Category: Health

Source: Health Quality and Safety Commission – Press Release/Statement:

Headline: Call for nominations for three positions on the Perinatal and Maternal Mortality Review Committee

Perinatal & Maternal Mortality Review Committee

Applications close Monday, 9 April 2018

The Health Quality & Safety Commission’s Board is seeking three new members to join the Perinatal and Maternal Mortality Review Committee. The members will be from perinatal and maternal related disciplines of midwifery, obstetrics, neonatology, or primary care; and those with knowledge and experience in health service provision to Māori. 

The Perinatal and Maternal Mortality Review Committee is a mortality review committee established under Section 59e of the New Zealand Public Health and Disability Act 2000. The Committee is required to review and report on infant (up to 28 days) and maternal mortality and morbidity, as directed by the Board, for the purposes of improving care, quality and safety, and saving lives.

There are three positions available. We are requesting nominations for, and applications from, practitioners with expertise in the areas of maternal and perinatal care, midwifery, and primary care, and with knowledge and experience in health service provision to Māori.

All applicants are required to have the following:

• wide professional or cultural networks
• credibility in relevant communities and respect of peers
• strong personal integrity and ethical behaviour
• commitment to the issues at the heart of the Committee’s business
• critical appraisal skills, highly developed written and oral skills, strategic thinking
• experience in working with Māori and Pacific peoples
• broad life experience
• appropriate clinical or professional experience
• ability to engage with the other members of the committee and contribute constructively.

Collectively, the committee must have the following expertise:

• quality improvement and risk management; quality assurance in the health sector
• data and information gathering systems and analysis
• clinical epidemiology
• DHB service provision and management
• clinical experience in neonatal paediatrics, perinatal pathology, obstetrics, midwifery and other clinical expertise relevant to the PMMRC’s function
• Māori health
• knowledge of the health of other ethnicities, particularly those at higher risk
• consumer participation and representation.

If you would like to nominate suitable candidates, please complete the nomination form below and email it to Dez McCormack.

If you would like to apply directly, without nomination, please complete the application form below and provide your current curriculum vitae, by email to Dez McCormack.

Downloadable documents

Application for appointment (472 KB, doc)
Nomination form (435 KB, doc)

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Source: Health Quality and Safety Commission – Press Release/Statement:

Headline: Eighth biennial Australian and New Zealand falls prevention conference

Reducing Harm from Falls

The eighth biennial Australian and New Zealand falls prevention conference is being held on 18–20 November 2018 in Hobart, Tasmania. 

The programme includes plenary lectures by speakers from the UK, USA, Australia and New Zealand. Topics are related to falls prevention in the community, hospital and aged care settings (and much more). 

For more information download the conference brochure or visit the conference website.

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Source: Health Quality and Safety Commission – Press Release/Statement:

Headline: What cancer taught me

Partners in Care

Author and young cancer survivor Jake Bailey made international headlines when he delivered his end-of-year prizegiving speech as head boy of Christchurch Boys’ High School in December 2015, just one week after being diagnosed with Burkitt’s non-Hodgkin’s lymphoma.

Jake, who has been in remission since 2016, shared the story of his diagnosis and subsequent treatment at the Health Quality & Safety Commission’s Let’s Talk forum. He discussed the highs and lows – from delays in diagnosis, to the incredible team of health care professionals he considers himself lucky to have worked alongside during his treatment.

While he was invited to speak at the forum about the areas of his treatment which could have been improved, Jake is quick to reiterate how grateful he is for everything his health care team has done for him, and how his experiences within the system were overwhelmingly positive. He noted that, while it’s confronting for patients and professionals to look at the times where things went wrong, it’s important to do so, particularly for the benefit of the patients who will come after him.

A series of system failures meant Jake wasn’t diagnosed as early as he could have been. Scans which could have helped diagnose his condition weren’t looked at by his doctors or dentists, his pain was put down to his wisdom teeth which were subsequently extracted and his pain levels were downplayed.

The type of cancer Jake had is incredibly fast growing and can double in size every 24-48 hours. By the time he was diagnosed, his body was riddled with tumours and the tumour in his jaw was sticking out through the holes left by the removal of his wisdom teeth. The delay in diagnosis bought him within two weeks of death.

“When you’re 18 years old, that’s far closer to death than you are comfortable being,” he noted with a laugh.

He has several examples of ways the system failed while having treatment, and recalls an experience where he was transferred through the hospital for a scan without a face mask, and picked up a bug.

Jake spent 50 days straight in Christchurch Hospital’s bone marrow transplant unit leaving only once to make the speech which thrust him into the spotlight. That time was spent in an isolation room where visitors had to go through two airlocks and two hand washing stations before even making it onto the ward.

“I genuinely believe that through sharing the details of my story, I have the ability to positively influence the consumer experiences of future patients. It’s important to me to be part of the change I want to see.”

While he looks back on his time in hospital with positivity, Jake says he was lucky to have a strong and confident advocate – his mum Janine – but he realises that many consumers may not have such strong family support.

“While my outcome may not have been different, had I not had my family there to advocate for me, it would have been a much longer and slower process to be diagnosed and treated.

“It was them who pushed for me to be seen by specialists, it was them who took me to appointments, it was them who pushed for answers when we felt like we weren’t getting any.”

Jake sees the dedicated health care professionals as the biggest asset of our health care system.

“The most important part of my experience with our health care system was the people who stood beside me throughout it. And that wasn’t just my family – it was a team of truly incredible medical professionals, who I will forever be connected to.

“The staff that made the biggest impact for my family and I were those that saw us as part of the health care team. They understood the psychological impact that isolation can have and made allowances to minimise this.

“They approached their job in a holistic way and gave support on a real and personal level. They made an effort to get to know us as real people– they were humble, hugged me when I cried, talked to me when I was lonely, laughed with me and ultimately saved my life.”

Jake will remain forever grateful to the amazing health care workers who supported him and says that the points he makes should be seen as the failures of a system, not the individuals who work within it.

Jake has written a bestselling book about his experiences called Jake Bailey: What Cancer Taught Me.

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Source: Health Quality and Safety Commission – Press Release/Statement:

Headline: Dr Lynne Maher on co-design

Partners in Care

Dr Lynne Maher presented at the Health Quality & Safety Commission’s Let’s talk forum on 8 March 2018. Lynne is the Director of Innovation at Ko Awatea, Counties Manukau Health, Honorary Associate Professor of Nursing at the University of Auckland, and has led the co-design movement across New Zealand.

She began by asking the audience how many people had ever accessed the health service for themselves or their families – not surprisingly, everybody in the room had. She then asked how many people would describe their experiences as ‘excellent service’? Only about ten people in the room put their hands up. Lynne saw this as an opportunity to learn about integrating the voice of consumers into the design of improved services.

“The response of consumers is a key component of co-design, to create a feedback loop for the design and development of health services,” she said.

“Generally, when consumer voices are integrated into the design of health services, research has shown a number of benefits. For example, patients are more able to take their medications correctly and feel more confident and empowered in their own health care management, which can reduce access to health care services.”

She said that when considering co-design, many mainly focus on working with patients and families. However, co-design is actually about working with everybody who is involved in or impacted by the health care process.

“It is important to understand staff perspective and there is a significant amount of research that demonstrates when staff feel fulfilled and able to work in a positive way, this translates into patients and family/whānau having a more positive experience.”

What is co-design?

Co-design is a process where a challenge or an opportunity is identified. A range of people who have experience and expertise in delivering or receiving services are engaged. The experiences they have are shared and captured with specific attention to how they feel at each step and any ideas they may have for improvement.

We are also capturing consumer experiences that may not have been good. We are gathering ideas for improvement, asking those intricately involved in the care: “How did it make you feel?” and also what ideas they have to improve the service.

Co-design enables us to:

• explore experiences, which helps us to better understand the root cause of the problem – people feel more engaged with the solution if they understand the problem
• engage and build partnerships between staff and consumers from the start
• better utilise all of the expertise available to us, especially from consumers and staff.

Lynne emphasised the importance of considering appropriate combinations of tools to capture experiences. Surveys provide excellent high-level understanding. This can be enhanced by even a short face-to-face discussion which provides much more depth about the experience.

“This storytelling also be very cathartic – people like to feel listened to – it can be therapeutic for patients to tell their story to get it off their chest and feel heard.”

She said capturing the evocative emotions from interviews with patients was key and could reveal subtexts.

In co-design, we are particularly listening for words that depict emotion: ‘In reception I was scared, but by the time the nurse came to talk to me I felt more comfortable’.

The data we capture helps us to map the care journey from multiple perspectives.

“The maps visually represent the story.

“Co-design is about turning experience into action and this results in improvement. It helps to draw out what is happening.”

She said this is a positive way to enable healing and build confidence and competence in health care services.

“Co-design helps to create a health service that can truly be known as world class.”

The Commission is committed to using co-design; a tool which is integral to its programmes.

You can find out more about co-design here: www.hqsc.govt.nz/partners-in-care/work-programmes/co-design/.

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Source: Health Quality and Safety Commission – Press Release/Statement:

Headline: The ripple effect

Partners in Care

Ngāti Kahu Ki Whaingaroa, Te Aitanga-a-Māhaki

Te Rina Ruru’s life changed the morning her brother Ray had a car accident which left him with a traumatic brain injury. She was 16 at the time and struggled to cope. Te Rina shared her story at the Health Quality & Safety Commission’s Let’s talk forum on 8–9 March in Wellington.

“I remember walking into the hospital, the corridors were dark and there was a sense of foreboding in the air. Our beautiful brother lay peacefully in a silent room. We didn’t understand what the doctor was talking about. To us he looked perfect. Despite what he looked like on the outside, the real injury was inside,” recalls Te Rina.

“They called it a traumatic brain injury, but no one sat us down and explained what that meant.”

The family had no idea what to expect in the coming months; Ray spent three months in hospital and five months in rehabilitation.

At the rehabilitation unit, the whānau didn’t want to leave Ray alone, as he had been hit by other patients in the night and left too long without basic cares. So they juggled their lives, from work and studying to child care and being with Ray at the centre. However, there were real concerns about their own safety from other patients who would be physically and sexually abusive towards them when they visited. The whānau were left to manage alone so they made the difficult decision to take Ray home.

Home brought new and unforeseen challenges. Ray is a 6’3” 120 kg wheel-chair bound, non-verbal man. He slept in the lounge and her mother in a Lay-Z-Boy beside him, with her sister and two children in one room and Te Rina in the other. They shared Ray’s 24/7 care, with various home-based support workers coming into help.

Te Rina says her mother was under immense pressure; while worrying about her son, she was also trying to keep the family afloat, trying to maintain the mortgage payments, feed the whānau, support them and navigate the health system.

They were labelled ‘a difficult family’ because they demanded a high standard of care for Ray.

“Was it too much to ask,” says Te Rina “to ask for care workers to be trained in washing and caring for my brother and for counselling support for the children and my mother?”

The family’s focus shifted to Ray’s needs and as a result everyone’s lives were impacted. They all tried to carry on, but were struggling under the pressure.

After the accident everything changed. Her brother was her biggest support and suddenly she had to be his – it was like the floor had been pulled out from beneath her.

Te Rina struggled under the pressure and turned to self-harm as a way to cope.

“One night it got really bad – I was home alone and all I could do was think, my brother was different, my mother was different, I felt so alone. I walked into the kitchen, opened the draw and grabbed the biggest butcher knife I could. I was drenched in blood on the kitchen floor. I knew I couldn’t do anything else… I knew I couldn’t do that to my family, they had been through enough.”

Instead, her response has been to learn as much as she can about the health system, even going to university to study.

She has also become an advocate for whānau going through the impact of living with a family member’s trauma. Her family established the Brain Injury Support Network to support family/whānau going through similar trauma, and started a new initiative, Camp Unity for children and young people working through trauma and low self-esteem to build healing communities.

Te Rina’s dedication to her brother and whānau shows through the ongoing care of her brother at home. Her plea is for more support for family/whānau as they are adjusting to their loved one being a changed person with new and challenging demands, which are not just emotional, but can significantly change the dynamic of the family through the ongoing dedication of time, resources, 24/7 availability and care.

As a family they didn’t get counselling or advice on how to help each other or the larger whānau network.

“Ray’s daughter would visit every fortnight and one day my mum and I were sitting talking to her about how we could all go camping,” says Te Rina.

“I looked down and saw scars on her arms and legs.”

Te Rina had many thoughts racing through her head: ’has my beautiful niece been going through this alone?’ ‘Is this my fault?’ “I felt like our world was shattered again.”
It took Te Rina a while to realise she wasn’t that 16-year-old any more. Over the last ten years she has met many children who were self-harming. There were so many other families and so many other children who were or still are battling with the same challenges.

This led her to establish Camp Unity, alongside friend and counsellor Char Rain, to support children and young people experiencing self-harm and trauma.

Te Rina talks about ‘the ripple effect’.

“People don’t really talk about the ripple effect, the effect of trauma across the whole whānau, like the ripples in a pond. This was the inspiration to create Camp Unity which brings vulnerable children together in a safe and secure environment where they are free to be themselves.

They have made it their mission to empower every child to have a voice. Camp Unity develops strength and unity and forms healthy relationships, teaching children to understand their individuality and develop their self-worth.

“They arrived broken, they were totally different, and now they can’t wait for the next camp.”

Te Rina challenged delegates at the forum to think about the consumers and family/whānau going through their services right now. She asked “What can you do to alleviate some of the burdens of the health system right now so that, instead of fighting the health system they can heal with each other?”

She ended to a standing ovation.

More information about the Brain Injury Support Network and Camp Unity is available at www.facebook.com/NZBrainInjurySupportNetwork and www.facebook.com/CampUnity01.

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