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Welcome to the fifth edition of the Southern DHB Bulletin, our newsletter for staff, stakeholders and the public. It has been over a month and a half since I commenced as Southern DHB Acting CEO following the departure of our former CEO Brian Rousseau. I would like to thank everyone who has helped me settle into the role as we continue to navigate our way through this interim period before the appointment of a new CEO.
As you may be aware Brian Rousseau is now the CEO of Central Adelaide Local Health Network. We wish him all the best and pay tribute to his many achievements during his eight and a half years with the DHB in this edition of the Bulletin.
It has been a significantly busy time over the last few months. In August Southland Hospital hosted a visit by the Hon. Tony Ryall, Minister of Health, to see first-hand our great progress on our Theatre Compass and Productive Theatre projects, which are being supported by the Ministry. The On the Right Track project (which is to improve our Shorter Stays in the Emergency Department target) was also on the agenda, with the Minister commenting he was pleased at the connectivity between all the projects occurring.
South Island Chairs and CEOs were invited to attend a strategic meeting with the committee to give an outline of their DHB's current capital challenges and a brief on how the DHBs are working together.
On 24 November the National Health Board (NHB) will hold its monthly meeting at Southern DHB. This visit south will provide the NHB with an opportunity to interface more with our DHB as well as other South Island DHBs.
There have been many other note-worthy events and progress made on priority projects, which are highlighted in this newsletter. We hope you enjoy this read.
While Deputy Chief Executive Officer (CEO) and Southland Chief Operating Officer Lexie O'Shea fulfils the role of Acting CEO, some other interim changes have been made to Southern DHB's Executive Management Team until a permanent CEO commences with the DHB.
Leanne Samuel, Southern DHB Chief Nursing and Midwifery Officer, has been appointed Interim Southland Chief Operating Officer during this period and is based in Southland.
Otago Deputy Chief Nursing and Midwifery Officer Tina Gilbertson is now Acting Chief Nursing and Midwifery Officer (CNMO) while Heather Casey, Southern DHB Otago Nursing Director (Mental Health) fulfils the Deputy Nursing and Midwifery Officer role.
For further clarification on the current Executive Management Team structure please visit the Southern DHB Executive Management Page
It was with sadness that Southern District Health Board (Southern DHB) said farewell to former CEO Brian Rousseau on 16 September. Brian left to commence a new role as CEO of Central Adelaide Local Health Network.
Brian had been at the helm of public health care in the South for the past eight and a half years.
Prior to becoming CEO of Southern DHB in May 2010 following the merger, Brian was CEO of both Otago DHB and Southland DHB from 2007 (becoming the first CEO in the country to be the CEO of two DHBs at the same time) following four years as CEO of Otago DHB.
Many milestones and innovations were achieved during Brian's leadership, thanks to his tireless advocacy for healthcare in the Southern region, his tenacity and support. Some of these milestones have included
The development and opening of Dunstan Hospital and its models of care.
|2006||The agreement on a single laboratory provider, Southern Community Laboratories (SCL) in 2006.|
|2007||Instigation and leadership of the Southern Alliance.|
|2007/08||The establishment of the Southern Blood and Cancer Service.|
|2010||The Merger of Southland and Otago DHBs to establish Southern DHB.|
|2010||Approval of the Dunedin Master Site Plan.|
|2010||The retention of neurosurgical services for the region.|
|2010/11||The creation of a single Primary Health Organisation to cover the Southern region.|
|2011||The Signing of the Principles of Relationship Agreement between Murihiku and Araiteuru Rūnaka and Southern DHB.|
Brian was always a strong proponent of collaboration with other organisations, to ensure the financial and clinical stability of public health services in the South.
As well as the forming of the Southern Alliance in 2007 and then the merger, Brian strongly supported the successful relationship between the DHB and the Dunedin School of Medicine and University of Otago.
Dr John Adams, Dean of the Otago University's Dunedin School of Medicine/Southern DHB Executive Team member, says throughout his time Brian played a significant role in the good working relationship between the two organisations.
"He clearly understood the benefits for both organisations of the concept of the 'Teaching Hospital', and has taken opportunities to actively pursue that. We certainly wish him well from the School," says Dr Adams.
The foundations Brian has laid will continue to reap the benefits for many years to come, such as the continued growth of the South Island Neurosurgical Service and the continued progress towards Southern Clinical Services.
Southern District Health Board's (Southern DHB) 2011 Annual Report is now available.
The Annual Report outlines Southern DHB's performance financially and our achievements against our key health priority targets in the 2010/11 financial year.
The document also features "The Year in Review", which highlights our many milestones and successes as well as a new section profiling our current Board members.
"There were considerable achievements in the 2010/11 year, which included providing our community with excellent access to elective surgery, with the DHB meeting its elective targets," says Southern DHB Acting Chief Executive Officer Lexie O'Shea.
"In 2010/11 the Southern District continued to have one of the highest rates of immunisation coverage in the country for children turning two years old, with the DHB exceeding the national immunisation health target of 90%.
"We also broke even financially with a small surplus and the new Southern Primary Health Organisation (PHO), created to replace the District's nine PHOs, came into being to create better efficiencies in community health care."
The 2011 Annual Report also highlights the momentum Southern DHB gained in Maori Health, Health of the Older Persons and Mental Health and Addiction Planning.
Mrs O'Shea says there were plenty of achievements in 2010/11 that Southern DHB staff and the community it serves can be proud of.
"From the on-going development of Neurosurgery, running the highly successful e-prescribing quality pilot to the assistance we provided our Canterbury colleagues following the tragic earthquake - it's all documented in our Annual Report so that we can look back on how much we accomplished."
"We hope the community will view our report and gain a better understanding of our strategic vision and priorities, which aim to improve health services and health outcomes for our population."
Southern DHB is pleased to welcome a number of new recruits to our Southern DHB Executive Management and clinical teams.
Introducing John Pine, General Manager, Human Resources
General Manager, Human Resources (GMHR), John Pine, commenced with Southern District Health Board on 29 August.
Mr Pine,who moved from Wellington to take up the role. He has a wealth of human resource, leadership and health sector experience, having previously worked as the General Manager, Human Resources for Hawkes Bay DHB, the Ministry of Agriculture and Forestry and ENZA/Turners and Growers. We are now very fortunate to have him at the helm of Southern DHB's Human Resources Team.
Mr Pine has been a part of two major organisation mergers - Turners and Growers/ENZA and the Westpac/Trustbank, so is well versed in the challenges and opportunities of mergers.
|John Pine - GM HR|
He says the geographical size of the Southern District and the challenge of continuing the DHB's integration journey particularly appeals to him.
Mr Pine is based in Dunedin and travels to Invercargill and other locations in our region regularly.
John Simpson, Chief Information Officer
John Simpson commenced the role of Chief Information Officer on 12 September 2011.
Mr Simpson initially joined Southern DHB in February 2008 as Regional Services and Technology Manager and has been Acting Chief Information Officer since August 2010.
In his new Chief Informations Officer role Mr Simpson will be linking closely with a yet to be appointed South Island IT Programme Director and the South Island IT Alliance, who together will have South Island wide responsibility for regional IT strategy and planning.
Mr Simpson is responsible for implementing this agreed South Island IT strategy across the Southern DHB District.
|John Simpson - CIO|
He continues to be based in Dunedin, and will travel to Invercargill and other locations in our District on a regular basis.
Appointment Made to the Position of Public Relations and Communications Manager
Southern DHB is pleased to announce the appointment of Stephen Addison to the position of Public Relations and Communications Manager.
This new position will be an addition to the current Executive Management Team structure, with the current Communications Officer reporting to this role.
Mr Addison comes to us with a raft of experience in public relations/communication and journalism roles. He is currently employed as Principal Advisor - Sector Relationships and Engagement with the National Health Board.
He has extensive health sector experience at a senior level and has held interesting roles for New Zealand Cricket and the Department of Conservation. Mr Addison currently resides in Wellington and is excited about returning to Dunedin.
He will commence the role on Monday, 5 December.
Joint Appointment of a Senior Lecturer in Neurosurgery/Consultant Neurosurgeon
Mr Reuben Johnson has been appointed as a senior lecturer in neurosurgery at the Dunedin School of Medicine and consultant neurosurgeon at Dunedin Hospital.
The new position was created to help provide a strong academic presence for neurosurgery in Dunedin as part of the newly established South Island Neurosurgical Service. Mr Johnson is due to take up the role in mid-2012. His appointment will be split 50:50 between academic and clinical duties.
An academic neurosurgeon trained in Glasgow, London, Cambridge, Oxford, and Melbourne, Mr Johnson is also a molecular neurobiologist with a doctorate in neurogenetics from the University of Oxford. His neurosurgical interests include neuro-oncology, functional neurosurgery, and minimally invasive spinal surgery.
Mr Johnson's recent clinical appointments have been as a Neurosurgery Registrar at John Radcliffe Hospital in Oxford and as a Neurosurgery Fellow at Royal Melbourne Hospital. He is currently undertaking a fellowship in minimally invasive spinal surgery and scoliosis surgery in Italy and will complete a further fellowship in skull base neurosurgery before coming to Dunedin.
Dunedin School of Medicine Dean Dr John Adams says that he is delighted that the University has been able to appoint someone of Mr Johnson's calibre to the position.
"His impressive academic background places him well to help develop the school as a leading centre for neurosurgery teaching and research. His expertise in neurobiology also holds the potential for fruitful collaborations with neuroscience researchers in the wider University," Dr Adams says.
Martin MacFarlane, Clinical Director of the South Island Neurosurgical Service, also welcomed this appointment.
"The skills in both clinical neurosurgery and academic neurosurgery that Mr Johnson will bring will contribute significantly to the provision of a high standard of neurosurgical care for patients not only in the Southern District area, but to the South Island in general and to the ongoing development of clinical and academic neurosurgery in New Zealand," Mr MacFarlane says.
Southern DHB Acting CEO Lexie O'Shea says she is pleased the Neurosurgery Unit at Dunedin is moving from "strength to strength" with the appointment of Mr Johnson "who will support our other permanent and highly skilled Consultant Neurosurgeon Mr Ahmad Taha".
Based in the Department of Surgical Sciences at the Dunedin School of Medicine, Mr Johnson's academic duties will include contributing to the undergraduate and postgraduate teaching of medical students and establishing a research programme.
Southern DHB's Southland Site Appoints Nurse Practitioner Candidate to Provide Advanced Nursing Care for People 65+
Southern DHB's Southland site recently appointed Margaret O'Connor, a Nurse Practitioner Candidate, to a new role providing holistic advanced nursing care for people aged 65+.
The position, which has been established in conjunction with Presbyterian Support Services, sees Mrs O'Connor providing early proactive clinical nursing assessment, assistance with planning intervention for patients with complex geriatric issues and case management for those 65+ with chronic conditions and/or those who are using multiple medications.
Mrs O'Connor also offers support for people with complex conditions who are making the transition from hospital to residential aged care, provides clinical coaching, mentoring, supervision and gerontology education as well as providing vital clinical nursing expertise to all nurses in acute, community and long term settings.
Jenny Hanson, Southern DHB Nursing Director, Medical Directorate (Southland) says Mrs O'Connor's role has received positive feedback, as there are a number of complex patients that health professionals can now refer to Margaret for assessment and on-going care.
"This role was identified as a need in our On the Right Track (keeping the Emergency Department for emergencies only) project. Mrs O'Connor has a primary (community) and secondary (hospital) focus which allows her to help the elderly stay well in their homes once discharged from hospital as well as potentially preventing admissions to our Emergency Department."
Mrs O'Connor comes to Southern DHB with a wealth of nursing experience in the aged care sector. She worked at Gore Hospital for four and a half years as the Assessment, Treatment and Rehabilitation Coordinator and Needs Assessor before working for Presbyterian Support Southland as a Facility Manager for 13 years where she spent the last 11 years working at Resthaven village in Gore.
She has completed a Graduate certificate in Care of the Terminally Ill and then went onto complete a Clinical Masters of Nursing at Otago Polytechnic in 2009. She now has to present her portfolio to the Nursing Council to progress her Nurse Practitioner registration.
Mrs O'Connor says she is every enthused about her role with Southern DHB. "I love to work with older people as they teach me something different every day," she says. "It is extremely challenging and rewarding working alongside this population group who are sometimes on the last stage of life's journey."
The Nurse Practitioner Candidate position is full time Monday to Friday. Mrs O'Connor can be reached at email firstname.lastname@example.org
Southern DHB paid tribute to the work of its enrolled nursing workforce in late September and celebrated their successful transition to a new scope of practice.
In 2009 the Ministry of Health asked the Nursing Council of New Zealand to work with them and DHBs to expand the role and training of Enrolled Nurses. In March 2010 the revised scope of practice was released along with the decision to give the title of Enrolled Nurse (EN) to all second level Nurses. A process was put in place to allow all ENs to transition to the new scope of practice.
The new scope allows Enrolled Nurses to work in more areas such as: nursing assessment, educating health consumers, working with health consumers with mental health concerns and working under the direction of a health professional who is not a nurse.
To complete the transition our EN staff commenced producing comprehensive portfolios from 2010 onwards that showed how they met the competencies within the new scope.
Southern DHB is extremely proud that 100 nurses out of 104 in Dunedin have completed their transition so far while in Southland 21 out of 23 have completed theirs. The remaining nurses yet to complete their transition are in the process of doing so now, or may not have undertaken the portfolio development due to circumstances such as impending retirement.
|Robyn Hewlett, Dunedin Hospital Enrolled Nurse and Chairwoman of the National Section of Enrolled Nurses with her Dunedin colleagues.||
Southland Enrolled Nurses (from left to right) Daphne Mitchell, Alison Glass, Fiona Cools, Sharon Taylor (obscured), Adrienne Pope, Nicola McLeod, Julie McDonald, Jan Stevenson-Brown, Anne McFarlane, Alison King, Phyllis Donaldson, Suzette Morgan and Shirley Reed. Absent but have completed transition: Helen Powley Rose Folster, Phillipa Sinclair, Noelene Scully, Colleen Norman, Chris Downey, Michelle McNeill and Shirley Leisnham.
Afternoon and morning tea celebrations and speeches were held in late September at the Dunedin and Southland sites respectively to acknowledge the skills, knowledge and commitment of Southern DHB's Enrolled Nurses.
At the Dunedin celebration, Enrolled Nurse Robyn Hewlett, who is Chairwoman of the National Enrolled Nurses Section and a prolific advocate for the Enrolled Nurses workforce, was also honoured for her leadership locally and nationally. Mrs Hewlett and the National Section played a key role in helping the Ministry draft its new scope of practice for Enrolled Nurses.
Establishment of a Health of the Older People Planning Advisory Group
Southern DHB sought nominations in October for the soon to be established Health of Older Peoples' Planning Advisory Group.
This group will act in an advisory capacity for on-going planning and service development specific to Health of Older People.
The group will include an initial set membership and also have the ability to appoint members on and off as required in relation to a specific work-stream activity. The group will link with the wider Health of the Older Person forums including the OPEN Network and other networks both established and yet to be established across the Southern DHB District.
Nominations for the group closed on 4 November and we hope to finalise membership soon.
Health of Older People Portfolio Analyst
The DHB is currently in the process of recruiting to a new position which will sit within the Health of Older Persons Portfolio team to support the progression of the Health of the Older Community Models of Care Service Development Plan. Applications for the position have closed and we hope to confirm an appointment to the position by mid November 2011.
Health of the Older Community Models of Care Service Development Plan
As you will recall Southern DHB commissioned Auckland Uniservices in April 2011 to undertake a review of community health services for older people, to identify what works well, what can be improved upon and how best to fill any service gaps.
This piece of work was undertaken to expand and develop services in the community so older people can be better supported to live safely in their own homes for as long as possible.
Following the review a number of recommendations were proposed. In large they recommended a structure which involved building on the strengths of primary care (community-based services) and existing community based service delivery to enable integration between services, reduced duplication and reduced risk of disconnect between multiple services that may be involved in supporting a person's care. The proposed approach involves over time a significant realignment of service delivery for older people with a community based setting.
The recommendations made by the review team were considered by the 'Review of Community Services for the Older Person' Steering Group and submitted with feedback to the Community and Public Health and Disability Support Advisory Committees in July 2011. The recommendations were subsequently adopted in principle by the Southern DHB Board in July 2011.
What are the Outcomes from the Plan?
- People will be supported to live in their own home as long as possible as they age or develop long term conditions/disabilities.
- All older people with an identified health need will have an actively managed culturally relevant lifestyle and support plan and these support plans are consistent with funding parameters.
- Services will be provided through a restorative approach to maximise function and independence.
- The Southern community will have equity of access to services based on a clinical and comprehensive assessment of their needs.
- Community, intermediate and secondary care services will be planned and coordinated to optimise access to services within the available health budget.
- Services will be provided within a quality framework which ensures the best quality of care is delivered and continuously improved upon.
- Stakeholders are engaged in the planning process so that the diversity of the Southern community's needs are addressed, services are coordinated and stakeholders are well informed.
- The Southern community is clear on what services are available and how to access them.
How can you stay informed?
Planning and Funding has launched a bi-monthly newsletter to provide regular updates to all key stakeholders in the initial stages of service development, and quarterly thereafter. This information will be made available via the DHB website on the 'Health of Older People' page from mid-November 2011.
In the interim if you have any questions please contact Leanne Illingworth, Portfolio Manager, Health of Older People and Disability by emailing email@example.com or phoning 03 470 9740.
Implementation of District Wide Care Coordination Centre
The DHB has commenced the implementation of a district wide Care Coordination Centre , based on the Dunedin site, which will provide a single referral and assessment service across the district for those who may require community based treatment and support. This service includes the Rural Hospital sites.
The Care Coordination Centre will provide a single referral and assessment pathway which will streamline processes for people requiring assessment and allocation of community based treatment and support. The outcome of the function of the centre will be consistency in practice and processes as well as providing equity of access to support services across the Southern DHB district.
Once fully implemented there will be a single point of entry for referrals and assessment for services irrespective of who funds the ongoing treatment and support. The Care Coordination Centre will initially accept referrals for all aged care community based support services, Dunedin based personal health services, Dunedin based ACC referrals and referrals for access to Long Term Chronic Care funded services. Referrals to Southland based community treatment services such as District Nursing and Physiotherapy will continue as they do at present.
The Single Point of Entry process within the Care Coordination Centre will be managed by Clinical Coordinators who are Registered Nurses with experience in the community sector. The assessment process will be carried out by Clinical Needs Assessors utilising the InterRAI assessment tools.
The centre will not include referrals for Child and Adult Mental Health services or under 65 Ministry of Health funded Disability Services.
Southern DHB is implementing InterRAI, an international clinical-based tool which will greatly enhance the needs assessment process of the elderly and the allocation of support services across the Southern District. The application of the electronic assessment system commenced in late 2010, with the completion date scheduled for 30 June 2012.
The InterRAI system includes two tools - Contact Assessment and Home-Care Assessment. The Home-Care Assessment is a comprehensive, clinically based tool to identify the holistic range of needs required by an individual with complex need, in order to live safely in the community. The Contact Assessment is a shorter version for people with a lower level of need. The assessment process is completed by a Clinical Needs Assessor in conjunction with other relevant clinical staff for each individual client.
Elaine Chisnall, Southern DHB General Manager, Mental Health and Community Support (Otago) says InterRAI will vastly improve the assessment process compared to the current paper-based system.
"The paper based system was based on a subjective rather than objective clinical approach. It does not have any mandatory fields to answer unlike InterRAI and is not as clinically based and focused.
"Using a paper-based system means we are unable to easily pull reports together on various trends and other information. We also know that there are inconsistencies between the DHB's different sites, which mean inequalities in support may exist.
InterRAI ensures assessors ask and complete all mandatory fields when assessing a client. These include fields on diet, nutrition, continence and cognition etc. When filling in an assessment, certain answers or a combination of answers may trigger more clinical questions to be asked.
"For example it may ask more questions around falls and whether a person requires more equipment around their home environment."
Other changes to the assessment sytem include the requirement for all Clinical Needs Assessors to be Registered Health Professionals under the Health Practitioners Competency Assurance Act and hold a current Annual Practising Certificate.
Once the implementation within the aged-care assessment services, is completed, the intention is to roll-out access to the InterRAI system to other clinical services and the primary care (community based services).
Future of Wakatipu Health Services Update
Southern DHB has appointed its General Manager, Finance and Funding, Robert Mackway-Jones to lead strategic planning on behalf of the DHB in Central Otago.
Mr Mackway-Jones' role will be to lead and coordinate the strategic planning aspects of the recommendations of the National Health Board's Expert Panel for health services in the Wakatipu and liaise with the community reference groups.
Mental Health and Addictions Plan Update
A sector wide draft Mental Health and Addictions Plan for 2012-2017 has been completed and is now with the plan's Core Planning Group for feedback. Once this group has given its feedback to Southern DHB's Planning and Funding Team the document will be "peer reviewed" by a yet to be chosen group of experts. Southern DHB management will then present the draft Mental Health and Addictions Plan to the joint Southern DHB Community Public Health and Disability Advisory Committee for recommendation to the DHB Board at its February meeting. This will seek approval to commence public consultation on the document with the community. If you have any queries please contact Mental Health and Addiction Portfolio Manager Gemma Griffin on firstname.lastname@example.org
More Restored Nursery Rhyme Tiles Returned to Southland Hospital thanks to the Generosity of the Community
Eight more sets of children's nursery rhyme tiles have been restored and returned to Southland Hospital, thanks to the generosity of restorer Robert Clendon and the Southland community.
The tiles were unveiled on 8 September in the bottom corridor of Southland Hospital, where they grace the walls next to the previously restored sets.
In attendance for their unveiling were Southern DHB staff, management, community donors and supporters of the restoration.
Leanne Samuel, Southern DHB Acting Chief Operating Officer, acknowledged at the unveiling the support of several donors who made the restoration of this particular set of tiles possible. They are the Brealey family, Southland Hospital Museum and Elizabeth Kelly, Lions Clubs of Zone Six and Lynette Batt and the Southland Hospital Volunteers.
|Hospital Management and Community members at the opening for the tiles from right to left: Janet Earl, Elizabeth Kelly, Shona Fordyce, Jenny Lemin, Ian Winwood, Pam Bennett,Ohai Nightcaps Lions Club, Dennis Dean, Mossburn Lions Club, and Lesley Gray (Southland Hospital Museum group).|
Southland Hospital's nursery rhyme tiles were originally made by H.& G. Thynne, tile makers, of Hereford, England as a result of an initiative of the Little Southlanders, a Southland Times children's page, which raised the STG 220.00 cost in the early 1930s.
The tiles were installed in a frieze two tiles deep around the Children's Ward of the old Southland Hospital, when it was opened in 1937. More than seventy years later the Southland community has funded the restoration of these much loved and beautiful tiles which are enjoyed by people of all ages when they visit Southland Hospital. Only one more set of tiles remains to be restored. This one will be the trickiest to restore due to it having been broken in multiple places.