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DHB’s turbulent year

A 2018 of turbulence and challenges has seen Hauora Tairawhiti respond with expanded services and improvement in equity for Maori, says chief executive Jim Green.

He told his board, sitting for the final time this year, that an expected challenging year had presented difficulties encompassing clinical and service pressure, financial issues and industrial unrest.

Chief financial controller Craig Green said the board was on track to record a $10 million deficit for the financial year.

Board chairman David Scott said Hauora Tairawhiti was expected to be one of the first health boards to sign its new annual plan with the Government, which would result in “a realistic budget”.

Jim Green said the board would have to keep within that budget.

The Ministry of Health has since signed off the annual plan.

Hauora Tairawhiti was recovering from the strike by nurses. It had been a difficult period of time and relationships were still improving.

“I am, however, satisfied with the responses we are making to these challenges,’’ said Mr Green.

“It is important to see, and make seen, the real improvements that all the hard work put in by people from governance level to all parts of our organisation — and wider in the sector — is making.

‘‘We are seeing significant improvements in equity for Maori.

“We are seeing expanded services for people in our community, with much more of that occurring here closer to home.

“We are further improving the quality of care and taking on new ways of working to keep up the momentum.”

Mr Green said staff were trying to catch up with elective services.

Discharges were on target but a lot of effort was being put into patients who had been waiting for a first specialist appointment longer than the stipulated period.

Ear, nose and throat, neurology and urology needed close monitoring while orthopaedics had been granted an exemption.

The mental health inquiry had delivered a “sobering report’’, which “puts down the facts as we ourselves know them to be as part of living and working here in Tairawhiti”.

Issues such as poverty and poor living conditions were important factors and were “more pronounced in some parts of the country’’.

Jim Green identified challenges still facing Hauora Tairawhiti. They were —

Suicide, with Tairawhiti the worst-affected district.Improving hospital out-of-hour services.Attracting skilled specialist staff.Connecting and improving pathways for people with long-term respiratory conditions.Improving health equity.Improving cervical screening rates.Improving immunisation rates.Improving cervical screening rates.Rheumatic fever.Financial sustainability.

Mr Green also presented to the board what was titled Celebrating 20 Amazing Things We Have Done. These were —

1. The opening of medical day unit Kahikatea.

2. The cervical screening team supported 54 high-need women in special colposcopy appointments. Mr Green described the development as ‘‘a big step up’’, particularly for Maori women, but said “it’s not enough”.

3. Maternity unit Puawai Aroha ‘‘leads the way in health board maternity services” including in attained high figures in terms of vaginal birth rates for first-time mothers.

4. Adopted the “ground-breaking” CX bladder cystoscopy service, which avoids the need for a scope into the bladder and travel to another hospital.

5. Gained approval for a new cardiology service including the first-ever locally-based cardiologist.

6. Bought cleaners, orderlies and security staff back ‘‘in-house’’ as Hauora Tairawhiti staff members. Jim Green said the move was “one of the best things we have ever done” and allowed for career progression and better training. Mr Scott and Craig Green said it was noticeable that the new staff members ‘‘felt part of the team’’.

7. The development and extension of the registrar workforce.

8. The Win 18 plan, which included primary health providers, made the hospital more prepared for winter and less people had to spend time in hospital.

9. Became the first health board to implement the Maternity Growth Assessment Protocol (GAP) Tool. Jim Green said the GAP tool had helped staff detect 75 percent of growth-restricted babies — up from 20 percent.

10. Adopted Sentimag Magnetic Lymph node technology, which is used in biopsies for patients undergoing a b mastectomy for breast cancer.

11. Tooth decay had been dramatically reduced in 12-year-old Maori children from 1.39 restorations a child to 0.82.

12. A new care pathway was introduced for mini-stroke patients.

13. The Te Kuwatawatu mental health service, described as “providing a ground-breaking service for whanau” — but also known to be highly controversial — was accessed by more than 1340 people.

14. Consumer engagement became part of the clinical governance committee.

15. A project aimed at eradicating hepatitis C, and involving community partners, began.

16. The cardiac project Saving 1000 Lives earned approval and was being implemented.

17. Manaaki Tairawhiti made system improvements to improve support for whanau.

18. The advanced care plan (a person’s end-of-life plans or wishes) document was developed.

19. Neo-natal nurses and the flight team started transfers of infants.

20. The hospital day co-ordinator role was established in a safety move supported by the New Zealand Nurses Organisation.

Jim Green thanked staff for “making a difference”.

“It is deeply appreciated by those receiving the direct benefit and the community.”

There would be staff members committed to proving healthcare over the holiday period, he said.

“We are indebted to them all.”

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