Taking the Initiative

Monday morning saw me shadowing staff in Module 7 at the Manukau SuperClinic. It was a great morning spent observing the team at work and seeing them put the ‘granny test’ into action. If you haven’t already heard me talk about it, the ‘granny test’ is a way of determining whether or not the care we deliver is of a sufficient standard by considering whether you would be happy if your own granny received it. If you would be, we’re obviously on the right track. If not, how can we improve our care so that both you and granny are satisfied?

The team at Module 7 has taken that challenge onboard with their First Specialist Assessments for respiratory cancer referrals. Previously the median time for a FSA grading was around six or seven days – that means granny was waiting an extended period of time between being referred with cancer and seeing a specialist.

Now, for the first time, the Respiratory Service has managed to reduce the grading time to one day. This is hugely beneficial for our patients who are often anxious and stressed. Especially at such times, people hate being left in limbo. Fortunately, we now offer our patients the speedy sense of assurance and progress they need. It’s a direct result of the Respiratory Service’s hard work, particularly that of RN Denise Burt who has personally driven the initiative. I was most impressed.

I also observed the impact of DNAs on our services. In some patient groups, DNA rates are as high as 20%, meaning that one in five outpatients misses their appointment. We know there are many reasons for this – people have difficulty getting time off work, they don’t have any transport to get to our services, or family or caregiver responsibilities interfere. They’re all valid reasons, especially for our community in Counties Manukau. At the same time, however, each DNA costs us about $2000, wasting resources which could be better utilized.

A solution which may address part of the problem is to take more of our services out to patients rather than expecting patients to come to us. It’s clear that DNA rates improve when services are located in satellite clinics out in the community. People can attend more easily because the service is closer and more convenient. What do you think? Is it a good idea to develop more satellite clinics in key areas of Counties Manukau as a way of addressing DNAs?

As many of you have heard at this week’s staff forums, the Planning and Delivery Organisational Design Consultation Document is now out. I’d encourage you all to give feedback before consultation closes on October 10 as it’s really important we get this right. I know many people have already taken a look and given me initial ideas. Thanks for this constructive feedback and for the professional way you are all handling the extent of change this document proposes. I know it can be an unsettling time but it’s also an exciting one.

Speaking of which, Saturday night turned out to be very exciting with Ireland’s magnificent victory over Australia. They really set the tournament alight! Although I’m Welsh, I also have an Irish grandmother so I’m thrilled a northern hemisphere team has a chance of getting to the finals this time round.



Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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