As you know, I’m hugely proud of CMDHB, of the work we do for our community and of the quality of the care we provide. But rather than read my words about how great I think we are, this week I’ve asked our Head of General Surgery, Andrew Connolly, to share what he likes about CMDHB for you. I think he really captures some of the many great aspects of our organisation.

I started at CMDHB in 1990 as a junior registrar, and 20-something years later, I’m still here and I love it. Some days I can’t believe I get paid to do the work that I do.

Where do I start in explaining why? For a start, I’ve got fantastic colleagues. The camaraderie in our department, and with the rest of the hospital, is magnificent. We’re also very lucky to have an extremely dedicated bunch of nurses. My colleagues are fiercely loyal and fiercely competitive. We just get on and get things done.

As a result, I think we’ve got the best surgical department in the country and training opportunities with us are highly sought after. We do a huge number of acute and elective operations, and registrars want to come and learn here and be part of that. I’m enormously proud of the surgery we do.

That excellence is across the board. Many of the services CMDHB provides, and the individuals involved, are the best nationally, if not internationally. Talented people are everywhere.

Even so, we’re always looking at ways to improve, to do things better and smarter. Everyone’s geared to getting the patient better – whether it’s the tumours that our department removes or some of the stuff the orthopaedic surgeons put back together or the badly disfigured people the plastics team sort out. And we don’t have a problem in saying it went wrong. It’s a very open, supportive culture.

I also like the patients who are almost universally grateful and it’s great to see them get treated properly and respectfully. We always place the patient at the centre of the problem and wrap the solution around them.

In General Surgery alone, we are responsible for about 39,500 bed days of care at Middlemore every year. What the vast majority of every one of those 39,500 days has in common is the high quality care the patients receive. It’s great to work for an organisation where compliments far outweigh complaints.

After 22 years on and off at CMDHB, I still really enjoy it. It’s something that gets into your soul – you just want to be part of it and never leave.

Andrew’s right – there is definitely something extremely rewarding about being part of Team Counties and we’re extremely fortunate to have so many of you onboard who have also dedicated many years to CMDHB and helping our community. Have a great week – I’ll update you on the progress with the 1000kg initiative in my next post.

Geraint

So next Wednesday I’m meeting with our dietitians to discuss how we can set this up and how we can best support those of you who choose to join in with your weight loss. I’m absolutely committed to this aspect of staff wellness and want to make sure we have all the necessary support and advice available to help you with this. Following Wednesday’s discussion, I’ll then find a date to have a launch event. I’m not suggesting anything over the top – just an event for those of us who are interested to come along, get support and encouragement from others, and register our starting weights. I propose we lose our collective weight by August 31st, giving us at least five months to achieve our goal before showcasing this success at the Asia Pacific Forum (APAC) in Ko Awatea in September. I also look forward to posting pictures of me jumping out of a plane right here on my blog in September.

Getting back below 100kg (the weight limit for parachute jumps) and jumping out of a plane are two goals I’m looking terribly forward to ticking off my personal bucket list. To those of you who’ve already indicated your interest in this challenge, and to those who may be considering taking part, it would be great to hear what items you’ll be ticking off your own bucket list as a result of losing weight. I’m the first to admit I find weight loss challenging but I also see this as a great opportunity for us all to achieve some personal goals and have some fun along the way.

On a different note, in my blog at the end of January I talked about why we need to change the way we work in response to the growing and changing demand on our health system. I mentioned that we’re on a four year journey called Achieving a Balance during which time we’ll focus on two strategic objectives – building a Sustainable health system and delivering Excellence in health care. By December next year, we will have implemented a range of plans to deliver against these strategic objectives. Each strategic intervention will have specific measurable outcomes to enable us to track our progress through to December 2013 and beyond.

We’re not alone on this journey. All health systems face the same challenges to achieve sustainability while being excellent in an increasingly difficult fiscal environment. Here’s a link to an article from an international think tank that comments on these very issues.

CMDHB is changing. We’ve grown from a small intimate service provider to a large and complex organisation, in fact the largest employer in Counties Manukau. While it’s essential that we retain our DNA and what makes us Team Counties, we can’t keep working the way we were when Middlemore and CMDHB were smaller and more intimate places. Instead we need to change how we go about making decisions; managing, prioritising and allocating our effort; and measuring our success.

The update on this is that we’re currently doing a stock take of the various work programmes underway at CMDHB to understand how our current activity is aligned with our two strategic objectives. We’re also doing a stock take of our meetings to help us understand how they support our decision making. We expect to get results in the next month or so.

The end result is that this process should help declutter your time, create greater clarity around the organisation’s decision-making processes and allow decisions to be made as close as possible to the front line. I don’t want to slow down what we’re doing but actually allow you to improve your focus and increase our pace over time. You’re too busy to waste time in unproductive meetings or doing work which duplicates what’s gone before. If we are going to have time to care, we don’t have time to waste.

Geraint

Your responses also reiterated to me what a common challenge weight loss can be, not just for me but for many of us and for many people in our community. For that reason, I want to share with you a suggestion someone made which I’ve been thinking about – that we, CMDHB staff, collectively aim to lose say 1000kg over the next six months. Participation would of course be voluntary and we’d organise some nutritional clinics to advise and support staff who were taking part on how to lose weight safely and effectively. Staff could weigh themselves and contribute their progress towards an overall total. The goal (I’ve just suggested 1000kg) would be set to reflect the level of staff interest, but the more the merrier! Indeed, try to imagine what 1000kg of fat would look like – if I remember correctly, Jamie Oliver tried that a while back.

For me, losing weight is about being light enough to achieve a personal ambition but others will have their own reasons. Either way, I think this could be a really good way for those of us who need or want some extra motivation, to commit to a healthier lifestyle and contribute to a healthier outlook for our organisation. I’d certainly be happy to lead from the front and, hopefully, contribute 8kg of weight lost to our overall total.

But these are just my thoughts – what do you think? Would you like to take part? Email me your reaction at ceoblog@middlemore.co.nz.

I called this post A Big Idea – partly because of what I’ve just proposed but also because there is another, very big event looming on CMDHB’s horizon.

Because we are a large DHB, we traditionally host some major national conferences for the health sector. You may remember the series of sustainability conferences we held a few years ago or the conference we co-hosted last year with the Canterbury District Health Board in Christchurch. Conferences are important because they allow you to hear the latest thinking and talk with colleagues from both New Zealand and abroad about the latest challenges in healthcare. They also allow us to showcase our work on a bigger stage and demonstrate to others what a leading organisation CMDHB is.

This is why I’m extremely pleased and proud to announce that this September (18^th – 21^st) at Ko Awatea, in partnership with Boston’s Institute for Healthcare Improvement (IHI) and supported by the Health Quality and Safety Commission, we’ll be hosting what is effectively the third largest conference in healthcare in the world – the Asia Pacific Forum (APAC). We expect over 1000 delegates from across the region will be attending.

In addition, we’ve just confirmed Dr Donald Berwick, the former President and CEO of the IHI, as a keynote speaker. Widely regarded as the most influential thinker in healthcare globally, he’s coming here for a week prior to the conference, to meet and talk to many of you, because he’s interested in the innovative work we’re doing, particularly around Saving 20,000 Bed Days.

Dr Berwick’s accolades are numerous – until late last year, he was working in the Obama Administration as the Administrator of the Centers for Medicare and Medicaid Services. He has also served on the faculty of the Harvard Medical School and Harvard School of Public Health, as vice chair of the US Preventive Services Task Force, as the first “Independent Member” of the Board of Trustees of the American Hospital Association, and as chair of the National Advisory Council of the Agency for Healthcare Research and Quality. His interest in CMDHB and attendance at the forum is a tremendous honour, and testament to the world-class, leading-edge work you all do. I cannot wait to welcome him here and share the best of CMHDB with him.

The four-day forum is a real opportunity to celebrate our local excellence with a wider international audience. As you know, I’m extremely proud of the work that goes on here and thoroughly believe it deserves an international audience. And where better in the world to run one of the biggest and most prestigious conferences than in South Auckland? I can’t think of a place more deserving of that international attention. While international experts from around the Asia/Pacific region will come and learn from us, they’ll also be sharing their initiatives and ideas to address the challenges of the future. Alongside Dr Berwick, there’ll be a great cast of local and international speakers which I hope all staff will take the opportunity to hear. We’d love as many of you to be involved as possible.

I’m sure you’ve got an idea now of how very excited I am that this forum is coming to Counties. So here’s where I want to bring the two strands of today’s post together to make one truly BIG idea… How about we set CMDHB’s weight loss goal for the next six months and then, when we’ve collectively lost 1000kg (or however many we decide), we showcase this extraordinary effort and achievement to an international audience at APAC? It could be a celebration of Team Counties’ amazing efforts on one of the world’s biggest healthcare stages… Thinking big to get smaller!

Geraint

It also made think about the fact that I’ve recently turned 50.

I suppose this milestone is one of the times in your life when you take stock. Curiously, I don’t actually feel any older than when I was 25 but it does seem like an appropriate point to reflect on what has happened and my goals for the year ahead.

One of my main objectives over the past year has been to really take control of my health. I remember reading an article in The Herald last year and realising with shock that I weighed the same as All Black John Afoa. Something had to change.

It was also important to me to model the kind of behaviour CMDHB promotes and encourages in our community. Obesity is a very real issue for our community and I wanted to support our efforts to change that by first changing myself.  

So over the past year, I’ve lost 20kg by eating and drinking less, and moving more. I’m thrilled that I’m now closer to Richie McCaw, in weight at least!

But I still have another 8kg to lose before I’m light enough to fulfil one of my lifelong ambitions – a 12,000 foot parachute jump. Although I want nothing more than to throw myself out of a plane and achieve this goal, I just can’t shift that last bit of weight. The number on the scales isn’t moving.

Does anybody have any suggestions (surgery not included)? I need your advice…

My last blog post – Sustanability and Excellence – was also a way of taking stock and outlining for you the journey CMDHB will be on over the next four years. I’ve overheard some corridor conversations around this but wonder whether this really set the context for you in a way that was meaningful or whether it has opened up a can of worms and generated more questions… Either way, if you have thoughts about it, drop me an email on ceoblog@middlemore.co.nz.

Many of you are also going to be interested in how the health system in New Zealand is evolving generally. Take a look at the Ministry of Health website where you’ll find the briefing given to the incoming Minister of Health. It tells the story of where the health system is going in the next few years and gives you an idea of the environment we will be pursuing our own change agenda in.

As you know, I’m always keen to hear more from you and have conversations across all levels of the organisation. In particular, I’m really interested to hear from staff about our communications going forward and whether they’re delivered in a relevant and useful way. It’s really important to me and to the work we’re doing that we get everybody onboard.

So I’m proposing I hold a regular ‘Coffee with the CEO’ hour in Ko Awatea. As many of you know, I already use Ko Awatea’s atrium as my office when I’m at Middlemore but I want to go one step further and put on morning or afternoon tea on a regular basis for any member of staff who wants to come and say hello. I’ll find a space and put on some coffee and buns but I’m counting on you to come and eat them (otherwise I will, and then I’ll never get to do my parachute jump!)

More details soon. Have a great week.

Geraint

PS: For those that missed it, check out TV3’s piece on our new laparoscopic simulator, or LapSim. Thanks to the Lion Foundation, the new simulator in CTEC is helping change the way we train obstetric and gynaecology staff. Great stuff.

Firstly, it’s important to reiterate why change is necessary. As I’ve mentioned, the demand on the health system is both growing and changing. The reality is that if we don’t change the way we work, Middlemore will eventually seize up and we’ll simply run out of beds. And our most valuable resource, our workforce, will get burnt out. Patient care will inevitably suffer.

This clearly isn’t an option. We can’t just sit back and wait for this to eventuate, especially when we know that often hospital isn’t the right place for some people to be treated because modern medicine has made alternatives at home possible. In fact, hospital is a very expensive way of providing some services which could be provided in the community. And there’s a lot more we can do to build up primary and community care so that people can be looked after at home.

The bottom line is that we need to design a sustainable health system that is fit for purpose. By ‘sustainable’, I mean sustainability both in the way it works (that people are treated in the right place and at the right time) and in terms of the environment. We need to move to a system that allows staff the time to practise at the top of their skills and get maximum job satisfaction. In other words, a system that allows staff the time to care.

At the heart of this is the issue of excellence. We already have many examples of excellence at CMDHB but we want to expand on these so that excellence is universal. Our quest for excellence will, of course, be underpinned by the Triple Aim: to ensure we address issues of population health such as health inequalities, to continue to improve the patient experience and to reduce cost per case.

We’ve talked previously about wanting to be the best healthcare system in the Asia/Pacific region by 2015. This isn’t just a vague hope but in order to achieve it, we do need to set ourselves some clear benchmarks by which we can measure our progress. As such, we’ve been mapping out a four year journey – called Achieving the Balance: Delivering Sustainability and Excellence – and it’s this framework that I am outlining today.

Essentially over the next four years as we move through this period of change, all of our work as an organisation will be aligned with our strategic objectives of either Sustainability or Excellence. Under these objectives come a range of strategic interventions. And finally at the third tier down, there are the various ‘executable strategies’ or work programmes we’ll be delivering to make this change happen.

For the visual among us, it looks like this:

SUSTAINABILITY

1. Establishment of four community localities and devolution of services to locality clinical partnerships
2. Reducing demand on the system

Executable strategies include:

• 20,000 Bed Days
• Six Hours is Ours
• Primary Options in Acute Care

3. Maintaining financial sustainability (capital and operational)

4. Building capacity/organisational sustainability

Executable strategies include:

• Workforce development
• Change Management
• Financial Strategy
• Clinical Leadership

5. Ensuring environmental sustainability

6. Working with DHB partners in the region

EXCELLENCE

1. Patient Experience

Executable strategies include:

• Zero Patient Harm (Patient and Whaanau Centred Care, Quality Improvement and Patient Safety)

2. Value For Money

Executable strategies include:

• Thriving in Difficult Times

3. Population Health

Executable strategies include:

• Services and Programmes
• Health Equity
• Whaanau Ora

The leads for each executable strategy will be announced in the weeks to come. There is currently also a stock take happening of the various work programmes already underway at CMDHB so that we can make sure what we are doing aligns with our overall strategic objectives. We are also looking at streamlining decision making so we don’t waste your time and precious health dollars in duplicating work.

No doubt as we progress there will be more added to the list above as it’s very important that everything we do aligns to either Sustainability or Excellence going forward.

The other thing I want to note is that communication around this issue is vital. Major transformation programmes fail because of poor project management and poor communication. Aware of that, we are putting a lot of effort into ensuring we have top quality project management and getting our communications right. This blog is just the start of a major communications exercise involving staff, staff organisations such as unions, patients and the wider community. There will be a series of communications coming that will keep you informed as we go.

Finally, after all this talk about sustainability, I’d like to share an announcement that comes as a direct result of your feedback on my earlier blog post – Going Green.

In the coming weeks, a paper will be put to the board with the aim of us entering into a programme to become the first certified sustainable hospital in Australasia, led by Dr David Galler and Greg Simpson. Closer to the time, I’ll be blogging with David so he can tell us more about it but for the moment I want to let you know that this milestone, to consider such an undertaking and to bring it before the board for their consideration, is a direct result of your feedback on my blog and your clear enthusiasm for us to pursue environmental sustainability.

Your feedback really is making a difference and creating change. As I said last week, please use this blog as an opportunity to start those conversations and keep making that change happen.

Geraint

It promises to be a really exciting year at CMDHB with lots of positive change heading our way. As I said before Christmas, there’ll be lots of exciting developments in our work with primary care, particularly focussed on taking pressure off the hospital through the Saving 20,000 Bed Days campaign. We’ll also see the growth of the Clinical Services Building this year, with most of the building taking place in the next 12 months ahead of the opening in late 2013. This progress will bring us a lot closer to having a truly 21^st century hospital at Middlemore. And, as ever, we will continue to invest in staff as a fundamental part of how we deliver worldclass healthcare.

The tradition at this time of the year is to take stock and set objectives for the months ahead so I’d by really interested to find out what you think CMDHB’s New Year’s resolutions should be. What are the things that you’d like to see happen? What would you like us to stop doing? What would really improve your quality of working life? Email me at ceoblog@middlemore.co.nz and let’s come up with our own set of resolutions (that we keep through till 2013 of course!)

On that note, thanks again for all the comments I received in response to my blog last year. They didn’t go un-noticed. In fact, in a couple of weeks I hope to make some big announcements resulting directly from the suggestions you made. Watch this space!

Speaking of feedback, I’m very keen for this blog to be more than words. The next step is for it to become a really meaningful way to share – your thoughts as well as mine. I hope this year staff and the wider community will engage and enter into discussion which can lead to action and help our organisation improve.

Next week I want to talk to you about the changes we‘re facing and how they link together. While people are really excited about all the work we’re doing, some have said they’d like to get a sense from me about how it all adds up to the bigger picture. So, next week I’ll be painting that picture for you and, hopefully, beginning to give you an idea of where you fit and the very important role you will play.

Hopefully you’ve read an email I sent out last week about our progress in setting up a transition team to help manage the change ahead of us at CMDHB. One of the team’s key objectives is to ensure we don’t spend money on poor decision making and, instead, put as many resources as possible towards better patient care. I want to point out that this team won’t lead to an increase in managerial costs as it’s important we keep these under control. The team should help put a really effective decision making structure in place so staff are empowered to make decisions rather than relying on a long chain of committees. The team’s work should make life simpler for you, put you more in charge, and contribute towards our efforts to improve your working life. 

Of course, as we move to being one of the largest employers in Counties Manukau with a $1b turnover (which would make us one of the biggest companies in New Zealand), the challenge is to ensure we retain our ‘can-do’ culture within this bigger, more formal framework. How do we make sure that we keep the sense of everybody knowing everybody and being one team? How do we take CMDHB to the next phase of its evolution while keeping our unique identity? There are certainly plenty of challenges ahead in 2012.

I’d like to take this opportunity to welcome Dr Gloria Johnson, our new Chief Medical Officer for Hospital Services who started earlier this month. Gloria was previously the CMO at Northland DHB and brings with her a huge wealth of experience as well as a great deal of energy and a fresh pair of eyes.

I’m also pleased to announce the return of Margie Apa. Many of you will remember Margie as our former General Manager – Pacific before she joined the Ministry of Health as Deputy Director General. On her return to CMDHB next month, Margie will be the lead for Strategic Development and will bring many of the skills she’s developed at the Ministry to us and our community.

Finally, I’d like to say how much I’m looking forward to working with you all over this coming year. I’m really confident that this will be an exciting and fun year for us at CMDHB. Even after five years in this role, I still have to pinch myself that I’m lucky enough to be part of the best team I’ve yet worked with in my career.

Geraint

Here’s an excerpt:

A New York City subway train holds 1,200 people. This blog was viewed about 7,600 times in 2011. If it were a NYC subway train, it would take about 6 trips to carry that many people.

Click here to see the complete report.

It is extremely pleasing to reflect on the past 12 months. 2011 has been both busy and demanding but despite this, we’ve managed to excel in many areas. Thanks to all staff, we’ve treated more patients than ever before with higher quality care and in a quicker, more responsive way. That doesn’t happen by accident but through professionalism and hard work, both of which you have consistently demonstrated this year.

Some highlights which you should all be proud of are:

• Despite seeing record numbers of patients in ED, we continued to provide top quality service and maintain our performance against the national six hour target. This confirms that we are not just the largest ED in Australasia but also the best.
• We delivered over 500 more elective operations than in 2010.
• At the same time, we reduced the incidences of Central Line Associated Bacteraemia which resulted in better services for patients in our Intensive Care Unit.
• We reduced the number of falls leading to harm in the hospital, again through the excellent work of the Zero Patient Harm initiative.
• We’ve had a 26% increase in the number of medical staff in the organisation since November 2008.

2011 has also been the year to lay foundations for the future. We know that demand on the hospital is growing and that we can’t continue working the way we have been. Instead, we need to redesign how the healthcare system works so that we’re able to provide services while allowing you, our professionals, to practise at the top of your licence. This needs to be based on really strong relationships so we’ve spent a lot of time this year fostering our relationships with our primary care colleagues; primary health organisations, particularly ProCare; the Greater Auckland Integrated Health Network (GAIHN); the National Hauora Coalition and Alliance Health Plus. The focus has been on working together to decisively begin shifting care so that people are able to stay well at home and in doing so, start easing pressure off the hospital to the effect of about 20,000 beds days. Next year we’re planning some really groundbreaking initiatives with this campaign but more on those in the new year.

For now, we send you our best wishes and hope you have a very Merry Christmas. It’s a time to reflect on what we’ve achieved, spend time with your family and whaanau, and recharge your batteries in anticipation of the year ahead. Have a safe and happy holiday, and I’ll be back here blogging on January 20.

Geraint and Professor Gregor Coster

They’re daunting because you suddenly remember exactly just how much you have to do, both at work and at home, before Christmas. And unlike most things, you can’t reschedule Christmas day.

This year this busyness comes off the back of a very long 12 months in which we’ve achieved a huge amount delivering ever higher standards of care and making the best use of our funding. It always seems to me such a long haul from Queen’s Birthday to Christmas with only one official public holiday to get us through the toughest part of the year. And now, unsurprisingly, we’re all a bit tired and frazzled just as the work load ramps up very quickly. Somehow it all seems to get done but I know many of us are very weary on our feet. I just want to thank you for the incredible hard work and professionalism you’ve shown this year and beg you to hang on for just a few more days. I also hope the weather improves as you all deserve a really good, and sunny, break.

I also find this time of year frustrating because a lot of really good work stops for several weeks. While it’s nice to have a break, it’s frustrating because I want to push on with the very many exciting things underway in the organisation. Despite that, what is most important is to take the opportunity to relax and recharge. As Shontal commented on an earlier post, part of keeping well is having regular breaks, taking care of ourselves and exercising in moderation throughout the year.

Of course we are a 24/7 operation and many of you won’t be getting the kind of Christmas break most people have. Although I know hospital can be quite a fun and special place at Christmas, I’d also like to acknowledge that those staff who are working will be taking time away from family and friends to keep our services running. I hope you’re also able to get a good break in the near future.

Inevitably at this time of the year, my thoughts also start turning to next year. I think 2012 will be really exciting for us at CMDHB. A lot of the changes and investments we’ve made this year have been aimed at building our capacity and capability so that we can begin to think about how to improve services in the face of a growing population and increasing levels of chronic disease. That investment has already led to some fantastically creative, innovative and ground-breaking ideas. There’s the work of Gill Cossey and the Surgical teams looking at how we can reduce our waiting times for surgery so that patients are treated even faster than the waiting times being set by the new Government. We’re looking at ways to keep our Emergency Department working as smoothly as we can despite increases in demand. There’s work underway to improve end of life care. And we’re putting a lot of effort into the Saving 20,000 Bed Days initiative to help rebalance the health system. Bubbling just underneath the surface is a huge amount of creativity which I know will make 2012 a year of great change, great momentum, great professional satisfaction and, dare I say it, great fun.

All of the changes we’re putting in place, all of the improvements we’re seeking and all of the courses we’re putting on in Ko Awatea are aimed at one thing which is one of my major reflections from the last year or two. When I look back at my career, which is now stretching out to 27 years, I’ve seen a healthcare system which has become ever more complex while the people within it have been ground down, to the extent that the reason why they joined healthcare in the first place and their values about caring for people have somehow got lost. One of my key objectives, both personally and professionally, is to get back the reconnection between the values we all hold and what we do on a daily basis.

Why is this so important to me? Many years ago, my family hired a nanny to look after our young kids. Soon after she started, she discovered a breast lump and over several weeks we watched her get more stressed, worried, unhappy and scared. We didn’t know about the lump and assumed our children were the cause of her distress. But when we asked her about it, she explained that she’d discovered a lump and had been to the hospital I was then in charge of. What followed was a story about missed appointments, lost x rays and unorganised tests, the sum total of which was that it had taken over two months for her to learn whether or not she had cancer. Firsthand I saw the toll that that experience took on someone I knew.

Fortunately she is now fine but what has always motivated me since then is a desire to ensure that that doesn’t happen again. Many of you may have read the sad story in the Weekend Herald about a young woman who tragically didn’t receive a breast cancer diagnosis in time and is now preparing for her last Christmas with her family. It reminded me of our nanny and underlined for me both the importance of what we do and the responsibility we all carry. So if you hear me talking about the need for improvement, staff engagement, passing the granny test, reconnecting with values and improving our standard of care, I guess all I’m saying is that I want to make sure we have a service that truly looks after people, be they patients or staff.

Geraint

Last week a smokefree campaign was launched to remind patients, visitors and staff that all of our sites are smokefree, including the grounds of Middlemore. I spoke to the concierges to learn more about what they do and acknowledge their contribution to the enforcement of our smokefree policy.

Speaking to the concierges

It’s no secret that smoking is very bad for you but as an ex-smoker myself (and yes, I should have known better) I know how hard it is to give up. On the flip side, if somebody as weak-minded as me can do so, then giving up is possible! I asked the concierges about the experience of challenging people who smoke on our grounds and what message is most effective in changing people’s smoking behaviour.

People who smoke, especially those who have done so for a long time, are aware that smoking is bad for them but have become “immune” to the message. What people instead respond to are messages about the impact smoking has on others. As cited by ASH (Action on Smoking and Health), it is estimated that 50 babies die tragically every year in New Zealand from Sudden Infant Death Syndrome caused by second-hand smoke exposure. Certainly a statistic that makes me stop and think after my child health blog a couple of weeks ago.

One of the lasting thoughts I took away from the discussion with the concierges has been to think about the challenge of change. How do we support each other to make change happen? How do we change our approach to problems in order to arrive at a different solution? If simply delivering the message were all that were needed, then no one would smoke anymore, be overweight or drink too much.

As Einstein once commented, the quickest route to insanity is continuing to do the same thing but expecting a different outcome.

So in order to achieve our objectives, we have to often change our focus. If we want to seek a different solution, we have to be prepared to challenge ourselves about how we approach the problem. You can’t blame people into success.

In the case of smoking, this means not always demonising the individual but finding out what would influence them the most. Or in the case of medical errors, as Dr Mary Seddon and I recently blogged about, it means using a Just Culture framework to analyse the system rather than pointing the finger at the staff involved. I include myself, as CEO, among those who could sometimes apply a different focus to problems in order to solve them. Whether or not it’s our approach to medical errors or our approach to helping people stop smoking, sometimes the most powerful lesson is to stop a minute, think about our behaviours and reflect on how we can support others into success.

This week I’ve had the great pleasure of thanking both people and organisations for their continued commitment to us at CMDHB. It’s hugely important to me to acknowledge the enormous generosity of our partner organisations which makes it possible for us to offer many opportunities to our staff and community, such as scholarships and state-of-the-art equipment and facilities. The Lion Foundation has donated over $1 million to develop our clinical skills training facility which opened this week. Money raised through South Auckland Health Foundation has gone to Kidz First and countless other projects. And the Tindall Foundation has supported our Grow Our Own Workforce initiative over several years.

These few examples reflect the generosity of people in the South Auckland community and I’m really grateful for all of the continued support we receive.

Speaking of Grow Our Own Workforce, have a look at this clip which featured on ONE News on Saturday night. It’s a great example of us working with a partner organisation, in this case the Tindall Foundation, to provide our community with opportunities and turn lives around. Again – supporting each other to make change happen.

Finally I’d like to pass on some comments from members of our board which were discussed at a recent meeting. They’d received great feedback from our community, including the comment that the service received in the public sector was the very best. The feedback was all overwhelmingly positive and, yet again, deserves acknowledgement and sincere thanks to you all for your continued great work.

Geraint