This newsletter is produced by Community and Public Health as a vehicle for promoting positive korero on hauora Māori within Waitaha.
Contributions and feedack are welcomed to assist in supporting our commuities and the many dedicated kaimahi and organisations out there who support Māori health within our rohe.
In this issue:
What do you get when you combine a cheap Android tablet, some skilled wood carving, grey paint, an old bedside hospital locker, and a good dose of clever software engineering?
The answer is a simulated X-ray control panel that looks and acts like the real thing at a fraction of the price for the state-of-the-art Manawa Simulation Centre.
The panel was completed by the Medical Physics and Bioengineering department at Christchurch Hospital, in collaboration with staff from Ara Institute of Canterbury, and was created to enable radiology students to practice their X-ray technique in a safe, radiation-free environment.
The Medical Imaging area needed a fully functioning X-ray control panel, says Biomedical Engineer Michael Sheedy.
“These are very expensive but in a few weeks we were able to design and produce a replica at an extremely reduced cost that emulates everything the real one can do.”
A team of technicians ‘hand sculpted’ the case from MDF and mounted a sheet of plastic to simulate the leaded glass and wired up the electronics, including a real X-ray exposure button for added realism.
“We are very pleased with the result,” Michael says.
Manawa, the health research and education facility, is a collaboration between Christchurch’s health and tertiary education sectors, bringing together the Canterbury District Health Board, Ara and University of Canterbury to help create and train the health workforce.
The simulation floor at Manawa enables large-scale simulations in real world healthcare environments and provides access to advanced clinical equipment that students would normally only see during placements.
Clinical Skills Co-ordinator Christine Beasley says the project team have really worked their magic to meet the needs of the Ara students.
“This enables students to get the full experience before they use them on clinical placement and we are thrilled with the outcome.”
Chief Executive David Meates celebrates the upcoming launch of the book Rising from the Rubble by Drs Mike Ardagh and Jo Deely, which details the Canterbury Health System’s response to the 2011 Canterbury earthquakes, from the immediate emergency response to sustaining health services over the following years, in challenging circumstances. With the Healthy Commute programme now in full swing, David also encourages staff to give biking, bussing, carpooling or walking to work a go.
This issue also highlights a presentation given by Doug Eby and Donna Galbreath, representing Alaska’s Southcentral Foundation, where they discuss the Nuka System of Care – a healthcare model that has turned the population with the worst health statistics in North America into one of the best, and how the principles may be applied in other countries to improve health outcomes for indigenous and minority communities. We look at how a simulated X-ray control panel for radiology students to practice their X-ray technique came to be through collaboration, and we celebrate the success of a PhD student who has been selected for the national hockey team, the Black Sticks.
You can read the Canterbury DHB CEO Update in two different formats:
A collaborative multi-agency approach aims to ensure Cup Day 2018 at Riccarton Park is a safe and enjoyable experience for all racegoers.
Race-day organisers, Police and Canterbury District Health Board are keen to reduce the consequences of excessive alcohol consumption. Initiatives include a crack-down on pre-loading – where patrons have been drinking to excess prior to their arrival at the racecourse.
Riccarton Park Operations Manager Eric Cormack says “we are determined that this will be a great day out at the races and enjoyable for all participants. We want to strongly discourage people from turning up at the grounds intoxicated, with the message that our security team will be refusing entry to anyone who has overindulged before they arrive.
He warns “if you are judged to be intoxicated you may be asked to take a breathalyser test if you want to enter the grounds. If the reading exceeds 400 micrograms (mcg) of alcohol per litre of breath, you will be refused entry.”
“We are not here to spoil your fun, but we take our responsibility as licensees seriously and are very conscious that intoxicated people can ruin more than just their own day out,” says Eric Cormack.
Last year on Cup Day, around 250 disappointed people were turned away from the gates for being intoxicated.
“Once inside the course the same rules apply – if you are deemed to be intoxicated you will be asked to leave.”
Medical Officer of Health Dr Cheryl Brunton says that Community and Public Health strongly supports the measures Riccarton Park is taking to reduce the harm caused by excess alcohol and to help ensure people stay safe.
“Be mindful about how much you drink before and during the event, or your race day might end early when you are denied entry, or asked to leave because you’ve had too much. It’s better to have good memories and no regrets.”
Bringing alcohol into the racecourse is not allowed, and a temporary alcohol ban will be in place from 7am to 12 midnight in the area around Riccarton Park Racecourse on Saturday 17 November. The ban will apply to the area bounded by both sides of Yaldhurst Road to Middlepark Road; Epsom Road to Racecourse Road; Buchanans Road to Masham Road to Yaldhurst Road.
Entry to the racecourse is restricted to those aged 18 and over.
Chief Executive David Meates reflects on Canterbury DHB’s 2017/18 performance against the National Health Targets, thanking staff for their commitment to improving our health system and meeting the needs of Cantabrians. He also reminds everyone to look out for each other this Wednesday 14 November, which is the second anniversary of the 2016 7.8 North Canterbury earthquake ─ and who you can contact if you or someone you know needs help.
This issue also highlights the science behind and dangers of antibiotic resistance as part of World Antibiotic Awareness Week (12 – 18 November), and what one of our teams is doing to facilitate the sensible use of antibiotics. We acknowledge the success of one of our photographers, who won four awards at a conference in the United Kingdom last month, and we let you know the results of a Commuter Challenge: was the winner using an e-bike, an electric scooter, a bicycle, bus or car?
You can read the Canterbury DHB CEO Update in two different formats:
WellNow Canterbury is our community health magazine which goes to every Canterbury mailbox twice a year. This spring edition doubles as the Canterbury Health System’s Quality Accounts, to provide a picture of how well our Health System is meeting Canterbury’s health needs, and showcase our work to improve services and standards of care.
The online-only version features a “How we measure up” section, charting our performance against the National Health Targets, and quality and safety markers as set by the Health Quality & Safety Commission, as well as other key measures.
You can read the full online magazine in two different formats:
Canterbury DHB is getting behind this year’s Patient Safety Week (PSW 2018) topic of infection prevention and control, with the focus on good hand hygiene.
Effective hand hygiene helps stop the spread of microorganisms (‘germs’), including those that can cause antibiotic-resistant infections.
We encourage you to show your support for PSW 2018 by washing and sanitising your hands regularly, and always after going to the toilet and before eating.
Not just during patient safety week, but throughout the year the Canterbury DHB Infection, Prevention & Control Team works alongside our staff to help prevent healthcare-acquired infections and in doing so, reduces antibiotic use.
Louise Brown from the Infection Prevention and Control Team at Burwood Hospital says this approach underpins all of the work the Infection Prevention and Control Service carries out.
“Prevention of infection measures range from basic hand hygiene of staff and the isolation of patients with high-risk organisms, effective cleaning and disinfection of equipment and surfaces, right through to education, research, surveillance activity and audits.
“Good hand hygiene from patients and staff is the simplest, most effective way to prevent infections and has an important role in reducing antibiotic use,” says Louise.
Each year Patient Safety Week is promoted by the Health Quality & Safety Commission and they have produced some colourful and engaging graphics to help get this year’s message across.
For more information on this nationwide initiative you can visit the Health Quality & Safety Commission website: https://www.hqsc.govt.nz/our-work/system-safety/aotearoa-patient-safety-day/
Road Accident Remembrance Day will take place tomorrow, 3 November 2018. This is a time for us to reflect on the lives affected by road traffic crashes – the injured people themselves, their families, health care staff, first responders and our community.
With the country’s busiest trauma centre, this opportunity to reflect is even more poignant for Canterbury DHB staff across Burwood and Christchurch Hospitals in particular, as they manage with the physical and emotional consequences of road traffic accidents on a daily basis.
Over half of all trauma injuries presenting to Christchurch Hospital are as a result of traffic accidents; whether involving people as drivers, passengers, motorcyclists, cyclists or pedestrians.
Emergency Department Clinical Director David Richards says the Emergency Department is generally where many of the injured, and their families, end up after road traffic accidents.
“Whether the injury is relatively minor or something life-altering, road traffic injuries cause distress and disruption, not just to the injured themselves, but also their families and friends and the health care staff treating them.
“Although a daily occurrence, the dedicated hospital staff are not immune to the impact of road accidents.
“Whether it be a driver of a vehicle suffering life-threatening injuries after a serious crash, a small child knocked over by a bike or an elderly woman injured reversing her car in a supermarket carpark, all of these patients require the care and attention of hospital staff,” says David.
Canterbury DHB extends its sympathies to the families of road accident victims and acknowledge the many hundreds of individuals and families living with the life-long health impacts of road accidents.
Road accidents affect individuals in different ways, and Road Accident Remembrance Day encourages us to reflect on the impacts of traffic crashes and always do our best to drive responsibly and safely.
We hope everyone can use the day to think about how their driving can impact on the lives of others if something goes wrong, so they can avoid being the cause of a serious accident.
Welcome to Community and Public Health's Sexual Health Newsletter. It provides up to date information to health co-ordinators in schools and others working in the area of sexual and youth health in the Canterbury/ West Coast region. Any feedback is welcome.
In this issue:
The Countdown Kids Hospital Appeal kicks off today and will run until the end of October.
The nationwide appeal is in its 12th year, raising money for medical equipment for children across the country.
Of the $11.6 million raised since 2007, $1.2 million has been donated to Canterbury DHB's Child Health Division – funds which make a practical difference to the wellbeing of children in its care.
Seven-year old Keira Hubball and her mother Vickie Hamilton were special guests at last week's launch. Keira suffers from a metabolic condition that means she is in a wheelchair and has recently lost her vision, so she is a regular visitor to Christchurch Hospital.
Countdown Group Manager Penny Hardaker says many of its staff have first-hand experience of hospital visits with their children and there is great enthusiasm and determination to raise funds for such a worthy cause.
Penny's own son contracted meningitis as a 2-year-old and, after years of follow-up care, she has seen how money raised via community fundraising has enabled the purchase of medical and play equipment to create a better experience for young patients.
This year's appeal will raise funds for medical and play equipment for use throughout the Canterbury Health System.
Clinical Director of Paediatrics at Christchurch Hospital, Clare Doocey, says “the generosity of Countdown staff never fails to amaze and Canterbury DHB greatly appreciates the time and energy they devote to the cause.”
The appeal also sparks friendly supermarket competition, as Stuart Coe, Store Manager Countdown Moorhouse Avenue can attest to, “every Countdown store wants to raise the most money for the kids, but we also help and support other stores with organising fundraising events. This year we're doing things like sausage sizzles, cake sales and a fashion show. Because we know the money is going to a local and noble cause it's easy to get strong support from our customers”.
Keep an eye out for events that may be happening at a Countdown near you.
The appeal runs until 31 October 2018.
To make a donation, you can:
Two people who have had head and neck cancers are encouraging others to be aware of their bodies and check out anything unusual.
Kathleen Campbell has had two cancers removed from inside her mouth. The first was a lump on her tongue four years ago, which Kathleen thought was a wart.
Her GP was concerned about the lump and referred her to a head and neck surgery specialist at Christchurch Hospital.
While Kathleen was waiting so see a specialist the lump kept growing so she consulted her GP again.
“My GP actually took a cellphone photo and sent it straight off to the specialist,” Kathleen says. The specialist saw her quickly, and a biopsy showed the lump was probably cancerous.
“They took out a wedge-shaped section of my tongue,” Kathleen says. “Thankfully it was caught early so I didn't need any chemo or radiation treatment.”
Last year Kathleen asked her GP to look at an ulcer that wasn't healing on the inside of her mouth. A specialist confirmed it was a cancer that had begun to eat into her jaw.
The second surgery was much more serious, requiring a piece of her jaw to be removed and be replaced with a piece of bone from her leg.
“Learning to talk and swallow were the toughest parts of my journey, and soon I hope to be able to eat food other than soft.”
Kathleen has recovered from her surgery, and wants other people to be vigilant against cancer.
“As soon as you suspect, get onto it, don't put it off. Both of mine were caught early because I didn't muck around. I listened to my body, I knew there was something wrong.”
Another patient, Bryan, was diagnosed with oropharyngeal cancer (a type of throat cancer) last year.
“I had a slight sensitivity in my neck that had developed into a lump,” he says.
Bryan's GP referred him to a specialist, who took a biopsy of the lump and diagnosed it as cancer. He had six weeks of chemotherapy and radiation therapy at Christchurch Hospital.
“My neck was a bit of a mess, because radiotherapy burns the outside of your neck as well as the inside. That took six weeks or so from the end of treatment to heal up – I continued losing weight for several months.
And my eating was different. Even now, I have much less saliva in my mouth, so I have to be careful to eat moist food.”
Bryan had surgery and chemotherapy 10 years ago for an unrelated bowel cancer. He says that was found when he went to his GP and a dietician after having trouble eating.
“Here I am 10 years later still going strong, and I hope I'll stay around a bit longer. The trick is, if you feel that something is wrong with your body, you should get it checked.
“I know it costs money to go to a GP, but it's a relatively cheap price to pay for something that could absolutely destroy your life if you didn't get it checked.”
More than a third of Cantabrians have had their flu immunisation already this winter and there's still time for the rest of us to protect ourselves.
Recent data shows that 184,610 flu vaccines have been distributed so far this flu season – more than the totals taken at the end of the season for the previous three years. This is equivalent to 36 percent of the population and puts Canterbury at the top of the country for distributed vaccines.
Canterbury District Health Board Medical Officer of Health Dr Ramon Pink says, “It's encouraging how many people have had their flu shots already but we can still do better.
“We would like to see much higher numbers with our Māori population, particularly our kaumātua over 65 who are funded for free shots and can set a good example for the rest of their whanau.”
Dr Pink says that there is a window of opportunity that people should jump on.
“So far this winter our flu numbers have been flat but from mid to late July we typically start to see the numbers rise. The flu shot can take up to two weeks to start protecting you so people should really get in now and urge their loved ones to do the same.”
This year's vaccines for New Zealand have been developed to offer protection against the strain that circulated in the Northern Hemisphere during their winter, which lead to the worst flu season in nearly a decade. Around 80 percent of people infected with the flu show minimal symptoms so can be spreading it to vulnerable whanāu and members of the community without realising.
Some groups qualify for free flu shots and flu immunisations are also available for a fee from general practices with some pharmacies also providing free and fee-paying immunisations.
“It's much easier staying well than getting better so I urge people to take every action they can to avoid catching or spreading the flu,” says Dr Pink.
For more information, locations of pharmacies providing flu immunisations, and some fun activities to keep the kids entertained for at least ten minutes, check out our flu-free website flufree.co.nz
Flu shots are free for certain Canterbury residents from your doctor, nurse or qualified vaccinating pharmacist if you're in one of these groups:
Flu shots are free only from a doctor or nurse if you're in one of these groups:
For more information on influenza visit flufree.co.nz
Canterbury District Health Board's popular hospital shuttle service for patients and hospital visitors has now moved from the Deans Avenue car park to Christchurch City Council's Lichfield Street Car Park building. The new car park is at 33 Lichfield Street, opposite the Justice Precinct and only a short distance from the hospital.
PLEASE NOTE THAT FROM AUGUST 2020 THE HOSPITAL SHUTTLE HAS MOVED BACK TO THE NEW DEANS AVENUE CAR PARK AND IS NO LONGER LOCATED AT THE LICHFIELD STREET CAR PARK.
For detailed information about the new Deans Avenue car park and hospital shuttle service including shuttle bus times and parking payment options, see www.cdhb.health.nz/shuttle
The DHB has made this move, in conjunction with the Council, to ensure that hospital visitors and patients can benefit from the brand-new car park facilities at the Lichfield Street Car Park building. It will make for a more pleasant and stress-free parking experience and – crucially on wet winter days – it is all under cover and well lit. Canterbury DHB Chief Executive David Meates says, “We set up our original hospital shuttle service back in October 2014 as a temporary stop-gap to ease our hospital parking problems, and we've transported nearly one million passengers since then. We know that parking at the hospital is still very difficult and will remain so until a replacement for the old blue public car park is built. Until that time we will continue to run a hospital shuttle to and from the Lichfield Street Car Park building to ensure that people get to their hospital appointments on time. I'm very pleased to announce this great improvement in our service – our thanks to the Council for the opportunity and for working with us towards this solution.” Christchurch City Council Chief Executive Dr Karleen Edwards says, “I'm delighted to partner with the DHB to get this initiative up and running. It makes perfect sense, and I'm thrilled the Council is able to assist.” Prefer to walk? It's roughly a 10 minute walk from Lichfield Street Car Park building to the hospital. While roadworks are going on, the best route is along Tuam Street. For more information, see cdhb.health.nz/parking or call 0800 555 300 . For parking rates, see ccc.govt.nz/carpark.
Hospitals in Christchurch rely on the help of hundreds of volunteers to assist patients, visitors and staff, and raise much-needed funds.
Canterbury DHB rural facilities also have “friends” of the hospital organisations, such as the Friends of Ashburton Hospital, and Tuarangi group which has been running for 42 years.
These groups give their time and skills to help staff, fundraise, and provide thoughtful donations to provide extra treats and care for patients.
The Friends of Oxford Hospital committee recently ran a fundraiser at the Oxford A&P Show for a future-proofed helipad for Christchurch Hospital as part of Māia Health Foundation's 13 Minutes campaign.
Over 200 people volunteer at Christchurch Hospital. Volunteers run the gift shop and trolley, help patients and visitors with other tasks such as calling taxis and reading, give company to patients, help people find their way around the hospital, and undertake many other tasks.
“The wayfinders are the smiley, happy face at the front of the hospital,” says Christchurch Hospital Coordinator of Volunteers Louise Hoban-Watson.
“We have such a wide range of volunteers and they all come here for different reasons. And we're just so fortunate to have them.”
Louise says volunteer donations and work often fly under the radar.
“People don't realise that the chair they're sitting on, or the fish tank, or TV and art work were funded by the volunteers. A lot of people think that it's just all paid for by the DHB.”
Since 1999, Christchurch Hospital Volunteers has made donations worth a total of around $2 million to Christchurch hospital, including grants for staff training and conferences. More information about fundraisers and what funds are used for can be found on the Christchurch Hospital Volunteers Facebook page.
Burwood Hospital Coordinator of Volunteers Rachael Walker says around 120 people volunteer at the hospital.
“Without all the time and energy that the volunteers put in, we wouldn't be able to run the programs that we do.”
Burwood volunteers serve in the Gift Shop, help maintain the gardens and pool, run the library trolley, give computer tutoring, provide pet therapy with their dogs, and more.
Most volunteers are retired, Rachael says, and give a few hours of their time each week.
“We've just got a new piano in the foyer, so we've also got some young people who come in and play the piano for us to make it a welcoming environment.”
Money raised by Burwood volunteers goes toward patient comfort and, beginning later this month, staff training.
Canterbury DHB Chief Executive David Meates says the hospitals are better places because of volunteers.
“It's National Volunteer Week, which is an opportunity for us to recognise the enormous help Canterbury DHB gets from volunteers, and thank them for that.
“The time that people donate to supporting our patients and staff is priceless.”
Herewini Banks was 74 years old when she gave up smoking. She remembers the exact date and time she quit – 4.30pm on 15 July 2016.
“It was three weeks before my birthday when I gave it up, so it's never too late to quit.”
Two years on from her decision to quit smoking, Herewini (Te Wheke, Takahanga and Tuahuriri) reflects on what life is like being Smokefree.
“My clothes don't smell of smoke, my hair doesn't smell of smoke, my car doesn't smell of smoke” says Herewini. “And I have more money now, I can buy what I need at the shops.”
Describing herself as a “pretty hardcore smoker” Herewini says people are really surprised to hear she has given up. “Most people are as pleased as punch when they find out but they are also pretty surprised.”
For Herewini having others smoking around her hasn't been a problem. “I really thought it would be – but it hasn't.” But she has discovered that getting frustrated is a trigger for her. “Yesterday I was driving in the rain, it was hosing down and the window wiper was scraping across the window. It was really irritating and I couldn't stop and do anything about it…boy did I ever want a cigarette then” she laughs, “but I would never consider getting one, the craving goes anyway.”
With the Rapaki Marae being Smokefree, Herewini remembers what it was like having to go off-site for a smoke. “It used to be me that said ‘come on pariahs, let's go' when we had to go off-site for a smoke. Now I have a bit of a giggle when I see them go off, I don't have to do the walk of shame. I don't know if having the Marae Smokefree will make anyone quit but it could be easier for people who are trying to quit.”
So, to anyone thinking about giving up smoking – “think of your bank account and just do it, do it any way you can.”
World Smokefree Day is on Thursday 31st May 2018.
Free support to become Smokefree is available from Te Hā-Waitaha 0800 425 700 or go to www.stopsmokingcanterbury.co.nz.
Medical staff can't just use Snapchat or WhatsApp when they want to send private information to another professional, so what can they do when they need to get a second opinion in a hurry?
An app for Canterbury health professionals lets medical staff confer or safely share a photo at the click of a button.
Christchurch Hospital Paediatrician Dr John Garrett says the Celo app has been invaluable for his work.
“I go to the Chatham Islands twice a year to see paediatric patients over there. One of my patients was also a patient in the plastic surgery service here.”
The patient's mother told John they were planning to fly to the Christchurch plastic surgery clinic for a follow-up appointment regarding a scar.
The trip would have been a considerable expense for Canterbury DHB.
“But more importantly, it involves three or four days of time off work for that parent, time off school for the child,” John says.
“So what I was able to do with Celo was take a picture of the scar, send it straight to the plastic surgeon he was going to see, and within five minutes have her let me know that the scar looked fine. He didn't need to come to his appointment in Christchurch.”
John says the app is also useful when he is on call.
Registrars can share images with him instead of describing conditions on the phone.
“And then we can make better decisions for that patient,” John says.
Celo is the preferred method of communication in the Paediatrics department, and John is looking forward to it being more widely used in the hospital.
Celo will also soon be used in the West Coast DHB, where clinicians regularly confer with Canterbury DHB staff.
While consumer apps such as WhatsApp allow encrypted image sharing, there are issues with using them in the health system.
Messages and images are stored on each phone and anyone who uses or steals the device can see them.
Celo behaves more like a mobile banking app, where nothing is stored on the device and nobody can access information without the user's unique PIN code.
All users on a Celo network are verified, so there is no chance of a user accidentally sending patient images to someone who doesn't work in healthcare.
Celo Chief Executive Stephen Vlok says the immediate mission is to educate staff on why Celo is important.
“Privacy is becoming more important and Celo offers an alternative to consumer-grade apps.”
There are seven other organisations in New Zealand using Celo, and Mr Vlok expects to announce more soon.
“Beyond Australia and New Zealand, we have targeted the United Kingdom, Europe, Canada, Singapore and the United States as markets for expansion.”
Celo has been developed in partnership with Canterbury DHB as part of the health board's focus on using technology to improve healthcare for patients and staff.
Christchurch Hospital staff are calling for wider use of a “phenomenal” app that reduces hassle and shortens patient stays.
Cortex is an app for iPhones and iPads that digitises patient notes and makes them instantly available to all medical staff in a patient's care team.
In mid-2017, three wards ran a three-month pilot of the app, which was used by nurses, doctors and hospital pharmacy as well as allied health professionals.
“At the end of our 12 week trial we weren't willing to give it back,” says Clinical Nurse Specialist Stacey Simpson.
“General Surgery was given permission to continue using it because I think they would have had a revolt if they'd tried to take it off us.”
The app allows health professionals to “subscribe” to a patient they are looking after.
That gives them access to a timeline of information including clinical notes and tasks that need to be completed.
Under the old system, Stacey says, doctors on medical rounds would write observations onto stickers, which they would later stick to a patient's clinical notes.
“They'd complete them, but they were sometimes hard to read and easy to lose.
“It could sometimes be five or six hours before these stickers would be applied to the notes. So if a nurse had not been on the ward round with the doctors, it was literally the patients telling us what the doctors had said.”
With Cortex, doctors add the notes to the app as they do rounds, save them, and sign them off so other staff can access them immediately. That means nurses doing their 10am board round can see new notes instead of relying on old information.
A board round is where the care team gathers round an electronic whiteboard on the ward each morning to discuss and exchange information on each patient to ensure they get the right care.
Physical notes are usually stored in one place, but they can go wandering with another health professionals who is using them, or if the patient is taken to another ward.
“For nurses particularly, and for allied health, everybody now has visibility of the electronic notes so you don't have to go and find the physical ones,” Stacey says.
“The whole closed-communication loop is just phenomenal. I mean, the amount of time it saves nurses and increases patient confidence day-to-day is a huge benefit.”
The app also reduces competition for shared computers in busy wards.
Charge Nurse Manager Jessica Carey says the standard method of sending a task to a house surgeon used to involve paging them. This meant waiting by the phone until the doctor could call back, often causing the doctor to leave a ward round to go to a phone.
“Now I can delegate a task to a house surgeon on Cortex. The house surgeon then accepts my task, and I can see when they have,” she says.
“If they were in clinic for the next two hours they can add a comment so I know the likely time frame for a response.”
A busy house surgeon could even delegate the task to someone else who was free to pick it up, Jessica says.
“I don't have to wander back and forth to a paper note every half hour to see if something has been done.”
According to Canterbury District Health Board data, the average length of stay decreased by 20 percent and readmission decreased by 12.5 percent in the wards where the app was trialled.
Dr Chris Rumball, clinical lead for the app's developer Sense Medical, says the reductions were entirely down to the use of Cortex.
He says patients are happy to get out of hospital quicker, and shorter stays mean lower risk of infection.
“The sooner you're in and out of hospital, generally the better off you are.”
Shorter stays also reduce demand for beds, which Dr Rumball says is a big issue coming into winter when more people are sick.
“This has enormous implications for reduced costs and better planning.”
The official plan for Cortex is to deploy it throughout Canterbury DHB's new Acute Services Building so that staff are trained and practiced in its use before the new facility comes on line.
Dr Rumball says Sense Medical also has bigger plans for the app.
“There are many areas, both in the hospital and the community, where bringing a multidisciplinary team closer together will improve the quality of patient care” he says.
“There's plenty of interest from other DHBs and community health organisations, and we're starting to look at Australia.”
Cortex has been co-developed by Sense Medical as part of the Canterbury Health System's focus on using technology to improve healthcare for patients and staff.
A team at Christchurch Hospital is 3D printing models of babies' chests to train surgeons for a life-saving procedure.
Oesophageal atresia is a congenital abnormality that affects 1 in 4000 babies.
The most common form of oesophageal atresia is when the upper oesophagus, which should run from the mouth to the stomach, instead comes to a dead end. The lower section of the oesophagus connects the windpipe to the stomach.
The baby cannot swallow food, and there is a risk it will overflow into the lungs. There is also a risk breathing will pass air into the stomach rather than into the lungs.
Professor Spencer Beasley, a paediatric surgeon at Christchurch Hospital, is one of the foremost global experts on oesophageal atresia.
“We normally do the surgery within a day or so of birth, which entails separating the lower section of oesophagus from the windpipe and connecting it to the upper section so the baby can swallow saliva and food.”
He says the surgery is common enough that paediatric surgeons will certainly come across it, but rare enough that it is difficult to train them in the procedure.
“Up until now, people have their first attempt at doing the surgery with actual patients.”
Simulations for the surgery created overseas often involve practicing on animal tissue or live animals.
“This presents huge ethical problems, cost problems, and procurement problems,” Spencer says.
Paediatric Surgeon Jon Wells had the idea to 3D print a model to simulate the surgery, and Spencer helped him develop it.
They collaborated with the Canterbury DHB Medical Physics and Bioengineering department to create a lifelike replica of a ribcage, based on CT scans of a real baby.
They also developed a synthetic skin and, most importantly, a replica of an oesophagus and windpipe with the most common form of oesophageal atresia. This contains different layers of synthetic tissue that behave naturally and cause realistic problems for surgeons.
The ribcage is reusable, and the internal organs are easily and cheaply replaced between simulations.
“One of our aims is to make this model deliberately cheap so it can be used anywhere in the world,” Spencer says.
The team has also collaborated with Toronto University, which has supplied software that measures surgeons' efficiency in the simulation. Final-year medical student David Nair has been responsible for establishing its validity as an effective and useful training model.
The 3D-printed simulation has been developed in partnership with Canterbury DHB as part of the health board's focus on using technology to improve healthcare for patients and staff.
Teri Jackson was diagnosed with acute myeloid leukaemia (a cancer of the blood and bone marrow) just before her year 12 exams.
“I was pretty much hospitalised from October until halfway through February and I only got a few days outside,” she says.
Meanwhile, her friends were enjoying one of the best summers on record.
But thanks to a helpful friend and innovative use of virtual reality (VR) technology, Teri got to experience a little bit of the world outside her room.
Teri met MRI technologist Peter Dooley a few times while getting scans.
“And he just kind of showed up one time in the ward and said ‘Here's a VR headset',” she says.
Peter has been working on using virtual reality to improve outcomes for patients.
He has successfully used VR to prepare young patients for MRI scans, resulting in fewer failed scans and because a general anaesthetic was needed less often, a much shorter wait time for a scan.
Peter wants to find new uses for VR, and says he was interested to see what Teri and her friends could do with the headset and a 360-degree camera.
Teri's friend Hunter Benbow took the camera out and made immersive movies and photos to be viewed on the headset.
“It was quite neat, I just set the camera up on a hill near Lake Lyndon. That was one trip. I also took it around town and took five-minute clips around the place. I even strapped it to the tractor,” Hunter says.
Peter says the process is helpful for the patient and also for family and friends who want to be involved.
“Teri was in a dark room, then she puts this headset on and all of a sudden she's up in the mountains, or she's on her mate's tractor,” he says.
“When someone gets sick the family and friends want to help, and there's not much they can do. This is a great way to include them.”
Teri says the technology has potential to improve hospital stays for a lot of long-term patients.
“It felt a little bit like an escape. Obviously, I couldn't go outside so having outside brought to me was pretty cool.”
Simulations in healthcare are great for training, but can be expensive.
A team headed by Christchurch Hospital anaesthetic specialist Dr Daniel Hartwell has designed a low-cost, highly-realistic simulator that plugs in to everyday medical equipment.
Previous medical simulation systems tended to be very expensive and/or unable to be transported easily.
“Nurses and technicians are all part of the same team, and so everyone needs access to the same system,” Daniel says.
Most systems use mock monitors, designed to look like the real thing.
“The issue with that the mock monitor and how it behaves is not the same as the ones actually used, so their value for training is limited,” Daniel says.
Biomedical Engineer Michael Sheedy from the Canterbury District Health Board (Canterbury DHB) Medical Physics and Bioengineering Department helped Daniel develop a system that would use the same equipment clinical staff used every day.
“You wouldn't train a pilot in an Airbus A380 and then expect them to fly a 747,” Michael says.
At that stage, Daniel had been using calibration devices to run simulations of his own design. These devices are used to check equipment, and can be used to make certain displays appear on medical monitors.
“Dan was like a DJ, controlling all of these pieces of kit to control the monitors,” Michael says.
Throughout 2016 and 2017, the pair developed software to allow someone to control the calibration device wirelessly from a tablet computer. They envision creating a series of modules to expand the usefulness of the simulator.
The first module, called RESPIRECO2, is a device that generates carbon dioxide to imitate different human breathing patterns, which show up on real monitors.
Daniel has conducted simulations for anaesthetics teams using partial and full mannequins, and actors. He has tested the simulator in surgical theatres, the intensive care unit, ambulances, and a medical transport helicopter.
The simulator is also used for training in Christchurch Hospital's Emergency Department, and futher testing is being carried out at different hospitals around New Zealand and in Australia.
The Hartwell Simulator has been developed in partnership with Canterbury DHB as part of a focus on using technology to improve healthcare for patients and staff.
Christchurch Hospital introduced new software called ScOPe in 2013, originally designed to replace paperwork for surgical staff.
Surgeon Saxon Connor says that over the past five years Canterbury DHB staff have worked with the developers to tailor the software to create a better system for patients and staff.
Staff use ScOPe to manage patient flow, update and observe their information in surgical theatres, and record operation notes.
Improved patient flow means patients aren't prepped for surgery prematurely and that the post-op team and family are in the recovery area at just the right time. All these efficiencies together ensure as little theatre downtime as possible and less time spent waiting by patients and staff.
Surgeons also use ScOPe to check on long-term outcomes, which Saxon says used to take hours of registrars' time to look up manually.
“We've got real-time visibility over what's happening in the theatre block,” he says.
Nurses, anaesthetists and surgeons previously filled out a series of paper forms, which were often incomplete or illegible.
The forms were used to create waiting lists several pages long, which surgeons had to hunt down and print out.
“Of course, as soon as I did another clinic, that list was out of date,” Saxon says.
If surgeons made extra time on their daily list, they would call and ask administration to book in more patients.
“There was no way of ranking patients or working out who should be next, it was just kind of this random process, so it wasn't particularly fair or streamlined.”
The digital forms in ScOPe are pared back to essential questions surgeons need to answer; they are quick to fill out and always legible.
ScOPe also gathers information about surgeons, and is better at predicting how long certain procedures will take.
“Surgeons are always optimistic and say it'll take an hour when it takes three,” Saxon says.
The information creates a more accurate waiting list for each surgeon, and allows them to control it themselves. Surgeons can see which patients have been waiting the longest and book them in if space appears on the list.
They can even take patients from other surgeons' lists, with their permission.
“It's fair and transparent,” Saxon says.
An operation note is now available for other staff to see before the patient hits recovery. Previously this was dictated, transcribed and published – a process which often took several days.
Clinical Nurse Specialist Kirsten Walsh says ScOPe lets nurses plan recovery beds and surgery preparation that depends on knowing accurately how long active surgeries are going to take.
Much of this information was difficult to get before ScOPe, and clinical staff would phone between wards and the surgical block to update each other – all taking up valuable time and increasing the likelihood of confusion.
“It has certainly reduced the number of phone calls back and forth,” she says.
“Discussion around surgeries can happen a lot sooner because we can see our capacity, we can see our demand. It's all there on a large display screen and is updated regularly.”
Canterbury DHB uses ScOPe as part of its focus on using technology to improve healthcare for patients and staff.
Families in the Hurunui and Kaikōura districts can once again ensure their children have the best protection available against the flu this winter – and it won't cost a cent!
Young people from six months to 17 years of age living in the Kaikōura and Hurunui areas (within the Canterbury District Health Board) can receive free flu shots.
The flu vaccine is now in General Practices so people should call their local General Practice team to book in their flu shot. It's important to get your annual flu shot or immunisation as soon as possible so you're protected before flu season strikes. Other members of your family/whānau may even qualify for a free flu shot – it pays to ask.
Canterbury District Health Board Medical Officer of Health Dr Ramon Pink says the flu is much worse than a common cold.
“It is a very serious illness, that can't just be ‘shaken off'. It's been a severe flu season in the Northern Hemisphere, a possible predictor of what we may see in our winter. It's so important that people get vaccinated – not just to protect themselves but also prevent them from passing it on to whānau, friends and workmates.”
In the US, influenza has caused over 28,000 hospitalisations and 151 paediatric deaths in the 2017-2018 season. In New Zealand, flu-related illnesses cause 400 deaths a year and account for 45 percent of illness days each winter in New Zealand, Fightflu figures show.
This year's vaccines have been developed to offer protection against the strain circulating in the Northern Hemisphere winter.
Influenza infection rates are generally highest in children and healthy children are the major cause of the spread of the virus in the community. Around 80 percent of people infected show no symptoms so you can spread the flu bug without knowing you have it – and the elderly, pregnant women and people with chronic health conditions are particularly vulnerable.
“As we're seeing at the moment in the South Island with the spread of the measles virus, it is much better to protect yourself from contagious illnesses by getting vaccinated than dealing with the stress and hardship of getting sick.”
Canterbury District Health Board is urging people to protect their whānau and the wider community by getting their flu shots now. Getting your flu vaccination every year offers the best protection against the flu.
Even if you don't qualify for free immunisation, you may still be able to get one for free from your employer. Flu shots are also available for anyone, for a fee, from a doctor, nurse or some pharmacists.
Flu immunisation is free for certain Canterbury residents from your doctor, nurse or qualified vaccinating pharmacist if you're in one of these groups:
Flu immunisation is free only from a doctor or nurse if you're in one of these groups:
For more information on influenza visit www.fightflu.co.nz.
Canterbury DHB Chief Executive David Meates, today welcomed the Prime Minister's announcement of an additional $28 million over the next three years to support the wellbeing of children in Years 1-8.
“We've been concerned about the impact of the quakes on the wellbeing of children in Canterbury for some time now. To date there have been a number of agencies and individuals involved in supporting Canterbury kids, including our own small School-Based Mental Health team who have done an amazing job.
“This new targeted funding will allow us to provide more and earlier support for schools to take a holistic approach to the wellbeing of some of our most vulnerable community members. Many of these children have grown up in households where parents have had to focus considerable time and energy on dealing with significant post-quake stressors such as ongoing battles with insurance and house repairs. This is in addition to the anxiety and fear of experiencing the many thousands of quakes which have hit our region.
“This boost to the number and range of health professionals and support workers focused on the wellbeing of young children will see those in need receive support sooner. We will be working closely with the Ministry of Education to design a system that works for children, their families/whānau, caregivers and teachers.
“I am thrilled that Sir John Hansen chair of the Canterbury Clinical Network will lead the development work on this initiative. While much of the detail is still to be worked through, a decision has been made to start with two Kāhui Ako (Communities of Learning) – Tamai located in Christchurch East and Hornby in the West.
“We are keen to retain and build on the expertise already in place and envisage a team which could include social workers, nurses or occupational therapists and others as part of the programme.
“Before the programme is rolled out to all quake-affected schools in Greater Christchurch and North Canterbury, consistent ways of working, along with appropriate training will be developed to ensure that what we create is sustainable and effective.
“Focusing on the wellbeing of children is an investment in the future of our community, and we are committed to getting this programme up and running as soon as possible. Until the roll-out is complete we will continue to support schools through existing services,” David Meates said.
Inpatient falls continue to be the single major serious adverse events (SAE) reported by the Canterbury DHB for the 2016/17 financial year.
The release of a Serious Adverse Events report by each DHB is a Health Quality and Safety Commission (HQSC) initiative. The reports highlight events which have resulted in significant additional treatment, major loss of function, are life threatening or have led to an unexpected death.
Of the 73 adverse events identified as serious by the Canterbury DHB, 29 were patients who had a fall while in hospital – the same number as reported the previous year and 25% less than 2014/15 figures.
Chief Medical Officer Dr Sue Nightingale says “there continues to be a focus on identifying risk factors and tailoring falls prevention strategies to meet the needs of individual patients while they are in hospital and when they return home.”
A further 20 patients sustained hospital-acquired pressure injuries. These have been included in Canterbury DHB SAE reporting for the first time, with each case leading to an independent review and recommendations.
Canterbury District Health Board is currently working with ACC to design and implement a district wide three year pressure injury prevention improvement programme. “The Canterbury Health Pressure Injury Advisory Group has been proactive in developing and implementing pressure injury prevention strategies and the broadening of the programme will result in a data driven improvement approach to prevention across the district,” says Sue Nightingale
Some adverse events marked as serious in the July report have since been downgraded following further investigation, though each event is still followed up with a review process.
Nationwide, and in Canterbury, the highest reported event category related to clinical management, including pressure injuries and delayed or missed diagnosis or treatment.
Sue Nightingale adds that “serious adverse events are reviewed through a formal process with the aim of providing feedback to patients and families so they are aware of contributing factors and causes and how we intend to make our systems safer.”
As noted by HQSC Chair Professor Alan Merry, “an increase (in reported events) probably reflects a change in culture towards increased transparency and learning from system failings, rather than an increase in adverse events themselves.”
Sue Nightingale agrees. “At Canterbury DHB the implementation of an electronic incident reporting system means that staff feel comfortable reporting events and ‘near misses'. By looking into the factors that contributed to these events and reviewing what happened we can learn and improve our systems and processes to make them safer.”
“The emphasis is on improving systems to reduce the chance of something similar happening in the future. While we aim for zero harm, having a culture where staff are encouraged and supported to report near-misses and adverse events is vital to ensure the quality and safety of our treatment and care is constantly improving,” says Sue Nightingale.
Canterbury Health System is getting behind World Antibiotics Awareness Week and you should too – antibiotic resistance caused by the misuse or overuse of antibiotics is one of the biggest threats to global health today. So if ever there was good reason for having a health-themed week and something worth getting behind, this is it.
This week the World Health Organization is asking health systems across the world to promote the message that antibiotics must be ‘Handled with Care'. We agree.
Canterbury DHB CEO David Meates says if we carry on as we are, antibiotic-resistant microbes are predicted to kill more than 10 million people worldwide every year by 2050 and cost the global economy US$100 trillion.
“But we don't have to carry on as we are and there are things everyone, including you, can do to help – starting with finding out more by reading on.”
Each time antibiotics are used there is a chance that some bacteria will survive and be resistant to future treatment – which is why you should use them according to medical advice and only when it is absolutely necessary.
If we overuse antibiotics they might not work when you really need them and leave you vulnerable to new infections for a while. Even when used correctly, antibiotics can have side effects such as skin rashes, diarrhoea, or thrush – that may be because each treatment wipes out the good bacteria along with the bad and leaves the way clear for the wrong bacteria to become dominant.
As part of a joint project with the Canterbury Initiative, our other CCN partners – the Canterbury Community Pharmacy Group and the Department of General Practice at the University of Otago – we have created some resources for general practice and pharmacy.
Look out for a ‘waiting room' poster that pushes the message that antibiotics don't fix everything and prompts people to seek advice from their prescriber or a pharmacist.
Look out too for a ‘consulting room' pledge poster which confirms your health provider's commitment to always providing the best care for your needs – which will not involve prescribing antibiotics where they would do more harm than good.
“While the ‘Handle with Care' message is relatively simple and we hope this week will boost awareness of the issue, together we need to become part of a massive worldwide shift in how we think about using antibiotics,” Mr Meates says.
For more information, visit WHO World Antibiotic Awareness Week.
With the launch of Patient Safety Week, Cantabrians with prescribed medication are being encouraged to ensure they can answer three simple questions:
Canterbury Health System welcomes the choice of medicines safety as this year's theme for Patient Safety Week, because of the role everyone can play in preventing medicines-related harm.
Questions about your medication can be answered by your pharmacist or online via HealthInfo – a trusted, health information website informed and updated regularly by Canterbury clinicians. Another trusted online option is MyMedicines.
Canterbury DHB CEO David Meates is encouraging staff and the general public to get behind Patient Safety Week as the start of a new drive to increase awareness.
“The Health Quality and Safety Commission have set a totally achievable goal for us all during Patient Safety Week – to get into the good habit of ensuring we understand our medicines better by answering those three simple questions”
“One other key activity for our health system this week is to let people know about our medicines return service,” Mr Meates says.
Canterbury community pharmacies will now accept surplus (no longer needed) and expired medication for safe disposal. This removes a potential hazard from people's homes where old medicines can all too easily be taken in error or disposed of unsafely.
The service also allows people to return used medical sharps for disposal (including needle/syringes used for cytotoxic medication), as long as they are safely packaged as agreed by the pharmacy.
We have been working with our Canterbury Clinical Network partners the Canterbury Community Pharmacy Group to support and promote this service which is free to the community. Community pharmacies will use stickers on prescription bags, issue advice tailored to users of medical sharps, and have a general information flier about the service.
“All people need to do is to talk to their pharmacy first for advice on how to store and return items safely, and while you are at it – why not ask those three questions: What's my medicine called, what's it for, and when and how do I take it?”
Media queries can be directed to Canterbury DHB Senior Media Advisor: Jendy.Harper@cdhb.health.nz (03) 364 4122 or (027) 502 7523.
Canterbury District Health Board and the creators of Cortex, Sense Medical are delighted to introduce the newest version of the iPad and iPhone application to the wider health system. Cortex has been designed by clinicians for clinicians, to improve the quality of patient care and the efficiency of hospital care teams.
New Zealand software company Sense Medical will be presenting results of a major expansion of version 3 of their ground-breaking application ‘Cortex' at the HINZ conference in Rotorua next week.
The Cortex care coordination platform allows doctors, nurses and allied health clinicians to work together seamlessly. The application provides documentation of clinical notes, team and individual task management, electronic ordering of diagnostic tests, notification of results availability, and direct access to the results themselves – all at the patient's bedside.
Expanding the use of the platform within Canterbury District Health Board has produced dramatic results in the General Medical Surgical Division at Christchurch Hospital. Since the middle of June, patients have avoided more than a thousand nights in hospital; achieving an almost 20 percent reduction in the average length of stay.
Sense Medical's Co-Founder Dr Alistair Rumball-Smith, says the results are an exciting validation that using mobile technology can make a measurable difference to the efficiency of health care teams.
“DHBs around the country are under pressure to provide care with resourcing that cannot keep pace with increasing demand. Cortex can help ease some of this pressure through improving care efficiency, as these results from Canterbury confirm.”
The application was developed in collaboration with Canterbury District Health Board through their Via Innovations initiative, which was set up to support emerging health technology solutions.
Stella Ward, Executive Lead – Health Innovation at Canterbury and West Coast DHBs says the enthusiastic uptake of Cortex by clinicians and its proven benefits have led Canterbury DHB to commit to an expansion of Cortex across its hospitals, starting with the new Acute Services Building which has been designed to be ‘paperlite' from day one.
“Removing paper from the inpatient journey helps to ensure that notes are legible, handovers are clearer and critical clinical information is always available to the right people at the right place and at the right time.”
“Cortex is a key component of our emergent paperless and world-class mobile environment in our hospitals.”
“We're excited to be able to provide our clinicians with a tool that allows them to work smarter, quicker and more safely,” Stella says.
The HiNZ Conference is New Zealand's largest digital health event and is being held in Rotorua for three days from 1 November. The conference will attract a diverse group of over 1000 delegates including clinicians, health sector managers, academics, educators, government, IT professionals and industry.
“All the key players in health and technology will be there and I look forward to conversations about how well Cortex is working for us and how it might benefit users on a national scale,” Stella says.
Further information about Cortex is available at >http://www.sensemedical.co.nz.
It's gardening season in the garden city – time to reach for the spade, the wheelbarrow, the gloves, the face mask and the handwash!
Canterbury has the country's highest incidence rates of potentially-fatal Legionnaire's disease, while New Zealand has the highest reported incidence of the disease in the world.
Contact with compost and potting mix is a main contributor – that's where the Legionella longbeachae bacteria can lurk, putting at risk gardeners who inhale the dust.
Even using unwashed hands to remove a mask can be enough to become infected.
“It's a timely reminder to our community that hand washing immediately after gardening is very important in protecting against Legionnaire's disease,” says Canterbury Medical Officer of Health, Dr Ramon Pink.
“Reducing the risk of becoming infected is vital as more of us get out into our gardens with the longer days and warmer weather”.
A recent CDHB-funded study of the disease by University of Otago researchers found that gardeners washing their hands immediately after use protected against the disease, by minimising exposure of the bacteria to the face.
Legionnaire's causes a form of pneumonia, and the report also recommends long term smokers and those with cardiac or respiratory conditions take particular care of their hygiene during and after gardening.
In the last 12 months, 271 cases have been notified nationwide, 49 of those in Canterbury.
Of the patients that are hospitalised with the disease, 30% require intensive care unit admission.
Symptoms include dry coughing, high fever, chills, diarrhoea, shortness of breath, chest pains, headaches, excessive sweating, nausea, vomiting and abdominal pain.
So how can you minimise the risk?
There are five simple steps for gardeners to follow when using compost or potting mix.
Canterbury DHB chief executive David Meates attributes Canterbury DHB's high achievement in the latest National Health targets, to the extraordinary people working in the local health system.
Today the final quarter four Health Target results were released and the Canterbury DHB is one of only three DHBs to achieve five out of the six health targets set by the Ministry of Health. None of the twenty new Zealand DHBs achieved all six of the targets. Health targets are a set of national performance measures specifically designed to improve the performance of health services and they reflect significant public and government priorities and provide a focus for action.
The only target not achieved by Canterbury DHB was Shorter Stays in ED in June. The target is to have 95 percent of patients admitted, transferred and discharged from the emergency departments within six hours. Canterbury achieved 94.4 percent of the target. “Given the huge pressures that our health system has been under, including extremely busy general practice after-hour services and the highest emergency department presentation days in Canterbury's history, the focus on ensuring that patient flow has been maintained has been outstanding. Our health system is full of extraordinary people who turn up every day to do the very best for our community,” David Meates says.
Data show that across Canterbury, 80 percent of people who present to the Christchurch Hospital Emergency Department are admitted, transferred and discharged in under four hours. From April 2016 to March 2017, the average time spent in ED was 2.7 hours per person. This makes each ED attendance approximately 50 minutes shorter than the national benchmarked average. It also allows for 23,087 more patients to be assessed and treated in our ED using the same resources.
Canterbury DHB was ranked in the top four for delivering faster cancer treatment, increased immunisation and raising healthy kids. The other targets it achieved were for better help for smokers to quit and improved access to elective surgery.
“It's by asking questions that challenge the way we do things that ensures we keep making our health services more efficient, and better for our patients,” Meates added.
More information about the national health targets can be found here www.health.govt.nz/healthtargets.
Chatham Island residents are receiving greater levels of health care, which is resulting in fewer residents leaving the island to enter long term residential care, fewer hospital stays and a significant reduction in emergency life flights.
The Canterbury District Health Board took over the responsibility for the provision of health services to the Chatham Islands on 1 July 2015 – a move that has resulted in operational cost savings, increased access to health care and improved outcomes for the residents.
There has been a reduction in operational expenditure, primarily the result of decreasing transport costs following investment in a TeleHealth facility, along with upgrading radiology equipment and a server upgrade. Significant investment is required to upgrade the community dental and health clinic facilities in the very near future.
“There is a significant increase in need for both personal cares and support care being delivered in the home. This is being driven by an ageing population and improved community integrated health assessments which identify service needs early,” says Manager Rural Health Services, Win McDonald. She adds that all community needs are being met – using a combination of home support workers, Maori Community Services and registered nurses.
In the last financial year, over 1180 specialist appointments were delivered for Chatham Island residents. These included paediatrics, orthopaedics, Well-Child, radiology, community mental health, obstetrics and gynaecology, occupational and physiotherapy, older person's needs assessment, podiatrist and diabetes nursing. Visits were coordinated with a visiting ACC team working closely with the Occupational and Physiotherapy staff with ACC sharing the cost of this service delivery.
Chatham Islands Clinical Nurse Manager, Sally Lanauze says that by fully utilising a whole system approach, they have been able to overcome some of the challenges of distance.
“The direct connection to Christchurch Hospital, both via direct flights and quick and easy access to services like visiting specialists and TeleHealth, which connects specialists in Christchurch Hospital with medical staff on the Chatham Islands via video conferencing, means the islanders now have the same access to health services as all other Cantabrians.”
Sally adds that the provision of specialist support in times of an emergency, and where staff have been on duty for long hours, only enhances patient safety.
The orthopaedic team visited the Chatham Islands in September last year and again in May this year. During the second visit, a number of patients who had already received surgery were seen and discharged. During the two-day May clinic, 55 patients were seen and six minor surgeries performed. Following assessment, 24 patients remain under Orthopaedic care and 31 patients were discharged.
New contracts were put in place with a visiting podiatrist and on-island physiotherapist and the Lead maternity Carer contract was renewed. Dental services were provided by a private dentist in February, this was the second clinic and again the service was fully booked for 14 days.
Rural Canterbury Primary Health Organisation appointed a Primary Mental Health Nurse/Registered Counsellor to deliver independent counselling services in June.
Sixty-three of the 112 eligible Chatham Island women took part in the biennial breast screening clinics run by BreastScreen South. For those who were unable to attend planning is underway for a further clinic in May 2018.
The Health Centre and Ha O Te Ora O Wharekauri Trust are working more closely together to coordinate visits to the health centre with other needs like shopping, as well as arranging the follow-up support in the community. “This closer working relationship provides a more consistent level of health care and helps prevent injuries in the home for our elders within the community,” Sally concludes.
If you live in Canterbury – you have options!
At this time of year our hospitals are busy providing care for those who are very sick and need specialist hospital care. If you come to ED and it's not an emergency, you could be in for a long wait as those in the greatest need are always seen first.
You can save time and phone for health advice from the comfort of home – call your own general practice team 24/7. And call sooner rather than later – don't wait for things to get worse before seeking medical advice. It's always better to nip things in the bud rather than waiting until you get so sick that hospital is the only option.
If you haven't already had your influenza immunisation, it's not too late, and it's the best protection available to keep you flu-free this winter. Talk to your general practice team and it's also available at some pharmacies.
Below are some tips from Medical Officer of Health Dr Alistair Humphrey to help as you embark on the clean-up, if your home or property was affected by the floods over the past few days.
Many areas have a ‘boil water' notice in place, so please check for the latest info.
Ear ache and a lump in her throat turned into an unexpected cancer journey for Cosette Calder. The 42 year old Christchurch woman was diagnosed with throat cancer two years ago – a common, yet mostly unmentioned, cancer that falls into a number of other cancers that can occur in the head and neck area.
One of these cancers is diagnosed in Canterbury/West Coast/Nelson Marlborough regions up to six times every week. Treatment of head and neck cancers often have a greater effect on a patient's quality of life, more so than the treatment of cancers found in any other part of the body.
It's a cancer that can go easily undetected – the symptoms often being very mild, and quite common. For Cosette, she was coughing a lot, and sometimes had the taste of blood in her mouth. She experienced pain when yawning. A sensitive throat made swallowing food uncomfortable. A visit to her general practitioner resulted in a referral to the Ear Nose and Throat department at Christchurch Hospital. Here she was told she was most likely experiencing the early stages of throat cancer. Further tests confirmed this.
“I was shocked and upset. However I was thankful that I had an early diagnosis, as this gave me the best chance at being cured and leading a healthy normal life after treatment,” Cosette says.
Head and neck cancers often go undetected, because many people don't recognise the early warning signs and symptoms, says a Christchurch Hospital Head and Neck Surgeon, Dr Robert Allison. Since these cancers occur in a range of sites, they can cause a range of different symptoms, such as an ulcer on the tongue, a one-sided sore throat, a husky or hoarse voice, a painless lump in the neck, swallowing problems or changes to your skin in your face and neck area. Any of these symptoms that persist for more than three weeks should be checked by a doctor.
Dr Allison says treatment is complex and can involve major surgery, radiotherapy and chemotherapy. “In Christchurch we see between four and six new head and neck cancer patients per week and some types are becoming more common, particularly cancer of the throat (oropharynx) and the thyroid gland.” Treatment can have a significant effect on a patient's ability to eat, swallow, or talk. Surgery can have a major effect on a patient's appearance, he adds.
July 27th is the international day of recognition for head and neck cancers every year. This is being recognised locally with a drop by information stall in the main foyer of Christchurch Hospital, run in conjunction with the Cancer Society. The purpose is primarily to raise awareness and educate people about the prevalence of this disease and donations can be made to the Canterbury Head and Neck Cancer support group from 9am to 12 noon.
“Many patients we treat have advanced cancer, which means treatment is more complex with a lower chance of treatment success. Even if the cancer is successfully treated, it can still have a major effect on a patient's quality of life,” Dr Allison adds.
“If general practice teams and members of the public were more aware of the early signs and symptoms of head and neck cancer, then we would see patients with less advanced symptoms and consequently a better rate of treatment success.”
So what causes head and neck cancers? There can be many different causes, in the past, smoking and drinking were the main contributors. While they are still key causes, cancers of the throat are increasing due to the Human Papilloma Virus. (H.P.V). Medical professionals are hopeful the recent introduction of universal immunisation with Gardasil, will mean that cancers of the throat due to H.P.V will become less common in future years.
For Cosette, her treatment journey was long and hard. First up was a minor surgery to do a biopsy on the tumor that had been discovered in her throat. The next procedure was to insert a feeding tube called a PEG into her stomach – difficulty eating is common. For two months during and after treatment, this is how Cosette feed herself.
For six weeks, Colette underwent intensive chemoradiation – which combined chemotherapy (once a week) and radiation (five times a week). Before this began she had a plastic mask made of her face and shoulders, which she would wear during radiation treatment. This mask would be placed over her head and attached to the table she lay on to keep her in the right position during the treatment. “This was the single hardest part of facing the treatment.”
Two years on, Cosette says she is happy to be clear of cancer, and is now actively involved with the Cancer Society Head and Neck Cancer Group and with an online Facebook support group. “I feel happy and healthy again, but it was a gruelling experience. I have my life back and I and enjoy seeing my seven year old son passing his milestones. I am grateful for my second chance.”
If you are undergoing treatment for a head and neck cancer or you are a survivor, you may be interested in joining the head and neck support group. Contact Pene Clifford, Cancer Society on 03 379 5835.
“The support group offers information, access to health professionals, and the support of others to help people through the challenges of treatment and beyond,” Pene says.
Last year, the Canterbury DHB worked with Cancer Society, Canterbury – West Coast Division to develop a range of Head and Neck Cancer pamphlets for the public.
Find out on the Canterbury – West Coast Division of the Cancer Society website or call the Cancer Information Helpline on 0800 226 237.
Canterbury DHB has brought a range of services in-house, including all food services, and at Ashburton Hospital our orderly, cleaning and laundry services.
The move is the first time in 13 years that the DHB has managed these services itself. In March, Canterbury DHB announced it would take over management of all food services from existing provider Medirest, a subsidiary of Compass Group, after the contract expired on 30 June. This followed the decision in September last year not to sign up to the national food service contract.
Acting Chief Executive, Mary Gordon, says over 99 percent of staff had transferred from the previous Compass Group contract, and that food services would continue as usual.
“It's exciting to be welcoming around 300 new staff as a result of the transfer of services in-house. Our intention was that all staff were retained by Canterbury DHB and we are proud that almost all have opted to transfer to become Canterbury DHB employees.
“We are fortunate to have our own well-established, proven and fully-owned, Cook-Chill production unit so we will continue to use the same food production methods. This means we can make savings and deliver more than we could have on the national contract. As a result of the transfer of services any profits from café sales will now be funnelled back into the Canterbury health system.
“We're very thankful for the great service Compass Medirest has provided over the last 13 years. I would also like to thank them, their union, and all the staff who have worked cooperatively behind the scenes on the details to ensure the smooth transition for launch day.”
Food services at Canterbury DHB covers all the meals and beverages for patients, including those with a wide range of dietary requirements, Meals on Wheels, and the provision of food in cafés which are open to staff and the public at Christchurch Women's Hospital, Christchurch Hospital, Burwood Hospital, Ashburton Hospital and Hillmorton Hospital. The DHB prepares and serves more than one million patient meals each year and delivers more than 120,000 meals on wheels.
While there are no immediate changes planned for current menus, which enjoy high levels of customer satisfaction, over time there will be some enhancements to the range of healthy choices available, says Mary Gordon.
The DHB has also developed a new brand for the transferring services to recognise that it will be a separate ‘business unit' within the DHB. The new brand name for this branch of services – ‘WellFood – A fresh approach to food'– is a further signal of the desire to gradually “freshen” up the food options, says Mary Gordon.
“Entering this next phase is very exciting for Canterbury DHB – welcoming our new staff and continuing to enhance our food services for patients, staff and visitors – and to those receiving Meals on Wheels at home.”
All Right? has launched a free wellbeing toolkit to support young people with their mental health and wellbeing.
Sparklers consists of 36 activities that teachers can use to help their year 1-8 students become calmer, happier, and more ready to learn. The activities take between 10 minutes and 1 hour, are aligned with the school curriculum, and cover a wide range of wellbeing topics including managing emotions, living in the moment, being grateful and showing kindness.
Research associate at AUT University's Human Potential Centre and All Right? Advisory Committee member Dr Lucy Hone, says Sparklers will help young people learn the skills they need to build positive mental health.
“Sparklers enables young people to learn strategies that improve wellbeing and build resilience. The activities are designed to help students feel good and function well, and improve their ability to cope with change and navigate the challenges life throws at them,” says Lucy.
Dr Hone says student wellbeing is strongly linked to learning.
“Students with high levels of wellbeing make better learners, find it easier to focus in the classroom and are able to build stronger and meaningful relationships,” says Lucy.
Canterbury DHB's clinical director for Child Adolescent and Family Dr Harith Swadi, says Sparklers has been developed in response to requests from schools for more support to meet the wellbeing needs of Canterbury students post-quake.
“Schools are crying out for more support so they can meet their students' wellbeing needs,” says Harith. “There's a tremendous desire amongst schools to do more in the wellbeing area but up until now there hasn't been a lot of practical guidance on how to go about it.
“Sparklers pulls together evidence based wellbeing activities in a way that's easy to implement in the classroom. The activities are simple, easy, and proven to work,” says Harith.
“We've piloted Sparklers in several Canterbury schools and the response has been amazing. Schools are incredibility enthusiastic about Sparklers and the activities are making a real difference,” says Harith
All Right? manager Sue Turner says that while Sparklers had its genesis in recovery from the greater Christchurch earthquakes, its content is relevant to tamariki throughout New Zealand.
“We think of Sparklers as a kind of gift to the nation. It's a really positive thing that's come out of the earthquakes, and its benefits will extend far beyond Canterbury,” says Sue.
Sue says in addition to the 36 activities for teachers, All Right? has created six parenting guides.
“The parenting guides provide handy tips and tricks on the key areas parents often ask about, including how to help your child be calm, be grateful and manage worries.
“Raising a resilient and happy child isn't always easy but there are things parents and carers can do that can make a big difference. Just like us, tamariki face daily demands and worries. Knowing what these are and the best ways to address them can prevent little things turning into really big things,” says Sue.
Sparklers has been made possible thanks to funding from the Canterbury Earthquake Appeal Trust and Canterbury District Health Board and support from the Canterbury DHB's Community and Public Health and School Based Mental Health Team.
The latest Canterbury Wellbeing Survey shows the wellbeing of greater Christchurch residents continues to improve.
Chair of the Psychosocial Governance Group Evon Currie says since the first survey in September 2012, quality of life indicators have been on an upward trend.
“Just over eight in ten (82 per cent) survey respondents rated their quality of life as good or extremely good,” Evon says.
Another measure of wellbeing, the WHO-5 Wellbeing Index, has also shown an upward trend since the survey began, she says.
“The results indicate that life is getting much better for the majority of people in greater Christchurch – it's clear that time is a great healer,” Evon says.
“Fewer people now have unresolved insurance claims or are frustrated by living in a damaged environment and the proportion of people who feel encouraged by the signs of progress in the city continues to rise.”
While many are doing better, things are still “not so rosy” for a significant section of the population, Evon says.
“It is clear that the recovery is far from over for some in our community,” she says.
“People surveyed are much more likely to have a lower quality of life score if they rent, are on a low income, have a health condition or disability, or if they have unresolved insurance or EQC claims.”
Evon says the Survey also highlights that questions remain for some Cantabrians about the quality of their earthquake repairs.
The Survey findings will guide the delivery of services and supports in greater Christchurch.
“More than six years on from the first earthquake, agencies remain committed to working together to ensure services continue to adapt to meet the needs of those whose recovery is not over,” she says.
“The wealth of information provided by the Survey will help ensure recovery policies and programmes reflect the real needs of our community.”
The results are in and they show Cantabrians are excited about smokefree venues. Even better, people are actively choosing to support venues that have smokefree outdoor dining areas.
These are part of the findings from the Fresh Air project, a collaboration between the Cancer Society and Canterbury District Health Board, who with the support of the Christchurch City Council, ran a summer trial to stub out smoking in the outdoor areas in a number of cafes and restaurants in the city.
During the six month project, 20 venues were invited to make their outdoor dining areas smokefree. Eighteen took up the challenge and became totally smokefree hospitality venues.
Former manager of the Ilex café in the Botanical Gardens, Liz Parlane says they had a really positive reaction to the project trial. “It gave us permission to say we're smokefree and reinforce that the whole park is a smokefree area.” Current manager Amy Stones says it was a useful way to raise awareness among tourists of the city's no smoking areas.
Tania Hughes owns Savoir in Merivale and says the transition to no smoking outdoors went really smoothly. “It's all been positive, and I've had really good feedback from my customers.”
Liz Chesterman, chief executive of the Cancer Society Canterbury and West Coast division says the Cancer Society was heartened by the positive response to the summer trial. “The results of this project show that New Zealand's goal of being smokefree by 2025 is achievable. We believe this is the beginning of a groundswell towards smokefree communities everywhere.”
Manager of the Communities team at Community and Public Health Kerry Marshall, praised the partnerships with the Cancer Society, Canterbury DHB, Community and Public Health, City Council and all the business owners that made the project work. She also congratulated the cafes on having the courage to try something different.
“These business owners have been willing to take part in something innovative. I commend them for being brave and stepping out of their comfort zone.”
In its response, Councillor Glenn Livingstone said on behalf of the Christchurch City Council that it was taking its mandate as a clean, green city seriously and literally.
“We hope more venues see this as a positive move. It's not only proved itself good for the community, but also good for business.”
Emily Box of the Cancer Society says half of the pilot venues reported they had customers visiting specifically because they had smokefree outdoor areas.
Other results showed that out of the 18 venues…
With smoking still the leading cause of preventable death in New Zealand, Emily says the results show there is an appetite among Kiwis to embrace a smokefree environment. “The next step for the Fresh Air project is to share our results, and encourage more venues to join the Fresh Air movement, and help move New Zealand closer to its Smokefree 2025 goal.”
Canterbury District Health Board is partnering with new stop smoking service Te Hā – Waitaha to encourage people to become smokefree on World Smokefree Day (31 May).
Canterbury DHB Smokefree Manager Vivien Daley says World Smokefree Day is the perfect time to quit for good.
“In the first two weeks of May we laid down a challenge to Canterbury smokers to be smokefree by World Smokefree Day. The response has been awesome, with 65 people signing up to the challenge on the Te Hā – Waitaha website,” says Vivien.
“While we know that most smokers want to quit, we're delighted at how much appetite there was to quit for World Smokefree Day.”
“Stopping smoking isn't always easy, but our client-centred, face-to-face approach is working. Everyday we're helping people save money, look after their health and the health of their whānau.”
Vivien says creating more smokefree spaces can help people to stop smoking, and prevent people from starting smoking in the first place.
She says that the findings of the recent Fresh Air smokefree outdoor dining pilot, being released later today, show that an overwhelming majority of people support making places like hospitality venues completely smokefree, inside and out.
“There's a real groundswell in our community to make smokefree the normal thing to be.
A great example is Canterbury's newest rugby league club, the Rolleston Warriors who we've helped to become completely smokefree.”
Go to the Te Hā – Waitaha website for support to stop smoking or more information or phone 0800 425 700.
The Canterbury DHB's performance in Quarter 3 of the 2016/2017 National Health Targets show the DHB continues to strive toward keeping Cantabrians well.
Canterbury DHB acting chief executive Mary Gordon says the DHB has done exceptionally well considering the pressure still facing our health system.
“It's great we've exceeded the faster cancer treatment target for the second consecutive quarter. I'm really pleased that 87 percent of patients received their first cancer treatment (or other management) within 62 days of being referred with a high suspicion of cancer,” Mary says.
“Our teams are continuously working to improve the capture and quality of the Faster Cancer Treatment data, and reviewing patient pathways to improve timeliness.”
Everyone in the Canterbury health system has worked tirelessly to try and maintain performance on the health targets, Mary says.
“Unfortunately we just missed the ED health target this quarter with 94 percent of patients admitted, discharged or transferred from ED within 6 hours.
“The average time in ED was only two minutes longer than the previous quarter and four minutes longer than the same quarter last year.”
Mary says it is only a small group who are having longer stays, which backs clinical staff reports that they are assessing and treating people with more complex needs – and this takes longer.
“Initiatives to support HealthTarget performance have included the implementation of strategies to manage demand in the community and improve flow in Emergency Department (ED) and throughout the hospital.
“The supports in place in the community, such as the Acute Demand Management Service, have meant 34,000 people in Canterbury have been provided care in the community over the past year, rather than being admitted into hospital.”
Great work continues at a primary care level with immunisation rates showing strong coverage across all population groups, Mary says.
Canterbury DHB met the Health Target for most ethnicities this quarter (98 percent Asian, 96 percent Pacific and 96 percent New Zealand European) but Māori rates were down to 91 percent, which meant we just missed the target this quarter vaccinating 94.4 percent of eligible children.
“Opt-off and decline rates stayed steady this quarter at 4.2 percent of the eligible population being unreachable due to parental choice.”
The focus on children remains strong with Canterbury making big improvements in the Raising Healthy Kids target – achieving 93 percent of four-year-olds identified as above the 98th centile for their BMI (height and weight measurement) who were referred for clinical assessment and healthy lifestyle intervention.
“This result demonstrates the change in process by Before School Check nurses, and understanding the importance of quickly passing on the referral to the Healthy Lifestyles Coordination Service. Our result is consistent across all ethnicities and population groups.”
The Healthy Lifestyle Coordination Service includes Triple P Healthy Lifestyles Programme; a positive parenting programme and Active Families: helping our families to be more active in a meaningful way.
Making sure smokers attending primary care are offered advice to quit continued to improve in Quarter 3 to 87.1 percent – a 2.1 percent increase on the previous quarter.
Finally, Canterbury delivered 15,004 elective surgeries, 97.7 percent of the target delivery.
“There is a recovery plan in place to support reaching target by the end of the financial year,” Mary Gordon said. “While there is a need for us to do better in some areas, it is encouraging to see the progress we have made across the board is sustainable.
“These results are a credit to those working hard throughout our health system,” she said. “I know how much work has gone on to achieve 97.7 percent of our elective target, and I want to acknowledge and thank everyone who has gone the extra mile so more people receive the treatment and care they need,” she said.
Read more about Canterbury's Health Targets.
This message is for the attention of existing and potential suppliers to the Canterbury and West Coast DHBs
We want to alert you to a fraud scam that is targeting existing and potential suppliers of goods to the DHBs, as well as other institutions and businesses in New Zealand. Please take the necessary precautions so that you are not a victim of this scam.
While the DHB cannot prevent this fraudulent activity we are supplying the Police with details to investigate the matter as we become aware of specific instances.
The fraud scam involves purchase orders and requests for product quotations that purport to originate from the DHB but are in fact fraudulent.
The scam operates in the following way: the supplier will receive an email requesting a quotation for goods. The email being used for this is firstname.lastname@example.org purporting to originate from the DHB-Accounting Unit. Once the quotation has been provided, a purchase order is emailed to the supplier that bears little resemblance to an authentic DHB purchase order. The purchase order typically instructs delivery to an address not affiliated with the DHB. After shipping the item/s, the supplier never receives payment and is unable to retrieve the shipped products.
It appears that suppliers are being instructed to ship the goods to a freight forwarder/logistics company, who are then instructed to send the goods off-shore.
Should you wish to refer this matter to the NZ Police, contact Detective Sergeant Mike Cartwright of the Financial Crimes Unit at the Auckland Central Police Station. Detective Sergeant Cartwrights' email address is email@example.com. The relevant NZ Police File is 170112/1414.
If you require further information please contact a member of the Canterbury DHB purchasing team.
Page last updated: 3 October 2018
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