CE update News and views about our health from
NOVEMBER 2019 Waikato DHB Chief Executive Dr Kevin Snee
This month sees the October result of our finances showing that we have improved again but we are still not quite on plan. I will also discuss our approach to developing services in Tokoroa; why our involvement in Future Proof is so important; mental health services development; measles update; the opportunity to significantly increase the presence art in our hospital; the most recent impact of industrial action on our services and the impact it has had over the previous year; engagement with PHOs at a Midland Region level; the outcome of the restructure consultation and how we proceed from here.
Speaking Up for Safety
Discharge planning
Almost half our staff have done the Speaking Up for Safety one hour training session. While that sounds impressive, we still have over half that should be booking in now and attending. 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.
A programme of work focusing on the ‘Last 1000 Days’ has been established to bring together a number of programmes aligned to good discharge planning. From December 2019 projects under the workstreams of pyjama paralysis, red days, green days and criteria-led discharge will be launched. I will provide a full report on the programme to our commissioners in January.
I received an email from one of our staff who is a volunteer Speaking Up for Safety trainer and she told me about a special session she had run for attendants. Many of whom struggled with speaking up as they were often treated by other staff (not all, but a majority) as, in their words, “the lowest of the low”. She said: “Their stories saddened me – when did we stop respecting people for being people no matter what role they had? The Speaking Up programme is also about culture change, making our DHB a place where our staff look forward to coming to work thereby ensuring our patients have the best care. This won’t happen unless we all respect each other – I think we speak the words but our actions say something completely different.” Thank you, for bringing this to my attention. I was also saddened by this as whatever people’s jobs are in this DHB they deserve to be treated with respect. Over the coming months I will be spending time in some services and also doing a shift with different staff groups. First off will be the attendants in December. I will use the opportunity to find out what they would like to see as a way of the DHB appreciating them and their work. There is a lot we do in terms of celebrating their successes, and I am told they are one of the most appreciated and popular groups when we share their stories on social media etc. However, for some reason, personal staff behaviour towards attendants (and potentially other support groups) does not always align with our values.
Healthy people. Excellent care
I would like to comment on an example of how our discharge processes are changing based on learning from some recent poorly managed discharges that I expressed concern over. A gentleman from a rural town was cleared for discharge on a Saturday morning. His wife did not drive, they could not afford to hire an ambulance and no shuttle was available. His family who lived a distance away were not able to collect him. He was safe for discharge and previously he may have been a candidate for the InterCity bus as a way of getting him home over a weekend. Learning from previous situations further discussion and options were explored. These included transport options such as Driving Miss Daisy, fleet car (driven by staff member) using backload option of ambulances from Tokoroa (where the ambulance was delivering a patient and returning back to base empty) or taxi hire. The patient did stay in hospital overnight in order to organise this because the ambulance backload option was available the following day. It is good to see staff are clearly reflecting on recent issues – we need to review whether other options could have been utilised to get the gentleman home safely the day he was fit for discharge.
