CE update - January 2020

CE update

News and views about our health from

JANUARY 2020 Waikato DHB Chief Executive Dr Kevin Snee

Welcome to the New Year; I trust everyone who took time off had a relaxing break with family and friends.

A big thank you to those who worked over the holiday period to ensure our core services continued. Also, thanks to Tanya Maloney for acting in the Chief Executive’s role during this time.

A warm welcome to our new executive director hospital and community services, Leena Singh, who started with us on 13 January. Many of you will already know Leena who worked with the DHB as a consultant during 2019 to create a comprehensive resource review document.

We began the year with our new executive structure in place and are now working to confirm the permanent appointments to those roles. My thanks to those staff who have agreed to take on these significant roles in an acting capacity while we complete the recruitment process.

This is likely to be a busy year for the DHB as we are building the structures and strategy which will support our people and communities into the future.

It is not a simple task and I appreciate your patience and support. We will continue to work closely with teams to ensure relevant staff input into strategy development and that any new investment is fit for purpose and has a positive impact. We will share any further updates as quickly as possible.

We will be trialling a new format for the next CE Update utilising our Newsroom platform. You will still receive an email but it will contain a single link to view the full contents of the CE Update.

Novel coronavirus (2019-nCoV)

While there remain no confirmed cases of the novel coronavirus in New Zealand, the Waikato DHB Public Health Unit is working closely with the Ministry of Health and with our local government agencies and health providers to ensure we are prepared.

The emergency management manager and director of operations have assisted with drafting a DHB incident management structure in anticipation of a potential coronavirus CIMS response. Active engagement with Infection Control, Respiratory and the Emergency Department has also been undertaken to ensure a whole-of-DHB wide approach.

I want to assure you that the risk of transmission on our sites is extremely low. Robust processes are in place to protect staff, patients, whānau and visitors.

Information for staff on novel coronavirus is available on the intranet. There are guidelines for clinical staff and frequently asked questions relating to all staff. This will continue to be updated. Further information is also available on the Ministry of Health website.

Healthy people. Excellent care

Introduction from Leena Singh I am pleased to have returned to the DHB and look forward to working with everyone.

During my time in 2019 whilst reviewing the DHB I was struck by how many dedicated staff Waikato has. This was a key reason for my decision to return in 2020 in a capacity where I can work directly with clinicians, support staff and managers of our hospital and community networks to assist in delivering quality equitable, accessible and safe health services while also managing our return to financial sustainability.

Over the next month I will be attempting to get to as many of the departments and community groups as possible throughout our network to introduce myself and get an initial sense of our priorities and challenges. Please feel free to stop me if you see me around and say “hello” or feel free to drop me an email with your thoughts on the opportunities for doing things differently.

Leena Singh Executive Director Hospital and Community Services

CE update Whakaari/White Island update

Australian High Commissioner, Patricia Forsythe visited Waikato Hospital on 30 January with to meet and thank the DHB staff who provided care and support to Australian citizens injured in the Whakaari/White Island eruption.

Commissioner Forsythe said:

“We don’t have the words to express what we feel for all of you and what you did in the days after the Whakaari/White Island event.”

“Australia was significantly impacted by this event, but my very first message to our Government was that our people were in good hands and the hospitals where the victims had been sent would look after them well. I just wanted to say thank you

on behalf of the Australian people for what you did in the most extraordinary circumstances.”

Waikato Hospital received eight patients on the day of the eruption. Two have since been repatriated to Australia, three transferred to the National Burns Unit in Middlemore Hospital, two passed away and one remains in our HDU. We did have to cancel a number of appointments and procedures which also had an impact on acute patient times over this period.

Theatres managed to maintain some level of business as usual throughout, but provided a reduced level of elective service.

Although the impact has been considerable, our staff have responded admirably to a difficult and unique event.

Australian High Commissioner, Patricia Forsythe visits Waikato Hospital

Financial performance

The result for December is $0.6m unfavourable to budget.

The December result can be attributed to the Holidays Act accrual which was not budgeted for and the consequential impacts of the Whakaari/White Island events.

Delivering the savings plan will be challenging, but the executive leadership team is focused on finding a way to achieve the budgeted result in a clinically safe way, with particular attention to those areas over budget.

JANUARY 2020

JANUARY 2020

CE update

Waikato DHB to improve rural hospital retrieval services

Waikato Hospital is a major trauma hospital, a tertiary care provider to four other midland areas and our four rural hospitals.

We have recognised that there are times when our ability to retrieve severely ill patients from outlying parts of Waikato and the Midland region is overwhelmed.

The DHB has recently dedicated project and service management resources to work with our key clinical staff and stakeholders across the DHB to improve rural hospital retrieval services.

I am committed to resolving this long-standing system issue with a recommended outcome this month. Interim measures have been implemented until the final and sustainable solutions are arrived at.

It should be noted that any transport system may be susceptible to the impact of events such as severe weather, road closures or multiple and simultaneously competing demands for the same services, but this should be kept to a minimum.

Waikato Hospital’s status as a major trauma hospital and tertiary provider places high demands on the transport system. Over the past 10 years demand has grown significantly due to growth in population and the burden of chronic diseases, coupled with advances in clinical technology and medical therapies.

I am aware that staff are under pressure working in the relative isolation of our rural hospitals in general, and more so when faced with seriously and critically ill patients. When transport assets are not readily available, this adds to those pressures. The DHB is indebted to the skills and dedication of our clinical and non-clinical staff that work in our rural health facilities.

Alliance

Te Korowai Waiora, the Waikato Health System Plan, confirms the need for transformation. We have worked to establish the Waikato Primary and Community Healthcare Alliance which met for the first time in January. The Alliance brings together key stakeholders in our Waikato health system, including primary and secondary care, community pharmacy, allied health, St John, and interim Iwi MÄ ori Council representation.

The Alliance will be supporting the development of new locality-based integrated models of care addressing inequities and improving health outcomes. Further discussions will be occurring with the Alliance around an enhanced primary and community care model needed to deliver better outcomes and ensuring the membership of the alliance reflects the group’s purpose.

A general sense of excitement and alignment was felt in this first meeting recognising that community investment and workforce development will be vital for success.

Update on executive restructure

In December I shared the decision on the second phase of our executive leadership refresh, which ensures we have a leadership structure in place that supports our goals to improve healthcare service delivery to our community and the experience of staff and stakeholders who work with the DHB. The new structure is a simplified approach, reducing the number of executive roles to nine and creating reporting lines for teams and work streams which have a natural alignment.

This is intended to improve efficiency and reduce the risk of silos. The structure was achieved through a combination of expanding some roles, adjusting reporting lines, and in some cases it was necessary to disestablish positions.

With the new roles now established we will begin external recruitment this month and aim to have permanent appointments in place as soon as possible. In the interim a number of our former executives have agreed to fill the new roles in an acting capacity, for which I am grateful.

JANUARY 2020

CE update

Working with the attendants

Towards the end of last year I mentioned in one of my updates that the attendants had expressed concern about how badly they were treated by some staff and how they felt powerless to address this.

This saddened me as whatever your job is in this DHB you should be treated with respect, so this year I have decided to spend time in some services doing a shift to see what work life is like on the shop floor. It also gives me a different insight into the way the organisation works - you are a bit more anonymous walking around in a blue shirt than you are in a suit!

Last week I spent a shift as an attendant and I’d firstly like to thank Nigel who looked after me as a novice and showed me the ropes. There are 113 attendants in Waikato Hospital who work around the clock to provide core support services to the rest of the hospital. They do a great job. They are passionate about what they do and those I spoke to love their job. They really engage well with our patients and provide comfort and reassurance for them and their whÄ nau.

Our attendants are a well organised group, focused on helping hospital staff, patients and visitors and their tasks can range from taking a letter from one side of the hospital to the other, to helping unload seriously injured patients from the helicopter, delivering medical equipment to services, transporting deceased to the mortuary, helping to turn patients after surgery with all sorts of surgical equipment connected to them, or wheeling discharged patients to the carpark.

There are also many attendants working behind the scenes who collect the rubbish, linen and medical waste, stock shelves, pick up and deliver mail, make sure clinical records turn up on time, attendants in ICU, Endo and the Transit Lounge, and shuttle drivers. There is a very long list.

I enjoyed the shift and it was good just seeing the integral role they have in running the hospital. The experience gave me insights into how we could improve flow in the hospital and also how we could use technology to improve the way attendants were deployed.

It is also a timely reminder for those who haven’t attended a Speaking Up for Safety training session to please go online and book one. I want to make it clear that this is a very important programme and will only work well if the Speaking Up for Safety C.O.D.E. and process is understood by everyone.

My next shift will be working with the security team.

CE Dr Kevin Snee with attendants, including Nigel (back right)

CE update

JANUARY 2020

Shift to hybrid fleet saves money, reduces emissions This month, seven hybrid Toyota Prius and Camry vehicles joined the Waikato DHB’s vehicle fleet, adding to the 10 which arrived last November.

By the end of 2023, the hybrid fleet will be up to 390, replacing the majority of the petrol fleet. This change has been fuelled not only by environmental motivations but also the lower running costs hybrid technology offers.

Waikato DHB’s sustainability coordinator Katie Hine worked on the project with procurement senior specialist Sarah Macrae. The carbon inventory Hine developed for Waikato DHB as a benchmark late last year showed fuel from the vehicle fleet makes up about 9% of the DHB’s overall carbon emissions.

“Shifting to hybrid will contribute to lowering these Katie and Sarah with new hybrid car emissions,” Katie says. “The hybrids will deliver an estimated 39% reduction in fuel, which is a great step towards lowering our carbon emissions and saving money.”

Sarah confirms that from a procurement perspective it was important to look at the value of the hybrids as part of the wider cost picture. “In fact the price of the Prius hybrid turned out to be about the same as a standard vehicle fleet replacement. The Camry hybrid is a bigger car and costs a little bit more, but the savings in fuel are also greater.”

Hybrid vehicles were chosen because the infrastructure for fully electric vehicles cannot support longer journeys to smaller towns and rural areas in Waikato and the cost of putting in charging bays on DHB sites could not be justified at this stage.

“Hybrid was a perfect compromise - it gives us reliability and cost savings, as well as reducing our fleet carbon footprint,” Katie says.

The cars are getting the thumbs-up from staff too for being so quiet, easy to drive, and equipped with standard features that were not available in some of the older fleet cars they are replacing.

Baby Friendly Hospital Initiative accreditation

Gynaecology surgery to start at Thames Hospital

It is with pleasure that we announce Waikato DHB primary and tertiary services across Taumarunui, Tokoroa, Te Kuiti, Thames and Hamilton have passed the Baby Friendly Hospital Initiative (BFHI) audit and are accredited to March 2022 as baby friendly facilities.

From mid-February 2020 the Waikato Women’s Health Service will commence fortnightly gynaecology operating lists at Thames Hospital. As many of you will know, Women’s Health underwent significant transformation following the loss of training accreditation in 2015. Since that time, the service has gone from strength to strength, regaining accreditation back in early 2019, with a fully recruited Senior Medical Officer (SMO) team, nine Obstetrics & Gynaecology trainees as well as sub-specialty fellows.

This required a huge effort from all staff from frontline and support staff to lactation consultants through to clinicians including midwives, nurses and doctors across our maternity services.

Monitored by New Zealand Breastfeeding Alliance, the BFHI is a key quality improvement tool for DHBs that supports babies, mothers and whānau to breastfeed. Baby friendly facilities also work to ensure that all women, regardless of their feeding method, receive unbiased information, support and professional advice on feeding their babies.

Congratulations to all staff involved in this great Waikato team achievement.

The Women’s Health Service is now in a position to branch out into the rural areas, starting by offering non-complex gynaecological surgery at Thames. This exciting development will be the start of more services being offered in the rural areas which we hope will improve equity and access for the many women who do not reside in Hamilton.

This update will be published monthly, if you have anything happening in your area and think I should know about it please email news@waikatodhb.health.nz