraAlliance,whichconnectstomanywhānauataserviceprovisionlevel
WaikatoDHBwillmonitorPHOenrolmentsbyprovidingacomparisonoftheenrolledpopulationwithinourthreelocalPHO’srelativetoCensusdatathatrelatestotheWaikatoDHBdistrictbythefollowingdates-
FirstdatasetbyJune2016
SeconddatasetbyDecember2016
ThirddatasetbyJune2017
WaikatoDHBwillmonitorPHOenrolmentsbyethnicityonaquarterlybasis.
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AccesstoCare–AmbulatorySensitiveHospitalisation(ASH)Whyisthisapriority?
ASHisaproxymeasureforavoidablehospitalisations,andunmethealthcareneedinacommunitybasedsetting.TherearesignificantdifferencesinASHratesfordifferentpopulationgroupsandakeyfocusonactivitiestoreduceASHmustaddressthecurrentinequities.
TotalWDHBpopulation
BaselineMeasure
0-4years 9088
45-64years 7956
Objective Actionstodeliverimprovedperformance
Measure Reporting
Fewerpeopleareadmittedtohospitalforavoidableconditions
During2016/17WaikatoDHBfurtherdevelopandstrengthenthework-streamaroundimprovingambulatorysensitiveadmissionsrates.Thiswillcontinuetobeajointprimaryandsecondarycarepieceofwork.
Workwithprimarycarealliancepartnerstoreduceambulatorysensitiveadmissions.
AmbulatorySensitiveHospitalisationsratesper100,000fortheagegroups0-4and45-64yearsareattained.
Forbothagegroups0-4and45-64years:
NarrativeandquantitativereportagainstallASHinitiativesbyquarter4reportingperiod2017.
UntilthatreportiscompletedquarterlyreportswilltrackeachASHinitiativebyhealthpriorityandethniccomparisonofutilisationofservices.
Continuesharingambulatorysensitiveadmissioninformationwithourprimarycarealliancepartners(toaiddecision-makingfrom1July2016to30June2017)
Datasharingprocesscontinues
Topfiveambulatorysensitiveadmissionareastobeconsideredforprioritisationbymapofmedicinegovernancegroup.AninitiativeviatheMAPofMedicinewilllooktoimprovereferralpathwaysbetweenprimarycareandsecondarycareinregardstoASHhealthpriorityareas.(CompletedJune2016)
AreasforWaikatoDHBdistrictforwardedtomapofmedicinegovernancegroupforconsiderationbyquarterone
Target
0-4years-<7956
45-64years<5836
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Objective Actionstodeliverimprovedperformance
Measure Reporting
EnsurethattheMAPofMedicinehasastrongequityfocusintegratedintoitsapproachinordertosupportachievinghealthequityforMāori(July2016).ThiswillincludethedevelopmentofnodeswithintheMAPofMedicinethatlinkhealthprofessionalstoservicesthataddressdeterminantsofMāoriASHratessuchasincome,housing,foodsecurity,socialservicesandpreventativehealthservices.
Asthma
ContinueimplementingWhareOra(WO)ahealthyhomesinitiativeswhichseektomakehomeswarmerdrierandhealthierandsaferbyinstallingarangeofproducts(floorandceilinginsulation,thermalcurtains,heatingdevices,dehumidifies,mouldkits,firealarmsanddraftstoppers)andreferontosocialsupportservices/WhānauOraifrequired.
Respiratoryinfections-pneumonia
ContinueimplementingWhareOra(WO)
RheumaticFever/HeartDisease
ImplementationofactionsidentifiedintheWaikatoDHB’sRheumaticFeverPreventionPlan2015-2016(refertoRheumaticFeversectionofthisplan)(quarterlyreportstotheMinistryofHealthonprogressagainstactionsandtargetsdetailedintheplanandareductionintheincidenceofRheumaticfeverratesisevidenced.
Complete400HealthyHomeAssessmentsintheWaikatodistrict(ByJune2017)
ContinuesuccessfulcrosssectorapproachwithstakeholdersinWhareOraprogramme(ongoing).
EnsurewhānauarereceivinginterventionassistancefromWhareOraprogrammewithin7weeksofbeingreferred.(ongoing)
Monthlyreporting
22
ChildHealth(Breastfeeding)Whyisthisapriority?
Breastfeedingprovidesinfantswithnutritionalneedsandbuildsimmunityforthefirstsixmonthsoflife,toprovideprotectionagainstarangeofconditions.Breastfeedingalsoprovidesbenefitsintermsofbondingbetweenmamaandpēpiandcansupportbetterhealthoutcomes.Researchshowsthatchildrenwhoareexclusivelybreastfedforaround6monthsarelesslikelytosufferfromchildhoodillnessessuchasrespiratorytractinfections,gastroenteritisandotitismedia.Breastfeedingbenefitsthehealthofmamaandpēpi,aswellasreducingtheriskofSUDI,asthmaandchildhoodobesity.Nationally,breastfeedingratesforMāoriinfantsstartataslightlylowerrateasthetotalpopulation,anddropoffmorequicklythanthetotalpopulationatthe3and6monthtimepoints.Breastfeedingisanimportantareaoffocusbecausethereissignificantroomforimprovement,andbreastfeedinghaswide-reachingbenefitsandpotentiallyresultsinreducedcostforfamilies.
BaselineMeasure
Māori ExclusiveorfullybreastfedatLMCdischarge(4-6weeks)
66%
Exclusiveorfullybreastfedat3months
43%
Receivingbreastmilkat6months 50%
Non-Māori ExclusiveorfullybreastfedatLMCdischarge(4-6weeks)
73%
Exclusiveorfullybreastfedat3months
60%
Receivingbreastmilkat6months 64%
Target
6weeks-75%
3months-60%
6months-65%
23
Objective Actionstodeliverimprovedperformance
Measure Reporting
IncreasetheproportionofMāoriinfantsthatarebreastfed(fullyandexclusivelyat6weeks,and3months)
(exclusively,fullyandpartiallybreastfedat6months)
Promoteandtrainkaimahithatworkwith,orintendtoworkwithhapῡMāori,onhowtousethenewlydevelopedHapūWanangaCurriculum(KaupapaMāoriPregnancyandParentingcurriculum)fortheMidlandregionthatpromotes,empowersandencouragesbreastfeeding.
2xtrainingsessionsthroughoutMidlandregionbyJune2017
6monthlyreport
PromotebreastfeedingtoMāoriwhānau/communitiesbyholdingLatchOnandWorldBreastfeedingweekactivities,raisingawarenessoftheimportanceofbreastfeedingandtoassistwithMāoriuptake.WaikatoDHBwillencourageMāoriwāhinetoparticipateinmediaandothereventsheldbyMāoriprovidersandPHO’s.
Akeyobjectiveofallpromotionactivitieswillbetohighlighttheimportanceofbreastfeedinginbuildingimmunityagainstarangeofinfectiousdiseasesandcombatingchildhoodobesityanddiabetes
ParticipationinLatchOnandWorldBreastfeedingEventsduringAugust2016
Annualreport
WaikatoDHBwillpromotetheuseoftheMidlandbreastfeedingapp.
Ongoing 6monthlyreport
WaikatoDHBBreastfeedingChampionwillcontinuetoprovideworkshop/sontheimportanceofpromotingbreastfeedingtoPHOstaffwithintheWaikatoDHBdistrict
1workshopbyDecember2016
Annualreportt
WaikatoDHBand/orTePunaOranga,activeinvolvementintheBreastfeedingActionCoalitionKirikiriroa(B.A.C.K.)rooputodiscussactivitiesthatwillincreasethenumberofMāoribreastfeeding,supportedthe
Attendance80%ofscheduledmeetingsbetweenJune2016-July2017
6monthlyreport
24
Objective Actionstodeliverimprovedperformance
Measure Reporting
developmentofthecontentoftheapp.Theappwillbepromotedviaprimarycare,healthpromotionandthroughourHapῡWanangaclassesandHapῡWanangapost-natalclasses.
MidlandMaternityActionGroupiscommittedtoincreasingbreastfeedingratesintheMidlandDHB’s.
DevelopaMidlandBreastfeedingFrameworktoinformandprioritisebreastfeedinginitiativesintheMidlandregion.
Q1-Q42016/17
MidlandBreastfeedingApp–BreastFedNZ
Midlandbreastfeedingfriendlyaccreditedspacesadded
WCTOandpregnancyandparentingserviceprovidersadded
IssuesandbarrierstobreastfeedingidentifiedinfocusgroupsofMidlandbreastfeedingframeworkareaddressed,whereapplicable
Evaluationofeffectivenessanduptake.Contentisreviewedagainsttopicsofsmokefreepregnancies,safesleeping,mentalhealthmessages,alcoholanddrugs,maternalnutrition,immunisation,etc.
IncreasedvisibilityofMāoribreastfeedingwomen,partnerandwhānausupportinapp,website,andresources
12monthmark:September2016
Implementthe‘MidlandUseofDonorBreastmilkProtocol’
Q22016/17
25
CardiovascularDiseaseWhyisthisapriority?
Theburdenofcardiovasculardisease(heartandstroke)isgreatestamongtheMāoripopulation,andmortalityismorethantwiceashighcomparedtonon-Māori.CVDriskassessmentsareanimportanttooltoenableearlyidentificationandmanagementofpeopleatriskofheartdiseaseanddiabetes.FastaccesstotreatmentforheartrelatedattacksisessentialtoachievehealthequityandimprovehealthoutcomesforMāori.
BaselineMeasure
Māori 84%
Non-Māori 89.3%
Objective Actionstodeliverimprovedperformance
Measure Reporting
IncreasethepercentageoftheeligibleMāoripopulationwhohavehadtheirCVDriskassessedwithinthepast5yearsanddecreasethenumberoftertiarycardiacinterventionsperformed
Design,developandimplementassessmenttoolsbasedontheHHTamarikiAssessmentToolspecificallytargetingKaumatuatoincludeaspecificCVDriskassessmentreferralpathway.
ToolspecificallydevelopedforKaumatuaandKuiabyDecember2016
6monthlyreport
ReviewandimplementKaitiakiandKaitakawaengaculturalassessmenttoincludeaspecificCVDriskassessmentreferralpathway.
CulturalassessmentreviewedandimplementedbyDecember2016
6monthlyreport
Target
90%
26
CancerScreening(Cervical)Whyisthisapriority?
In2012,Māoriwomenweretwiceaslikelyasnon-Māoritodevelopcervicalcancer,and2.3morelikelytodiefromit.Regularcervicalscreeningdetectsearlycellchangesthatwould,overtime,leadtocancerifnottreated.Nationally,cervicalscreeningcoverageforMāoriis62.2%,comparedtocoverageinEuropean/Otherpopulationswithcoverageat82.2%.ImprovingscreeningcoverageandmonitoringofthetimelinessandexperienceofcolposcopyforMāoriwomenisthereforeanimportantactivity.
BaselineMeasure
Māori 60%
Non-Māori 80%
Objective Actionstodeliverimprovedperformance
Measure Reporting
RaiseourMāoricervicalscreeningratestomatchorbetternationaltargetrequirements
WiththeestablishmentoftheProjectBoard,communicationbetweentheDHBandthethreePHOstodeterminehowbestlimitedfundingcansupportMāori(andPacificIsland)womentoparticipateincervicalscreeningthroughimplementingprojectswillcontinue.
Holdmonthlyregionalcervicalscreeningcollaborationmeetingsandannualsmeartakerupdatefocusedonimprovingqualityandincreasingcoverage.
Monthlymeetingsandannualsmeartakerupdateoccur
ContinuetoprovidecervicalsmearsatnocosttoalleligibleMāoriwomenlivinginWaikatoDHB.OfferPHOsadditionalfundingforoutofhourssmeartakingonafeeforservicebasis.
IncreaseincervicalscreeningratesbyPHO
Quarterlyreport
Undertakeapilotproject(betweenJune2016toDecember2016)toidentifyandoffercervicalsmearteststoinpatientsandoutpatientswithinWDHB
Keymeasurements:
-Numberofwomenoverdueforscreen
-Thenumberofwomenofferedcervicalscreen
-Thenumberofwomenscreened
Reportatconclusionofpilotprogramme
WaikatoDHBwillworkwiththenewsupporttoscreeningservicesprovidertocreateanactionplanthatwillfocusonincreasingthe
Keyactivitieswithmeasurableoutputs
Annualreport
Target
80%
27
Objective Actionstodeliverimprovedperformance
Measure Reporting
numberofeligibleMāoriwāhinewhohavehadacervicalscreeningeventinthepast36monthsandtoensurethatMāoriwomenaresupportedtoattendcolposcopyappointments.
28
CancerScreening(Breast)Whyisthisapriority?
Historically,Māoriwomenhavesignificantlyhigherincidenceandmortalityfrombreastcancercomparedtonon-Māori.InequitiesinaccesstoscreeningservicesneedtobeaddressedtoensureMāoriwomenexperiencethebenefitsofearlydetectionofbreastcancer.
BaselineMeasure
Māori 60.1%
Non-Māori 68.1%
Objective Actionstodeliverimprovedperformance
Measure Reporting
RaiseourMāoribreastscreeningratestomatchorbetternationaltargetrequirements
WiththeestablishmentoftheProjectBoard,communicationbetweentheDHBandthethreePHOstodeterminehowbestlimitedfundingcansupportMāori(andPacificIsland)womentoparticipateinbreastscreeningthroughimplementingprojectswillcontinue.
Holdmonthlyregionalbreastscreeningcollaborationmeetingsandannualbreastscreeningupdatefocusedonimprovingqualityandincreasingcoverage.
Quarterlyreport
WDHBwillcontinuetocontactwomenwhohavenotbeenscreenedorareunderscreenedidentifiedbyBreastScreenMidland(BSM)viadatamatchingorasnon-responders.
Maintainanuptodatedatabaseofwomenwhohavenotbeenscreenedorunderscreened
MonthlyreporttoBSM
PromotebreastscreeningtoMāoriwomeninHamiltoninparticular,i.e.MAMAgrammonthofMay.
MAMAgrameventMay2017 Quarterlyreport
BSMwilllead,implementandevaluatetheactivitiesoutlinedintheBreastScreenMidlands(BSM)regionalplan.
ImplementationandevaluationofactivitiesoutlinedintheBSMregionalplanfollowthetimelinesprovided
Quarterlyreport
Undertakeapilotproject(betweenJune2016toDecember2016)toidentifyandoffermammogramtoeligibleinpatientsandoutpatientswithinWDHB
Keymeasurements:
-Numberofwomenoverdueforscreen
-Thenumberofwomenofferedmammogram
-Thenumberofwomenscreened
Reportatconclusionofpilotprogramme
Target
70%
29
Objective Actionstodeliverimprovedperformance
Measure Reporting
SupportcollaborativeworkingrelationshipsbetweenprovidersacrossthebreastscreeningpathwayviatheregionalbreastscreeninghuiheldtwiceayearandtheBSMcoordinatorwhomeetswithkeystakeholdersonamoreregularbasis.
Attend2xhuiayear 6monthlyreport
WaikatoDHBwillcontinuetoworkwiththeUniversityofAucklandtoexplorereasonsforlowersurvivalforMāoriwomenwithbreastcancerandtodevelopandinterventiontosupportMāoriwomenwithbreastcancertohavelongersurvival.
Anacademicpublication 6monthlyprogressreport
ImplementotherinitiativesasagreedbetweenTePunaOrangaandBSMmanagersthatwillenhancetheparticipationofMāoriwāhineinBSM–TheimprovementinMāoriBSMcoverageasoutlinedintheBSMplanand/ortheWaikatoDHBMāoriHealthplan,withspecificreferencetoincreasingcoverageinHamilton,Tokoroa,MorrinsvilleandKihikihi/TeAwamutu(townswherethereisasignificantvolumeofMāoriwāhineandtheBSMmobileisvisitinginthisperiod).ThereiscurrentlyaServiceLevelAgreementbeingdraftedbetweenBSMandTePunaOrangawhichwillincludeactivities.
Measureswillbedeterminedaspereachinitiativeimplemented.
Quarterlyreports
30
SmokingWhyisthisapriority?
HapuMāoriwahinehaveveryhighsmokingprevalence(threetimeshigherthanthenationalprevalence).Smokingduringpregnancyincreasestheriskforpregnancycomplicationsandtobaccosmokeharmsbabiesbeforeandaftertheyareborn.
BaselineMeasure
Māori 60%
TotalWDHBpopulation
82%
Objective Actionstodeliverimprovedperformance Measure Reporting
Smokingcessation:PercentageofpregnantMāoriwomenwhoaresmokefreeattwoweekspostnatal
Promoteandtrainkaimahithatworkwith,orintendtoworkwithhapῡMāori,onhowtousethenewlydevelopedHapῡWanangaCurriculum(KaupapaMāoriPregnancyandParentingcurriculum)fortheMidlandregionthatpromotes,empowersandencouragesmamatobesmokefree.
2xtrainingsessionswithinMidlandregionbyJune2017
6monthlyreport
ContinuetodeliverHapῡWanangaclassestargetingyoungMāorimama,withaspecificfocusonbeingsmokefree.Provideareferralpathwayformamaandwhānautobesmokefree.
12classesbyJune2017 6monthlyreport
HapῡWanangaPost-natalclasseswillmeasurethepreviousandcurrentsmokingstatusandprovideareferralpathwayifneeded.
2xclassesbyJune2017
6monthlyreport
Target
95%
31
Objective Actionstodeliverimprovedperformance Measure Reporting
Design,developandimplementassessmenttoolsbasedontheHHTamarikiAssessmentToolspecificallytargetingwāhinetoincludeaspecificsmokefreereferralpathway.
ToolspecificallydevelopedforwāhinebyDecember2016
6monthlyreport
ReviewandimplementKaitiakiandKaitakawaengaculturalassessmenttoincludeaspecificsmokefreereferralpathwayforhapῡmama.
CulturalassessmentreviewedandimplementedbyDecember2016
6monthlyreport
32
Immunisation(1)Whyisthisapriority?
“Immunisationisthemosteffectivewaytoactivelyprotectyourchildfrompreventablediseases,rangingfromwhoopingcoughtomeningitisandmeasles”(ImmunisationAdvisoryCentre,2013).AlthoughimmunisationratesarehighthereisstillalargehealthequitygapbetweenMāoriandnon-Māori.InitiativesneedtotargetMāoripēpiinordertoachievehealthequity.
BaselineMeasure
Māori 88%
TotalWDHBpopulation
91%
Objective Actionstodeliverimprovedperformance
Measure Reporting
Raisethepercentageofourpēpifullyimmunisedby8monthsofage
ImplementationoftheHHTamarikiAssessmenttoolwithaspecificimmunisationforpēpireferralpathwayinatleast3othersettingswithinWaikatoandthewiderMidlandregion,toincreasewhanauenrolmentthatmayhavebeenmissedinothersettings.
HHTamarikiAssessmentToolispilotedinatleast1settingattheendofeachofthefollowingquarters-
Q1-Firstsetting
Q2-Secondsetting
Q3-Thirdsetting
6monthlyreportonHH
ReviewandimplementKaitiakiandKaitakawaengaculturalassessmenttoincludeaspecificimmunisationforpēpireferralpathway.
CulturalassessmentreviewedandimplementedbyDecember2016
6monthlyreport
HapῡWanangaclasseswillcontinuetoreviewfeedbackfromparticipantstopromotediscussiononimmunisationforpēpi.
Ongoinginfutureclasses
6monthlyreport
HapῡWanangaPost-natalclasseswillmeasurethenumberofeligiblepēpiandwhethertheyhavebeenfullyimmunised.Areferralpathwaywillbeofferedtowhānau.
FirstclasscompletedbyDecember2016
SecondclasscompletedbyJune2017
6monthlyreport
Target
95%
33
Objective Actionstodeliverimprovedperformance
Measure Reporting
MaintainourUnderFivesImmunisationSteeringGroup
Quarterly
Actionstosupportincreasingchildren'simmunisationrates(fortwoyearsandfiveyears)to95percent:
- Include,monitorandincreasethefour-year-oldmilestoneaspartoftheimmunisationalliancesteeringgroupoutputs.
Quarterly
34
Immunisation(2)Whyisthisapriority?
In2014Māorihadthesecondhighestrateofinfluenzaconfirmedhospitalisation,49.2per100,000.The65yearsandoveragegroupalsohavethehighestratesofinfluenzaadmissionstoICU.A75percentinfluenzavaccinationrateisrequiredtoprovidethebestprotectionforthisagegroupandinparticularforMāori.IfweareabletoincreaseimmunisationratesforMāoriwewillseeasignificantreductioninoverallinfluenzacases
BaselineMeasure
Māori 55.25%
Non-Māori 56%
Objective Actionstodeliverimprovedperformance
Measure Reporting
IncreasethepercentageofKaumātuaandKuia(65yearsandover)seasonalinfluenzaimmunisation
ContinuetoworkwithlocalMāoriprovideronKaumātuaprogrammestopromoteandprovideaccesstoout-reachfluvaccinationservicestoMāoriwithintheWaikatoDHBdistrict.ImplementationofprojectinMarch2016tocoincidewiththebeginningofthe2016fluimmunisationseason(MauriorakingāKaumātua)andwillcontinuethroughtoSeptember2016.
WorkingwithMāoriproviderswillensurethatimmunisationischampionedonawidefrontratherthanjustthroughGPservicesormoremainstreamservices.
TePunaOrangawillreportonthenumberKaumatuaandKuiaimmunisedataprogrammeoreventTePunaOrangawasapartnerat.
Quarterlyreport.
ContinuetospreadthehealthmarketingcampaignthatpromotesthebenefitsofimmunisationandidentifieswhereKaumātua65yrs+cangetfreeimmunisation(campaignimplementedinMarch2016ledbyTeTumuakiAnaruThompsonandhiswife).
EnsurethatKaumātua65yrs+canaccessfreeinfluenzaimmunisationfromnotonlyGP’sbutalsoPharmaciestoensureawiderrangeofservicescanprovideimmunisation
Numberofeventsand/ordisplaysthemarketingcampaigntookplace.
Providealistofparticipatingpharmaciesandotherservicesthathavefreeinfluenzaimmunisationfor65yearsandover.
Target
75%
35
Objective Actionstodeliverimprovedperformance
Measure Reporting
inamoretimelyandefficientmanner.
Design,developandimplementanassessmenttoolbasedontheHHTamarikiAssessmentToolspecificallytargetingKaumatuaandKuiawithaspecificseasonalinfluenzareferralpathwayforthe2017influenzaseason.
ToolspecificallydevelopedforKaumatuaandKuiabyDecember2016
6monthlyreport
ReviewandimplementKaitiakiandKaitakawaengaculturalassessmenttoincludeaspecificseasonalinfluenzareferralpathway.
CulturalassessmentreviewedandimplementedbyDecember2016
6monthlyreport
TheMidlandHealthNetwork(MHN),NationalHauoraCoalition(NHC)andtheHaurakiPHOwillprovideinformationandvaccinateKaumātua65yrs+acrosstheWaikatoDHBdistrict
WaikatoDHBandTePunaOrangawilldevelopabusinesscaseforanon-siteHartiHauoraHubwhichwillconducthealthpromotionandopportunisticscreeningandimmunisationofMāori.Oneoftheservicesprovidedwillincludeopportunisticimmunisationagainstinfluenza.Thebusinesscasewillbedevelopedby1stJuly2015
TheMidlandHealthNetwork,HaurakiPHOandtheNationalHauoraCoalitionPHOwillallcollaborateindevelopmentofannualPHO/DHBInfluenzastrategy(completedby30thJune2016)
WaikatoDHBwillcollectandmonitorthehealthsectorsperformanceforMāori/highneed65yrs+onamonthlybasisfromGP’sPharmacistsandprimarycareasa
Successwillbemonitoredthroughthecompletionoftaskswithinspecifiedtimeframesandevidenceofanimprovingtrendand/orattainmentoftheseasonalinfluenzaimmunisationtarget.
36
Objective Actionstodeliverimprovedperformance
Measure Reporting
whole(from1stJuly2015to30thJune2016
37
OralHealthWhyisthisapriority?
NationallyasatDecember2014,76%ofallpre-schoolersand64%ofMāoripre-schoolerswereenrolledintheCommunityOralHealthServices(COHS).TheinequitybetweenMāoriandnon-MāorienrolmentsissignificantthereforetheneedformoreMāoritargetedinitiativesandprogrammesiscrucial.
Objective Actionstodeliverimprovedperformance
Measure Reporting
IncreasethenumberofMāoripre-schoolchildrenenrolledintheCommunityOralHealthService
DentalConditions
WaikatoDHBwillworktopromoteearlyenrolmentinChildOralHealthServicesandworktopromoteOralHealthwithwhānau.
OralHealthInformationwill
WiththeimplementationoftheNationalChildHealthInformationplatform(NCHIP)intocommunityoralhealthservicesenrolmentfrombirthwillbeusedforenrolmentforCommunityOralHealthandloggingoforalhealthmilestonesinadditiontodatamatching
OralHealthCo-ordinationandHealthPromotion
CommunityOralHealthwillpromoteoralhealthforpre-schoolerswithaparticularfocusonMāoriWhānau.
NCHIPwillbeusedtorecordenrolment
Quarterly
HartiHauora(HH)TamarikiAssessmenttoolreferralpathwayisevaluatedreviewedandimplementedinWaikatoHospital,withaspecificCOHSreferral
HHTamarikiAssessmentToolisevaluated,reviewedandimplementedbyDecember2016.
PublishevaluationfindingsinAcademicJournalby
Target
95%
38
Objective Actionstodeliverimprovedperformance
Measure Reporting
pathway.
December2016.
6monthlyreportingonHH
ImplementationoftheHHTamarikiAssessmenttoolwithaspecificCOHSreferralpathwayinatleast3othersettingswithinWaikatoandthewiderMidlandregion,toincreasewhānauenrolmentthatmayhavebeenmissedinothersettings.
HHTamarikiAssessmentToolispilotedinatleast1settingattheendofeachofthefollowingquarters-
Q1-Firstsetting
Q2-Secondsetting
Q3-Thirdsetting
6monthlyreportonHH
39
MentalHealthWhyisthisapriority?
NewZealandhasveryhighratesofcompulsionofpatientsundertheMentalHealthAct,comparedwithsimilarjurisdictions.Māoriarenearlythreetimesaslikelyasnon-Māoritobetreatedunderacommunitytreatmentorderwhichrepresentsasignificantdisparity.
BaselineMeasure
Māori 384
Non-Māori 301
Objective Actionstodeliverimprovedperformance
Measure Reporting
ImprovementalhealthandaddictionoutcomesforMāoriwithinHealthWaikatoservices
TheestablishmentoftheworkinggrouptoimproveMentalHealthandAddictionoutcomesforMāoriwithinHealthWaikatoserviceswillcontinuetomeetandplanactivitiesthatwillimpactpositivelyonreducingsection29ratesforMāori.
Improvingtrendinthereductionofsection29CommunityTreatmentordersevidenced.
Quarterlyreporting
Target
N/A
40
Objective Actionstodeliverimprovedperformance
Measure Reporting
TheworkinggrouphasdevelopedasetofindicatorstomonitorperformanceofHealthWaikatoservicesforMāoripatients.
MonitorthepercentageofMāoriwhohaveanacuteadmissionwithin28daysfordischargefromtheinpatientunitascomparewithotherethnicities
PercentageofMāoriinadultinpatientbedsplacedinseclusionandthenumberofhoursMāoriareinseclusionascomparedtootherethnicities
PercentageofMāoriwhoarefollowedupbyCommunityMentalHealthTeamwithin7daysofdischargefrominpatientunit.Measureifthecontacthasbeentelephoneorfacetoface.
PercentageofMāoriwithcurrenttreatment/recoveryplansinplaceascomparedwithotherpopulationgroups.
Aspecificmethodologyhasbeenchosentoprovideanalysisofandmonitorperformanceagainstindicators.Providemonthlyreportsofresults.
WhilsttherearesignificantconcernsabouttheuseandsenseofthisKPI,theDirectorofClinicalServicesforHealthWaikatowill:
•activelyencouragejudicioususesoftheMHA,asclinicalneedsdictate.
•encourageallResponsibleClinicianstoreviewtheiruseofIndefiniteCTorders
ProgressreportedquarterlyinPP26-–MentalHealthandAddictionsServiceDevelopmentPlan
41
RheumaticFeverWhyisthisapriority?
RheumaticfeverisaseriousbutpreventableillnessthatmainlyaffectsMāoriandPacificchildrenandyoungpeopleaged4to19years.ReducingrheumaticfeverwillcontributetoachievingequityofhealthforMāori.
TotalWDHBpopulation
BaselineMeasure
2013/2014 4.8per100,000
2014/2015 3.6per100,000
Objective Actionstodeliverimprovedperformance
Measure Reporting
Reductioninthenumberandrateofhospitalisationsforacuterheumaticfever
ImplementationofactionsidentifiedintheRheumaticFever2015refreshedpreventionplan.
ActionswillbemeasuredspecifictotheactionsnotedintheWaikatoDHB’sRheumaticFeverPreventionPlan
Quarterly
WhareOrahealthyhomesinitiativewillbepromotedandimplementedthroughouttheWaikatoregionforeligiblewhanau.
400healthyhomesassessmentscompletedfromJune2016-2017
Monthlyreporting
EnsurethatallcasesofacuteandrecurrentacuterheumaticfeverarenotifiedwithcompletecaseinformationtotheMedicalOfficerofHealthwithinsevendaysofhospitaladmission.
Annual
Ensurepatientswithahistoryofrheumaticfeverreceivemonthlyantibioticsnotmorethan5daysaftertheirduedate.
Undertakeanannualauditofrheumaticfeversecondaryprophylaxiscoverageforchildrenaged0-15years,youthaged15-24years,andadultsaged25+years.
Identifyandfollow-upknownriskfactorsandsystemfailurepointsincasesofrecurrentrheumaticfever.
Follow-uponanyissuesidentifiedbythe2015/16auditofrecurrenthospitalisationsofacuterheumaticfeverandunexpectedrheumaticheartdisease.
Target
1.2per100,000
42
Objective Actionstodeliverimprovedperformance
Measure Reporting
Confirmationandexceptionreportagainsttheactionstodeliverimprovedperformance
PleasealsoseetheWaikatoDHB’sRefreshedRheumaticfeverpreventionplan-
http://www.waikatodhb.health.nz/assets/public-health-advice/public-health-topics/rheumatic-fever/The-Waikato-DHB-refreshed-2015-Rheumatic-Fever-prevention-plan.pdf
The-Waikato-DHB-refreshed-2015-Rheumatic-Fever-prevention-plan.pdf
43
SuddenUnexpectedDeathinInfancy(SUDI)Whyisthisapriority?
ThetargetforSUDIwillbeloweredfrom0.5to0.4SUDIper1,000livebirths.ThetargethasbeenloweredtomatchthereducedrateofSUDIamongnon-Māoriinfants(0.38SUDIper1,000livebirthsduring2010-2014).YetthereisstillasignificantdifferenceinSUDIratesbetweenMāoriandnon-MāorifamilieslivinginWaikatoDHB.
Thetargetfor‘CaregiversprovidedwithSUDIinformationatWellChildTamarikiOraCoreContact1’isloweredfromallcaregiversto70%ofcaregivers.Thetargethasbeenchangedfromafinaltargettoaninterimtarget.Theinterimtargetisslightlyhigherthanlevelsofcurrentserviceprovisiontonon-Māori(62.6%)duetothehigherSUDIratesofMāori.
BaselineMeasure
Māori SUDIrateper100,000live
birthsbetween2010-2014
1.48per100,000live births
%ofcaregivers
providedwithSUDI
preventioninformationatWellChild
TamarikiOraCoreContact1
39.2%
Non-Māori SUDIrateper100,000live
births
.18per100,000livebirths
%ofcaregivers
providedwithSUDI
preventioninformationatWellChild
TamarikiOraCoreContact1
59.9%
Target
0.4SUDIdeathsper1000Māorilivebirths
IncreaseenrolmentandconsequentaccesstoWellChildTamarikiOraCore
Contact1of70%caregiversofMāoriinfantstoenabletimelyprovisionofSUDIpreventioninformation
44
Objective Actionstodeliverimprovedperformance Measure Reporting
ReductioninMāoriratesforsuddenunexpecteddeathinInfancy(SUDI)
PartnershipwithWhakawhetuNationalSUDIPreventionforMāoritoprovideworkforcedevelopmentplanforpreventiontrainingtohealthworkersandotherkaimahi
CreateplanbyendofQ2incollaborationwith‘calltoactiondiscussiondocument’(actionpointbelow)
Annualreport
WaikatoDHBwill:
PromotetheservicesofWellChildTamarikiOraprovidersandtimelyenrolment(4-6weeks)duringpregnancyandpost-natalperiod
WorkwithLMC’s,Maternityfacilities,NCHIPandtheChildHealthCoordinationServicetoensurethatthereistimelyenrolmentintoWCTOservices
EnsurethatWCTOprovidersbuildgoodrelationshipswithLMC’sandmaternityfacilitiestoensurereferralstoWCTOaredoneinatimelymanner.
WorkwithkeymaternitypeopleandWellChildTamarikiOraproviderswithWCTOQualityManagertodevelopacontinuityofCarepathway
WorkwithWCTOproviderstoensureSUDIinformationisincludedintheircore1check
Increaseinthenumberofcore1checksby31Dec2016
CompletedbyQuarter12016/2017
Annualreport
6monthlyreport
Q1report16/17
AsaresultoftheTamaitiHuiMay2016aCalltoActiondiscussiondocumentspecificforWaikatoregionaddressingantenataleducationandcare,andpostnatalcarewillbeproducedtoaddressSUDIriskfactors.InputfromWhakawhetu,TePunaOranga,WDHB,WaikatoCYMRC,maternitystakeholders,WCTOgovernancegroup,andPHOwillbeincluded.
Documentwillhaveanumberofactions-
1. CollaborativeapproachtoSUDIprevention
2. Specificactivities,initiatives,projectstoassistcommonvision
3. SupportforhealthservicestoimplementSUDIpreventionfactors,i.e.safesleeppolicies
4. Improvecommunicationbetweenprovidersandhealthandsocialservices
Annualreport
45
Objective Actionstodeliverimprovedperformance Measure Reporting
5. Improvedaccessforwhanau,hapῡmama,andcommunitytohealthresources/healthcare
Businesscaseforsustainablefunding
Reviewandamendifnecessary‘SafeInfantSleeping–Birthto1Year’policyusedwithinWaikatohospital
RenewalofpolicybyendofQ3
Annualreport
TePunaOrangamembershipontheWaikatoChildandYouthMortalityReviewCommitteetoproviderecommendationstoNationalCYMRCwhocaninfluencepolicyataNationallevel.
Attendanceatminimumof90%ofmeetingsthroughouttheyear
6monthlyreporting
WaikatoDHBwillinvestinpēpi-pods,mini-pod,wahakuraandcotsforatriskwhānau.
Purchaseaminimumof400safesleepdevices.
SafeSleepmessagesandpracticesaredistributedwithpēpipodsandwahakuratohighneedswhānauresidingwithintheWaikatoDHBregion
Minimumof400pēpi-podsandwahakuradistributedJune2016toJune2017.
QuarterlyreportfromChangeforourChildren
Thenumberofpēpi-podsandwahakuradistributedtowhānaudata,loadedontoChangeforourChildrendatabase
WaikatoDHBwillpromoteSafeSleepmessagesandtheWaikatopēpi-podsandwahakuraprogrammeatcommunityeventswithspecificemphasisonsafesleepday.
Participationinatleast1eventduringsafesleepday
Annualreport
Promoteandtrainkaimahithatworkwith,orintendtoworkwithhapūMāori,onhowtousethenewlydevelopedHapūWanangaCurriculum(KaupapaMāoriPregnancyandParentingcurriculum)fortheMidlandregionthatpromotesSUDIpreventionmessagesandsolutionsforwhānau.
2xtrainingsessionsthroughoutMidlandregionbyJune2017
6monthlyreport
46
Objective Actionstodeliverimprovedperformance Measure Reporting
HartiHauora(HH)TamarikiAssessmenttoolreferralpathwayisevaluatedreviewedandimplementedinWaikatoHospital,withaspecificSUDIpreventionreferralpathway.ThepathwaymayrequireaccesstoasafesleepdeviceorreferraltoservicesthatsupportSUDIprevention,i.e.WellChildTamarikiOraenrolment,immunisationforpēpi,smokefreepathwayorbreastfeedingsupport.
HHTamarikiAssessmentToolisevaluated,reviewedandimplementedbyDecember2016.
PublishevaluationfindingsinAcademicJournalbyDecember2016.
6monthlyreportingonHH
ImplementationoftheHHTamarikiAssessmenttoolwithaspecificSUDIpreventionreferralpathwayinatleast3othersettingswithinWaikatoandthewiderMidlandregion,toincreasewhanauenrolmentthatmayhavebeenmissedinothersettings.ThepathwaymayrequireaccesstoasafesleepdeviceorreferraltoservicesthatsupportSUDIprevention,i.e.WellChildTamarikiOraenrolment,immunisationforpēpi,smokefreepathwayorbreastfeedingsupport.
HHTamarikiAssessmentToolispilotedinatleast1settingattheendofeachofthefollowingquarters-
Q1-Firstsetting
Q2-Secondsetting
Q3-Thirdsetting
6monthlyreportonHH
ReviewandimplementKaitiakiandKaitakawaengaculturalassessmenttoincludeaspecificSUDIpreventionreferralpathway.ThepathwaymayrequireaccesstoasafesleepdeviceorreferraltoservicesthatsupportSUDIprevention,i.e.WellChildTamarikiOraenrolment,immunisationforpēpi,smokefreepathwayorbreastfeedingsupport.
CulturalassessmentreviewedandimplementedbyDecember2016
6monthlyreport
WhareOraassessmenttoolwillbereviewedtoincludeaspecificreferralpathwayforSUDIpreventiontoensureasafesleepdeviceforpēpiisavailable,suchasapēpi-podorwahakura.
WhareOraassessmenttoolisreviewedtoincludeaspecificsafesleepdevicereferralpathwaybyDecember2016.
Monthlyreporting.
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LOCAL PRIORITIES AND INDICATORS
1. SupportingWhānauOraProviderCollectivesandWhānauOraCollectivePlan
WiththedisestablishmentoftheWaikatoRegionalLeadershipGroupforWhānauOraandthe
movetowardstheCommissioningAgencyTePouMatakanatheshapeofWhānauOraonour
local landscape has shifted significantly. Currently the Waikato DHB district has only one
WhānauOracollectivewithinitsdistrictwhichisfundedbyTePouMatakanatheWhanauOra
CommissioningagencyfortheNorthIslandandthatisTeNgira.
Te Ngira comprises of membership from Wāhi Whanui, Raukura Hauora, Nga Miro and Te
Kohao Health. Formerly these providers had aligned themselves to Te Koiora our Northern
CollectiveandtotheNationalUrbanMaoriAuthority(NUMA).
AsawayforwardtheWaikatoDHBhascommittedtodeveloping“TePoutamaoWhanauOra”anaction
planwithTeNgiratostrengthentheimplementationofWhanauOrawithintheWaikatoDHBdistrict.
“TePoutamaoWhanauOraActionPlan2016”will define jointwork and support fromWaikatoDHB
towardsTeNgiraandWhanauOraasaformalprogrammewithintheWaikatoDHBdistrict.Keyareasof
focuswillfocusonthreekeyareas:
1. Mahitahi-toworkasoneincollaboration
2. Kaitiakitanga-IwiguardianshipinrelationtoWhanauOra
3. Puawai–tosupportWhanauOracapacitydevelopment
Actionsagainsttheabovethreestrategicdirectionsaredetailedinthefollowingactiontables.
WorkingwiththeWhānauOraPartnershipgroupiscrucialtoimprovingthehealthofMāoriinWaikato.TheactivityinthefollowingactionplancannotbeachievedwithoutcollaborationbetweenWhānauOraproviders,TePunaOranga(MāoriHealthService)andWaikatoDHB.
InNovember2015,theWhānauOraPartnershipGroupagreedtoasetofindicatorstosupportWhānauOra,includingfivekeyareasforthehealthsectorthatcontributetoWhānauOratoachieveacceleratedprogresstowardshealthequityforMāoriandPacific,andWhānauOrainthenextfouryears.Theindicatorsare:
• Mentalhealth(reducedrateofMāoricommittedtocompulsorytreatmentrelativetonon-Māori);
• Tobacco(95percentofallpregnantMāoriwomensmokefreeattwoweekspost-natal);• Asthma(reducedasthmaandwheezeadmissionratesforMāorichildren(ambulatory
sensitivehospitalisations0-4years));• Oralhealth(increaseinthenumberofchildrenwhoarecariesfreeatage5);
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• Obesity(byDecember2017,95percentofobeseMāorichildrenidentifiedinB4SchoolCheckprogrammewillbeofferedareferraltoahealthprofessionalforclinicalassessmentandfamilybasednutrition,activityandlifestyleinterventions).
Objective Actionstodeliverimprovedperformance Measure Reporting
TosupportthecapabilityandcapacityofWhānauOrawithintheWaikatoDHBdistrict
TheWaikatoDHBhascommittedtodeveloping“TePoutamaoWhānauOra”anactionplanwithTeNgirathroughoutthe2016-2017periodtostrengthentheimplementationofWhānauOrawithintheWaikatoDHBdistrict.
“TePoutamaoWhānauOraActionPlan2016”willdefinejointwokandsupportfromWaikatoDHBtowardsTeNgiraandWhānauOraasaformalprogrammewithintheWaikatoDHBdistrict.Keyareasoffocuswillfocusonthreekeystrategicdirections:(1)Mahitahi-toworkasoneinthespiritofco-operation.Keyareasoffocusinclude:
-progressingintegratedcontracts
-identifyhowWaikatoDHBcangivesupportto
TeNgiracollectiveimpactproject
-sharingofinformationandexpertisetosupport
WhānauOraprogrammewithintheWaikato
district
-secondmentstosupportWhānauOra,
-mediaandcommunicationsplantopromote
WhānauOradevelopmentsandsuccessesinthe
Waikatodistrict,
-promotionasappropriatetowhanauonhow
toaccesswhānaudirectfunding/support,
-formalisationofprocessestoensurethatthe
WhānauOracollectivescanparticipatein
WaikatoDHBAnnualPlanningandMāoriHealth
Plandevelopment,
-completionofastocktakeofhowothersectors
areprogressingWhānauOrawithaviewto
identifyopportunitiestocollaborate.
Quarterlyreportcompleteddetailingprogressagainstinitiativesandactivitiesin“TePoutamaoWhanauOraActionPlan”2016-2017,90%ofactionsandoutcomesdetailedinplanattained.
Quarterlyreporting
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(2)Kaitiakitanga-Iwiguardianship,Keyareasoffocusinclude:
-establishmentofprocessesthatsupport’ourIwi
RelationshipBoardIwiMaoriCouncilto
effectivelymonitorandevaluateWhānauOra
withintheWaikatoDHBdistrict
-ensurethatsuccessstories,keytrendsandthe
performanceofWhānauOraimplementationin-
theWaikatoDHBdistrictispresented2xper
yearbyTePouMatakanatoIwiMaoriCouncil.
(3)Puawai–tosupportWhānauOracapacity
development,keyareasoffocusinclude:
-progressingintegratedcontracts,
-identificationoffundingshortfallsthatimpede
WhānauOrarolloutintheWaikatoinclusiveof
serviceprovisiongapsinHauraki,Raukawaand
Maniapoto.
-workforcedevelopment/trainingfor
WhānauOrakaimahi,explorationofthe
feasibilityofhowresearchcandemonstrate
thevalueaddedbyWhanauOra.
Quarterlyreportcompleteddetailedprogressagainstinitiativesandactivitiesin”TePoutamaoWhānauOraActionPlan”2016-2017,90%ofactionsandoutcomesareattained.
Quarterlyreporting
StrengthentherelationshipthattheWaikatoDHBhaswithitslocalWhānauOracollective
WaikatoDHBwillactivelypromoteWhānauOracollectivesprogrammes,initiatives,projectsthatimprovethehealthofMāoriintheWaikatoregion.
Annualreport(quarter4)onactivityundertakentoprogresstheWhānauOraapproach
Quarterlyreporting
WaikatoDHBwillcollaboratewithWhānauOracollectivestomeetthenationalindicatorswithintheMāoriHealthPlan.
Activecollaborationandengagementinatleast3projectsthroughouttheWaikatoregionwithWhānauOraCollectivesbetweenJune2016-June2017
Quarterlyreporting
TePunaOrangawillactivelyconnectwhānauandcommunitieswithWhānauOraCollectivesservices.E.g.OneofthereferralpathwaysusedinHapῡWanangaclassesinHamiltonforCommunityOralHealthServicesincludeRaukuraHauoraOTainui.
Referralpathwaysforassessmenttools(HH,KaitiakiandKaitakawaenga),andprogrammessuchasHapῡWanangawillbereviewedand
Quarterlyreporting
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monitored6monthly
MentalhealthandAddictions
WorkinggrouptoimproveMentalHealthandAddictionoutcomesforMāoriwithinHealthWaikatoservicesestablishedandindicatorsidentified.
Improvingtrendinthereductionofsection29CommunityTreatmentordersevidenced.
MonitorthepercentageofMāoriwhohaveanacuteadmissionwithin28daysfordischargefromtheinpatientunitascomparewithotherethnicities.
PercentageofMāoriinadultinpatientbedsplacedinseclusionandthenumberofhoursMāoriareinseclusionascomparedtootherethnicities
PercentageofMāoriwhoarefollowedupbyCommunityMentalHealthTeamwithinsevendaysofdischargefrominpatientunit.Measureifthecontacthasbeentelephoneorfacetoface.
PercentageofMāoriwithcurrenttreatment/recoveryplansinplaceascomparedwithotherpopulationgroups.
Quarterly
Tobaccocontrol Trainkaimahithatworkwith,orintendtoworkwithhapūMāori,onhowtousethenewlydevelopedHapūWanangaCurriculum(KaupapaMāoriPregnancyandParentingcurriculum)fortheMidlandregionthatpromotes,empowersandencouragesmama.
2xtrainingsessionsthroughoutMidlandregion
Quarter4
51
WaikatoDHBiscommittedtoaheightenedfocusinthisareatoachieveacceleratedprogresstowardsWhānauOraandhealthequity.ThroughTePunaOranga(MāoriHealth
Design,developandimplementassessmenttoolsbasedontheHHTamarikiAssessmentToolspecificallytargetingwāhinetoincludeasmokefreereferralpathway.
Toolspecificallydevelopedforwāhine
Quarter2
ReviewandimplementKaitiakiandKaitakawaengaculturalassessmenttoincludeaspecificsmokefreereferralpathwayforhapῡmama.
Culturalassessmentreviewedandimplemented
Quarter2
Asthma ContinueimplementingWhareOrahealthyhomesinitiativeseekingtomakehomeswarmer,drier,healthiersaferandreferontosocialsupportservices/WhānauOraifrequired.
Complete400HealthyHomeAssessmentsintheWaikatoDHBdistrict
Quarter4
Oralhealth HartiHauoraTamarikiAssessmenttoolwillincludeanoralhealthenrolmentassessmentandreferralpathwayofallchildrenadmittedandscreenedusingtheHartiHauoratool.
IncreasedenrolmentofMāoritamarikiandPacificchildrenwithCommunityOralHealthService
Quarter3
HartiHauoraTamarikiAssessmenttoolreferralpathwayisevaluatedreviewedandimplementedinWaikatoHospital,withaspecificCommunityOralHealthServicereferralpathway.
ImplementationoftheHartiHauoraTamarikiAssessmenttoolwithaspecificCommunityOralHealthServicereferralpathwayinatleastthreeothersettingswithinWaikatoandthewiderMidlandregion,toincreasewhānauenrolmentthatmayhavebeenmissedinothersettings.
HartiHauoraTamarikiAssessmentToolisevaluated,reviewedandimplemented
AssessmentToolispilotedinatleast1settingperquarter
Quarter2
Quarters1,2,3
Obesity HartiHauoraTamarikiAssessmenttoolwillincludeabodymassindexassessmentandreferralpathway
Toolincludesabodymassindexassessmentandreferralpathwayofallchildrenadmittedandscreened
Quarter4
Partnership WaikatoDHBactivelyengageandcollaboratewiththeWhānauOraCommissioningAgenciesinitspriorityprogrammeplanninginitiatives
AnnualreportonactivityundertakentoprogresstheWhānauOraapproach.
Quarter4
52
Service)wearerunninganumberofholisticprojects/programmestoachievetargetedimprovements.Theseprojects/programmeswillimpactonanumberofdifferenthealthindicators.Thefollowingtableprovidesasummaryoftheseholisticprojects/programmes.
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2. WorkforceObjective Actionstodeliverimprovedperformance Measure Reporting
AworkforcethatisreflectiveandresponsivetotheneedsofMāori
BiculturaleducationforWaikatoDHBstafftobuildculturalcompetency
E-learningBiculturalEducationTrainingandEthnicityDataCollectiontrainingdevelopedandimplementedbyWaikatoDHB
AllnewandexistingstaffwhohavenotcompletedTreatyofWaitangitrainingareenrolledontotheonlineTreatyofWaitangiandhealthcaree-course
AllstaffworkingdirectlywithMāoripatients,whānauand/orcommunityaresupportedtoattendTeAraTotika(TOWworkshop)
ContinuetopromoteHauoraMāoriTrainingFundtokaimahiworkingintheunregulatedhealthanddisabilitysectorwithintheWaikatoregion.
Gateway-exposureofMāoristudentstohealth(year12/13)(April2017)
ContinuetoworkwithHumanResourcestosupportgatewayplacementsatWaikatohospitalforMāoristudentsinterestedinahealthcareer
Annualreport(quarter4)onproportionofstaffinselectedcategoriesinMidlandDHB’swhoareMāoriwithsignificanttrendsidentified
Quarterly
3. VirtualCareObjective Actionstodeliverimproved
performanceMeasure Reporting
SystemIntegration
Healthneedsassessmenttoolsusedintheareasofchildhealthandmentalhealthandaddictions.
Updatereportidentifyingprogressmadeduringthequarteragainsttheactionstodeliverimprovedperformance.Thereportwillinclude:
WhethertheDHBisontrackmeetingeachdeliverablebytheendofquarter4,includingcommentonspecificactionsdeliveredinthequarter
Wheredeliverablesarenotontrackthereportmustincludemitigationstrategiesandnew
Quarterly
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Objective Actionstodeliverimprovedperformance
Measure Reporting
timeframesfordelivery
Wherequantitativemeasuresarereported–Reportsmustincludebaseline,targetandquarterlyperformanceprogress
PharmacyActionPlan
Developandimplementmedicinesadherenceandoptimisationservicesofhighquality(thePharmacyCouncilofNewZealand’sMedicinesManagementCompetenceFrameworkandtheNationalPharmacistServicesFrameworkaregoodreferencesindevelopingtheseservices)thatmustincludetargetedvolumesforeachservicebyyearend
Developandimplementanefficientmedicinessupplychain
Commissionservicestobestmeettheidentifieddemand.
Updatereportidentifyingprogressmadeduringthequarteragainsttheactionstodeliverimprovedperformance.Thereportwillinclude:
WhethertheDHBisontrackmeetingeachdeliverablebytheendofquarter4,includingcommentonspecificactionsdeliveredinthequarter
Wheredeliverablesarenotontrackthereportmustincludemitigationstrategiesandnewtimeframesfordelivery
Wherequantitativemeasuresarereported–Reportsmustincludebaseline,targetandquarterlyperformanceprogress
Quarterly