Lets Beat Diabetes

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					          ConnecT                                                                                       The newsletter of Counties Manukau
                                                                                                          District Health Board. June 2005




Let’s Beat Diabetes                                                                              Message
Twelve months of community consultation,
partnerships and collaboration all came
together on May 25th, with the launch of the
                                                  from the Counties Manukau community
                                                  into developing the plan
                                                • The strong buy in local and central organi-
                                                                                                 from the
Let’s Beat Diabetes Plan: A five year plan to
prevent and manage Type 2 Diabetes in
Counties Manukau, at the TelstraClear Pacific
                                                  sations have to Let’s Beat Diabetes
                                                • The action that is already taking place as
                                                  part of Let’s Beat Diabetes.This includes
                                                                                                 Chief
Stadium in Manukau.
More than 150 local organisation represen-
tatives and community members gathered to
                                                  the Community Action Fund, Manukau City
                                                  Council and the inclusion of healthy urban
                                                  design concepts at Flat Bush and the
                                                                                                 Executive
                                                                                                 As the year flies by, it is exciting to see so
celebrate the launch and the positive spirit      collaboration with major players in the food
                                                                                                 many developments really taking shape
and enthusiasm associated with the plan.The       industry to make the food environment in
                                                                                                 around our organisation and community.
plan, officially launched by the Minister of      Counties Manukau healthier.
                                                                                                 One of our most rewarding achievements
Health, the Honourable Annette King, is         The launch was opened with a karakia and
                                                                                                 recently has been the launch of the Let’s Beat
aimed at long-term sustainable changes to       mihimihi by Whitiora Dunne Cooper,
                                                                                                 Diabetes plan.The Honourable Annette King,
prevent and/or delay the onset of diabetes,     supported by the Whare kura o Piripono
                                                                                                 Minister of Health, spoke at the event which
slow disease progression, and increase the      kappa haka group.The blessing of the plan by
                                                                                                 was attended by over 200 people and
quality of life for people with diabetes.The    Whitiora Dunne Cooper and Pastor Chris
                                                                                                 entertainment was provided by a number of
plan has already gained international           Sola was particularly special.The night
                                                                                                 cultural groups giving the event a definite
acknowledgement at the recent World Health      concluded with entertainment by Drums of
                                                                                                 Counties Manukau flavour! Television One also
Organisation Assembly meeting in Geneva.        the Pacific, who not only had the entire crowd
                                                                                                 ran a headline news story the same night
The key points from the Ministers speech        out of their seats doing the Cook Islands
                                                                                                 outlining the issues our community is facing
include:                                        tamure (hula dancing) but also had the
                                                                                                 with diabetes.The Board and I are extremely
• The importance of tackling the diabetes       Minister of Health and other speakers
                                                                                                 pleased with the work done to bring the plan
   epidemic in Counties Manukau                 performing solo on stage!
                                                                                                 to this point and we sincerely thank all the
• The importance of the significant input
                                                                                                 individuals who have given input to us to
                                                                                                 ensure this plan meets your needs.This is the
                                                                                                 beginning of a five year long journey to
                                                                                                 manage diabetes in our community and I
                                                                                                 invite you to be actively involved. We all have
                                                                                                 an important role to play for the sake of our
                                                                                                 children and grandchildren.
                                                                                                 The facilities projects are continuing to take
                                                                                                 shape with Hawkins Construction now
                                                                                                 confirmed as the main contractor.Today sees a
                                                                                                 crane going up in front of the Adult Medical
                                                                                                 Centre at the Middlemore site as the next two
                                                                                                 levels are developed – exciting stuff!.
                                                                                                 Directly above the Emergency Department,
                                                                                                 work is about to begin on the National Burn
                                                                                                 Centre.The Centre will contain 12 beds and
                                                                                                 two burn isolation rooms in ICU and will
                                                                                                 cover all phases of burn treatment.There will
                                                                                                 also be a gymnasium, active daily living
                                                                                                 kitchen and separate outpatient area within
                                                                                                 the unit.The Centre will provide treatment and
Health Minister Annette King and CMDHB chairman Pat Snedden.                                                             Continued on page 4.
       If you have a story you would like included in Connect please contact the Editor via e-mail: lryoung@middlemore.co.nz
Patient Flow Programme
What is this all about?                            identify possible improvements, implement          Ambulatory Services. Her role is to lead the
                                                   the ‘quick wins’ or easy changes straight          programme, lead the process and to be
The Patient Flow Programme is about
                                                   away before coming up with a ‘future state’        responsible for the day-to-day running of the
making the journey through our hospital
                                                   or what would be a better way of doing             programme. She will also run the bed
quicker and easier—from a patient’s
                                                   business, before making major change               management workstream.
perspective! The programme recognises that
                                                   recommendations to the Steering Group and          Justine Patterson will lead the Acute
a patient’s time is valuable and as important
                                                   being involved in the implementation of            Admission & Transfer Workstream on a part
as our own. We want to identify areas that
                                                   those changes. It is anticipated that the          time basis. Justine is a familiar face around
hold patients up, either within teams or from
                                                   entire process for each workstream will be         many different parts of Middlemore
one area to another. We also want to look at
                                                   approximately a twelve to eighteen month           Hospital, having been in a variety of roles in
what (if anything) can be removed within
                                                   process once all the approved recommen-            nursing (including Coronary Care Charge
our processes, which will lead to our staff
                                                   dations have been implemented.                     Nurse) before joining the Medicine, Acute
having more time to spend on important
                                                   We are also working with various NZ DHB’s          Care & Clinical Support Business
aspects of patient care.
                                                   including Canterbury, Waitamata and                Improvement Team.
The programme isn’t run by management
                                                   Auckland who are at various stages of              Jenny Pooley will return from maternity
and changes won’t be identified by
                                                   similar programmes to see what we can              leave in mid June to lead the Pre-Admission
management. All information and discussion
                                                   learn.                                             Elective patient processes also on a part
is developed in the workstream groups
                                                                                                      time basis. Jenny was most recently the
which will consist of hands-on staff               Who’s involved?
                                                                                                      Service Manager for Radiology and prior to
members.                                           The Steering Group consists of Brad Healey
                                                                                                      that had a hand in both nursing and
                                                   (GM Acute Care, Medicine & Clinical
What will the programme cover?                                                                        management roles that included MSC,
                                                   Support), Chris Fleming (GM Surgical &
The programme will be divided up into                                                                 Anaesthetics, Orthopaedics and Emergency
                                                   Ambulatory Services), Ian Brown (Chief
smaller workstreams. These will be; Acute                                                             Care.
                                                   Medical Officer), Dale Oliff (Director of
Admissions & Transfers, Bed Management,
                                                   Nursing), Jenni Coles (Intermediary Care           How to get involved…
Diagnostics, Discharge Planning and Pre-
                                                   Change Manager), Mary Seddon (Head of              Contact programme Manager Kara Pugh
admission Elective Processes. These
                                                   Quality Division of Medicine)                      for more information or requests to be
workstreams will be led by a Workstream
                                                   The Programme Manager is Kara Pugh.                included in one or more of the workstreams
Leader and will comprise of ‘coal-face’ staff
                                                   Kara has been seconded from the Quality &          (xtn 7663 or e-mail
who work in these areas daily. These groups
                                                   Risk Manager position within Surgical &            kpugh@middlemore.co.nz).
will map out what currently happens,




Community Based Rehabilitation
The Assessment,Treatment & Rehabilitation          In the first 12 months of operation, as the        will help to reduce this sense of abandonment
Service is pleased to announce the Community       service evolves, the team will work predomi-       and to smooth the transition to home. It will
Based Rehabilitation initiative is up and          nantly (but not exclusively) with patients over    also support carers of stroke patients at home,
running.                                           65 years of age, who have a diagnosis of           and reduce carer stress.”
CBRT provides rehabilitation to older patients     stroke.                                             The patient is provided with equipment
with a diagnosis of stroke. The team               The team will work mostly within the               services and support; and given access to other
functions to support early discharge from          Mangere, Papatoetoe, Manukau, Howick and           relevant services that help with stroke rehabili-
hospital and prevention of admission from the      Otara catchment areas.                             tation like GP’s, practice nurses and support
community.                                         The service includes comprehensive, multidisci-    agencies like the Stroke Foundation.
Community Based Rehabilitation is a process        plinary assessment in the patient’s home by a      CBRT is a priority 1 initiative in keeping with
of relearning old and developing new skills that   team including a doctor, physiotherapist, nurse,   the CMDHB's goal to enhance and expand
maximise independence and quality of life, in      occupational therapist, dietician, speech-         community initiatives.The service is also in
the patients own environment.                      language therapist and social worker.              keeping with the "life after stroke" Stroke
“Most patients prefer to be at home, if            A client-centred approach is used by the team,     Foundation guideline, which is a guiding
possible. Community home based rehabilitation      to help develop a day-to-day rehabilitation        document for services throughout New
is often more relevant to the person in the        programme to suit the patient’s needs.             Zealand.
home environment as their tasks are more           Doctor Green says “Patients often feel             Please contact Dr Geoff Green, at the
meaningful” says CMDHB Geriatrician,               "abandoned" when they are discharged home          Assessment,Treatment and Rehabilitation
Doctor Geoff Green.                                with a disability such as a stroke.This service    Department for further information.


2 J UNE 2 0 0 5
Horse                                      Primary Health
riding                                     Care Workforce
adventure                                  Development
                                           There are lots of initiatives currently taking     Targeting high school students for
                                           place to help address some of the workforce        a career in health
                                           issues in primary care in Counties Manukau.        Health care as a career has a bit of an image
                                           Below is an update on a few of the initiatives     problem with high school students these days.
                                           from the CMDHB Primary Health Care                 To help address this, a DVD and poster
                                           Workforce Development Action Plan.                 profiling primary health care workers has been
                                                                                              produced. It targets Year 9 & 10 students and
                                           NGO, Community and Primary Care
                                                                                              focuses on communicating the range of health
                                           Workforce Census
                                                                                              career options available, portraying health as
                                           CMDHB has recently distributed workforce
                                                                                              a fun and interesting sector to work in, and
                                           questionnaires to NGO, community and
                                                                                              encouraging students to take science. A BIG
                                           primary care providers and their staff within
                                                                                              thank you to all those people who gave their
                                           Counties Manukau.This census will provide
                                                                                              valuable time to be interviewed for this
                                           vital information for planning purposes for the
                                                                                              project.
                                           health workforce needs in the Counties
                                                                                              For queries or feedback on any of the items
                                           Manukau district. It will provide a snapshot of
On Monday 14th March 2005 a group                                                             above please contact Bronwyn Anderson,
                                           the size, demographics, competencies, skill
of 11 people ventured away from the                                                           Project Manager Primary Healthcare
                                           levels and location of employment. It will also
hustle and bustle of Auckland to the                                                          Workforce Development on 09-262 9566 or
                                           inform short, medium and long term
Sea-View safari Camp in Katikati for                                                          at bronwyn.anderson@cmdhb.org.nz.
                                           workforce planning initiatives.
an adult riding adventure. This group      It is vital that all organisations contacted get
was made up of consumers and               involved in this census to assist us all to
support staff from the Intensive           work together to achieve ways
Community Team (ICT). The ICT              to meet our future workforce
supports persons experiencing mental       needs.The final report will be
health issues.                             publicly available (at a top-level
Why horses? The benefits of horse          only and not identifying any
riding have been extensively researched    individual responses). If you
and shown to increase concentration,       would like to participate in this
motivation, promotion of reminiscence      census and have not yet received a
(which is alertness and emotional well     survey please contact Hamish
being). The camp was overnight which       Crooks at 4PM Consulting on 09-
allowed time to relax, play sport, swim,   263 6385 or at
play the guitar and sing in addition to    hamish@4pmgroup.com.
the two hour horse trek.
All group members enjoyed this             GP Locum Scheme
adventure and we worked well as a          GPs have highlighted a locum doctor
team.                                      service as a high priority to allow them
We look forward to planning more           time-out to upskill, take leave, etc. We
adventure based activities.                are currently looking for a locum to help
Many thanks to the CMDHB for               us pilot test this locum doctor scheme
allowing us to make this happen.           around South Auckland. We are looking
                                           to recruit this position by the end of June
Haidee St John                             for a 4-month fixed term contract with
Occupational Therapist ICT Kowhai          CMDHB.




                                                                                                                             J UNE 2 0 0 5 3
Message form the CEO, continued from page 1        A new initiative to give the public greater        successfully in the Waikato district and we
                                                   access to health information is about to go        look forward to making it available for our
rehabilitation for the most severe burn patients
                                                   live. You will soon see the new Webhealth          community.
from across the country as well as continue to
                                                   kiosks around the region in some shopping          In the next issue of Connect, I will review our
provide a regional burn service for the northern
                                                   malls, libraries and other public areas.The        achievements for the 2005/2006 year. All the
region.The Cardiac Catheter Laboratory
                                                   kiosks will give the public access to up to date   best for the coming winter weeks.
modification designs have been completed and
                                                   health information on line. In some areas, there
the first stages of work are underway. I will
                                                   will also be assistance to help people become
update you in the next Connect as work is
                                                   acquainted with the computers and how to use
expected to progress at a rapid rate from here
                                                   them. Webhealth is already running                 Stephen McKernan
on.



ORL summer studentship student                                                                           Healthline
Danuta Young wins Wallath prize                                                                          telephone
                                                                                                         service arrives
                                                                                                         Counties Manukau residents can now
                                                                                                         access free health advice over the phone.
                                                                                                         Healthline, incorporating PlunketLine, is a
                                                                                                         24 hour, toll free service that can be
                                                                                                         accessed from a landline or cellphone.
                                                                                                         The initiative is funded by the Ministry of
                                                                                                         Health, and run by McKesson Ltd in
                                                                                                         partnership with St John and Plunket.
                                                                                                         Healthline is being rolled out across the
                                                                                                         country after a successful pilot
                                                                                                         programme in Canterbury, West/East
                                                                                                         Coast and Northland.
                                                                                                         Calls are answered by Registered nurses
Brian Jones, Auckland Medical Research Foundation; Danuta Young, Medical student and prize               or specially trained Plunket Nurses, who
winner; Associate Professor Wouter-J.F. Ten Cate, Supervisor and ORL Consultant; Associate               can assess a person’s condition, and
Professor Merv Merrilees, Head of School of Anatomy, University of Auckland.                             recommend the best course of action. Self
                                                                                                         care may be recommended or the nurse
ORL consultant Danuta Young is a 4th year          Fiji this July. It is the second time that an
                                                                                                         may direct the caller to their GP, nearest
medical student at the South Auckland              ORL project has won the prize. Henry Kwok
                                                                                                         Accident and Medical, or emergency
School of Medicine. Supervised by Associate        previously won for his project 'Temporal              department.
Professor Wouter ten Cate, Danuta conducted        Bone Resection and QOL" supervised by                 The service means people who are worried
a study on the accuracy of Otomicroscopy in        Professor Randall Morton .                            about health symptoms can get helpful,
the Diagnosis of Paediatric Middle Ear             Many Otolaryngologists rely at least in part on       accurate advice, without necessarily having
Effusions.                                         otomicroscopy to determine the presence of            to make a time to see the doctor. It also
Danuta conducted the project as part of the        fluid within the paediatric middle ear.The aim        provides a valuable service for people who
University of Auckland Research Office             of this study was to determine the accuracy of        live in remote areas who are unsure about
Summer Studentship Programme, with                 otomicroscopy in diagnosing paediatric middle         making the trip to other health services.
funding from the Auckland Medical Research         ear effusions. 67 children receiving                  Healthline general manager, Michelle
foundation.                                        tympanostomy tubes at the Manukau Surgery             Branney says “Healthline is about getting
ORL Consultants Mr. Zahoor Ahmad and               Centre, were included in the study.                   the right care, at the right place at the
Professor Randall Morton, were members of          The findings of the study indicated that              right time.” She also says the service
the research team and Vicki Dixon from the         otomicroscopy can be a highly accurate                offers locations where after-hours services
Audiology Department at MSC was of                 method of diagnosing middle ear effusions in          can be accessed.
invaluable assistance for the data collection.     children. Otomicroscopy was found to be more          Plunketline Chief Executive Paul Baigent
Danuta Young was recently awarded the              accurate compared to tympanometry. Data               says the “Healthline partnership, with its
Faculty of Medical and Health Sciences             indicates that the potential value of                 increased technology and service levels, is
Wallath Prize for the top-scoring summer           otomicroscopy for health professionals                set to become a valued service to family
                                                                                                         members of all ages throughout New
studentship in a clinical discipline for this      dealing with otitis media with effusion, as well
                                                                                                         Zealand”.
project. The study will be presented at the        as for the otitis media with effusion screening
                                                                                                         Healthline, incorporating PlunketLine can
International Meeting of the Australasian          program in New Zealand, should be further
                                                                                                         be accessed on 0800 611 116.
Society of Paediatric Oto-rhino-laryngology in     explored.


4 J UNE 2 0 0 5
Tamaki Oranga is changing                                                                             District
                                                                                                      Strategic
As a service we are changing our approach to       which staff can base their practice with
the way we care for individuals with mental        clients.
illness. We are really excited about the change
                                                   Where is Tamaki Oranga now?
and the difference it is making for clients with
mental illness as well as staff at Tamaki
Oranga.
Tamaki Oranga is a minimally secure
                                                   Tamaki Oranga is halfway through making
                                                   the changes needed to perform inline with the
                                                   MOH Blueprint. Staff are incorporating
                                                   principles of the Recovery model in their
                                                                                                      Plan
inpatient unit with 20-beds for men based in                                                          Phase One (Plan Development) of the
                                                   practice, and we have had success in
Bairds Road Otara. It was established in                                                              District Strategic Plan review for the next
                                                   developing individual and collaborative
1999 after the disestablishment of Villa Six                                                          five years is now complete after three months
                                                   programmes for clients that focus on
at Kingseat with the intention of providing                                                           of consultation with the community and
                                                   community based activities, education, and
long-stay accommodation and rehabilitation                                                            CMDHB stakeholders.
                                                   work.
to men who have experienced long-term                                                                 Over this time Community Liaison Manager
                                                   We’ve forged successful links with community
difficulties with mental illness who could not                                                        Tony Kake, spoke with nearly 500 people,
                                                   based services that provide ongoing opportu-
live well in the community. Currently Tamaki                                                          about issues that Counties Manukau
                                                   nities for clients at Tamaki Oranga. Early
Oranga is undergoing an enormous change,                                                              community’s face, to be taken into consid-
                                                   changes have already resulted in measurable
moving from an extended-care unit to an                                                               eration in the strategic plan.
                                                   outcomes, such as shorter lengths of stay for
intensive recovery focussed unit.                                                                     The following outcomes were determined
                                                   clients.
In 1998 the Ministry of Health (MOH)                                                                  from the feedback:
published the Blueprint for Mental Health.         Where Tamaki Oranga is Heading                     1. Improve society’s response to health need
This was a National Mental Health Service          Our vision is to receive funding and staffing to   2. Improve child and youth health
Development Plan which set out what kinds          support individual programs and community          3. Reduce the incidence and impact of
and what levels of service are required for        activities that enable each client to spend a         priority conditions focusing on:
different groups of people.                        large part of his day out of the centre. It is        • Diabetes
For Tamaki Oranga to meet the MOH                  expected that all clients will spend less then        • Cardiovascular disease
Blueprint guidelines and to provide the best       18-months at Tamaki Oranga before moving              • Chronic respiratory disease
possible service to consumers, we need to          into a less restrictive environment. When             • Cancer
develop a practice based on the principals of      clients leave Tamaki Oranga it is expected            • Mental health
recovery and incorporate these into the            that they would have developed skills to           4. Reduce inequalities in health status
planning for clients. An intensive recovery        enable them to continue to live well with and      5. Improve health sector responsiveness to
approach was identified as been more cost          without the presence of mental illness.               individual and family/whanau need
effective in the long-run in that it reduces       The re-branding of Tamaki Oranga into a            6. Improve the capacity of the health sector
length of stay (LOS) and time spent on             recovery centre is to be road-showed in the           to deliver quality services
waiting lists. Specific training in the recovery   community from July 05. We want to increase        Tony Kake says Phase Two (Consultation)
approach and other areas has been (and             the links Tamaki Oranga has with the               will start mid-July.This will involve wide
continues to be) offered in order to up-skill      community, normalise its presence, what it is      consultation throughout the Counties
staff. With a unit that is staffed 24-hours a      we do, and who our clients are.The road-show       Manukau District through formal presen-
day, you can imagine how difficult this has        will focus on decreasing stigma for clients at     tations, public meetings and media releases.
been. Even with such difficulties, staff have      Tamaki Oranga and de-bunking myths about           It’s hoped consultation will be complete by
managed to undertake training, and a new           the service.                                       the 19th of August where a sub-committee of
framework and language has been provided on                                                           elected representatives will hear submissions.




“Kiwi Life” session
Nau Mai, Haere Mai - New migrants and              The session includes the basic fundamentals        years and still haven’t seen a doctor”. He says
settlers have a new way of getting to know the     and terminology we use in New Zealand,             he talks about all aspects of health, from the
Counties Manukau health system.                    which in most cases, is extremely different to     differences between Eastern and Western
Community Liaison Manager Tony Kake, hosts         a migrants home country.                           medicine, to how New Zealanders’ pay for
a monthly session at Highland Park                 Things we take for granted like, what is a GP,     their healthcare.
Community House, to give an overview of the        a PHO or the number to call for emergency          The “Kiwi Life” session aims to make new
health system and answer people’s questions.       services, can all be very foreign to some          settlers comfortable and aware of the services
Tony Kake says “it’s all part of the               migrants.                                          we offer, and present the options available to
orientation service available to new migrants”     Tony Kake says “some people who attend the         them.
to acquaint them with life in New Zealand.         session have been in the country for three


                                                                                                                                      J UNE 2 0 0 5 5
Exciting new equipment for opthalmolgy service
                                                                               invasive. It is repeatable and can document improvement and deterio-
                                                                               ration in the eye, which often saves the need for repeated Fluorescein
                                                                               procedures.
                                                                               Now that the Manukau SuperClinic has an OCT and a state of the art
                                                                               digital fluoresein angiography camera, it lacks nothing in its ability to
                                                                               provide world class medical retina service. It also makes the CMDHB
                                                                               Ophthalmology department very attractive as a centre for medical
                                                                               retina, both to potential retina specialists and to industry looking for
                                                                               cooperative research trial sites“.
                                                                               This is particularly important and timely as the department is currently
                                                                               in the process of recruiting a medical retina Ophthalmologist.
                                                                               Vic Middlemiss - Ophthalmology Service Manager




The Ophthalmology department at Manukau SuperClinic is very
pleased to announce the arrival of a new item of diagnostic equipment.
We have recently acquired an Optical Coherence Tomography (OCT)
apparatus.This has been generously donated by The Southern Trust via
the South Auckland Health Foundation and follows on from the Trust’s            OCT image of a normal retina
sponsorship of a digital eye camera in November 2004.
CMDHB Ophthalmologist Mark Donaldson explains the importance of
acquiring this equipment and outlines what it does.
“The OCT has become an extremely important diagnostic tool for
medical retina over the last 2-3 years. It uses a laser technique to build
a cross-sectional image of the retina.This shows the 12 cellular layers
and provides for accurate measurement.
The images generated from this device give much more detail than can
be gained clinically and supplement Fluorescein Angiography to a great
                                                                                OCT image of a detached retina
extent.The OCT doesn’t require a dye injection and is completely non-




Respiratory medication review clinic
The Respiratory Medication Review Clinic is a         containing current medical and medication          rehabilitation programme were identified as a
new service development at Middlemore                 history, drug related problems and recommen-       motivated group who would benefit from the
hospital based on the principles of pharma-           dations.The report is peer-reviewed before it’s    service. We have extended our service to
ceutical care. In 2002, a medication review           sent to the patient’s general practitioner (GP)    accept referrals from other health profes-
clinic was piloted in the dialysis centre at          and community pharmacist.The report is also        sionals involved in the care of respiratory
Middlemore hospital.The positive outcomes             entered into Soprano medical documents on          patients.
from this pilot encouraged us to further              Concerto.                                          Currently, eighteen patients have been
evaluate the effectiveness of this service for        In order to use data from the reviews for          reviewed with positive feedback from patients
other patient populations with chronic                research into the improvement and                  and GPs. A minimum of fifty patients are
diseases. Patients with chronic respiratory           development of the clinical pharmacy service,      required for the results of this clinic to be
conditions, such as asthma and chronic                written consent is obtained from the patient at    published.
obstructive pulmonary disease, often present          the start of the review process. Patient and       Referrals can be made on the standard
with other co-morbidities and take multiple           GP surveys are also conducted for this             referral form, and sent via fax or internal
medications.                                          purpose.                                           mail.
                                                                                                         Please send referrals to:
The Review Process                                    The Referral Process
                                                                                                         Judith Ling / Rajesh Babu
The reviews aim to identify drug related              At present, the majority of patients are
                                                                                                         Pharmacist, Medicines Information
problems, provide medication education to             referred to the Respiratory Medication Review
                                                                                                         Middlemore Hospital
patients, update medication profiles and liaise       Clinic by the Pulmonary Rehabilitation
                                                                                                         Email: JLing@middlemore.co.nz
with primary care providers.The pharmacist            programme co-ordinator, Lorraine Forbes-
                                                                                                         Rajesh.Babu@middlemore.co.nz
conducting the review generates a report              Faulkner. Patients attending the pulmonary
                                                                                                         Internal fax: 8057


6 J UNE 2 0 0 5
Counties dietitians celebrate
and plan at the gardens
Twenty three CMDHB dietitians recently           Vivian Tompson and Franica Yovich, began a          An important part of the team day involved
enjoyed a team day in the delightful             needs assessment in the primary health care         planning for next year. From an original list
surrounds of the Botanic Gardens, reflecting     setting.This exciting initiative aims to develop    of over 50 projects submitted, a theme of
on highlights from the past year.                a programme to “train the trainers” in              safe practice emerged. Groups of dietitians
Renal dietitians have developed new large-       obesity management.                                 worked together to identify standards of care
print meal guidelines to improve patient         As a team, dietitians received training and         that will be a priority for updating in the
understanding of their dietary needs. Bahee      engaged in Professional Supervision for the         coming year.
Manickavasagar has adjusted recipes              first time. With the enacting of the HPCA           Not all of the day was hard work.Team
provided by Pacific Island patients so that      Act in September, our continuing competency         building games and eating delicious food were
they meet dietary needs for chronic kidney       programme became compulsory.This                    also on the programme, the latter being
disease. Once photography is complete, the       energised us to document our professional           particularly important for dietitians!
long awaited renal cookbook will be a reality.   development activities and develop portfolios.
Diabetes dietitian Lynne Ferguson has            It has been a big year!
arranged for food photographs to be printed
for patients who learn best visually. Patient
education material was also prepared in the
eleven main languages spoken by our
Counties Manukau community.
Trisha McCord, dietetic assistant, joined our
dietitians working with adults in Home
Healthcare. We developed this new role in
response to difficulties in dietitian
recruitment.The role, together with
development of best practice caseload
management by dietitian Sandra van Lill, is
enabling more effective patient intervention
and monitoring.
A return to work programme has seen our
community paediatric dietitians involved in
the re-training of Catherine Wheeler,
returning after a number of years raising a
family.This is a particularly important
initiative given our difficulty in recruiting
experienced paediatric dietitians.
This year two public health nutritionists,


New HRC Grant for DHB researchers
A multidisciplinary research programme, led      with 10-15% of these patients developing           and intense scrutiny by specialised assessing
by Dr Pamela Melding of the Mental Health        unanticipated cognitive problems post-             committees.
Services for Older People at Waitemata DHB       operatively that could be permanent.This 3-        Those taking part in the project include Dr
has received a grant of $721,000 from the        year study addresses a major health issue for      Pamela Melding, Dr Francois Stapelberg, Ms
Health Research Council of NZ.The grant will     older people. By identifying patients most at      Snezana Mitrovic-Tosovic, Dr Richard
be used to investigate the incidence and risk    risk for POCD, future patients may be better       Worrall, Professor Rocco Pitto, Associate
factors for postoperative cognitive decline      informed and anaesthetic or surgical               Professor Paul Merrick, Mrs Joanna Stewart,
(POCD) in older New Zealanders having            techniques may be modified to reduce any           Professor Keith Wesnes.
elective joint replacement surgery.The study     risk.                                              (Mental Health Services for Older People,
will be conducted at Counties Manukau DHB        The HRC received 250 applications in its           Centre for Clinical Research & effective
and managed through the Centre for Clinical      annual project round and awarded a total of        practice.)
Research and effective practice (CCRep).         75 contracts.These were chosen in a two-step       Project Title: Post operative cognitive decline
Up to eight thousand older patients have         process involving local and overseas expert        in New Zealand: what are the risks?
elective joint replacement surgery every year,   referees who work in the same research area,


                                                                                                                                    J UNE 2 0 0 5 7
CMDHB supports the Body
Odyssey Health Festival
Webhealth Launch                                  Maraerobics
www.webhealth.co.nz                               The DHB also supported a “Maraerobics”
The new Counties Manukau Webhealth                event during the health festival- Maraerobics,
website was launched on the 26th of May,          being aerobics instructed mainly in Maori.
and to celebrate, there were performances         The idea of the event was to promote
from Dawn Raid Entertainment, Nathan King         physical activity in a fun way. Around 2000
(lead singer of Zed) and reggae band Three        tamariki/children attended but they weren’t
Houses Down.                                      the only ones in on the action- health board
Webhealth has been specifically developed to      members Pat Snedden, Paul Cressey and
provide another avenue of access for people       Manukau Mayor Sir Barry Curtis also got
to connect with Health and Social Services.       involved.
Community Liaison Manager Tony Kake says                                                           CMDHB staff on the recruitment drive!
                                                  Health Careers Expo
“there are around 1,000 organisations             The Body Odyssey Exhibition triggered
already linked to the Webhealth website, and      CMDHB and Manukau City Council to use
were encouraging more to register”.               the event to highlight health directions,
Mr Kake says the website gives people an          activities, issues and progress in the region.
opportunity to find health or social service      The Health Careers expo at the TelstraClear
organisations that are specific to their needs.   Pacific Events Centre went ahead on
The website gives people information about        Saturday the 28th of May, with CMDHB
various services available in Counties            staff out in force to get young people excited
Manukau, any costs associated with the            about a career in the health industry.
service, any cultural specific services, or       There were around 15 stalls featuring
location.                                         different organisations, with various
For more information visit the website or call    educational institutions represented to show
0800 WEBHEALTH.                                   the health-sector courses they have on offer.

                                                                                                   Body Odyssey – a great
  Women’s Sexual Health                                                                            learning experience
                                                                                                   For a patient, understanding how the body
                                                                                                   works is an integral part of managing self care,

  integration project                                                                              and for children with chronic illness, an
                                                                                                   excellent way of developing coping strategies.
                                                                                                   This understanding took on a new dimension for
   The Women’s Sexual Health project has          include primary, school health, at-risk          a group of seven young patients in the Kidz
   commenced as part of the overall Sexual        young, and Maori and Pacific youth.The           First hospital, when they visited the Body
   Health plan for the CMDHB.                     Women's Sexual Health integration project        Odyssey exhibition at the Telstra Clear Pacific
   The women's sexual health integration          is sponsored by Nettie Knetsch (GM               Events Centre.
   workstream was identified in response to       Women's and Kidz First) and Keith                The young people visited during the exhibitions
   the need to address a number of issues- the    Allenby (Clinical Director of Women's            ‘Teen week’.They were supported by nursing
   increasing incidence of sexually transmitted   Health).                                         and hospital play specialist staff as they took in
   infection, abortion rates in the Auckland      Manager of the project Lesley Powell, is         the larger than life models of the body and
   region and increase in teenage pregnancy       currently consulting with stakeholders to        explored its functions.
   rates. The project will explore ways of        identify possible gaps in service delivery.      Hospital Play Specialist Carol Bolton says “the
   delivering to more woman, culturally           The project will identify recommendations        computer programmes were brilliant tools for
   appropriate services which are accessible      and propose pilot models of care for             understanding the special functions of our
   to improve the uptake of sexual health         implementation in early 2006.                    bodies and the self care required.” She says
   assessment, screening and contraceptive        If you have any feedback or would like to        “it was a special way for the young people to
   usage.                                         know more about the projects aims, please        gain further essential knowledge that they
   Gilli Sinclair is overseeing the various       contact Lesley Powell. 09) 2760044 ext           require, so they can manage the challenges of
   sexual health plan workstreams, which          2852.                                            chronic illness and in doing so, work towards
                                                                                                   meeting their optimum development in life.”

8 J UNE 2 0 0 5
                                            National Burn Centre
                                                     the National Burn Centre.
Sophie gets a                                        “What you’re about to build here is far better
                                                                                                      National Burn Centre
Middlemore                                           than where Sophie was treated in Australia. I    receives a Lions share
                                                     encourage all New Zealanders to get behind
welcome                                              this wonderful facility,” he says.               of support
                                                     Sophie’s visit to Middlemore was featured on     People normally expect to receive birthday
Remarkable burn survivor Sophie Delezio paid
                                                     ‘Close Up’ with the public generously            gifts, but Lions clubs around the country were
a special visit to Middlemore Hospital in May
                                                     responding with donations for the Centre.        happy to give to a worthy cause on their 50th
to show her support for the planned National
Burn Centre.                                                                                          birthday.
Accompanied by her parents Ron and Carolyn           Burns breakthrough                               The Lions, who have been raising funds for a
                                                                                                      high-dependency unit in the planned National
and brother Mitchell, 4-year-old Sophie toured
the site of the new facility and laid her stake      beckons                                          Burn Centre, presented a $300,000 cheque to
on what will be known as ‘Sophie’s room’.                                                             the South Auckland Health Foundation at
                                                     The plans are complete and building is about
The young girl was injured in a horrific                                                              their 50th anniversary celebrations in April.
                                                     to begin but the South Auckland Health
accident in December 2003 when a car                                                                  Foundation executive director, Pam
                                                     Foundation still needs support for the
careered through the wall of her Sydney-                                                              Tregonning, was thrilled to accept the
                                                     National Burn Centre.
based childcare centre.                                                                               donation for the high-dependency unit which
                                                     The Foundation is $200,000 short of its $1.5
With full thickness burns to 90-percent of her                                                        caters for critically ill patients.
                                                     million fundraising target for New Zealand’s
body Sophie’s chances of survival were slim                                                           “This is an outstanding achievement and we
                                                     dedicated burn treatment facility.
but in what has been hailed a medical miracle,                                                        are delighted with their contribution,” she
                                                     Plastic and burn surgeon and clinical leader
the young girl lived.                                                                                 says.
                                                     of the Centre, Stephen Mills, is urging the
Sophie’s parents shared their phenomenal                                                              All ten Lions districts across New Zealand
                                                     public to contribute.
story with the New Zealand public on TV1’s                                                            supported the project with the Auckland,
                                                     “It’s going to be a wonderful new facility
then ‘Holmes Show’ last year, raising an                                                              Waikato and Bay of Plenty districts adopting
                                                     which will help us provide optimum care for
amazing $230,000 for the National Burn                                                                it as their major fundraiser.
                                                     our country’s most severe burn sufferers. But
Centre.                                                                                               Mike Smith, Lions District Governor for the
                                                     we still need more support - please help our
The funds will support a paediatric room in                                                           Waikato region, says it is an excellent example
                                                     patients by making a donation,” he says.
the new facility where children like Sophie will                                                      of a national collective effort bringing about
                                                     For more information about the fundraising
be treated.                                                                                           results for a good cause.
                                                     campaign contact the Foundation office on
Ron Delezio says they were thrilled to visit                                                          “It’s wonderful that Lions could present such
                                                     270 8808, ext 8400 or visit www.burn.org.nz
and blown away by the outstanding plans for                                                           a superb gift on their own birthday!” he says.
                                                     A burn could happen at any time to any of us.




                                                                              The National Burn Centre fundraising tally leaps ahead with a
                                                                              $300,000 donation from New Zealand’s Lions Clubs. Executive
                                                                              director of the South Auckland Health Foundation, Pam Tregonning,
Sophie and Mitchell Delezio are full of smiles during their visit to          accepts the cheque from Lions Club representatives Philip Wyatt and
Middlemore Hospital.                                                          Geoff March. Photo courtesy of the Manukau Courier.


                                                                                                                                      J UNE 2 0 0 5 9
Fire protection
company rally to
support burn
centre
Fighting fire and limiting fire damage to
buildings and homes is a job Wormald takes
very seriously.
But while buildings can be repaired with
relative ease, often the damage to people by
fire has more lasting effects.
To help ease the pain of serious burns
Wormald staff are supporting the National        Kidz First Neonatal Intensive Care Unit is another incubator better off thanks to the support of
Burn Centre fundraising campaign.                the Yi Jin Cantonese Opera group. Pictured from left are members Helen Wu, Elaine Leung, Kin
The company presented a $10,000 cheque to        Yip and Grace Kan. Photo courtesy of Howick & Pakuranga Times.
the South Auckland Health Foundation in
                                                                                                   by the Langham Hotel, Auckland.
May and say this is just the beginning of its
money-raising efforts.
                                                 Singing the way to                                The leadership category was one of six
Sean Aucamp, Wormald marketing                   fundraising success                               awards presented in the 2005 Counties
                                                                                                   Manukau District Health Board's Leadership
coordinator, says they are supporting the
                                                 Local and international opera singers joined      Nurse Awards staged at Middlemore Hospital
National Burn Centre because a burn could
                                                 together to stage a concert in support of our     in May.
happen at any time to any one of us.
                                                 most fragile newborns.                            Ms Stickland, who is the district health
“Our main aim in raising this money was to
                                                 The Yi Jin Cantonese Opera, held in March,        board’s clinical nurse educator for emergency
aid in the treatment of burns patients and to
                                                 was an outstanding success raising $35,000        care, says she is delighted and honoured by
promote fire safety awareness,” he says.
                                                 for the Kidz First Neonatal Intensive Care        the win.
                                                 Unit.                                             “It was a surprise to be nominated and an
                                                 The funds will be used to purchase an             even bigger surprise to win,” she says.
                                                 incubator for the new facility which is due to    “When you go through your nursing training
                                                 open later this year.                             and working career, you see other deserving
                                                 The fourth annual opera event – and the           people being honoured and think it would be
                                                 second in support of Kidz First – was the         nice to be like them. It seems my turn has
                                                 biggest yet attracting 700 people.                come and it is really lovely to be recognised.
                                                 South Auckland Health Foundation executive        Now I’m looking forward to staying at the
                                                 director, Pam Tregonning, was among the           Langham Hotel, Auckland with my partner
                                                 guests on the evening and says it was a           and taking in a show – without our three
                                                 magnificent show.                                 kids!”
                                                 “It really was an elaborate performance with      Ms Stickland started nursing in 1976 and
                                                 some amazing artists performing.The               later moved into her current work area –
                                                 resulting donation is fantastic and we’re very    nursing education.
                                                 thankful for the group’s support,” she says.      “Anyone coming to work in the hospital’s
                                                                                                   emergency department gets an orientation
                                                 Nurse wins luxury                                 programme which I oversee but I am also
                                                                                                   involved in professional development and on-
                                                 break at Langham                                  floor training,” she explains.
                                                                                                   Middlemore Hospital’s acting clinical nurse
South Auckland Health Foundation Community       Hotel, Auckland                                   director,Tracey Mitchell says this year’s
Relations Officer, Nicki Winn, is delighted to   Middlemore Hospital’s Janice Stickland is         leadership awards attracted 116 nominations
receive a $10,000 donation from the General                                                        in total.
                                                 looking forward to putting her feet up in style
Manager of Wormald NZ, Keith Blind.                                                                “Janice won the Langham Hotel, Auckland
                                                 after winning a leadership award sponsored


1 0 J UNE 2 0 0 5
leadership award in recognition of her
excellence in daily practice and for being
someone that makes a difference. She is a
                                                 Easter treat                                   FreshED
very deserving winner who maintains dignity      from Buddle
and respect for patients, families and fellow
staff members at all times. Janice leads the
team exceptionally democratically and is a
                                                 Findlay                                        Pacific
mentor to many.”
Ms Stickland’s prize – a Five Star Fling
package in an Executive Room - was
                                                                                                and
presented to her on behalf of the Langham
Hotel, Auckland by the hotel’s business
development manager, marketing communi-
                                                                                                Maori
cations, Amanda Drummond.
                                                                                                Youth
                                                                                                Education
                                                                                                Festival
                                                                                                8-9 July 2005
                                                                                                TelstraClear Pacific
                                                                                                Events Centre,
                                                                                                Great South Road,
                                                                                                Manukau City
Langham Hotel, Auckland leadership award                                                        You may be aware that along with current
recipient Janice Stickland (centre) with the                                                    workforce shortages in the health sector,
hotel’s business development manager, marketing                                                 there are predictions of a critical shortage
communications, Amanda Drummond and                                                             of health workers in the future. The
Counties Manukau District Health Board’s                                                        upcoming FreshED festival is a great
director of nursing, Dale Oliff (right).        Nine-year-old Julieana Poto-Tangata enjoys      opportunity to talk to our potential future
                                                a visit from the Easter Bunny during her stay   workforce about the range of health
                                                at Kidz First. Julieana was one of many         careers available and what working in
                                                patients to take part in Easter activities      health is really like.
                                                hosted by staff of the Auckland office of law
                                                                                                Described as "cool, sassy & refreshing",
                                                firm Buddle Findlay. The firm’s Child
                                                                                                FreshED will have more than 6,000 6th &
                                                Health Foundation has also donated $15,000
                                                                                                7th form students attending over the two
                                                for a BRM 2 monitor for the hospital’s
                                                Neonatal Intensive Care Unit.                   days. CMDHB will be holding several
                                                                                                health careers workshops and a stall and
                                                                                                we are looking for health workers and
                                                                                                tertiary students who relate well to youth

 Winter woollies wanted                                                                         to come along and talk to the school
                                                                                                students about what they do.
                                                                                                If you are interested or know of someone
 The winter nip is in the air which means it’s   the benefit of Counties Manukau children       who might be we would love to hear from
 time to stay warm.                              up to the age of two. But we need more so      you. The more the better, and it is a great
 And what better way to do so than to stoke      please get those needles moving.               opportunity to reach this audience in a
 up the fire, pour a cuppa and get knitting!     Deliver your knitted goodies to the            setting that is fun and interactive. You
 The South Auckland Health Foundation is         Foundation’s community relations officer       might also catch some of the free live
 seeking new knitted or crocheted goods to       Nicki Winn - Support Building 30, level 2,     entertainment such as brotown on stage!
 help boost the stocks of its wool               Rm 237.                                        For more information on the festival check
 programme through the winter months.            To find out more about the Foundation’s        out www.freshed.co.nz
 Already more than 200 volunteers donate         wool programme please contact Nicki – Ph       If you would like to help or can suggest
 beautifully knitted clothes and blankets for    270 8808 or ext 2074.                          someone else who can please contact
                                                                                                Bronwyn Anderson or Akesa Burling.


                                                                                                                             J UNE 2 0 0 5 1 1
Kiaora kotou and a belated greetings                                                               New Starters,
to the six new midwifery graduates                                                                 Appointments,
                                                                                                   Farewells
                                                                                                   Human Resources: Farewell to Tess
                                                                                                   Richardson who has resigned from her role as
                                                                                                   RMO Consultant at CMDHB to take up a
                                                                                                   new opportunity with Contract Negotiation
                                                                                                   Services (CNS). Tess has made a
                                                                                                   tremendous contribution to CMDHB during
                                                                                                   her time here.Tess will be leaving on Friday
                                                                                                   15th July, and we wish her well for the future.
                                                                                                   Delivery Suite It is with great delight that
                                                                                                   the Women's Health Management Team
                                                                                                   welcomes Melissa Brown to the role of
                                                                                                   Delivery Suite Midwife Manager. Melissa
                                                                                                   brings a wealth of experience from across the
                                                                                                   Tasman and will be an asset to the service.
                                                                                                   Intensive Care Medicine A warm
                                                                                                   welcome to Catherine Simpson, who has been
Rebecca McGinty, Sarah MacDonald, Megan Penrose, Amelia Ofahengaue, Heather Tennent,               appointed to the position of Clinical Head of
Annabel Pepler (absent).                                                                           the Department of Intensive Care Medicine.
                                                                                                   Catherine is well known within CMDHB
The Women’s Health service historically opens two
                                                                                                   having been a Specialist in both Emergency
intakes throughout the year for a structured one year
                                                                                                   Care and Intensive Care and we are very
midwifery new graduate programme.This twelve                                                       fortunate that she is keen to progress into this
month commitment offers the opportunity of                                                         role.
consistent senior support and consolidation and                                                    This position has previously been very ably
development of practice and confidence.                                                            filled by Tony Williams who is now ready to
Counties Manukau is a dynamic and hectic                                                           “hand over the reins" and to devote more of
environment for a new midwife, witnessing and                                                      his time to research.Thank you to Tony for his
supporting pregnancies and arrivals of approximately                                               contribution over the past few years as
7,000 babies annually, with approximately 1,000 of                                                 Clinical Head.
these birthed in community units. Counties Manukau                                                 Ward 19 Farewell to Anne Nicholson who
provides the exciting prospect of providing Lead                                                   has moved to MSC-Recovery, Sharon Kumar
Maternity Care to over 52 percent of primary care        At one of the three compulsory “Update    who is moving back to Australia, and Andrew
women, one of the highest in a New Zealand facility.     Days” for Midwifery New Graduates.        Gilhooly, who is transferring to ICU. Ward 19
                                                         Heather Tennent and Megan Penrose         would like to thank all 3 staff for their hard
This prospect allows new midwives to genuinely work
                                                         mastering the practice of managing        work.They will be missed and we wish them
in collaborative partnership with the women and
                                                         shoulder dystocia at birth, under the     all the best.
whanau of our communities and provide midwifery          guidance of Delivery Suite Charge         CCP Update: Competent: Mohini Lal.
led care, with an emphasis on ensuring an opportunity    Midwife Betty McGregor.                   Advanced Beginner: Melanie Olliff.
for a ‘normal’ child birthing experience.
All new graduate midwives are given the fortune of
                                                                                                   Tamaki Oranga Ronnie Kirkwood is a new
                                                                                                   starter for Tamaki Oranga, in a newly
experiencing an unbending five to six month
                                                                                                   established position as OT assistant.
experience in our hectic delivery suite, three to four                                             Manukau Surgery Centre Farewell and
months in the high risk/antenatal ward and a three                                                 best wishes to Moira Jones, and Michelle
month placement in either a postnatal ward or                                                      Meyer who is going to England for her big
community unit.This rotation allows thorough consol-                                               OE. Welcome to Anne Nicholson from Ward
idation of the whole spectrum of the childbirth                                                    19 and Lilly Beth Que who has transferred
experience and the relevant practice, skills and                                                   from MSC2.
knowledge required.                                                                                Felicity Noble has achieved competent level in
Congratulations to these six midwives on their                                                     CCP, Congratulations to Eva Squire who had
successful appointment to these sought after positions                                             a beautiful baby boy Bobby born on 7th May.
and commend them on their choice of employment                                                     Burns Unit Welcome to Linda Jackson, who
and career path. Counties Manukau is a dynamic and                                                 comes on board as the new CNE for Plastic
                                                         And Sarah MacDonald and Heather
colourful community which brings significant                                                       Surgery and Burns. Linda comes to us with a
                                                         Tennent demonstrating their skills with
                                                                                                   wealth of experience and we look forward to
challenges and accompanying professional rewards.        shoulder dystocia scenarios, following
                                                                                                   having her as part of the team.
Best Wishes to you all and ‘welcome’.                    Betty’s presentation.

				
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