Although Southern DHB was created out of a merger of the Otago and Southland DHBs in 2010, a considerable amount of work has been needed within the Ministry to align the two DHBs' transactional and reporting systems.

It has been a complicated piece of work, affecting 29 Ministry systems and requiring careful management of the relationships between these systems.

I am delighted to say the first phase of that project, known as the Southern DHB Merge, has been completed successfully.

This means Southern DHB now appears as a single entity within our systems at the Ministry.

We have learnt a lot from the work that has been done and the problems solved along the way, and are now ready to enter the next two phases of the Merge project.

This involves national collections and data warehousing, which will be completed by 31 August 2012.

We will be supporting Southern DHB to manage any issues that might arise with the new system.

Graeme Osborne

Director, Information Group

We have developed SIRHEP with the South Island's DHB emergency managers and planners, who have collectively reviewed their health emergency plans and incorporated many of last year's emergency management lessons from Canterbury.

The SIRHEP sets out in one place a process for managing regional emergencies that has clear structures, roles, responsibilities and reporting.

Now in the event of an emergency, the South Island DHBs can tailor their response, either individually, regionally or nationally.

This is especially important when the resources of a single DHB could be stretched, and help is needed from within the South Island or nationally.

The SIRHEP is a robust model that has been designed to work with the Ministry of Health's national health emergency plan, and within the wider national emergency framework.

SIRHEP has been viewed this month by the South Island Alliance group, comprised of the South Island district health board chief executive officers.  The group was very positive about SIRHEP, and has passed on its appreciation to all those involved in the review and production of it.

Murray Halbert,

South Island Regional Emergency Management Advisor

At 9:26am on 26 September, ShakeOut aims to have one million people do a 'drop, cover and hold' earthquake drill.  This exercise is an opportunity for the health and disability sector to increase its ability to 'get thru' an earthquake.

We all need to make it through a disaster, but the health and disability sector has a particularly crucial role to play, providing ongoing services to those affected.

Emergency planning needs to happen before an event and ShakeOut is an opportunity for providers to focus on their emergency preparedness.  Your organisation needs to be prepared for a disaster, both at home and at work.  It is important to involve staff in your continuity plans, so they understand the role they play in your organisation's ability to recover.

We are using ShakeOut as an opportunity to talk staff through various scenarios, and raise awareness around issues such as providing supplies for those who are unable to get home, or who are needed to stay and work.  It can also mean managing the unexpected, such as family members turning up at your workplace, or people in need of medical or disability services.

More information on ShakeOut is available from www.getthru.govt.nz with further health and disability information on www.health.govt.nz/our-work/emergency-management

Charles Blanch

Director of Emergency Management

We have also funded an ERAS project for colon surgery patients at Bay of Plenty District Health Board (DHB). This project will also be rolled out at Waikato, Taranaki, Lakes and Tairawhiti DHBs.  Counties Manukau, Southern, and Capital & Coast DHBs are in the process of implementing ERAS this year.

It is pleasing to see ERAS being used more frequently in orthopaedics and general surgery, as well as being adapted to other specialties, such as gynaecology and urology.

Professor Andrew Hill, general surgeon, at Counties Manukau DHB says, "Through using ERAS we have halved the average stay in hospital for patients who have had colon surgery, from eight days to four days.

We have found the ERAS model encourages and supports patients to be more involved in their care and recovery, and gives them a better understanding of what is happening to them.

They then start to travel through their elective journey with more confidence because they know what to expect."

In terms of achieving greater productivity, the Ministry encourages DHBs to look at implementing a programme such as ERAS as a means of streamlining and standardising patient care according to best practice.

Clare Perry

Electives Manager

Associate Minister of Health, Hon. Jo Goodhew officially opened Hagley Outpatients, which has been built on the former Hagley Hostel Nurses' Home site next to Christchurch Women's Hospital.

David Meates, Canterbury District Health Board (CDHB) chief executive says Hagley Outpatients has been designed as a temporary solution to help relieve the physical constraints facing the Canterbury Health System following the earthquakes.

Mr Meates says the new Hagley Outpatients has been completed in 141 days (building started January 9, 2012); which is testament to the 'can do' attitude of CDHB staff and our contractors.

"While this has been built as a temporary solution, the patient environment is very professional, and is a credit to everyone involved," he says.

Mr Meates says outpatients plays a crucial role connecting patients with health professionals.

Moving this service from the Parkside block frees up space at Christchurch Hospital to allow the construction of a new Acute Medical Assessment Unit
(AMAU).

The existing AMAU will move from Level One in the Riverside Block to the old Outpatients site on the ground floor of Christchurch Hospital in Parkside West, and the space where AMAU was will revert to a General Medicine ward.

A more permanent home for outpatients is required as part of the facility redevelopment plans for Christchurch Hospital campus.

"That's why we have built the building in modules so that in the future it could be picked up and moved to another site if required," Mr Meates says. 

The National Health Board's Capital Investment Committee, was involved in fast-tracking the funding decision behind the outpatient development. The proposal was considered a matter of urgency as part of the Government's commitment to rebuilding Canterbury. 

Link to original release.

Visioning workshops have already identified some issues, and ultimately TPOT will improve efficiencies in time and resources for theatre teams.

One of the clinical leads involved is Ear Nose Throat (ENT) specialist, Nicola Hill. She says what attracts her to the programme is that it is process-focused, rather than outcome-focused.

"We are not being told to achieve a pre-determined outcome, but are given tools to improve areas in our systems that we think could work better," she says.

"I think there is real potential for smoother running of our operating lists and improved job satisfaction for staff."

Orthopaedic surgeon, Neville Palmer, says he's also hoping that TPOT will improve the efficiency of the operating theatres, so that the patients' progress through the system can be smooth and uninterrupted to a quality end.

"My objectives are pretty simple - I don't need complex processes to implement them," he says.

The project follows the modular 'Productive' series developed in the UK, which according to TPOT Programme Facilitator, Martin Anderson, has definite advantages.

"Using a navigated path brings a more systematic approach, which does take time, but will result in a change of culture and better sustainability."

With theatre teams, Charge Nurse Managers and clinical leads working alongside Martin and the Project Implementation Team, any changes coming out of the project will be made by staff and not to staff - an important difference.

"This way staff identify and resolve day to day frustrations, focus on gathering robust data and contribute towards developing the 'perfect operating list'," Martin says.

Although it is too early in the process to identify any big issues, Martin has an idea of the type of efficiencies they might find.

"It is likely we will see some streamlining of theatre scheduling systems, greater consistency across specialties and more capacity to fill vacancies in a theatre schedule if there is a late cancellation."

The National Health Board is funding this TPOT project as one of 12 DHB projects through the Elective Services Productivity and Workforce Programme.  A key outcome will be significantly improved productivity, and more people treated sooner.

From the June edition of the NMDHB- DHB Connections Newsletter 

It is a good example of regional cooperation amongst DHBs and with other health-related organisations working towards a common goal.

Through-out the campaign we are sharing information and experiences between the four Northern Region DHBs (Northland, Waitemata, Auckland and Counties Manukau DHBs.)

We are also collaborating with the wider health sector providers such as age-related residential care and primary care, all in the name of reducing preventable patient harm. 

Our key focus areas of the campaign are:  

• Reducing falls
• Reducing pressure injuries
• Medication safety
• Improving the communication processes in the transfer of care
• Reducing healthcare-acquired infections.

To support the sharing of information and resources we launched a First, Do No Harm website as a hub for the campaign, to both raise awareness of the patient safety initiatives, and provide a means for staff to be actively involved in contributing to better patient outcomes.

The website is effectively helping us to engage with staff based at multiple locations across the region, as well as those in the primary health and age-related residential care sectors, who are also engaged in the campaign.  This allows the sharing of strategies that have been effective so the region can work and learn together while reducing duplication of effort and waste of limited resources.   

The campaign is running well, with positive results already being achieved across the DHBs involved.

The campaign team has already hosted a Global Trigger Tools education event to reduce patient harm caused by errors in hospitals, and a first learning session focusing on falls and pressure injuries.

These both had good participation from both the acute care and age-related residential care teams from the region.  More information on these events will be available on the First, Do No Harm website soon.

Karen O'Keeffe

Clinical Lead - First, Do No Harm (NDSA)