ISSUE 210 • February 2015

News, views and information from Waitemata District Health Board

ULTRASOUNDMACHINE ARRIVES

MEALTIMEHELP FUELRECOVERY

BIRTHDAYWISHES FORWAITAKERE

CADETS GETHANDS ON EXPERIENCE

From the chief executiveRelieving suffering – a focus on patient experienceTwo years ago we defined the purpose of our organisation to be:

• to relieve suffering

• prevent, care or ameliorate ill health

• promote wellness.

Central to relieving suffering is the need to focus on patient experience. Too many interactions with healthcare services can be frightening and at a very difficult point in a person’s life. All staff members have a critical role to play in helping patients and their families through this period.

Simple things like being welcoming, a friendly smile or introducing yourself all helps patients feel more at ease.

Ensuring patients are well informed and truly partners in care not only improves patients experience but will lead to better patient outcomes.

A focus on patient experience is really about respecting the intrinsic dignity of every single person who uses our service. They could be our parents, our children, our friends and if not, they’re someone else’s loved ones.

In March, we will celebrate Waitemata DHB’s first ever Patient Experience Week. Our first patient experience week is a demonstration of our commitment to ensuring the patient experience is our focus. The week will bring together several activities that encourage patients and visitors to engage with our services and that also encourage our staff to connect with patients and visitors and view their experiences of our services from different perspectives.

Activities during the week will focus on three key themes:

1. Shared values

2. Listening

3. Working together.

Several activities will take place at both North Shore Hospital and Waitakere Hospital sites. Among the activities is a session in which Air New Zealand will share the experience of its customer journey with Waitemata DHB staff.

There’ll be a video booth where patients, visitors and staff can record their experiences of our care or their experience working here. Booths will be set up in the main foyers of NSH and WTH.

We’ll have tablets out and about for patients, their family and friends to complete the quick Friends and Family test to rate their experience of our care.

We’re also going to be encouraging staff to make a pledge for change on global Change Day – 11 March. We’re asking staff to ‘act’ their pledge during patient experience week. Change Day gives those who work in healthcare a voice, an opportunity and the ability to improve the delivery of healthcare in New Zealand - make a pledge, no matter how small, to do one thing (or many things) to improve the healthcare experience for all New Zealanders.

This will be an exciting week, an opportunity for Waitemata DHB to prove we are committed to improving the experience of all patients, their family and friends who come into our care.

This action is our way of ensuring the patients of Waitemata get the best care possible and that our staff have the best resources and facilities to make that happen.

Take care Dale

Dr Dale Bramley

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Dear Dale

We have three computers at North Shore Hospital for staff to use in their break. Only one is almost good. The other two are terrible. Don’t we deserve better? Thanks for pointing this issue out to us. We have acted immediately and upgraded the computers so please, enjoy.

Dear Dale

Have you ever tried to eat cereal with a fork? Also, plastic knives and bendy forks make it impossible to eat solid food. Please can we have some metal cutlery? Thank you for letting us know. We raised this issue with our caterers and have sought an immediate change. This has now been corrected so that our staff can expect proper cutlery from now on.

If you have a question for Dr Dale Bramley, please email deardale@waitematadhb.govt.nz.

Waitemata DHB Emergency Medicine Specialist, Dr Tom Webster trains with a team of Emergency Department staff on the ultrasound procedural training unit.

ESC clinical director, Dr John Cullen, David Penny of Fairfax Media and Waitemata DHB emergency medicine specialist, Dr Tom Webster

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Just over seven months since its official launch in July 2014, the Well Foundation has secured its first major achievement - well exceeding a $125,000 target to purchase an Ultrasound Procedural Training Unit for the Waitemata DHB.

The foundation, which is the official fundraising body for the Waitemata DHB, is thrilled with this result and grateful to everyone who contributed towards what has been its highest priority project since launch.

It’s been a collective effort according to Well Foundation CEO, Andrew Young, with many organisations and individuals from across the Waitemata contributing.

“We had a fantastic kick start of $20,000 at our launch from the Mad Butcher & Suburban Newspapers Community Trust,” says Young. “We were extremely grateful to also receive $72,443 from The Trusts Community Foundation which gave us the significant boost needed to raise all of the funds by our first Christmas.”

Other funds came from individual donors and local rotary clubs keen to get the training unit into the hands of Waitemata DHB doctors and nurses as soon as possible.

The support received was so strong that when an urgent request came in from the Renal Ward at North Shore Hospital for an ultrasound machine specifically designed for kidney patients at a cost of $52,000, the foundation was able to rally the additional funds.

“The Waitemata DHB’s renal services are facing extreme pressure and demand with people from all over Waitemata requiring various treatments,” says Young. “We are so pleased to buy this advanced ultrasound machine so they can not only see more patients in need, but also do a wider range of treatments.”

The Ultrasound Procedural Training Unit, the first of its kind in New Zealand, will be housed in the Awhina Department, which is responsible for teaching, research and innovation at Waitemata DHB.

The unit’s state-of-the-art Blue Phantom mannequin parts have life like anatomy to train staff to perform ultrasound guided medical procedures.

Well Foundation celebrate first major milestone

The SonoSite ultrasound scanner gives an exact picture of the placement of surgical instruments or needles inside the body. Ultrasound is increasingly being used in surgical procedures such as biopsies, anaesthesia, emergency care, chest drainage, catheter insertion, and complex injections.

Dr Tom Webster, an Emergency Medicine Specialist, is one of the many medical professionals at Waitemata DHB excited that the training unit is now available and certain of the benefits for his department.

“Having the ability and training to do ultrasound guided procedures will result in greater patient safety and comfort,” says Dr Webster. “Additionally, having

ultrasound trained physicians in the Emergency Department will lead to earlier diagnosis and treatment. I’ve seen the difference it’s made in the USA; patients’ stress levels go right down because they get information sooner and they relax once they know what’s going on.

“I know the whole team will benefit, the nurses, the anaesthetists, everyone - and above all, our patients.”

From the chairman

New Minister Outlines Expectations

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Happy New Year, I hope you enjoyed some time with family and friends over the holidays.

A New Year is a time to look ahead, as a DHB we have some additional direction in the first letter of expectations we received from the new Minister for the next financial year (2015/16). The six key themes, which will frame our priorities for the next annual planning process are:

• Fiscal discipline – an on-going requirement to budget and operate within allocated funding and continue to seek efficiency gains and improvements in purchasing, productivity, quality and service delivery.

• Leadership – effective, embedded clinical leadership with a specific requirement to demonstrate how we will foster clinical leadership.

• Primary and secondary care integration –moving services closer to home.

• National health targets – continue to focus on achieving performance against these targets including a new target, 62 day faster cancer treatment.

• Tackling key drivers of morbidity – continuing to do what we can do to reduce the incidence of obesity, whilst a national stocktake of ‘what works’ to reduce obesity is undertaken. Support cross-agency work that delivers outcomes for children across the dimensions of health, education, social and justice and reduces the number of children living in material hardship.

• New Zealand Health Strategy - the Minister has asked the Ministry of Health to refresh the New Zealand Health Strategy, I regard this as a very welcome move. When completed this will provide District Health Boards and the wider health sector with a clear strategic direction and road map for delivery of health services into the future.

Further information, that will assist our planning, is yet to be revealed in the Government’s 2015 budget process.

We must take a strong interest in the Ministry of Health’s four-year plan when it becomes available, as this will provide further clarity about how we manage our resources and prioritise into the future.

There is now doubt that we work in a very challenging environment and we all need to face the reality that our world is changing. We cannot meet these new challenges by continuing to do things as we have before. Innovative new models of care are no longer a theoretical discussion - we will need to move rapidly to these new models. Without this we will not be able to provide the best possible access and quality to our patients and population in this challenging and changing world.

Thank you all for the efforts I trust you will make to ensure we meet these new expectations.

Dr Lester Levy

Describe the most memorable gift you’ve ever received: Marrying my soul mate Dave. I was widowed at a young age, and as others in the same situation might appreciate, it can be sad and lonely place for some time, so meeting my soul mate was the most wonderful gift I have been blessed with.

In a film being made about your life, what genre would it be and who would play you? The film will be a Fantasy genre, full of light, laughter and the odd tragic moment, my house will be a compound based on Rivendell from Lord of the Rings and Uma Thurman will play me – as I said it’s a Fantasy.

What do you cook when you want to impress a guest? I would ask my husband Dave to cook – The kitchen, house, cats and guests will be safer and happier that way.

What was the first record or cassette you ever owned? Probably the Wombles of Wimbledon Down, followed by Abba and then Duran Duran – the musical journal of an 80’s teenager.

What’s the best thing about your job? Every day I have the opportunity to add value to what we do at Waitemata DHB and every day I will take the opportunity to lead, discuss or facilitate ways that we can do things better for our people and our community.

What would you do with one more hour of free time a day? Yay – more time for my MBA study.

What’s your best personal characteristic? Living in the moment.

Fiona McCarthy, Director of HRWho’s the boss?… a light-hearted look at what makes our senior managers tick

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Kay Hogan is very proud of the culture instilled at Waitakere Hospital.

Transforming Waitakere Hospital from a small hospital with just a few wards and limited expertise to a full service hospital was a big project.

Few knew this as much as Kay Hogan who was the associate director of nursing at the time and she’d be the first to admit the project was one approached with caution.

“We did walk into this with a bit of trepidation. I mean, who employs 500 people at once then flings the door open to an emergency department?”

Waitakere Hospital this month celebrates 10 years since becoming a full service hospital. Before 2015, Waitakere Hospital could really only treat new mums in the maternity ward and people at the other end of the spectrum in what were known then as geriatric wards.

For almost everything else, patients and their families from west Auckland were forced to travel to either North Shore Hospital or Starship Hospital with a severely sick child, a good 25 minute drive.

“There was a definite need here for a facility that could service the people out west and being from out here made me excited about the opportunity to be involved,” she says.

The plan was for the new and improved version of Waitakere Hospital to house an Emergency Department, medical wards, a lab, a pharmacy, a surgical department and more. A few months after opening, there would be another phase to the project including the introduction of children’s ward now known as Rangatira Ward and a Special Care Baby Unit.

Kay recalls current Workforce Development manager, Sarah McLeod, being in charge of recruiting staff for the new hospital.

“She and her team were just fabulous doing a wonderful job. Recruiting for 500 staff was such a huge undertaking and they did it well.

The Waitakere Way still alive and well today

With the hundreds of new staff on day one, orientation had to be held at Waitakere’s Trusts Stadium.

“We had lots of staff who lived in the west and they were jumping at the opportunity to work close to home which was expected but at the same time, we had plenty of staff coming from other DHBs who were excited about the opportunity to be a part of something new. It was attractive for them and those were the type of people and the type of attitude we needed to get it off the ground.”

Kay was part of small but dedicated team who managed the project including the likes of Rachel Haggerty and CEO at the time, Dwayne Crombie. Together they worked hard to develop not only a facility, but a culture which quickly became known as the Waitakere Way.

“It was all about building and maintaining relationships. It was about rather than

sending an email, go for a walk down the corridor and talk to the person. It was about saying good morning, interacting with other departments. I remember when the Waitakere Way concept was being developed by management. We needed to align with the DHB principles and we weren’t allowed to leave the room until it was sorted. That’s how important it was to us and it became that important to the staff because they would pull us up if we weren’t being consistent with that.

“We were proud to be from the west and while the hospital was getting bigger, we were still small in the grand scheme of things and that was going to be what set us apart. What’s even more amazing is that while the Waitakere Way isn’t talked about much these days, it’s an attitude that has remained as part of the culture, making this facility and the people truly unique.”

Short stop off turns into 10-year-long stay over

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Georgina Rainbow had never really spent very long in any one job when she arrived to work at Waitakere Hospital.

“I did a lot of travelling before I came here so it wasn’t unusual for me to work somewhere for a bit and then move on to another adventure,” she says.

This year in September, Georgina celebrates her 10 year anniversary at Waitakere Hospital. This month, Waitakere Hospital celebrates its 10th birthday since becoming a full service hospital complete with medical wards and an emergency department.

“I had been nursing for a long time and I came from working in the outback in Australia to be a nurse in the Coronary Care Unit,’ she says.

“It was very apparent that it had a very good, small feel. There was a real sense of family here and you could tell that almost immediately.”

After three years of working as a nurse, Georgina took on the role of duty manager in 2008. She was reluctant stepping into a managerial position but if you have had the pleasure of working with Georgina, you will know that she really had no reason to be hesitant.

“It did take some convincing but after lots of encouragement from other staff, I did it and actually enjoyed it.”

In 2011, with more of a push in that direction from her colleagues, Georgina stepped up at a time when a restructure has repositioned existing managers, to add hospital coordinator to her role.

“I was then the person to come to about anything so there was a lot to learn.”

Fortunately for her, Waitakere’s small, family feel means there’s always someone who can help or offer some advice.

She says one day, they may have a Japanese speaking patient come in and they urgently need to find out information from that patient.

“I know that if we have a Japanese speaking member on staff, someone close by will know who it is and it will be no trouble for them to pop up and help us out.

“This hospital seems to have been built on an important relationship culture,” Georgina says.

“I feel like I’m very lucky to have relationships with people across the organisation and can use those links to assist.

“I guess in the duty manager role, you’re looking after the whole hospital so you’ve got to have those skills and personality traits that make sure people feel comfortable sharing information with you.”

Georgina says being in a small hospital means staff all work in close proximity. This means instead of living at her desk emailing people, she makes sure to visit people to speak to them face to face.

“This is really how we work best. That’s how you form those relationships and foster them and I think it’s really important to keep that culture alive.”

connected“ ”

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Few know the hospital as well as these two with more than 50 years at Waitakere Hospital between them. And even after all this time, the pair say they’re still learning every day.

Marie Te Wake and Barbara Tangi have been around longer than Waitakere Hospital as it is known these days.

Marie started working at the original hospital site in 1974, 21 years before the west Auckland hospital became a full service hospital.

Barbara took her first job here as a 16-year-old working an after school job as a cleaner and in the kitchen when it was in Woodford House. Her mum pretty much ran the show in the kitchen and was famous for her chicken tetrazzini.

“We certainly have been around for a very long time. We must love it though because we’re both still going strong,” Barbara says with a laugh.

Both women are team leaders for non-

clinical support at Waitakere Hospital They’re based in one of the back corridors hidden from the public like one of the veins of the hospital. In short, Barbara and Marie look after the orderlies and cleaners, the backbone of the hospital that makes it all tick.

“We’re really proud of the work our team does here and we work really hard to make sure all our staff do the best job possible and have what they need to do that, “ Barbara says.

“It’s not always an easy job because we have to coordinate with all departments throughout the hospital but we make it work.”

“We try our best anyway,” Marie adds with a laugh.

The face of their department has changed dramatically over the past 10 years since Waitakere Hospital became a full service hospital.

“We’ve always been family orientated

around here and at the stage, we still are. We’ve grown bigger, especially over the last 10 years but the principles are still the same,” Barbara says.

One of the major changes they both point out is the ethnic diversity of the staff. Ten years ago, cleaners and orderlies were mainly of Pacific Island, Maori or Pakeha descent.

“We have a mixed bag nowadays with Indian, Malaysian, Philippine and Indian. What’s important now that we have so many different cultures is making sure we run the team in a way that is respectful to all cultures,” Barbara says.

“We do have to compromise sometimes in order for staff to not work in situations that they are culturally not comfortable in but we understand and the clinical teams we work alongside are happy to work with us to find a solution.

“In this organisation, we say Everyone Matters and I truly believe that people at Waitakere Hospital make sure of that.”

Pair really does make Everyone Matter

Marie Te Wake and Barbara Tangi.

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1. Staff from Anawhata and Titirangi wards come together with CEO Dr Dale Bramley.

2. Shuttle drivers Peter Read, Pele Maiava and Donald MacKenzie from Traffic Services.

3. Peter Smith is a popular face about the place, always offering up a greeting as he moves around the hospital making sure it’s spic and span.

4. Joan Graham of Kelston, Ruby Law from Laingholm and Pauline Lafotanoa of Glen Eden are just some of the lovely volunteers who help visitors find their way around.

5. Some of the dedicated staff in Waitakere’s Radiology department.

6. Physiotherapist Sarah Mighton with nurses Sarah Jenkinson, Evangaline Dizon and Kim Stormont in Waitakere’s Rangatira paediatric ward.

7. Teri Wi is one of the security guards and has worked at the hospital for the past eight years.

8. Frances Thompson and Susan Cluitt from the maternity ward.

9. Charge nurse manager of Rangatira Adelle Rongokea with Child Health nurse educators, Sarah Timmis, Janine Quiding and Angela Crozier.

10. Clinical director of paediatrics, Dr Seinafolava Meia Schmidt.

11. Limalima Alefaio, Sandra Peleti, Pepe Fuimaono and Eleesha Tomokino from our clinical support team.

12. Mahe Ha’unga, Tauafu Moala, Puleiala Tofaeono, Siai Sausau, Sera Tagaloa and Matangaro Jones of the Tautai Fakataha team who make sure our Pacific Island families feel comfortable during their journey to recovery.

13. Waitakere Hospital orderly, Rodrigo Bermudez.

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Waitakere Hospital is well known for being the small hospital with the big heart and it doesn’t take long to work out why.

The smiling faces throughout the west Auckland setting gives this hospital its’ reputation so we thought we’d show some of them off.

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Waitakere - Where nearly everybody knows your name

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Waitakere - Where nearly everybody knows your name

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Child care just continues to get better at RangatiraJenny Crawford remembers being faced with challenges on day one of being a dispensary team leader at Waitakere Hospital.

“I remember move in day and some of the shelves were too narrow and far too high but you just got on with it,” she says.

“It was all very exciting. I actually still remember sitting around watching the fax machine, waiting for the first patient.”

Jenny was at Auckland City Hospital but quickly jumped at the chance to work as a dispensary team leader at the new and improved Waitakere Hospital. She soon went on to become a paediatric pharmacist

“We got to start from scratch so it was very satisfying being able to set up all of those processes unique to our team,” she says.

“The only example of child health we had to follow was Starship but their setup was based on a very different module so we had to come up with all new policies that suited our systems and our patients, which was good.”

Tiana Brookes was just as excited coming on board as a play specialist.

The number of beds in the paediatric ward since 2005 has gone from 15 to 23 and now up to 33. The ward has undergone a major redevelopment in that time and they’ve now got a dedicated play room instead of the half-hearted play corner that used to be in the waiting area.

“We have come a long way and it has been a privilege to be a part of it all.”

Tiana says technology has been one of the biggest advances for her role in the past 10 years. “Kids get technology and they love it when we can incorporate that into their recovery or their time here,” she says.

Both women say they have noticed children’s health needs and social issues have become more complex technology they’re now able to use at Waitakere Hospital means the team are equipped to deal with most cases.

“We do a good job here. We still have a way to go but we have a good team and a really supportive community that will make sure we keep heading in the right direction,” Tiana says.

Angela Nightingill wanted to mark Waitakere Hospital’s 10 year anniversary by collecting photos from staff from over the past decade.

And boy did she get what she was after.

“As soon as I put the request onto Facebook, I started to get texts from the team saying they had some and they wanted to know if we were going to have a party to celebrate,” she says.

“It’s flown by but it’s a real achievement that the whole team is proud of.”

Angela started in 2005 and was the first nurse from Waitakere to gain her level four qualification while working there.

She is now the charge nurse manager of Titirangi Ward which was known as Titirangi Blue and Titirangi Green in 2005.

Trenna Wilkinson joined the team as a nurse educator.

“We had a lot of nurses who had come from other care facilities or overseas which was great but we realised at the last minute that they all needed to be assessed and approved to administer medication,” Trenna says.

“That meant we needed to assess and sign off 60 nurses in two days. It was hectic but we got there.”

Trenna is now the charge nurse manager of Wainamu Ward which connects up with Muriwai Ward on the lower ground floor of Waitakere Hospital. Upstairs is Angela and her team in the Titirangi Ward which connects Anawhata and Karekare Wards. The three upstairs wards were three of the new sections of Waitakere Hospital when it was opened as a full service in 2005.

“The idea behind this design was to keep the wards small, the teams close and the wards close to create better communication and better care,” Angela says.

And it’s a system that works well, they say.

Staff have formed tighter bonds between the wards, they’re able to share resources when needed and it means it’s a suitable setting to train new nurses which is a benefit to the whole DHB.

Trenna Wilkinson and Angela Nightingill.

Ward staff keep connections tight

Jenny Crawford and Tiana Brookes.

connected“ ”

We have been so lucky. Ten years of working in one of the nicest labs around with some of the best work mates you could wish for.

Waitakere Hospital’s lab started with three months of training and re-learning old Blood Bank skills as well as a new computing system.

In Haematology, we had training to use our brand new analyser and there was work to d adapting our microscopy reporting to align with North Shore Hospital’s policies. Then there was the exciting time of actually being in our new laboratory!

There were just four of us covering the roster and the solo evening and weekend shifts were a bit daunting at first.

In July 2010, the laboratory provided a 24-hour service so more staff came on board.

Being a smaller hospital means it has a community atmosphere and it has been easier to get to know staff from other

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Tucked away in the depths of Waitakere Hospital is another very important department that aims to get results every day in more ways than one. Instead of telling their story for them, staff from the laboratory of Waitakere Hospital decided to tell it themselves.

Memories of day one still fresh in labs

The Haematology team at Waitakere Hospital.

Haematology cherish decade By Bev Place and Jackie Crane

areas including the Orderlies, Outpatients, Dieticians, Support staff etc.

We have seen the hospital expand its services and the laboratory move making it

possible to extend the services we offer.

After years of commuting across Auckland we have both enjoyed working so close to home and love working here.

I began working for WDHB Lab for a second time in May 2002, knowing that a Lab was planned for Waitakere Hospital. I had hoped that I would get the chance to work here at Waitakere again, as I had worked in phlebotomy at Waitakere Hospital in the mid-1990s.

There was originally no plan to include a Microbiology Department within the Lab, however the Paediatricians insisted that we provide an urgent service for screening CSF and urine on West Auckland’s babies and children, so a Microbiology lab was planned and included.

It has been mainly a sole charge operated lab for the entire 10 years, with support in the past from Kevin Smith on a Tuesday and Thursday afternoon and most recently Karen Ansell overseeing the day to day running of the department.

I was very fortunate to have had the

Jumping at an opportunity By Phillippa Reidchance to operate the Evolis every Wednesday for a year or two, while a second person was rostered to cover the Micro dept.

We also had a blood culture machine at Waitakere for about two years, before it was reinstated at North Shore.

I feel very privileged to have had the chance to work within a real team atmosphere, close to home with a great friendly group of people.

I look forward to being a part of the continuing development and growth of the Lab.

Phillippa Reid.

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Who: Sue Blainey , ward clerkWhere: Anawhata Ward

Sue is that ‘one in a million’ person you hope to meet in your life, whose very essence is about customer service with a smile and a can do attitude. Both patients their families and the MDT would agree that she’ll go beyond to help in any way if she can.

We are all greeted with a good morning and a smile to boot. Her genuine warmth and concern for others is truly because everyone matters. Sue listens and I watch her in the chaos as she deals with patients and family concerns at the front desk. She is attentive, focused and, above all, shows a connectedness which is awesome to witness. Sue starts to deliver meals if she sees any delay. A bell is to be rung to alert nursing staff when this happens, but Sue will ring it and start the process herself.

Sue sits with confused or distressed patients trying to help until nursing staff arrive. She is caring and compassionate in her approach and has a gentle nature which patients respond to well. Nothing is too much trouble for Sue. She has streamlined many historic practices on our ward, she has bought suggestions and has helped with the implementation of many projects on the ward. She is always looking for ways to improve and I believe this is displaying the value of Better Best Brilliant. Recently, she took on a small project to update the Waitakere Contact List as a way to reduce the amount of time spent looking for numbers and disrupting people when the wrong extension was rung. She is a fine example of a staff member who is here for all the right reasons in our promise of ‘best care for everyone’.

She has recently helped Waitakere Hospital duty managers set up scanning ability to the office printer. She understood that this service would assist communication about patients rapidly between organisations. She was very patient teaching us how to use it when it took her away from her own busy environment. She may not consider this to be of great importance, but it was because she went that extra mile that her actions have gone on to benefit the whole hospital.

Nominated by Donna Riddell and Georgina Rainbow.CEO Dr Dale Bramley with Health Hero, Sue Blainey.

We’re so fortunate to have the generous support of the City Cake Company and the Spencer on Byron Hotel. Both businesses generously supply us with the sumptuous celebratory cake and the reward which includes either a complimentary dinner for two or a relaxing night at the 4.5 star hotel.

And Waitakere is still growing with more plans to expand on the facility and its services for people of the west in the pipeline already.

New ED expansionA major expansion to the physical size and layout of Waitakere Hospital’s emergency department will see it almost double in size with the addition of 19 cubicles, four new rooms and extensive new patient and whānau facilities. The expansion will extend the emergency department footprint at Waitakere Hospital by 1313 square metres creating significant extra capacity to meet the needs of west Auckland residents. The state-of-the-art emergency department will provide a fit-for-purpose area that will ensure we can continue to provide high-quality round-the-clock care from an advanced facility. This is set to be completed by mid-2016.

Enhanced acute mental health service at Waitakere Hospital EDAn enhanced acute mental health service will be provided at Waitakere Hospital’s emergency department by April 2015. The new service will be provided 7 days a week with mental health service staff being based in ED. The aim is to provide specialist mental health assessment for those clients who present to the ED and also require mental health input. New staff are being recruited which will provide afternoon and evening shift cover. The day shift will continue to be provided by staff based in the community mental health hub, Waimarino. Waitemata DHB is initiating the enhanced service to improve the experience of people attending ED. Planning for the enhanced service is underway.

Upgrade to maternity servicesA significant upgrade of Waitakere Hospital’s maternity wards will see the unit revitalised to improve the experience of west Auckland women and their families using the service. The $987,000 refurbishment of the Te Henga and Piha wards includes a major amenities upgrade to support a more efficient use of space. The project will see an interior redesign within Te Henga ward to create a dedicated new space for women and families experiencing a still birth or the death of a baby. The Butterfly Suite will provide an environment to support families while they grieve, including an en suite, lounge and beverage bay. It also includes a significant upgrade of existing toilet and shower facilities in the wards and the addition of two en suites affording greater privacy and easier access to these amenities.

The future of Waitakere is bright

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Theatre upgrades will get the go ahead in MarchThe major refurbishment of four operating theatres at North Shore Hospital is set start by the middle of March.

Project manager on behalf of Facilities and Development, Joanne Evans, says theatre seven on level one of the hospital will be the first to undergo the refurbishment ahead of theatres eight, six and finally theatre one.

“The staged refurbishment considers the complex layout of services and allows for the need to shut down some areas during the works,” she says.

“Once the upgrade is complete, the floor size of theatres will be slightly increased to better-accommodate the modern equipment and technology required to perform an expanding range of complex surgeries.

“Building consent is processing and we expect that to be approved end of February,” Joanne says.

Meanwhile, staff are busy planning for the staged works and are meeting regularly to prepare for the moving process.

Once this refurbishment is complete, the theatres will be up-to-date with the latest international standards that will, in turn, improve our surgical workflow.

CEO Dr Dale Bramley says staff working in the operating theatres have done a tremendous job to ensure more patients are receiving timely access to the care they need.

“These upgrades will create a better ergonomic working environment and make it easier for our staff to keep providing care to the highest standards.” As well as increasing the size of the theatres, the works will include upgrades to critical infrastructure such as air conditioning, scrub bays and electricity distribution systems. Construction will take up to 18 months to complete.

New accelerated chest pain clinical pathway On 9 December Waitemata DHB will roll out a new clinical pathway for patients presenting to NSH with chest pain.

The new clinical pathway, designed in collaboration with the emergency department, general medicine and cardiology, has been developed by a project group led by Dr Jonathan Christiansen and comprising project manager Robyn Steinbeck, Drs Laura Chapman, Kate Allan and Andrew To, charge nurse managers Sue Lamb and Gina Watkinson, clinical nurse specialist Jo Wickham and quality lead Sandra Macaulay.

The new pathway, using an internationally recognised risk score, means very low risk patients presenting with chest pain can be discharged with prompt follow-up, avoiding unnecessary extended overnight stays. The new pathway is expected to result in shorter hospital stays, quicker discharges, less overnight stays and a freeing up of ADU/ED beds.

The work that’s led to the new clinical pathway is part of a national research project we’re collaborating on with Canterbury DHB into models of care and delivery of care to patients presenting to EDs with low risk chest pain.

The research project has been awarded a grant from the Health Research Council (HRC) as it has the potential to improve health outcomes and delivery of care.

Spending time in hospital is a relatively new experience for Brian Hart but thanks to the Protected Mealtime initiative, he knows it’s going to help him get healthy and get home faster.

The 81-year-old Henderson man was admitted to North Shore Hospital’s Ward 7 in January.

Without a lot to do throughout the day, Mr Hart looks forward to the sound of the food delivery service staff edging closer to his room.

“The meals have definitely improved from last year so I look forward to dinner as it helps break the monotony,” he says.

“My wife has always made beautiful dinners so meals are something I always look forward to and I know how good a nice meal can make me feel.”

The Protected Mealtimes initiative started being implemented throughout Waitemata DHB patient sites about six months ago.

The purpose is to protect mealtimes from unnecessary and avoidable interruptions, providing an environment conducive to eating, where staff are able to assist patients who would usually struggle to eat and give up.

Registered nurse from Ward 7, Emma Gray, says Protected Mealtimes are about making eating a priority at breakfast, lunch and dinner.

“We found that some patients weren’t recovering as fast as we would have expected and then we realised these patients weren’t all eating their meals,” she says.

“This meant they weren’t getting any nutrition and fuelling the body so therefore couldn’t mobilise as fast as we all hoped.”

Emma says reasons for patients not eating are varied. She says they may feel nauseated after a procedure, they may be in too much pain or too weak to eat or they may not like the food.

The food may have been positioned too far away from the patient, the food may be too cold or they are too shy to ask for assistance.

Mealtimes take priority on wards

There were also distractions such as staff collecting samples of blood from patients or coming to take patients for x-rays during mealtimes.

Emma says this has stopped in order for patients to focus on replenishing their energy levels.

A greater understanding in the importance of the patient meal experience and nutritional requirements are increasing within the wider healthcare team. Food and the service of food are now regarded by many as an essential part of treatment.

Emma says the introduction of the initiative has made staff take a moment to focus on the patient during these times too.

“Nutrition is just as important as some of our other tasks we rush around doing so bringing nutrition into the spotlight is a good reminder,” Emma says.

What has also been discovered is that mealtimes are not only a vehicle to provide patients/clients with adequate nutrition but also an opportunity to support social interaction amongst patients/clients.

The therapeutic role of food within the healing process cannot be underestimated, Emma says.

Above: Brian Hart of Henderson at North Shore Hospital.

Right: Ward 7 registered nurse, Emma Gray.

Key Points• Mealtimes are free from

unnecessary interruptions.

• Mealtimes are quiet and relaxed so patients can enjoy meals, limiting unwanted traffic through the ward during mealtimes.

• Recognise and support the social aspects of eating.

• Limit ward based activities, both clinical (i.e. drug rounds) and non-clinical (i.e. cleaning tasks) to those that are relevant to mealtimes.

• Focus ward activities into the service of food, providing patients with support.

• To emphasise to all staff, patients and visitors the importance of mealtimes as part of care and treatment.

14

Nursing is in the blood for 18-year-old Pamela Burton.

The recent school leaver from Westgate remembers hearing stories told by her grandfather about his mother who came to New Zealand from Burma and worked as a nurse. “I remember hearing about her as a little girl and that definitely influenced my move into nursing,” she says. “She was my inspiration and I’m her namesake so it all makes sense.”

And after three month stint being able to work alongside nurses in real time situations, she now knows she genuinely enjoys nursing. Pamela got experience nursing at Auckland Hospital as a cadet in the Rangatahi Programme run by ADHB but partly funded by Waitemata DHB. The Rangatahi Programme is an initiative run over summer that helps young Maori and Pacific youth get hands on experience in the job before heading into a fully-fledged degree. Pamela started the Rangatahi Programme on December 8 and will finish at the end of February. She’ll then start her Bachelor of Health Science with AUT in March.

“Helping Maori was my aim. Before this, I thought that just meant helping people avoid diabetes but after this experience, I know there is far more to it,” she says.

“Being a sick patient can be very distressing but I found that when patients knew I was the same culture as them, it would immediately put them at ease and they’d feel comfortable talking to me and asking questions which was great.” Pamela says learning to work with cultures outside of her own has been fascinating too. “I have definitely learned a lot more than I thought possible just in the last few months.”

She was surprised to see how much healing staff help with outside of the medicine patients need to take. “It can be really emotional and I really was the day I got to work in Starship. Meeting people, especially children, who are battling for their lives,”

“This whole experience has just made me more passionate and determined to succeed at uni and get back to it.”

While the Rangatahi Programme is partly

funded by Waitemata DHB to take place at Auckland Hospital, Waitemata CEO Dr Dale Bramley is hoping Waitakere and North Shore hospitals will be able to host our own cadets in the summer of 2015/16.

15

Eve Fairhurst, a nurse in ADU at North Shore Hospital, left Waitemata DHB for good in February after 30 years of being on staff. She wrote this letter as a final sign off before moving to the South Island.

On 1st of April 1984, North Shore Hospital opened its doors to acute patients. I transferred from Greenlane Hospital to Ward 5 at the brand new hospital which was the first ward to open. It was an interesting first few days. The patients trickled in slowly, initially. We realised we weren’t as prepared as we should have been when one of the early patients were admitted with a diagnosis of Epilepsy. He had a seizure shortly after admission to the ward but unfortunately, the cupboards had not been stocked with drugs and I was given the task of racing down to Pharmacy for urgent medication. I was five months pregnant at the time.

In 1985, North Shore Hospital crèche was commissioned. The hospital management at the time didn’t think there was a requirement for subsidised childcare on-site for staff- they needed some convincing actually! It was a lifesaver for myself and many other nurses, doctors and ancillary staff. It meant we could work full shifts and be reassured our children

Eve says farewell after 30 years

Nursing becomes a calling from young

Pamela Burton has really fallen in love with the idea of becoming a nurse.

were being cared for on-site. Apparently the food was delicious, my children now aged 27 and 30 still fondly remember the crèche custard served at lunchtime.

North Shore was not open overnight for some years and as a duty nurse manager, I was responsible with my colleague for ambulance arrivals in resuscitation. There were always plenty of surprises and challenges when those ambulance doors opened. The paramedics sometimes forgot that we didn’t have any ED doctors or anaesthetists available to attend to these unexpected arrivals. I recall on more than one occasion looking through the Yellow Pages for an anaesthetist to attend a patient urgently. It all seems incredulous to think back on it now, wondering how did we manage back then? We did though. We just got on with it.

I have come and gone from North Shore Hospital and have spent my nursing career predominately in ED and CCU, but this week I’m leaving for good emigrating to the South Island to be near family.

My last tenure in ADU has been fabulous and I wish I could take all the staff with me to the South Island but I don’t think Gina Watkinson, our manager, would approve!

She is the most excellent manager of a consistently busy department. The unit runs so smoothly because of her leadership, she is worth her weight in gold and I will be sad to leave but another chapter is about to unfold.

Good Luck for the future North Shore Hospital!

Signing off, Eve

Eve Fairhurst (centre) with her team.

What does your job involve? Transit care nursing is the provision of specialised clinical care for patients, while away from their routine clinical unit. Care is provided by experienced staff, providing clinical care, monitoring, continuation of treatment and support to meet clinical safety needs. We cover waitakere and north shore hospitals.

Why did you choose this field to work? It’s the variety, the autonomy, and the challenge of meeting many and varied clinical presentations. No day is ever the same – and may include :• A retrieval of a patient from whangarei • Transferring a burns patient to plastics

MMH• Monitoring a patient with a brain

haemorrhage, and transferring them to neurology ACH

• Transferring a paediatric patient to Starship

• Assisting with radiology procedural flow –x-rays and CT

What does the team love about this job? It’s the opportunity to make a difference in a patient’s journey. Coming from a variety of backgrounds –intensive care, emergency deptartment, surgical and

medical environments, we have a broad range of skills to offer. Ensuring patients are supported in a caring, respectful, professional manner is what we as a team strive to achieve.

What are the challenging parts? -Being able to meet the number of transit requests in a timely manner. Task manager gives us the ability to prioritise jobs as well as gaining information so we can plan equipment and ambulances, -Finding the patient notes and getting a formal nurse to nurse handover is imperative for a safe transfer, however busy wards can make this a challenging requirement.

Any advice for those wanting to go into your field of work Transit care nursing is a role requiring skilled nurses who think laterally and can work autonomously. Communication is a key part of our role, so being able to speak with varied health professionals, and provide a voice of advocacy for our patients is important. Confidence with cannulation, infusion management, oxygen, tracheostomies and other complex care needs, is a requirement as is a working knowledge of equipment, procedures and protocols.

Profile: Transit care nursing

16

This is in regards to Traffic Services for

allowing my daughter and I to travel on

the staff shuttle to and from North Shore

Hospital and Waitakere Hospital. They

were very helpful and understanding of

our current situation. Peter and his co-

workers went beyond the call of duty to

help us.

Thank you

L Morris

I would like to say a big thank you to the

Cardiology Ward staff for the wonderful

service and care shown while looking

after our mum during her stay.

The nurses and doctors were very helpful

and made my mum’s stay very pleasant.

Thanks again.

Pulotu Endermann

Te Atatu South

Compliments

Maori liaison representative and

kaumatua, Louise Elia and the Maori

Support Service have been very

professional. It has been wonderful

to have had a place to stay while our

mother was being cared for. We as

a family appreciate the work that

has been offered to our whanau. It’s

amazing. No words can explain how

we feel.

The immediate tactical plan from

hospital staff has been thorough too,

professional and clear.

Tino arohanui.

M Isaacs

Taupo

North Shore Hospital transit care nurses, Sun Jeon, Kent Unabia and Aruna Devi.

Contact Hinerangi Vaimoso with your story ideas on ext 2986 or Hinerangi.Vaimoso@waitematadhb.govt.nz© All material in Healthlines is copyright. It cannot be used or reproduced without the express written permission of Waitemata DHB.