The students were definitely the stars at the Grow Our Own Workforce Project Launch held Tuesday 3rd August at AUT – Manukau campus.

A major feat, given the star-studded line-up of VIPs in attendance. These included Mayor Len Brown, project sponsors Sir Stephen and Lady Margaret Tindall, Honourable Tariana Turia, CMDHB Board Members and CEO Geraint Martin, ADHB Chair Pat Snedden and CEO Garry Smith.

In a capacity crowd of 130 people, there was a mix of community, tertiary partners, high schools and government agencies to celebrate the official launch of the project.

James Cook High School led with their outstanding hakapowhiri to welcome the guests. Tangaroa College sang beautifully and Otahuhu College completed the programme with an agile and rythmic breakdance, no doubt echoing, their 1st XV rugby success. These three schools have been selected to work with CMDHB and the Pasifika Medical Association in becoming Health and Science Academies commencing in Feb 2011.

SEPTEMBER 2010

Growing Our OwnWe were privileged to acknowledge Sir Stephen &

Lady Margaret Tindall for their $1 million investment in South Auckland’s health workforce development. We now get the fantastic opportunity to make the vision and the dream become reality with our community.

The Grow Our Own Project is dedicated to having more Maaori and Pacific people consider health as a career, and then ideally be employed within South Auckland. We want to double the number of Maaori and Pacific we having working within CMDHB, across all health professions. This would enable CMDHB to have a workforce which would better reflect the community we serve.

The project currently has people already in the ‘pipeline’ through various initiatives including South Auckland Health Foundation and Tindall Foundation-funded Scholarships - over over 90 scholarships were awarded this year for 2010.

Te Kupenga Hoturoa PhO’s Pu Ora Matatini is working with 9 midwives and 70 nurses.

Also funded by The Tindall Foundation is Return to Practice which is working with 10 mostly Pacific midwives and 8 nurses to help them get back to practice in New Zealand.

Mahurirangi Norman Ringrose (James Cook Student) pictured here greeting Sir Stephen Tindall.

Careerforce is an industry training organisation which develops programmes to train people who work in the health and disability sector.

A new $3.0m fund has recently been set up to encourage innovative approaches to training. Counties Manukau DHB applied on behalf of the seven home-based support (HBSS) providers in our district and was successful in securing 100% of the funding applied for. The fund received applications totalling $33m for the $3m available.

General Manager, Adult Rehabilitation and Health of Older People, Jenni Coles said, “the important thing about this application is that the Careerforce funding will allow us to try a different approach to training support workers. The key part of the programme will be a roving assessor/trainer who will work alongside the HBSS trainers to tailor an approach which suits their particular workforce.”

In 2007 the first of the Careerforce qualifications (Level 2 Foundations) were developed and 161 support workers across Counties Manukau gained their qualification through a pilot programme. Since then a further 334 support workers have completed the Level 2 qualification with a further 64 still in training.

Project Manager, Ross Smith says, “the support for the training programmes from the HBSS and their staff has been fantastic. Counties Manukau DHB has the highest percentage of support workers trained in NZ with around 7 out of every ten support workers having completed Level 2 by the end of the year.”

The new funding will allow a good number of these support workers to carry on and complete the next qualification in the career pathway – Level 3 Core Competencies. This qualification has some specific unit standards which support the restorative model of home based support adopted by Counties Manukau and its providers which aim to support the older person to maintain their independence and remain at home for as long as possible.

Counties Manukau Successful With Careerforce Funding Application

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Welcome to the Spring edition of Connect. It seems that the year has flown by, but Spring is not yet being reflected in the numbers

we are seeing in the hospital.I want to congratulate all staff on a magnificent

effort as we coped with an extremely busy winter. I also want to congratulate staff on an outstanding achievement towards our quarterly health targets.

You have achieved:Shorter Stays in Emergency Departments - 96.7% of our patients waited less than 6 hours in Emergency Care. And we still improved on the previous quarter’s result. Well done, especially given the volumes!

Improved Access to Elective Surgery - 107% The Ministry’s provisional result for Counties

is 104%. This was taken from the national data set mid-July when a number of cases that had not been coded and submitted were missing from our results. We expect our true year end result to be at 107%, meaning that Counties Manukau population will have received 750 more surgical procedures this year than last year.

Shorter Waits for Cancer treatment Radiotherapy - 100%

No Counties Manukau patient waited longer than 6 weeks for the commencement of treatment for reasons of capacity constraint.

Increased Immunisation - 86% This exceeds the target of 85% and is and

improvement of 8% on year end 2009. The target for Maaori was 3% under target but this is still an improvement of 8% on last year. Pacific rates have shown the most improvement not only surpassing the required target but improving by

10% over the year These results absolutely reflect the dedication

of our staff. You really are delivering world-class healthcare to our community and I am very proud of your results – and the other results which we don’t have the space to publish.

This issue of Connect could be called the ‘workforce issue’. This is very appropriate with the plans for the Centre for Heath Services Innovation really taking shape and with the imminent start of Professor Jonathon Gray as the Stevenson Chair of Health Innovation and Improvement. This really feels like the beginning of a new era for Counties. I am very excited about the potential for our workforce, the potential for our staff to learn new skills and the potential for the young people of our district who will have far more opportunities to choose a health career.

Geraint Martin, Chief Executive

Auckland Spinal Rehabilitation Unit Two Day Workshop

When an “expressions of interest” request was floated to health professionals to gauge if a further workshop was required, the places were quickly filled.

The workshop began with a symposium led by Dr

Cynthia Bennett. This covered all aspects of spinal cord injury including medical complications and dysreflexia management.

The interdisciplinary team comprising of doctors, counsellors, occupational therapists,

physiotherapists, social workers and nurses all gave presentations starting from the acute management needs. A comprehensive overview was given of the processes in place to rehabilitate spinal cord injured clients for them to regain their independence, and to return to living with a spinal cord injury. A highlight for many attendees was when past patients shared their experience of rehabilitation,

and then the reality of living with a spinal cord injury. It was an intensely packed programme covering

issues including pain management, spasticity, urological management, grief, loss and hope, and sex and intimacy. After lunch on the second day the health professionals experienced the unit facilities in wheel chairs; negotiating the many pathways and slopes which was an interesting and noisy time! However a fuller appreciation of limited mobility was gained from this experience.

Over the two days everyone was fed with information and lovely food, and hopefully came away with increased knowledge in the care of the spinal -injured client and the needs of rehab.

Reviews from the workshop:“The whole workshop was very well

co-ordinated and arranged and the topics discussed threw a lot of light on areas of concern, and the food was heaven!”

“Congratulations to the staff who organised this meeting – one of the better meetings I have attended”

Auckland Spinal Unit’s vision is to promote best practice and provide ongoing education to community providers and health professionals working in the field of spinal cord Injury.

Dr John Tuckey - “ Urological management of spinal cord injury”

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With winter well and truly here, Healthline is reminding health service providers that it can help in times of high demand.

Healthline is a Ministry of Health-funded service, provided by Medibank Health Solutions (formerly McKesson NZ Ltd) and staffed by experienced registered nurses. Calls to Healthline from both landlines and mobile phones are free.

Medibank Executive General Manager Lesley Clarke says while Healthline is always available to complement primary health care services, it may be of particular value in times when services are under pressure.

“For example, our nurses can advise people who do not need to see a health professional how to safely manage their condition at home. They can help reduce pressure on emergency departments by diverting people with non-urgent conditions to the most appropriate level of care.”

She says Healthline nurses advise callers on the best course of action to take, depending on the seriousness of their condition.

“That could be to call an ambulance, go to the hospital emergency department, see a GP as soon as possible, or manage the condition at home.”

From April to June 2010, Healthline handled nearly 4700 calls from the Counties Manukau DHB area. Common reasons for calling included child vomiting, colds, coughs and fever, questions about medication, and abdominal pain in adults.

“Of callers with current symptoms who required triage services, 2 percent were advised to call an ambulance immediately or had an ambulance called for them by Healthline, 16 percent were advised to seek immediate care from the emergency department or their health care provider, 46 percent were advised to contact their health care provider either urgently or non-urgently, depending on their symptoms, and 36 percent were given advice on managing the condition themselves at home.”

Healthline is available 24/7 on 0800 611 116.

Healthline complements primary health care services

Middlemore Hospital Opens Bike Park

Designed to give our biking staff a secure and healthy alternative to driving, Middlemore Hospital’s new bike park opened in August. Giving 40 staff members a place to not only keep their bikes, but a place to shower after commuting, the bike park is directly opposite the entrance to the Edmund Hillary Block. If it proves popular enough, the bike park can be expanded to accommodate more bikes.

Pictured above: At the grand Opening GM Facilities Greg Simpson and our Board Chairman Professor Gregor Coster.

Professor Gregor Coster.

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Recently a Maaori woman arrived at Middlemore with her whaanau as she had been experiencing back pain. The pain turned out to be serious; the woman had advanced cancer and only a few months to live.

A family meeting was held to ensure all possible support was in place. A whaanau support team member opened with a karakia (prayer) to settle everyone and led the group in whakawhanaaungatanga (the process of getting to know one another). Everyone took part, including the social worker, occupational therapist, house officer and palliative care nurse.

Given the sad and unexpected news a positive tone was maintained during the meeting. The

social worker who is new to the team believes this was due to the process followed by the whaanau support worker. She also believes that recent tikanga best practice training increased her confidence in supporting the patient and family. As a new employee at Counties Manukau she has no doubt that these processes have lead to enhanced relationships and patient care.

Having a diverse workforce is as important to the health and wellbeing of our community as having the right equipment, professional training and management. Counties Manukau is the fastest growing district in the country and when we walk the halls of Middlemore, drop in to a Super Clinic or visit a local GP practice it’s easy to see the rich variety of cultures, ages, lifestyles, and health needs. In order to meet these needs our workforce must reflect the diversity of our communities.

To help champion this goal CMDHB recently joined the Equal Employment Opportunity (EEO) trust. EEO

helps organisations celebrate, grow and support diversity in their workplaces.

Already at CMDHB we have employees representing more than 20 nationalities and speaking over 70 different languages. Through projects and collaboration we will continue to grow our workforce to meet the needs of this district. We also want to celebrate and support our current workforce and its richness and diversity.

Over the next year EEO initiatives will take continue to develop, as we grow and celebrate our diverse workforce. These will include:• Furtherlearninginitiativestostrengthenhowwe

work with diversity• Enhancingrecruitmentandselectionprocessesto

help build a diverse workforce• Ensuringcurrentemployeesaresupportedto

move between health roles and professions• Continuingtoworkwithlocalschoolsandtertiary

providers to support young people into health careers in Counties Manukau.

Growing Workforce Diversity is Vital

Members of CMDHB diverse workforce with EEO Trust certificate. From left to right: Marie Petelo, Lab Technician; Eti Televave, Physiotherapist; Shankara Amurthalingam, Operations Manager Non-Clinical Services; Caroline Tichbon, Workforce Development Consultant; Steve Mihaere, Team Leader Orderlies; Alka Garg, Pharmacist Manager.

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Nestlé a finalist in Manukau Business Awards

Progressive Staff Support Kidz First Again

More than 19,000 staff throughout Countdown, Woolworths, Foodtown, Fresh Choice, SuperValue, Dick Smith and their support offices pitch together to raise funds each year. Events including a 500km cycle challenge, duathlons and a golf tournament are only a few of the events organised to help raise the money.

“Progressive Enterprises is passionately committed to continuing its support of these hospitals with the Fresh Future children’s hospital

appeal, ensuring children around the country have access to the best medical equipment and care,” says Peter Smith, Managing Director of Progressive Enterprises.

All the guests left the event feeling motivated and inspired to raise even more money this year than

the last.The Fresh Future Appeal is running for 12 weeks

from August until October - to get involved or for more information about the Fresh Future Appeal please get in contact with Michelle at the South Auckland Health Foundation, 09 270 8808.

The 2010 Fresh Future Appeal was launched Monday 2nd of August at the Manukau Super Clinic. The Fresh Future Appeal is in its fourth successful year and to date has donated more than $3 million to 10 hospitals throughout New Zealand.

Nestlé has been confirmed as one of three finalists for the Manukau Community Foundation Business Contribution to the Community award, as part of the Westpac Manukau Business Excellence Awards.

Over the past eight years that Nestlé has supported the South Auckland Health Foundation the company has donated over $156,000 to the Foundation, including $10,000 most recently for a soundproof booth from Spain, which upgraded the Counties Manukau DHB audiology unit.

South Auckland Health Foundation Public Relations Manager Michelle Kidd says Nestlé has made a significant difference to the Foundation in many ways.

“Not only do they donate funding, but also Nestlé product, and volunteer manpower. We are

never short on volunteers at events thanks to their generosity.

“The nomination is for the generous ongoing support the South Auckland Health Foundation and Kidz First have received from Nestlé.”

Nestlé Corporate Services Manager Maurice Gunnell says they are humbled by the nomination.

“The support we give is not something we do to get recognition, but is a way of giving back to the community our Manukau factory operates in.”

“We are proud sponsors of the South Auckland Health Foundation, and appreciate the chance to make a difference locally.”

The awards take place at the Telstra Clear Pacific Centre on September 17.

Our charity: The South Auckland Health Foundation is a registered charitable trust that supports and raises funds for the health services of Counties Manukau District Health Board.

All proceeds to Kidz First Children’s Hospital

RETcamThe Ophthalmology Department at Counties Manukau DHB was delighted to recently receive a new RETcam shuttle and the full complement of examination lenses funded by a generous donation from the Lion Foundation and provided via Designs for Vision.

The RETcam is a portable high resolution imaging module primarily used for examining

neonates but it can also be utilised for adults who cannot be positioned adequately at conventional retinal imaging devices.

The Clinical Director of Ophthalmology at Counties Manukau DHB, Dr Anmar Abdul-Rahman [pictured] said this will allow more efficient collaboration both regionally and internationally- a crucial element in developing the Retinopathy of Prematurity service in the largest birthing unit in the country. In addition to telemedicine this will allow teaching of specialists for examination of neonates and expansion of the service.

The Ophthalmology Department at Counties Manukau DHB would like to express their sincere gratitude to the Lion Foundation who have donated the full $200,000 required for the purchase of this device, and also to recognise the efforts of the dedicated staff in the Neonatal Unit at Middlemore Hospital for their on going support in managing Retinopathy of Prematurity.

Contact Michelle Kidd, Public Relations Officer, Ph 09 270 8808 or 021 901 705.

The kit had been donated to Progressive Enterprises Limited, by McCains Food Limited, and the Progressive team decided to re-donate the garden, valued at over $1000.00, to their neighbouring school Sir Keith Park.

School Principal, Kathy Davidson, was thrilled to receive the call asking if the school would like to accept this donation.

“Teaching life-skills to the older students (aged 16 – 21 years) is an integral part of our curriculum. We are very excited to be able to extend our ability to incorporate vegetable growing and food preparation programmes”.

The students intend to establish the gardens over the next couple of weeks and plan to invite the Progressive staff back to view the gardens and see the progress.

Contact Michelle Kidd, Public Relations Officer, South Auckland Health Foundation Ph 09-270 8808 or Mob: 021 901 705.

[L to R] Students Salesi Vave, Teokotai Koronui, Naomu Haverfield and Principal Kathy Davidson accepting the veggie patch from Progressives Adam Bentley.

Fresh Veggies For Sir Keith Park SchoolSir Keith Park Special School, based in Mangere, was recently presented with all the components to make four veggie patches.

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Dr Anmar Abdul Rahman, Clinical Director, Ophthalmology.

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The Public Health team was created in 2001 following the creation of DHBs and an enlarged responsibility for the organisation for the health of the whole population of Counties Manukau. The two areas functioned largely independently of each other initially, but have been doing more and more joint work. As we are caring for the health of all our population we require an integrated approach to be able to understand how best to achieve this and to support Triple Aim through the supply of information. The two teams are now united under the Health Intelligence Unit banner, and while they currently still occupy separate sites there is a commitment to having them co-located in the future.

The HIU includes several roles:• Systemsanalystsareresponsibleforthe

extraction of all patient level information that is electronically collected within the provider

arm. They provide a complete picture of patient activity, including PiMS, Laboratory, Pharmacy and Radiology. The software system used for all of this processing is called TRANSITION.

• Costingandreportinganalystsareresponsibleforuploading the costing data, creating the unit price for all activity for each patient.

• Clinicalanalystsarealignedwiththemajorservices within the organisation providing patient-level analysis, including costs and volumes for all of the patients who are treated within our organisation.

• Epidemiologyandpublichealthspecialists–threeSMOs and two registrars provide public health advice and analysis across the health spectrum.

• DemographyandGISanalystprovidingdemographic and spatial mapping analysis

• Systemmodellinganalystprovidingsupportfor

developing predictive modelsThe focus of the HIU is to support the Triple Aim,

assessing the health of the CMDHB population, the functioning of the healthcare being provided to that population, and linking the services we provide to the costs and benefits shown for the population of CMDHB.

Publications and reports are made available on the CMDHB website (under publications and newsletters/health status documents). Work is currently being done on creating a new HIU website which will include internal reports and analyses. In the meantime you can find out more about the Decision Support service by going to their website via Southnet.

Dianne Wilson, Operations Manager, HIUGary Jackson, Clinical Director HIU

The Health Intelligence Unit - what is it and why do we need itCMDHB is launching a new unit, the Health Intelligence Unit (HIU) by merging the Public Health team with Decision Support. Decision Support Services were created in 1995 and were based on the Middlemore hospital site and focused on inpatient and outpatient data analysis.

Advance Care Planning You may not have heard much about Advance Care Planning (ACP), but it is something we all need to think about at some stage for ourselves and for our loved ones – and for our patients. Advance Care Planning is all about choice – it is the process of thinking and talking about our preferences for end of life care and which can be recorded in an Advance Care Plan. The concept is not new - New Zealand is a bit behind many parts of the world in dealing with this sometimes challenging issue.

However, in 2009 ACP was introduced into a number of rest homes and private hospitals within the CMDHB area and has recently been launched into Pukekohe Family Health Care as a pilot project in Primary Care. The requirements for ACP to be introduced into Secondary Care are currently being scoped.

While it is not an easy subject for health professionals, ACP can be a welcome topic for patients who may be worrying about the sort of care they will receive at the end of life but who are reluctant to discuss with their families. Studies reveal that ACP fosters both a sense of control and peace of mind in the patient and reduces anxiety for the whole family.

We as health professionals may also feel ‘uncomfortable’ about engaging in end of life discussions, but having the right training and resources to assist with the legal and ethical issues involved supports the process enormously. These skills will be required increasingly in the future as we embrace more patient-centred care and better informed patients.

Michele Naish is CMDHB’s ACP Project Coordinator for secondary and primary care and is in the process of developing an appropriate training programme with the aid of Mary Stewart who has piloted ACP in CMDHB’s rest homes and private hospitals. “Our objective is to develop awareness and understanding about Advance

Care Planning and to provide the teaching of skills to assist health professionals to engage in discussion around end-of-life care. We would like everyone involved in a person’s care, from Primary to Secondary Care and among allied health workers to know of the patient’s wishes. An Advance Care Plan is a living document that can be updated as the patient’s circumstances change,” says Michele.

“Michele will follow the implementation of ACP at Pukehohe Health Care closely and will monitor, evaluate and support the process,” says Jeff Garrett, Clinical Director of Medicine and Project Sponsor. “People do not have to wait to become “terminally ill” to make an Advance Care Plan. Ideally we want to see all of our patients being offered this valuable tool early on, while they have the capacity to discuss their preference for care and treatment with families. When it comes to the stage where a patient is unable to speak for him or herself, the Advance Care Plan speaks for them, providing guidance around the care and treatment they want to receive and brings peace of mind to the family and health professionals in the knowledge they are following the person’s wishes.”

Please contact Michele Naish, Project Coordinator for Secondary and Primary Care on naishM@middlemore.co.nz for further information.

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Special guests, key stakeholders, colleagues, pilotees, friends and families celebrated the success of The Pacific Return to Nursing (PRTN) pilot journey at the Airport Oaks Holiday Inn conference centre on 23 July.

Guests who attended included Su’a William Sio, the Mangere Labour Member of Parliament, Denise Nelson from New Zealand Nursing Council, Pastor Chris Sola from Hosanna Harvest church and Debra Tuifao, Team leader of the Pacific Health Innovations from the Ministry of Health. Guests were welcomed by Workforce Development Manager, Jenna Clarke and Director of Pacific Development, Elizabeth Powell.

The PRTN pilot commenced in May 2008 and concluded in June 2010. The main objective was to achieve New Zealand nursing registration for a number of Pacific trained nurses currently working in New Zealand as health care assistants or in occupations outside of their nursing skill set.

As a result of the pilot, fourteen nurses have been successful, another fourteen are almost there and many have been successfully transitioned in other avenues of health so their skills and knowledge are used.

The highlight of the celebration evening was the accomplishment of the fourteen Pacific trained nurses who have successfully completed both phases of the International English Language Testing System (IELTS) and the 8-12 week Competency Assessment programme. Certification was awarded by Debra Tuifao (Ministry of Health) and the Registered Nurse Medal was presented by Denise Nelson (New Zealand Nursing Council).

The fourteen new Pacific New Zealand registered nurses are: Susanna Danford, Virisila Taito, Aliti Tora, Maraia Sakaraia, May Kennedy, Nalini Mani, Sharun Vandana, Emeli Munaf, Arti Lal, Ivy Mua PoChing, Vunirewa Uluilakeba, Vasiti Bogi Taserenavanua, Leilani Sapatu Jackson and Lisa Jone Fuata.

The evening was a good opportunity for all to network and for pilotees who are yet to conquer IELTS, to be encouraged to continue with their journey. This forum was also a good opportunity for evaluators Patricia Wright and Hilary Graham-Smith to inform pilotees and stakeholders about their involvement with the evaluation to achieve evaluation objectives.

Attendees enjoyed entertainment from the Auckland University of Technology Samoan Association group and a dance from Fijian pilotees and their family members.

Pacific Return to Nursing Celebration

Above and below: PRTN Graduates

Below: Jenna Clarke, Workforce Development Manager & Esther Faitala Pacific Workforce Development Programme Co-ordinator

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INOVATION IN ACTIONThe Supportive Independent Living Service

The Supportive Independent Living Service (SIL) is a partnership between CMDHB and Manukau City Council (MCC) Housing for Pensioners. The guiding principle of the service is the promotion of independence and support for ageing in place.

The team comprises Social Worker Josephine Cullen, and Occupational Therapist Michele Naish, who work collaboratively to identify gaps in service provision and implement support services which promote independence and facilitate access to services.

MCC has 15 pensioner complexes within Counties Manukau. Our aim is to work through each of these, one complex at a time. We liaise with the Housing Manager and her wardens for each complex. SIL commenced working at Otara Court in March 2010.

Otara Court had recently been updated and modified. These improvements have had a positive impact on the overall living circumstances of the tenants.

Otara Court is a culturally diverse complex with an already-established strong sense of community.

We visited each of the units and offered an assessment which aimed at identifying unmet needs. Tenants are free to choose to be involved with the Supportive Independent Living Service. We utilise the support of the translation service as and when required.

Of the 40 occupied units at Otara Court, 8 tenants have received additional aides to improve their safety at home, 5 tenants had referrals to the NASC team for additional practical supports, 3 referrals were made to the Community Geriatric

Team for specialised assessment, and 14 tenants have received additional WINZ benefits including one tenant receiving $1,300 in backdated unpaid WINZ benefit. Such interventions have supported independence, and improved the wellbeing of this particularly vulnerable group of people.

Following the completion of our work at Otara, we have worked with the tenants at Inverell Court. MCC has also recently updated these units. Here we found that 3 tenants required additional aides, and 2 tenants required assistance with additional WINZ benefits.

At Inverell, several tenants reported experiencing being hassled, on a fairly regular basis, by a group of youngsters demanding money under the guise of sponsorship. This behaviour included repeated calls in the evening when it was dark, banging on windows

and theft of articles left outside. The outcome of this was that contact was made with the community police officer, and a meeting organised with him and the affected tenants.

The tenants had their concerns listened to and the police officer was able to take action which provided reassurance and comfort to them. The tenants now have a known Police Officer to contact should these events reoccur, and the tenants have a greater sense of community support amongst each other.

Our service is a relatively new one, and we feel encouraged by the positive outcomes already obtained. We continue with our work through these complexes.

Josephine CullenSocial worker.

Partnership between CMDHB and MCC: Josephine Cullen and Mark Cumming.

Tenants feel community support being able to have a known Police Officer to contact.

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Venous Thromboembolism (Vte) Awareness Week

VTE is one of the major causes of preventable morbidity and mortality in hospitals. Every year, hospital-acquired VTEs kill over 800 New Zealanders – more than the annual NZ road toll - about 50 of whom are CMDHB patients. On admission to hospital, every patient needs to be risk-assessed for VTE and,

if required, receive appropriate prophylaxis. People worry about blood clots from flying long haul, even to the extent of buying their own Clexane; statistically however you are 1000 times more likely to have a clot from being admitted to hospital.

To highlight the dangers of VTE and promote best

evidence and practice as regards to risk assessment and prophylaxis, the Thrombosis and Anticoagulation Special Interest Group (TASIG) launched VTE Awareness Week prior to the weekly Grand Round on Friday 18th June 2010 and this initiative was continued in the foyer of Middlemore Hospital throughout the following week.

During the launch of the initiative at the Grand Round on 18th June, presentations were given on the initiative, the thrombosis and anticoagulation service, and the new anticoagulants and trials.

Throughout VTE Awareness Week, the CMDHB VTE risk assessment tools for surgical and medical patients, patient information leaflets, VTE alert stickers and general VTE-related information were on display for perusal by clinical staff. TASIG members and representatives from pharmaceutical companies were also available to provide information and education about VTE-related issues.

Clinical staff were encouraged to enter a quiz about VTE and entrants scoring 100% were entered into the lucky draw held during the Grand Round on 25th June, with the prizes being limited-edition specifically-designed ‘Stop the Clot’ t-shirts.

“Evaluate each patient upon admission, and regularly thereafter, for the risk of developing venous thromboembolism/deep vein thrombosis (VTE/DVT). Utilize clinically appropriate, evidence based methods of thromboprophylaxis”. (National Quality Forum (NQF) Safe Practice 28)

Above: The Thrombosis and Anticoagulation Special Interest Group (TASIG) are shown in the photo at the launch of VTE Awareness Week and are, from left to right: Sharon Jackson, Debi Smith, Anne Blumgart, Gordon Royle, Martyn James.

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We are especially interested in contributions from our community partners.If you have a story you would like to contribute for Connect please email it to the Editor at: lauren.young@middlemore.co.nz

Why was such a target introduced? The three main reasons are firstly that smoking is by far the largest preventable cause of death, disease and disability in New Zealand and in the world. And, secondly, that the health sector as a whole has been largely neglecting to address smoking and use evidence based best practice in treating nicotine addicted patients. This needed to change. And finally, if we supported more people to stop smoking, smoking rates would fall and New Zealand would have a healthier population overall, with less people needing to use our very stretched hospital resources.

We know that most people who smoke wish they had never started. About 75% of people would stop smoking today if it were easy. Unfortunately it is not easy. Nicotine addiction is up there with heroin as one of the most powerful addictions we have. We often mistakenly think of smoking as a “bad habit”, when in actual fact it is a powerful addiction. People trying to stop often experience unpleasant withdrawals which make stopping for some almost unbearable. However there are a number of medications available now which can take away the withdrawals and can make stopping smoking easier for people. Because of the Smokefree health target we are seeing more people trying the various medications and having more supported quit attempts, which is more than doubling their chance of becoming smokefree for good.

The target required a number of system changes

as well as new training for health professionals. Hospital staff have embraced the changes and huge progress has been made over the course of the year.

The blue line is the prevalence of smoking. That means the percentage of people over 15 years of age that are admitted to hospital that are identified as currently smoking. Currently about 19 to 20% of patients are identified as smoking.

The pink line shows how many people that smoke are getting help and support to quit. In June 2010 we reached 65%. In other words, 716 people who smoke got help in June - a huge improvement from a year earlier in July 2009 when just 90 people were offered help.

Our quality improvement goal is that 100% of people are offered support. Why should anyone miss out on support with something that is so readily available, so inexpensive, and so easy to do plus improve their chances of recovery, healing, and staying well? We are well on the road to achieving our 100%, thanks to all the nurses, doctors, midwives, physiotherapists, social workers, pharmacists, health care assistants, managers, and everyone else that is embracing smokefree and contributing to the huge change in practice that we are now seeing.

If you have any questions on the health target or smoking cessation contact Ingrid Minett at the Smokefree Service on 259 3896.

More Patients Now Receiving Help and Support to Be SmokefreeOne year ago all hospitals were given a new target to achieve. The target was that 80% of all people aged 15 years and older who smoke and are in our services for three hours or more are given help and support to quit smoking.

Here is how we are doing: