Apr 22, 2013 ... Barbara Metzger (standing) joins local children at a Smokefree event. Southland
Wahine Hapu smokefree programme success. Meeting the ...
A DV E R T I S I N G F E AT U R E
Better Health
W E L C O M E T O B E T T E R H E A LT H
Meeting the challenge
Over recent months I have written about the Southern Way, a programme to ensure that we provide the community with the quality health services it needs both now and in the future. It sets out to ensure that: • Patients are at the centre of everything we do • create a high performing organisation with a focus on quality • become a single unified DHB • provide financially sustainable and clinically sustainable services to the community We have many challenges ahead if we are to reach these goals as we fully complete the merger of the two former organisations and manage financial pressures and years of under investment in facilities and services. To achieve these goals will require change, which I recognise can be understandably confronting to staff and the community. The story below outlines the process we are undertaking, which will ensure that the decisions we make about changes to the organisation are good for the patient, good for the health system and are financially sustainable. It also sets out to ensure that we develop staff and remain a leading training organisation. You will be reading about these changes over coming months as we announce a proposal for the next stage of an organisational realignment, work with Health Benefits Ltd on savings from reduced duplication within the health sector and look at the way in which we can deliver better services more efficiently. This will include a proposal this week to look at the way in which we deliver our fertility services in Dunedin and whether we could provide a better service by outsourcing to a private provider. If we decided to move ahead with it, this proposal will ensure that clinical staff are transferred to any new provider and that we continue to provide an outstanding fertility service to the community. As always, if you would like to let me know what you think about this direction, please email me at
[email protected] Carole Heatly Chief Executive Officer
DHB-wide strategy targets world-class performance Southern DHB is rolling out a new quality improvement and performance excellence strategy designed to drive the organisation’s performance to world-class levels. The strategy, which works across all areas of the DHB, draws from international quality improvement and performance excellence philosophies whilst being tailored to meet the unique needs of DHB staff, providers and patients. The “Quality Improvement and Performance Excellence Strategy” has a four-fold aim: • To improve the health of the DHB’s population and reduce inequalities • To improve the safety and care experience of its patients • To improve the delivery of care within budget • To improve learning opportunities for current and future staff Together these aims provide a balanced platform that will guide future decision-making and planning, and ensure an aligned strategic focus across the organisation. The next few months will see the strategy rolled out across the organisation to introduce staff to the methodologies and tools that will support them to improve their quality improvement and performance measures. The first area to be focused on will be patient safety. The new strategy is part of the DHB’s ongoing commitment to achieving its “Southern Way” vision of becoming a high performing unified organisation which places patients at the centre of every decision it makes, and provides financially and clinically sustainable services to the community it serves.
Barbara Metzger (standing) joins local children at a Smokefree event
Southland Wahine Hapu smokefree programme success A Southland-based smoking cessation programme designed to work with women who are pregnant or who have a baby of up to six months of age is proving effective for local women according to latest national figures. Nga Kete Matauranga Pounamu is one of six providers around the country delivering the “Wahine Hapu” programme — a culturally based programme which is tailored to be effective for women and their families/whanau experiencing this important time in their families’ lives. The programme is delivered by a dedicated Wahine Hapu — coach who works with clients to helps them build their understanding of the risks posed by smoking, helps them identify their personal triggers, and assists them with creating tailored strategies for quitting and making their homes and living areas smokefree. The programme has performed consistently well since commencing six years ago and recently has achieved impressive results, especially when compared to national data. In the first quarter of the 2012/2013 year the programme achieved 142% of its target for enrolments and had 62% of
its clients self-reporting as being smokefree after 3 months, compared with a national average of 38%. “Finding out you are pregnant often gives women a stronger reason to give up, and this programme is especially tailored to help women and families during this emotional time,” explains Tracey Wright–Tawha, Chief Executive Officer, Nga Kete Matauranga Pounamu. “Our success to date is mainly due to having such a great coach in Barbara Metzger — the strong relationships that she builds with the individuals, taking time to work with them, to understand their challenges and to really listen to each woman, that’s Barbara’s unique brand of magic — it’s a real skill.” Having excellent referral pathways in place has also been credited with helping to make the programme a success, as Tracey Wright-Tawha explains: “We have strong Memorandums of Understanding in place with many local providers, including midwives, A&E staff, GPs and other community-based NGO (non-government organisation) groups who understand how the programme works and help us to reach out to more local women.”
Good progress made by Southern DHB on Wakatipu Health Good progress has been made by Southern DHB in implementing the National Health Board’s recommendations for the Wakatipu’s future health care provision, according to the Wakatipu Health Reference Group’s 2012 Annual Report. The reference group, which was established in October 2011, has been meeting regularly to provide input into health services planning for the area and to monitor the DHB’s delivery of the 21 recommendations laid out by the National Health Board in its 2011 report. According to the group’s annual report, during the last 15 months “there has been significant progress in improving the services offered to residents of the Wakatipu Basin”. This includes the following: • More outpatient services are being offered at Lakes District Hospital (LDH), thereby reducing the numbers of community members having to travel further afield.
• Significant progress has been made on developing the concept of a health campus for the Wakatipu Basin located on the current LDH site. • Increased ability for local doctors to undertake work in areas of special interest, further reducing the need for patients to travel to see consultants. • Confirmation that a CT Scanner is to be located in Dunstan in the near future. Of the 21 recommendations made in the original report, nine are complete, with the others all being in progress. Executive Director of Planning and Funding Robert MackwayJones commented: “We are really pleased with the progress we’ve made on a number of recommendations, which have resulted in improved health services being provided to the Wakatipu community, closer to their homes.” 0413n4552-18-F
How your home affects winter health
Now is the time of year to think about keeping your home healthy this winter. Housing conditions can contribute significantly to poor health, and factors such as temperature, humidity, ventilation and overcrowding all play a part in the health of your family. Public Health South Team Leader Tom Scott explains: “Surveys indicate New Zealanders spend 70 percent of their lives indoors, and around a third of our homes are damp. If a home is cold and damp, this is going to have a negative effect on health and will cost more to heat. Having a warm, dry and well-ventilated home is key to staying healthy through winter.” The Southern District Health Board (SDHB) supports retrofitting insulation into older and colder houses through the Healthy Homes Insulation grants. Criteria for these grants vary across the Southern District. People interested in getting an assessment should contact their local Council in the first instance. The Energy Efficiency and Conservation Authority (EECA) has a lot of good information on how to maintain a healthy home. More detailed information is available on the website http://www.energywise.govt. nz/tools/warm-healthy-home but the basics include: • Ensuring the wet areas of the house are well ventilated. This includes bathrooms, kitchens and laundries. • Check under your house. Is the underfloor well ventilated, are there any signs of dampness, mud or pooled water? This can be fixed by diverting water away from under the house, installing more underfloor vents and/or putting a vapour-proof barrier down to stop rising damp. • Avoid drying clothes inside. If you use a dryer ensure that it is ventilated to the outside. • Put lids on pots when cooking. • Avoid using unflued gas heaters. These add a lot of moisture to the air and should be used with the window open to let fresh air in and let toxic combustion gases escape. • Air your house at least once a day with windows and door open to create a cross-draught. Choose a time to do this when the home is not being heated. Heating accounts for about 29 percent of home energy consumption, yet a lot of NZ homes are still not warm enough in the winter. There are a lot of options that relate to heating but as a rule of thumb: • Living rooms should be at a minimum of 18 degrees Celsius (or 20 degrees for vulnerable groups such as the elderly, the ill, and small children) • Bedrooms should be at a minimum of 16 degrees. • When considering heating, you should take steps to minimise heat loss and if possible choose an efficient form of heating. Having thermal backed curtains that are drawn at sundown, draught-proof doors and windows, heatpumps, pellet fires or modern wood burners are all good ways of making homes warmer.
New liver diagnostic tool for Southern DHB Southern DHB clinicians are excited by the improved care the new Fibroscan tool will enable them to offer patients who have, or are suspected of having, liver disease. Fibroscan enables clinicians to diagnose and monitor liver health without having to resort to invasive procedures such as biopsies. Gastroenterology Clinical Leader Jason Hill explains, “Fibroscan is essentially measuring the stiffness of the liver, which is an indicator of the progression of liver diseases like hepatitis or cirrhosis. However, unlike previous techniques, using Fibroscan is painless, quick and easy. The scan only takes a few minutes, and patients are given the results straight away.” “This is a huge step forward for the quality of care we can offer patients as it will result in a significant reduction in the need to do liver biopsies, which are obviously more uncomfortable and time consuming for patients.” The Fibroscan is likely to reduce the number of liver biopsies by 50-60 percent and may be a more suitable option for a number of people, including those with bleeding disorders and children. The Fibroscan device will be based in the Department of Gastroenterology at Dunedin Hospital, but is portable, so clinics will be able to be carried out at other Southern DHB sites in the future.
Left to right: Southern DHB District Programme Leader Vaccine Preventable Disease Team Jillian Bonniface, Charlotte Garchow and Kate Lilley.
Immunise on time, every time to protect your child – it’s free Southern District will be celebrating Immunisation Week between 22-28 April along with the rest of New Zealand and about 180 other countries and territories as part of a World Health Organisation initiative. Parents are being encouraged to protect their families by ensuring they immunise their children on time, every time. Dr Keith Reid, Medical Officer of Health says immunisation is a great example of the importance of protecting individuals to then protect the communities of Otago and Southland, which in turn protects New Zealand. The global theme for 2013 is ‘Protect your world — get vaccinated”. Immunisation is one of the most successful and cost-effective health interventions and prevents between 2 and 3 million deaths every year. In New Zealand, there is a particular focus on whooping cough, measles and pneumococcal disease.
The national whooping cough outbreak is continuing and in the first three months of this year, in the Southern District there have been 72 cases of whooping cough. “The good news” says Dr Reid “is that parents can help protect their baby by getting them vaccinated free as part of the national immunisation schedule, starting at six weeks of age. Pregnant women can be immunised for free too from 28-38 weeks of their pregnancy, protecting themselves as well as their newborn babies.” Southern District is well on its way to achieving the Ministry of Health immunisation health target of 95% coverage by December 2014, currently having 93% of eight-month-olds fully immunised, against the national coverage of 89%. If you would like more information contact your family doctor or practice nurse, the local immunisation co-ordinator (Dunedin 03 476 9800 or Invercargill 03 211 0900), telephone 0800 IMMUNE or visit immune.org.nz
Southern DHB welcomes new executive director finance Southern DHB has welcomed Peter Beirne as its new Executive Director Finance. Peter comes with a wealth of executive-level experience in the Health and Human Services sector including over 20 years in senior executive roles. “Peter is a welcome addition to our leadership team. He has a great deal of experience and his background in health will help take the organisation forward,” said Southern DHB Chief Executive Officer Carole Heatly. Mr Beirne, originally from Palmerston North, is a Massey University graduate and a Chartered Accountant. His previous roles include Northern Territory Department of Health and Families Chief Operations Officer and Executive Director of Acute Care, Whanganui District Health Board General Manager Corporate Services/Chief Financial Officer, and MidCentral Health Ltd/MidCentral District Health Board Chief Financial Officer. Peter is pleased to be back in New Zealand and said, “What appealed about the role was that it is an executive role in a large DHB with a location away from significant population.
The region is well resourced in terms of health services including a tertiary teaching hospital and a modern hospital in Invercargill. There are a number of challenges for us all in the next few years which I am looking forward to.” Peter enjoys outdoor activities including skiing, cycling and tramping and is very much looking forward to exploring the area with his family. 0413n4553-18-F
