DECEMBER 2013

C nnect +A COUNTIES MANUKAU HEALTH PUBLICATION

HEART CHECKS

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I’ve had my heart health check!

Have you checked your engine?

MATERNITY CARESafe Sleep and Smokefree Pregnancy Pilot

Help to prevent heart attacks

and strokes

CONNECT+ I PAGE 2

ContentsOral Health Services 3

A new start 3

Pacifi c Cardiac Rehabilitati on (PCR) 4

Hand hygiene pays dividends 4

Advance Care Planning 5

Beyond 20,000 Days progress 5

A place for all 6

Thanks to Primary Care 6

Spotlight on maternity care 7

Midwives go live 7

Safe sleep for babies 7

Smokefree pregnancy pilot 7

100% free home insulati on 8

Singing uplift s staff 8

New 12 point fundraising plan 9

Whaanau suite 9

Thank you Warehouse shoppers 9

APAC Forum 10

Lend a hand 10

Core leadership programme 10

Walking the Talk 10

We need your feedback 11

Flu immunisati on rates improve 11

Our changing face 11

Pati ent feedback 11

My Christmas 12

A hairy situati on 12

Introducing Phillip Balmer 12

From the CEO

CM Health produces Connect+ three ti mes a year. If you have something to share, or would like to receive a copy of this publicati on, please contact the Communicati ons Team via email, communicati ons@middlemore.co.nz.

Over 200 CM Health staff took the opportunity to have a ‘Heart Check’ at Ko Awatea, which included a cholesterol level and blood pressure check and a personalised electronic ‘heart forecast’. As a result many people are committi ng to a healthier diet and a more acti ve lifestyle, with some making the decision to give up smoking.

“It’s important that everyone who is eligible has a heart check,” says Benedict Heff ord. “The more informati on we have about our health and how our lifestyle is impacti ng our health, the more we can take acti on to stay well.”

If you have concerns about your heart, please see your family doctor or practi ce nurse for advice and support.

Welcome to the Christmas editi on of Connect+. It is that ti me of the year that feels freneti c andrushed and with too much to do, but I want totake ti me to refl ect on the past year and the achievements of the organisati on.

We hosted the second APAC Forum in Septemberwhich was a huge success, with over 1,040people from 23 countries att ending the eventof the year. Over the course of 3 days people heard from some of the best minds in healthand quality improvement (locally, nati onally and

internati onally). Key note speakers included Maureen Bisognano, President andChief Executi ve Offi cer, Insti tute for Healthcare Improvement and Hon MichaelKirby, former Justi ce of the High Court of Australia.

Our 20,000 Days Campaign has been a huge success with an esti mated 23,060 healthy days being given back to our community. This really is an achievement and congratulati ons to all for your hard work on this. Further our Central LineAssociated Bacteremia (CLAB) project has had a huge impact.

Our performance in meeti ng the Ministry of Health Health Targets has beenoutstanding – we are the highest performing large DHB in the country andthat is something we can all be proud of.

Our localiti es project is humming along and is being used as an example by the Minister of Health in how to get it right. We now have 4 localiti es in place – Franklin, Eastern, Otara/Mangere and Manukau.

While it is with great sadness that we farewell our long-serving anddisti nguished Chair, Professor Gregor Coster, I am sure you will join me inwelcoming Dr Lee Mathias as our incoming Chair. Dr Mathias is also deputychair of ADHB. Dr Mathias has a wealth of private and public healthcare experience. She has worked in the health services sector for over forty years,as a clinician, a business owner, a consultant, an educator, and as a Board director. She has made an invaluable contributi on to midwifery and maternity care in New Zealand.

In recent years Dr Mathias has transferred her experience to the interrelatedareas of social, economic and housing developments. She has built areputati on as someone with high integrity, strong professionalism and passion, and is committ ed to high quality outcomes in all her endeavours.Dr Mathias was made an Offi cer of the New Zealand Order of Merit, and is anAccredited Fellow of the Insti tute of Directors in New Zealand.

We wish Dr Mathias a very warm Counti es welcome.

I hope you have a very happy and safe festi ve season and take ti me to rest,recharge and spend ti me with your families.

Best wishes

Geraint A Marti n, CEO, CM Health

Benedict Heff ord, Director Primary Health & Community Service has a ‘Heart Check’ at Ko Awatea.

CONNECT+ I PAGE 3

The philosophy of the community oral health services for children and adolescents is that “any child should be able to enter adulthood with pain free and disease free aestheti c, functi onal denti ti on, and positi ve dental self-esteem.”

The challenge for CM Health is that we have:

• the largest preschool child populati on; some 43,500 from 0 to 4 yrs, and,

• the largest school age populati on aged 5 to year 8 of school (12/13 years), some 78,000, and,

• the largest adolescent populati on aged year 9 of school up to and includ-ing 17 years, some 36,000, and,

• a high deprivati on concentrati on in our populati on, 38% adults and 54% of children & adolescents live in deprivati on 9 and 10.

Despite this, preschool enrolments have grown to 74% of eligible populati on in Counti es Manukau and school-aged children are enrolled at 97% of eligible populati on. CM Health and ARDS (Auckland Regional Dental Service) has made steady progress improving the enrolment of children in dental services, with 49% of children in Counti es Manukau being caries-free at age fi ve.

Improving this will take an eff ort over 2 to 3 years, parti cularly in high risk groups of Maaori, Pacifi c, and Asian / South Asian children.

In the last two years Mighty Mouth Dental have delivered a tooth brushing programme in 150 preschools, Kohanga reo, and Language nests in communi-ti es in Counti es Manukau. At any ti me during the school year and depending on when pre-schoolers leave to go to school, we have between 4,500 and 5,500 children brushing their teeth daily and parti cipati ng in food and drink matching games for healthy teeth versus unhealthy teeth.

Adolescent Dental Services have achieved 74% of eligible populati on att ending a dental service which is approximately 26,809 adolescents. This has grown from 43% only 5 years ago.

This growth has been achieved by the 78 contracted denti sts, and about half of adolescents receiving dental services on-site by Mighty Mouth or

Raukura Hauora O’Tainui at secondary and composite schools, or Youth Justi ce and CYFS Residences in the district. To date, 27 secondary or composite schools in Counti es Manukau are receiving on-site Dental Services, providing services to students who are unlikely to visit a denti st outside school.

High Needs Vulnerable Adults Dental Services

In New Zealand there is no funding for adults dental services apart from subsidised treatments for emergency dental/ relief of pain for adults 18+ with a community services card. However in 2012, CM Health won a tender for Dental Services for Women with Diabetes in Pregnancy (DIP) – a Ministry of Health funded Oral Health 2 year pilot for 400 women that completes at the end of 2014.

The pilot has been running for 2013 and we have collected entry surveys on the women’s atti tudes and behaviours around their oral health and data on treatments and clinical trends. We have noted transformati on in many women aft er dental treatment as they are now without pain and infecti on, can eat properly and are therefore more likely to eat healthier foods, and they can smile and speak without embarrassment.

The pilot is being evaluated by the Ministry of Health for cost effi ciencies of provided low cost dental services within current community oral health structure to high needs vulnerable adults.

Oral Health Services

Cutti ng the ribbon from [L] to [R] Robyn Hughes, Nurse Manager Theatre, Gill Cossey, GM Surgical & Ambulatory Care and Catherine Larsen, Service Manager Theatre.

A new start On 6 November a large crowd gathered for the Blessing of the new Operati ng Theatres, Theatre Admission and Discharge Unit (TADU) and Post Anaestheti c Care Unit (PACU) – all located on Level 2 of the Clinical Services Building (CSB).

For many staff this was the fi rst ti me they had seen their new areas and comments ranged from modern, spacious, amazing and ‘state of the art’.

“I was involved with the business case for these new faciliti es back in 2008,” says Gill Cossey, GM Surgical & Ambulatory Care. “Aft er presenti ng the business case to the Ministry of Health, we were delighted to get the go ahead, and I’m so excited to be blessing these areas with you today.”

“Our old theatre building has served us well for almost 50 years, but it’s ti me to move on,” says Wilbur Farmilo, Clinical Director Surgical Services.

“We now have more capacity and larger theatres, to carry out the modern surgery that we need to do. Our clinical staff are really looking forward to moving in.”

A lot of thought has gone into planning, designing and building the new faciliti es, with an emphasis on providing much needed pati ent and whaanau spaces.

“In our current building, we don’t have anywhere to take families to discuss cases or deliver distressing news,” says Wilbur. “In our new area we have a designated whaanau/family room, providing privacy for those diffi cult conversati ons.” (See the full story on the new whaanau room on page 9.)

“It’s been a lot of hard work to reach this stage, and everyone involved has done an amazing job,” says Catherine Larsen, Service Manager, Surgical and Ambulatory Care. “This includes architects, builders, engineers and the project team – in parti cular Patrick Long, Service Improvement Manager and

Roy Malto, Equipment and Asset Manager.

“All throughout this process we have been very lucky to have the support and buy in from our management and theatre teams, as well as people in the organisati on who use our faciliti es e.g. ward staff , orderlies and Allied Health. By reaching out to our staff , pati ents and families we have been able to look at ways of working smarter and more effi ciently and as a result have been able to deliver a wonderful facility.”

The Operati ng Theatres, TADU and PACU open in February 2014.

Did you know … the Operati ng Theatres are supported by the latest technologies in procedure lights, service pendants and an AV system in each operati ng theatre sending images/data/informati on to various monitors in theatre.

CONNECT+ I PAGE 4

Pacifi c Cardiac Rehabilitati on is a community based secondary preventi on programme established in 2011 aft er a Cardiac Rehabilitati on uptake and Chronic Care Management audit. It indicated that Pacifi c people were the less likely to att end and uti lise CR service in the community, have signifi cant high rates of hospital admissions and readmissions due to poor post discharge management and non-adherence to medicati ons. Research shows that ethnicity, age specifi c, socio-economic deprivati on and geographic regions are determinants of inequaliti es in accessing Primary healthcare and dispariti es in cardiovascular disease outcomes.

Pacifi c Health Development and Cardiology Nurses and PCR pati ents designed a tailored Pacifi c programme aft er a cardiac event. It contains causes of a heart event, preventi ng another, risk factors, medicati ons, exercise, nutriti on, and dealing with emoti ons and stress.

The purpose of this programme is to support Pacifi c people with heart disease to return to an acti ve and sati sfying life and prevent recurrence of cardiac events.

The focus of the programme is to support Pacifi c People to:

• Prevent further heart events by taking control of their life and improve quality of life.

• Reduce inequaliti es in health services and increase access to health services

• Have quality and longevity of life.

As the programme matures the content changes based on pati ent feedback. Att endance from 2011 was between 42-58%. This dropped signifi cantly when Pacifi c team support was withdrawn, but has since increased with Pacifi c fanau ola engagement. The improvement in att endance signifi es the value of culture and support from the Pacifi c Team engaging pati ent and fanau to understand the importance of the PCR programme towards bett er long term outcomes.

Pacifi c CR services engages fanau ola where pati ents and fanau are supported through educati on, informati on, physical acti vity and social support by a multi -health professional team of nutriti onist/dieti cian, nurses, fanau ola, physiotherapists, cardiologists, psychologists and pharmacists.

Ward 32 North was chosen to be a pilot ward for hand hygiene in 2009 – compliance was only 45%. A year later team work, encouragement and straight forward nagging saw a dramati c increase to 81%. However, when the focus shift ed the practi ce dropped to 58% in 2011.

Since then, ward champions Cara Bryson and Rae Iosia-Sipeli have introduced regular new strategies. They talk to the teams and watch to see barriers to good practi ce. The introducti on of a nail care kit has completely eliminated nail varnish amongst nurses on duty and has been maintained for 18 months.

We have many elegant and professional looking staff with sleeves butt oned at the cuff s. This means hand hygiene cannot be eff ecti vely carried out. An emphasis on ‘naked to the elbow’, started with many conversati ons, remind-ers and rewards, has seen a refreshing change to the casual dress code.

Thanks to everyone’s involvement, our latest stati sti cs are 81.3% – achieving the nati onal target. We are aiming for 100% thanks to a great team.

Jacqueline Watkins, Nurse Educator (Ward 32N / Gastro)

Hand hygiene pays dividends Kidz First Medical Some people say in order to make lasti ng changes, you need to lead from the top down. This is in fact the truth. Our Charge Nurse, Ambigay Ramsamy, is passionate about maintaining high standards in all areas of nursing and works with senior nursing staff to drive messages and practi ces of hand hygiene in our ward and to role model it with all.

Hand hygiene is included in the orientati on of our students, new staff , and doctors. We encourage all staff to wear short sleeve shirts, or at least roll up their sleeves; and not wear jewellery with gemstones; bracelets; or wrist watches as germs can live under the bands. We do reminders at handovers and weekly meeti ngs.

Someti mes our messages are not welcomed, however, as a pati ent advocate, if that was your mother or your child in the hospital, wouldn’t you want to protect them? We won’t stop pushing the message.

Our ward is well set up with hand gels everywhere. So come on other wards, lets aim high and set goals for the next Gold Audit, lets do it for our pati ents and for the sati sfacti on of doing a great job!!!

Marlene Turner, Acti ng Charge Nurse, Kidz First Medical Ward

Kidz First Medical Care Team – Marlene Turner – Staff Nurse (the second on the left in the front row), Ambigay Ramsamy, Charge Nurse Manager (fi rst on the left middle row).

Ward 32 North: L TO R: Cara Bryson, Wayne Bai, Charles Ho, Michael Webb and Jacky Watkins.

Pacifi c Cardiac Rehabilitation (PCR)

CONNECT+ I PAGE 5

Building on the success of the 20,000 Days Campaign which ‘gave back’ over 23,000 days of health to our community, Beyond 20,000 Days is a natural progression in bringing a range of initi ati ves that support good health and well being. Five key work streams are;

• Living well in the community

• Keeping people who are at-risk well in the community

• Rapid response to acute events in the community

• Coordinated and rapid care in Emergency Care

Beyond 20,000 Days progress

Practi ce nurse Rohini Devi ensures a young pati ent understands how prescribed medicines are to be used.

Advance Care Planning (ACP) is a concept that was introduced internati onally in the late 1980s, but has only gained momentum in New Zealand in recent years. In Middlemore, ACP started in the respiratory and orthopaedic wards, the Very high Intensive User Service and in AT&R wards. We have now also rolled out into Primary Care, where ACP should begin and it is working well in Pukekohe and Franklin.

ACP is a process of discussion and shared planning for future health care that assists the individual to identi fy their personal beliefs and values and incorporate them into plans for their future health care and end-of-life care. It is for the well and for the unwell, as we all know that our circumstances can change in an instant.

ACP assists in the provision of quality health care and treatment. It is becoming increasingly important, parti cularly with the growing range of medical treatment opti ons available and the enhanced recogniti on of the importance of pati ent involvement in medical decisions.

It is focused on the individual and involves both the person and the health care professionals responsible for their care. It may also involve the person’s family/whaanau and/or carers, if that is the person’s wish. The planning process assists the individual to identi fy their personal beliefs and values and incorporate them into plans for their future health care.

What is involved?

• It is about encouraging people, family/whaanau and health care professionals to have the conversati ons that really matt er.

• It is a journey of thinking, talking and planning.

• It is all voluntary

• Making sure pati ents have ti me and opportunity to ask the questi ons they would like

• The discussions give people the opportunity to develop and express their preferences for end of life care based on:

• their personal views, values and beliefs

Advance Care Planning

• a bett er understanding of their current and likely future health

• treatment and care opti ons available.

Ideally, you get to a point where you can set out in writi ng what is important to the pati ent, an Advance Care Plan.

In CM Health

To date, 60 CM Health staff have taken part in a two and a half day workshop which off ers advanced communicati on skills training. Staff then feel able to have these important conversati ons with pati ents and can help them develop their plans. These are then loaded into the pati ent database which can be shared with other DHBs if required. Nati onally there are a group of people working to develop a collaborati ve approach to Advance Care Planning in New Zealand.

Locally, ACP is an important part of our Localiti es initi ati ve. We are working with East Health to improve and increase ACP with their Palliati ve Care Package. This is also being done in Manurewa and Franklin.

Further ACP courses are planned both at Level One and Level Two. If this interests you, please contact Meg Goodwin, Project Facilitator.

• Safe and ti mely care for those who do need in-hospital care

Primary care is an essenti al component in this campaign which has pati ent wellbeing and pati ent care at its heart. Otara Family and Christi an Health Centre are strong supporters of Beyond 20,000 Days. Practi ce nurses Rohini and Siniva say that teaching health literacy to pati ents has become an important part of their roles. The Otara practi ce has been running Healthy Skin clinics for some months now and have noti ced that once people really understand what is happening with skin infecti ons they are much more likely to apply the medicati ons correctly and to take anti bioti cs as prescribed. “Doing this has meant we have had to change some prescribing habits, such as changing prescripti ons from 3 ti mes daily anti bioti cs to twice daily. This is much more manageable for parents with school-aged children,” says Rohini. “Further, we know that we are preventi ng avoidable hospital admissions by just spending more ti me with pati ents to explain what they need to do with their medicines.”

Paediatric specialist Dr Raj Maikoo also att ends a Healthy Skin clinic at the practi ce once a month which enables specialist advice to be given and thus good learning opportuniti es for the practi ce staff . Rohini would like to see this expanded to include WellChild services working much more closely with the practi ce and which could include home visits. “We also perform risk assessments and refer as necessary.” Rohini says that the practi ce wants to make a real diff erence in the community and it is by improving health literacy and supporti ng family and whaanau that long-term gains can be made.

CONNECT+ I PAGE 6

Each day, family doctors, nurses and other healthcare staff are hard at work around Counti es Manukau. We would like to recognize some of these stars and the eff orts they make to look aft er their pati ents and help achieve the nati onal health targets. Here are some of the highlights:

✪ The philosophy of Lela, a Practi ce Nurse at Crawford Medical Centre, is simple – “Your health is our focus”. So when a young female pati ent visited Lela for a prescripti on, Lela also took her blood pressure and encouraged her to have a heart check. She talked to the pati ent about the check and helped the pati ent realise that she needed to take care of her own health in order to be around for her children. Once the check was complete, Lela gave the pati ent informati on and advice on what she could do to reduce her risk of heart disease. She also recommended that the pati ent set some goals and involve her family in her health. The next morning the pati ent rang Lela to tell her about the healthy dinner she had eaten and the goal she had set herself to walk a certain distance each day. Great stuff !

✪ At Eastside Family Doctors, staff are committ ed to helping their pati ents stop smoking. When a pati ent menti oned she wanted to go on holiday to Fiji, the nurse found out how much it would cost and compared that to how much the pati ent already spent on cigarett es. When the pati ent realised that a holiday would cost only half as much as her cigarett es, she decided to become smokefree and use the money to pay for a Fijian holiday as her reward.

On Thursday 14 November people came from near and far to att end the open-ing of the long awaited Spiritual Centre at Middlemore Hospital.

‘Open to all’ – the new Spiritual Centre refl ects the religious and cultural diver-sity of staff , pati ents, families and the community.

In a busy and someti mes stressful hospital environment this warm and inviti ng space off ers a calm, quiet and supporti ve haven in the heart of the hospital.

Over 100 people att ended the offi cial opening, with many remembering the ‘old days’, where volunteers pushed pati ents in beds and wheelchairs to ser-vices held in a number of locati ons across Middlemore Hospital. “This proved quite diffi cult as the allocated space was oft en much too small and ill equipped for a service,” said Jenni Coles, former Director of Hospital Services. “Last minute requests by pati ents and families for religious ceremonies, such as mar-riages, were very diffi cult to organise and oft en had to take place on the ward.”

While the Chaplaincy team coped admirably under the circumstances, it was clear that a permanent and purpose designed facility was needed and follow-ing approval of the 2008 business case, which included a new Spiritual Centre, funds for the Centre fi t-out were released by the Ministry of Health.

It was during this ti me that Ross Keenan, then Chairman, and David Clarke, former CEO of CMDHB, in collaborati on with the South Auckland Health Foundati on, worked with a large number of community groups, churches and individuals, to raise funds that will now be uti lised to provide furniture, equip-

A place for all

ment and artwork for this highly regarded and special facility.

Special tribute must be given to the late Dr David Scott , whose vision of a non-denominati onal Centre never waivered. “It was David’s moti vati on, com-mitment and his success in rallying people in the community that contributed to making the Spiritual Centre a reality,” says Geraint Marti n, CEO CM Health.

“Although dad is not with us today, he would have been so proud of what you have achieved,” says Serena Scott Lowe, who spoke on behalf of the Scott family.

The new Spiritual Centre is located on the ground fl oor of the Clinical Services Building – just behind the main Informati on Desk. It is open 24/7.

Thanks to Primary Care✪ Dr Stephen Dorairaj at the Howick Medical Practi ce routi nely collects his pati ents’ blood pressure, weight and other measurements. This enables him to complete the necessary checks, such as heart and diabetes checks, according to best practi ce guidelines and meet the targets around immunisati on, breast screening and cervical screening.

Thank you to the General Practi ce teams in Counti es Manukau who have taken on extra work and tried new and proacti ve ways to make a diff erence for your pati ents.

L-R: Lela Tuifagalele with her colleagues Hesti e du Plesis, Sarah Jane Banfi eld, Yong Guo and Kathy Montgomery from the Crawford Medical Centre.

The Rev. Vosalevu Setoa Fina'i

The Rev. Sione Tu'ungafasi

The Rev. Lucy Nguyen

The Rev. Jin Hoang

Rev. Farther Sherwin Lapaan

Mr Ramon Manaloto

Ms Margaret Maurice

Mr Ropata George

Tig Scott (L) and daughter Serena unveil the framed photo of faith symbols.

Meet our chaplains

CM Health (CM Health) is trying a new approach to help pregnant women become smokefree and give their babies the best possible start to life. The pilot is initi ally funded for 12 months and focuses on Manurewa.It provides incenti ves as a moti vati on for pregnant women to complete a 12 week quit programme. Parti cipants receive face-to-face support, subsidised nicoti ne replacement therapy and, providing they remain Smokefree, vouchers for groceries, baby goods or other items. They can earn up to $300 if they complete the programme. Whaanau/family members can also parti cipate and receive vouchers (to a lesser value).The pilot, which started in late August 2013, already has:• 67 referrals • 35 people who have set a quit date • 14 pregnant women and 3 whaanau

members are between 1 and 12 weeks Smokefree so far.

CM Health and independent midwives have been strong supporters of the programme, referring many clients. Referrals are also coming from medical centres, family planning, social workers, teen parenti ng clinics and women themselves. To be eligible, women should be:• Up to 28 weeks pregnant• Maaori or Pacifi c• Living in Manurewa (including

Weymouth, Clendon and Wiri).If you know of anyone who fi ts the criteria and needs extra moti vati on to become smokefree, please ask them to email smokefree@middlemore.co.nz or phone 0800 569 568 to enrol.

Spotlight on maternity careSpotlight

Mata ki te rangi, i tōna moenga motuhake. Back to sleep in baby’s own bed.

That was the message of Safe Sleep Day, celebrated nati onwide and at CM Health on December 6 to raise awareness of Sudden Unexpected Death in Infancy (SUDI). SUDI is any death in the fi rst year of life that is sudden and unexpected, and about 60 Kiwi babies die from SUDI each year – 11 of these in Counti es Manukau.

Many of these deaths are able to be prevented through the use of safe sleep practi ces.

CM Health, in partnership with Whakawhetu Nati onal SUDI Preventi on for Maaori, promoted Safe Sleep Day throughout the region with acti viti es focused on the P.E.P.E message:

• PLACE baby in his or her own baby bed, face clear of bedding

• ELIMINATE smoking in pregnancy and protect baby with a smokefree whaanau, whare and waka

Smokefree pregnancy pilot

eks

l

eria and

Smokefree Pregnancy Services

Stopping smoking during pregnancy will give your baby the best start in life.Join our 12 week programme and receive:

Quit now.It’s about whaanau.

Smok

0800 569 568 or text 021 622 687

“The vouchers are just the plus to it. It’s my reward, something that I get to look forward to each week”

Image courtesy of One News

Scan QR code

Safe sleep for babies• POSITION baby fl at on his or her back to sleep

• ENCOURAGE and support mum, so baby is breastf ed

Hospital acti viti es included displays throughout Maternity and Kidz First faciliti es, while community promoti on included presentati ons and ‘pyjama day’ acti viti es at Well Child services, Papakura marae, GP practi ses and childcare centres.

For more informati on, please visit the Whakawhetu website: www.safesleepday.org.nz.

Midwives go livePregnant women in Counti es Manukau can now fi nd everything they need to know about the district’s Maternity Services in one place – online at www.healthpoint.co.nz/maternity.

CM Health uses the Healthpoint website to communicate informati on on General Practi ce (GPs), Hospital Services and Locati ons, and Mental Health and Addicti on Services to our community. The website has now been extended to cover all Counti es Manukau midwives and maternity services, both hospital-based and in the community. It can help you fi nd a midwife and support networks in your area, work out where to park when your baby is due and more.

Simply visit the ‘pink’ pages at www.healthpoint.co.nz/maternity to fi nd detailed profi les on Self Employed Midwives, Community Based DHB Midwifery Teams, Specialist Hospital Midwifery Teams, Obstetricians and Birthing Faciliti es. Midwifery profi les include details on what suburbs the midwife works in, how to make an appointment, the type of care provided, birthing faciliti es and postnatal care aft er baby is born. Birthing facility profi les detail the services that are available along with all you need to know about the locati on itself (maps, parking, conveniences etc).

“It is great that pregnant mums now have easy access to all maternity informati on in one place,” says Debra Fenton, Maternity Care Service Manager, CM Health. “Bett er informati on can help mums make more informed decisions about their maternity care leading to bett er outcomes for both mother and baby.”

CONNECT+ I PAGE 7

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for respiratory infecti ons than the nati onal average. Adults in Counti es Manukau also have a 55% higher admission rate for asthma than the nati onal average (hospitalisati on data 2011/12).

The programme has two interconnected components aimed at ensuring signifi cant housing and health improvements are obtain and more importantly sustained.

Firstly; we aim to insulate the homes of low-income families creati ng ‘healthier homes’ which are energy effi cient and ensure that the home contributes to the health of the family. We insulate the ceiling and the under fl oor (access permitti ng) with Greenstuf home insulati on.

Secondly; we aim to undertake a comprehensive health and social assessment of parti cipati ng families to ensure that they are accessing appropriate health and social services.

We need your help to identi fy and refer families who would benefi t the most from this 100% free home insulati on programme.

For more informati on contact the Warm Up Counti es Manukau team on 09 262 9583 or email Warmup@CMDHB.org.nz.

Warm Up Counti es Manukau is a free home insulati on programme for low income families with high health needs living in Counti es Manukau.

The programme is 100% free to families that meet the eligibility criteria.

Eligibility Criteria:

• Live in the Counti es Manukau, Papakura or Franklin area

• Live in a home built before 1st January 2000

• Own their own home or rent privately (NOT a Housing New Zealand home)

• Be the owner occupier or tenant and MUST have a Community Services Card

• Priority will be given to families with children (under 17) or seniors (over 65) living in the household with housing related health conditi ons.

Supporti ng evidence by health professional/s is welcomed.

We aim to insulate the homes of 3000 eligible families this year.

This programme is delivered through a working partnership between the Energy Effi ciency Conservati on Authority (EECA), Autex Industries, The Insulati on Company, Right House, CM Health and the Middlemore Foundati on.

The programme is targeti ng health conditi ons that can be exacerbated by living in cold damp homes, in parti cular respiratory conditi ons such as asthma, pneumonia and chronic lung disease (emphysema, bronchiti s, bronchiectasis).

In 2012 there were over 11,500 Housing Related Potenti ally Avoidable Hospitalisati ons for Counti es Manukau residents. Children accounted for nearly 40% of these admissions, especially children under the age of 5 years.

Admission rates for respiratory infecti ons in children in Counti es Manukau such as bronchioliti s in infants under 1 year old and bacterial pneumonia in children up to 14 years have been documented at 49% higher than the nati onal average for children.

Adults living in Counti es Manukau have a 43% higher admission rate

100% free home insulation

The fi ne voices of CM Health staff fi lled Ko Awatea recently as we connected through a fl ash choir to celebrate Mental Health Awareness Week.

The theme of the 2013 nati onal awareness week (October 7 – 13) was ‘connect’ – one of fi ve strategies to promote mental health and wellbeing.

CM Health’s Mental Health service organised a range of acti viti es to encourage staff to ‘connect’ throughout the week, including hand massages, tai chi, meditati on, knitti ng ‘n’ natt er and a shared lunch. The highlight of the week, however, was undoubtedly the fl ash choir, made up of volunteer staff and even some faces from our community.

Under the expert guidance of King’s College Choir Master, Chris Artley, the choir came together for the fi rst ti me on Wednesday October 9 and performed on Thursday October 10, aft er just 90 minutes practi sing!

Despite the lack of ti me together, the choir’s performance was met with rapturous applause and praise. Staff also enjoyed the opportunity to ‘connect’ with their colleagues. One staff member

later wrote, “I really enjoyed singing in it, as I think did everyone else, and the audience were very appreciati ve as well... Thank you so much.”

For informati on on mental health, please visit the Mental Health Foundati on’s website: www.mentalhealth.org.nz.

Singing uplifts staff

CONNECT+ I PAGE 9

Whaanau suiteWhen the Clinical Services Building opens, the theatres will have a whaanau suite next door thanks to a $140,000 donati on to the Middlemore Foundati on from the Pratt Foundati on, the charity arm of Visy New Zealand.

The purpose-built rooms allow families to grieve in private and can be confi gured for large or small groups, have smaller private meeti ng rooms, toilets, and areas for refl ecti on and quiet.

Visy NZ director Sir Dryden Spring said the Pratt Foundati on had a long history of working in the communiti es where its staff lived. “We have 350 people from South Auckland, and we know this is their hospital. It is where they come to see the people they trust to help them.”

General manager Andrew Gleason said his own experience at Middlemore ended with a positi ve outcome. “The people here were fantasti c, but the sad reality is not everyone enjoys the same outcome. So to be able to help fund an area used at such a criti cal ti me is an honour.’”

Visy has long been a Foundati on supporter. The packaging company supplies cartons, fi lled by schools with toiletries and other basics, which are dispensed in the hospital and community. Its own staff recently even packed hygiene kits.

Right: Sir Dryden Spring (left ) and Patrick Long, Service Improvement Manager.

Only 40 cents a day can make a big diff erence.

New 12 point fundraising planThe Middlemore Foundati on's Dozen Donors campaign urges people to give $12 on the 12th of the month for 12 months.

That’s $144, but let’s face it, who has $144 spare? This way it’s roughly 40 cents a day.

But what’s really needed is for a donor to commit to encouraging 11 others to do the same – making up their Dozen Donors. That way if all 12 donate, a useful $1728 will be raised.

Of course the questi on becomes, how many people can we get?

There might be 12 people in your area who want to help, or 12 family members, or 12 people in your sports team, church, choir, or service group.

Surely we have 12 surgeons, 12 administrators, 12 nurses, 12 midwives…and we’re quietly hopeful of more than a few dozen ward groups.

The Foundati on is also encouraging businesses to join in by urging employees to form a dozen, or smaller businesses to combine to form a hairdresser, panel beater or petrol stati on dozen.

Thank you Warehouse shoppersShoppers at The Warehouse have exceeded all expectati ons by donati ng more than $41,000 during the Add $1 campaign.

Region 7 stores – Balmoral, Lincoln Rd, West City, Westgate, Mt Roskill, Papakura and Clendon – encouraged shoppers to add $1 to their bill for Kidz First Children’s Hospital, where it will be used to fund Infant Warmers.

The target was collecti ng enough to fund one warmer, but the stores are well on their way to achieving a second, and with another campaign running just before Christmas, possibly even a third.

Warehouse Region 7 Manager Jonathan Percy has a six-week-old at home and said the cause was close to his heart. “You don’t realise the benefi ts unti l you see what goes on in our hospitals. Fortunately we did not need big interventi ons, but knowing the help is there is a good feeling. People have been very willing to support the cause. ”

Neonatal Unit nurse manager Niccy Brougham said customers could be very proud of themselves, as could The Warehouse. “Infant Warmers are essenti al for the care of criti cally-ill and premature babies.”

The next Add $1 campaign runs from December 4 to Christmas Eve.

And we’ll be urging service groups to get their members to take up the challenge, in the hope we can get some dozens from our friends at Rotary, Lions, Kiwanis and the like.

There must be a few sports clubs out there who have had to use our services too, so a dozen from your league, rugby, netball or hockey club wouldn’t go amiss either.

The plan’s success rests with people acti ng as champions and encouraging others to help.

It’s only $12 a month for 12 months – though we’d love to see people remain aft er the year.

Imagine what could happen. If 250 people organised a dozen– that’s a staggering $432,000 over the year, and all ulti mately from people giving less than 40 cents a day.

If you’re interested in a Dozen Donors all you have to do is organise a direct debit or automati c payment to the Foundati on’s account, at the ASB at Hunter’s Corner, 12 3113 0002022-00.

You should use your surname as a reference, followed by the number 12.

And we need to know who you are of course, so we can send receipts, because all donati ons are tax deducti ble. Send your name, address, phone number and email – or do all of your dozen in one hit if you prefer – to david.kemeys@middlemore.co.nz.

We’d love for you to start payments on January 12, 2014.

CONNECT+ I PAGE 10

Walking the Talk New York City Marathon Eff ort for Local CM Health Hero

CM Health staff member Anne Fiti semanu recently travelled to New York City for her second ti me to compete in the New York Marathon. The marathon was called off last year due to Hurricane Sandy, but Anne decided to go back and fi nish the journey she started. Here is her story...

“As a fi rst ti me marathoner I found the lead up was as good as the marathon itself. One of the most memorable things about the marathon was the cheers of the two million people who lined the New York streets to support us. As we ran through the Bronx, to the soulful sounds of the American African Church Choir, our spirits were uplift ed and kept us going. It was a surreal experience as I crossed the fi nish line with my friend of 40 years from New Zealand. As for the ti me it took – who cares? I had completed the 2013 New York Marathon, all 42.2kms and I felt proud.

“It was incredibly inspiring to see so many older people running and proves you can do whatever you set your mind to. Making the decision to parti cipate in the New York Marathon two years ago opened my life to a healthy, challenging but rewarding hobby and I wouldn’t change it.

“So what’s next? My plan is to conti nue running and encouraging Pacifi c women to get acti ve. I’m also planning on taking another group of Pacifi c women, either to Paris or London in 2015. If you are interested please contact me.” Anne.Fiti semanu@middlemore.co.nz.”

“I am privileged to be a pioneer delegate on the Leadership Academy Programme. It has been a valuable experience that will enhance and grow future Leadership at CM Health and the New Zealand Health Sector as a whole” Leadership Programme parti cipant

The fi rst Core Leadership Programme, in partnership with Ko Awatea, CM Health and the University of Waikato, is in full swing with 18 people, from a variety of backgrounds and specialti es taking part. It’s been quite a journey, starti ng in May 2013 with the Fundamentals of Leadership Programme and then an opportunity for parti cipants to apply for the 18 sought-aft er places on the Core Leadership Programme. The 30 candidates who did apply were put through their paces at an assessment centre, where they underwent a rigorous selecti on process. This included six scenarios to test their leadership skills.

So what is the Core Leadership Programme?

Using a range of learning experiences, parti cipants gain real skills and knowledge around authenti c leadership (focusing on knowing yourself and what you stand for), relati onal leadership (creati ng or contributi ng to strong relati onships within teams), and transformati onal leadership (leading, or being a vital part of the transformati on of your organisati on.

The programme also off ers enrolment and completi on of a Post Graduate Certi fi cate in Public Sector Leadership from the University of Waikato, along with eight workshop days focusing on Innovati on in Leadership.

“Following completi on of the programme in September 2014, we would like to see people conti nuing to work with their organisati onal mentors, to assist them to progress and to build a network, where we uti lise their leadership skills to drive organisati onal improvement and innovati on,” says Penny Impey, Programmes & External Faculty Manager.

Planning is underway for the next Fundamentals of Leadership programme, to be held early next year.

For more informati on about the Leadership Programmes go to www.koawatea.co.nz.

APAC Forum Over 1,040 delegates from around the world came and listened, learnt and networked, then left armed with tool kits, new connecti ons and inspirati on to improve the delivery of healthcare in their area. The overwhelmingly positi ve comments received were very sati sfying as APAC is a key element in Ko Awatea’s desire to be at the centre of quality improvement in healthcare. The clear demand for this type of conference around the world now sees Ko Awatea and CM Health taking APAC 2014 to Melbourne (1-3 September).

Core leadership programme

Lend a handWith the opening of the Clinical Services Building, the face of Middlemore Hospital is changing and we need your help.

Middlemore Hospital is currently looking for volunteer Ambassadors who can help people get the most out of their visit to our site. This might mean answering the recepti on telephone, greeti ng visitors at the front desk, pushing a wheelchair for a pati ent or helping direct people around our large site (including to parts of the new Clinical Services Building).

Ambassadors need to speak fl uent English and be able to walk around the hospital with ease. A minimum of four hours per week is required and parking is provided. All new Ambassadors receive Orientati on Training and access to discounts on a range of goods and services through the Staff Work Perks scheme.

For more informati on or to register your interest, please call Faye on (09) 276 0000 and ask for extension 2955.

Patient feedbackIt's always nice to hear people says nice things about their experience with us. Here is some recent pati ent feedback:

“Thank you to all. I was treated with great care and respect. Was always well informed and greeted with a smile. Thank you to all of you who were part of my care. I was with you for nearly 3 weeks and had two procedures and one surgery which I was very nervous about. Thank you to all who made it a lot easier to get through, I will not feel so apprehensive about coming to hospital again. Good luck to you all and thank you once again.” Pati ent of Ward 9

Cannot name 1 – but every nurse & Dr I was involved with needs a gold medal. The service was excellent. They made me feel comfortable. Made me feel at home & gave me heaps of encouragement to recover. Service cannot be improved. Thank you all very much for taking excellent care of me, my wife and family. Pati ent of ICU, HDU, Ward 8

The most amazing staff on Ward 11. You all do such an amazing job. Thank you especially to all the nurses, Drs, Healthcare assistants, tea ladies, cleaners that cared for me during my stay. You’re great stuff . May your feet make prints in many sands. Pati ent of Ward 11

More than 111,000 people or around 24% of the Counti es-Manukau populati on were immunised against infl uenza in 2013. This represented a fi ve percent increase on the previous year’s total of more than 90,000 or 19% of the populati on.

CM Health staff immunisati on rates also saw a big rise in 2013 – from 48% in 2012 to 64%. This was higher than the nati onal average of 58%.

The Nati onal Infl uenza Specialist Group (NISG) says a record 1.25 million doses of vaccine were distributed in New Zealand this year resulti ng in an esti mated 30% of the populati on receiving immunisati on by the end of the Government-subsidised immunisati on campaign in July.

“It’s great to see health professionals leading by example this season. CM Health has shown a marked improvement and this is a promising trend in a high health needs area. It’s a credit to the hard work and concerted eff ort of healthcare professionals in the DHB and local community,” comments Michelle Kapinga, chair of NISG.

Ms Kapinga says that now the challenge is to improve these rates again in 2014, especially as 2013 was one of the mildest fl u seasons for many years and complacency may creep in.

“Many vulnerable people are sti ll unprotected each year and this is a concern as we know how devastati ng a serious infl uenza outbreak can be to our at-risk groups. We never know when a really serious infl uenza virus may strike and any infl uenza virus has the potenti al to be serious for some people.”

She says that the 2014 campaign will focus especially on pregnant women and young children who are most at risk from infl uenza complicati ons.

The Infl uenza Kit is expected to be delivered by early February 2014.

Flu immunisation rates improve

Quality Accounts showcase DHB's focus on quality and safety

The Quality Accounts 2012-2013 are now available online (see the Noti ceboard at www.counti esmanukau.health.nz)

They showcase the commitment of CM Health to quality and safety, parti cularly with regards to performance against nati onal health targets, quality standards, pati ent safety prioriti es, service improvements and integrati on initi ati ves.

We encourage you to have a look at the inaugural Quality Accounts and provide feedback so we can conti nue to improve the Accounts. All feedback can be directed to Communicati ons@middlemore.co.nz.

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mmitment andregards

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We need your feedback

Our changing faceFinding your way around any hospital can be daunti ng, so Middlemore is introducing improvements to help people get to and from their desti nati ons. This includes:

• New signage being installed both internally and externally throughout the hospital and the Middlemore site.

• The name of some services are being simplifi ed and in many cases shortened

• Some buildings will receive new names

• Parking signage will be improved to assist you to fi nd parks close to your desti nati on

• The Rainbow Corridor is making a return and, in additi on to entertaining children and brightening up our corridors, it provides useful cues to help people fi nd their way around.

The changes to signage will take place over the next three months and informati on and an updated map will be provided to pati ents att ending hospital or clinic appointments where required to ensure they get to the right place quickly and easily.

If you require more help with directi ons or have any other queries while you are here at Middlemore Hospital, our volunteers will conti nue to be found in our central main recepti on area and are always happy to help.

get to and

CONNECT+ I PAGE 11

CONNECT+ I PAGE 12

Christmas allows me to refl ect on, and celebrate, the year that has passed and be thankful for the blessings of friends and family. I was brought up Catholic so church with my family has always been an important part of it but I’ve also spent several Christmas abroad with extended family (no white Christmas but defi nitely not a BBQ on a beach!). This year I’ll be spending Christmas with my fi ancé and his fam-ily. I’m looking forward to experiencing their traditi ons and sharing some of my family’s traditi ons with them.

Donna Bennett ,Senior Physiotherapist Paediatrics, Kidz First

To me this ti me of year is a ti me to appreciate your family and friends and spend special quality ti me together. But it is also a ti me to refl ect and think of those less fortunate.

This is the ti me of year to spread love cheer and Peace to others (Shame we don’t do this all year)

Special rituals would be Carol singing, Midnight Mass, Church on Xmas morning, Special Christmas lunch with Family.

Hayley Dempsey,RMO Daily Operati ons Advisor Ortho/MSC/Paeds RMO Unit

Phillip Balmer has recently been appointed Director Hospital Services at CM Health. Phillip joins us from Bay of Plenty District Health Board, we he was the Chief Operati ng Offi cer (COO) since 2009. Prior to joining Bay of Plenty, he was Chief Executi ve for a private hospital in Queensland and COO for an Orthopaedic Sports

Medical Hospital in Qatar. Today Phillip shares some of the challenges of his new role.

Cassandra was a Greek goddess blessed with the ability to predict the future but unable to get others to believe her predicti ons. In Greek mythology, she predicted the arrival of the Trojan horse and the ulti mate destructi on of Troy but could do nothing about it.

Healthcare is not dissimilar in many ways, with predicti ons that the rising demand will outstrip the available sources of funding. I have worked in healthcare in over six diff erent countries over the course of my career

and have seen people miss out. New Zealand’s goal is to ensure all have access to good healthcare but if we ignore this predicti on and carry on as usual, people will miss out.

I applaud the vision and eff orts of the leadership at CM Health (both clinical and management) in establishing an ambiti ous agenda for change to meet this challenge head on. We are asked to be ambidextrous in focusing not only on how we can improve healthcare delivery within our hospital system, but also on how we can improve the design and coordinati on of care with our primary and community care colleagues where our pati ents live. This can create a challenge for our thinking. In 1936, F. Scott Fitzgerald described this challenge: “the test of a fi rst rate intelligence is the ability to hold two opposing ideas in the mind at the same ti me, and sti ll retain the ability to functi on.” CM Health is leading the way in achieving system integrati on within New Zealand and working hard to ensure it gets this delicate balance right.

Phillip Balmer, Director Hospital Services

Read more of this arti cle at: www.teamcounti es.wordpress com/2013/11/14/introducing-phillip-balmer-director-hospital-services/

Please email communicati ons@middlemore.co.nz if you have any enquiries regarding this publicati on.

My Christmas

They work hard throughout the year to keep our faciliti es running 24/7, but CM Health staff are looking forward to the festi ve season too! To celebrate Christmas and spread some good cheer, we asked some of our staff about their favourite Christmas rituals and how they plan to spend the silly season.

Introducing Phillip BalmerDirector Hospital Services

How do you celebrate Christmas or the festi ve season? What does this ti me of year mean to you and your family/whaanau?

A hairy situation…

CM Health staff are selfl ess when it comes to showing their support for a good cause.

Earlier in September (when it was sti ll cold), fi ve brave individuals shaved their heads to raise funds for the Cancer Society. Bev Murphy, Fiona Walton, Janet Julian, Vannessa Sheerin-Crichton and Jennie Hunt all gave up their locks and raised $2,440 for the Auckland/Northland Branch of the Cancer Society.

Vanessa says “I've had varied comments about my new hair cut, but when I tell them it was for cancer awareness they all turn around and say 'Well that's ok then!’”.

On the fl ipside the men of CM Health have just completed “Movember”. Twenty of our best men joined together to form the “Mo Ko Awatea” and “Lambie Dandies” teams. Combined they raised $4,445 for men’s health. Get prepared to take up the challenge next year!

L-R: ‘Cancer Clippers’ Jennie Hunt, Fiona Walton and Bev Murphy lose their locks for a good cause.