CEO Award

Fit for the Future | Watch the video(external link)

When people look for help regarding their wellbeing, it should be both easy and accessible. They shouldn’t need to go to unfamiliar places, or have to wait for an appointment with someone that speaks to them in clinical terms and jargon.

Fit for the future aims to eliminate these challenges. As a project it brings together people and resources that can provide support, and ensure that there is a connection to the local community, services are easy to navigate, doctors speak in every day terms and in a language understood by the general population and there is support for our community’s social and mental health needs.

This targeted assistance ultimately enhances the patient experience, and allows the medical practitioners to provide the best possible level of care, through an increased level of mutual understanding.

Feedback from both staff and patients has been overwhelmingly positive, and in addition the improved access, reach and overall effectiveness, has created opportunities for significant cost savings.

Team: Camille Gheerbrant, Anna Newton, Brendan Short, Sarah Appleton-Dyer, Sarah Andrews Trish Palmer, Ruth Williams, Johnny O'Connell, Sue Hallwright, David Codyre, Raewyn Allan, Anne Bateman, Jill Moffat, Jane Petraska, Bev Monahan, River Paton, Karla Bergquist, Kristin Good

photo of the fit for the future project team

Finalists:

Kāinga Ora Healthy Homes: Home is where your heart is: Nicky Cranshaw and team Watch the video(external link)

Connecting and supporting patients with SCAD and takutsabo syndrome: Cathy Gasparini and team  | Watch the video(external link)

Excellence in Clinical Care

Valuing the time of our live kidney donors Watch the video(external link)

When people agree to become a kidney donor they were admitted to hospital the day prior to surgery. After talking to some of our donors, they said they didn’t feel valued, they felt they spent excessive time waiting and they had a poor night’s sleep before surgery.  They also didn’t like being away from whānau, and felt that they were taking up a hospital bed that they thought was needed for a sick patient.

The transplant team wanted to deliver a better patient experience so introduced day of admission surgery for kidney donors. This has led to a decrease in admission to theatre from an average of about 21 hours to just under two hours. All donors have said this has been a positive experience for them and they definitely prefer this rather than being admitted the day prior to surgery.

This project is a great example of delivering on our values with live kidney donors, enhancing their experience with the added bonus of improving the way we use Auckland DHB clinical resources.

Team: Karyn Lowe, Paul Manley, Ian Dittmer, Helen Pilmore, Michael Collins, Stephen Munn, Helen Whitehouse, Ann Rudolph, Karen Lovelock, Carl MuthuKumaraswamy, Peter Johnston, Sanjay Pandanaboyana, Martin Misur

photo of valuing the time of our live kidney donors project team

Finalists:

Orthopaedic patients getting the right care sooner: Desiree McCracken and team Watch the video(external link)

Reducing surgical site infections: John Boy Jerry Csapo-Camu and team Watch the video(external link)

Optimising Acute Patient Workflow in Emergency CT: Charlotte Cooper and team Watch the video(external link)

Excellence in Research

Intrauterine insemination: a pragmatic randomised controlled trial Watch the video(external link)

This is the first clinical trial of intrauterine insemination (IUI) with clomiphene citrate to show benefit when compared to expectant management. Two previous studies did not show benefit as they either did not use ovarian stimulation or did not include women who were truly infertile.

Women allocated to three cycles of IUI had more births than those allocated to expectant management (31 of 101 [31%] vs. 9 of 100 [9%], P = 0.0003; RR, 3·41; 95% CI, 1·71 to 6·79). There were two sets of twins, both in the IUI group. The number of women who would need to have three cycles of IUI to result in one additional live birth is five.

These results offer hope to couples trying to conceive as IUI is a simpler treatment than IVF. We hope to show in the future that three cycles of IUI is similar to one completed cycle of IVF.

Team: Professor Cindy Farquhar, Dr Emily Liu, Sarah Armstrong, Nicola Arroll, Sarah Lensen, Julie Brown

photo of intrauterine insemination project team

Finalist:

Is it Necessary to Fast Before Cardiac Catheterisation? Sheila Bacus and team Watch the video(external link)

Excellence in Process and Systems Improvement

Improving the care of cellulitis Watch the video(external link)

Cellulitis (an acute spreading infection of the skin and tissue) places heavy demands on both clinical resources and patient time. In 2016, Cellulitis ranked second on the list of causes of avoidable hospitalisation for Auckland DHB.  Data suggested (amongst other changes) that if processes across the wards were more streamlined, with only those admitted who couldn’t be administered IV antibiotics in another setting, this would free up both bed space and patient time.

In December 2016 a three day ‘Rapid Improvement Event’ (RIE) brought together key stakeholders from all disciplines, to work on accelerating and implementing changes to the way Cellulitis is managed at Auckland DHB.

Collectively, the RIE team and their process changes resulted in: reduced hospital stay time for patients, significant cost avoidance of more than $800,000 annually, a 12% reduction in patients admitted to the wards, and a significant reduction in the use of IV antibiotics. An independent study by The University of Auckland was also carried out confirming these results.

On-going improvement processes are also in place to continue to review any more complex pathways, ensuring sustained accountability under the medical directorate Management Operating System Process (MOS).

Team: Paul Birch, Dr Stephen Ritchie, Dr Rupert Handy, Bret Vykopal, Julie Hislop, Karen Schimanski, Dr Helen Liley, Dr Jim Kriechbaum, Eamon Duffy, Dr Michael Puttick, Dr Sarah Bell, Dr Gregory Wiggill

photo of improving the care of cellultis project team

Finalists:

Releasing Time to Care: Michelle Knox and team Watch the video(external link)

High Tech Imaging Client Centric Design Initiative in Primary Care: Alexandra Smart and team Watch the video(external link)

Best practice can work! A team approach to discharge planning: Andrew Jones and team Watch the video(external link)

Excellence in Community Health and Wellbeing

Multidisciplinary Diabetic Foot Service Watch the video(external link)

Diabetic foot ulcers are complex wounds that have a major long-term impact on the quality of a patient’s life. Ten out of every 100 people with diabetes will develop a foot ulcer sometime during their lifetime. A multi-disciplinary approach is shown to be effective in saving limbs and reducing the rate of major amputations.

A multidisciplinary diabetic foot clinic including a vascular surgeon, a registrar, nurse specialist, diabetes registrar, orthotist and podiatrist was established to ensure gold standard treatment of patients with foot ulcers. Since the clinic was introduced, the number of admissions and outpatient appointments to heal wounds has reduced.

Major limb amputation has reduced from 27 per cent to 3 per cent, while wound healing rates have increased from 69 per cent to 90 per cent.  This is has led to a big improvement in patient outcomes and has also reduced costs to the health system.

Team: Alicia Sutton, Venu Bhamidi, Michelle Garrett, Alexandra Noble-Beasley, Kara Hamilton, Shraddha Rasal, Sue Perrin, Andrea Connell, Steve York

photo of diabetic service project team

Finalists:

Kāinga Ora Healthy Homes: Home is where your heart is: Nicky Cranshaw and team Watch the video(external link)

Increasing Community Immunity: Jean McQueen and team Watch the video(external link)

Orthopaedic patients getting the right care sooner: Desiree McCracken and team Watch the video(external link)

Excellence in the Workplace

Releasing Time to Care Watch the video(external link)

In 2009, nurses were spending approximately 35 per cent of their time with patients. The remainder was spent on non-direct care activities, e.g. administration and searching for equipment. This had the potential to lead to sub-optimal care, reduced patient experience and lower employee satisfaction. Releasing Time to Care was introduced to help deliver better quality of care for patients, improving both the patient and employee experience.

In 2018, the average direct care time is 58 per cent, with 51 wards and services on the programme. Overall there has been a 23 per cent increase in direct care - that equates to 175,000 additional hours spent with patients over a year. 

Releasing Time to Care has also enabled us to give patients, whānau and staff a voice on how they want to be taken care of and how we can make Auckland DHB a better place to work.

Team: Margaret Dotchin, Michelle Knox, Michelle Griffen, Erin Ward, Abbi Harwood-Tobin

photo of releasing time to care team

To Thrive Watch the video(external link)

Auckland DHB’s TO THRIVE programme is a series of initiatives specifically targeted to support our lower income employees to:

  • Maximise their income through access to job specific training, financial capability education and career pathways within Auckland DHB.
  • Improve their health and wellbeing through access to a number of free initiatives, including health checks and by enhancing working conditions.

The programme is unique to Auckland DHB and sets up apart from other employers. The programme aims to increase employee satisfaction, engagement and improve workplace culture. TO THRIVE directly contributes to Auckland DHB’s vision of healthy communities, addressing within our own workplace the link between alleviating poverty and improving health.

Team: Alex Pimm, Melissa Russek, Anita Jordan, Sue Turk, Rama Narayan, Adele Thomas, Dinesh Sundararaj, Alberto Lenzi, Neil Browne, Maxine Stead

photo of to thrive team

Finalists:

Joy at Work: Harshna Mistry and team Watch the video(external link)

askHR: Ash Ford and team Watch the video(external link)

Individual Living our Values Award

Jan Curtis, Therapy Assistant

Jan works as a Therapy Assistant in the Musculoskeletal Team. She is the glue that holds the outpatient physiotherapy team together. She is quiet and unassuming but gets things done. Jan is very inclusive, and makes everyone she meets feel special and valued. 

Knowing that Jan is around and willing to go the extra mile, makes it a lot easier for the team. She is quick to identify when things aren’t going well and makes sure any issues are escalated appropriately; always a ready and able shoulder, for staff to use if needed. 

Jan is a key part of the knee replacement class. She knows all the patients who attend and is encouraging, genuinely caring about how they are doing.  A patient recently recognised Jan for her warmth and professionalism, and fondly referred to the team there as ‘Jan’s gang’. 

Finalists:

Emmeline Croft, Community Engagement Advisor SafeKids Aotearoa

Michelle Knox, Nursing Performance Improvement Team

Rosie Banbury, Cleaner

Team Living our Values Award

Living our values with Turehou Māori Wardens Ki Otara Trust

An approach by Turehou Māori Wardens Ki Otara Trust saw them partner with Auckland Regional Public Health’s (ARPHs) on alcohol work— the partnership a reflection of ARPHS respect of the Wardens as Treaty partners.

The partnership sees the Wardens providing Maori cultural insight regarding potential neighbourhood impact and equity, including geographically pin pointing areas as priorities for alcohol-harm related work and compliance.

The valued partnership means consultation with the Wardens is now a mandatory part of ARPHS Alcohol regulatory Protocol. Equally, ARPHS has helped to establish the Warden’s credibility as an important voice with the District Licensing Committee (DLC).

The partnership sees the two organisations effectively sharing information, including the Warden’s review of ARPHS strategy and policy from an equity viewpoint.

ARPHS is supporting the Trust in a number of ways to reduce inequities, particularly through helping to build community capability. One example is ARPHS support in developing the Warden’s skills in evidence collection and presentation— a necessary skill for opposing proposed licencing by the DLC,  and supporting the Wardens’ Te Tiriti claims.

The Ministry of Health has said this is possibly the first partnership and development model of its kind in New Zealand.

photo of living our values with Turehou Māori Wardens Ki Otara Trust team

Finalists:

Recruitment Team

Regional Youth Forensics

District Nursing- Maungarei locality

Orthoptist