Light Green, Dark Green and Real Green

My thanks to everyone who took the time to read my last message about Financial Sustainability. I’m really committed to keeping you informed about the progress of this work as we go along, so today I’m joined by Dr Claudia Wyss, the Financial Sustainability Taskforce Project Director, to talk us through the next steps.

Debates around savings often focus on light green or dark green dollars. Dark green dollars represent hard, ‘cash in hand’ savings while light green dollars are areas where systems improve without necessarily resulting in savings.

Our challenge is about value creation, either through hard dollars or by ensuring that our systems work more effectively, allowing us to maintain our financial shape. We will be talking more about light green and dark green savings in coming weeks, but in the meantime I’d like to draw your attention to this paper by Ko Awatea’s Boston partners, the Institute for Healthcare Improvement. Also of interest may be an article which crossed my desk this week from the Minister of Health. It forms part of the debate around this topic and gives us some food for thought as we move forward.

Claudia has already had some fantastic conversations with several services, Clinical Directors and General Managers who’ve identified lots of opportunities for change. It’s important to reiterate that the Financial Sustainability Taskforce is looking at how the whole system works and how we can remove components that do not add value. When we do things that don’t add value to the patient, it always costs money as well as wasting people’s time and effort. The taskforce is working to identify bottlenecks, wasted time, systems that no longer work and areas of duplication so that we can get better at managing patients in the face of rising demand. There will be reviews as we go, with a review of Ko Awatea already underway. This review will help ensure that it continues to add value to our work as cost effectively as possible while recognising that it holds some very valuable services that have been with the organisation for a long time.

We will come back to you through this blog to talk about practical examples of what we’ve found and what we need to change, but in the meantime if you’ve got any ideas for savings, improving efficiency or minimising waste, please email them to InvestingforourFuture@middlemore.co.nz.  Claudia will be talking to frontline services and attending almost every major service meeting to discuss findings and your ideas around improvements. Deputy CEO Ron Pearson and I will also be holding all-staff forums and meeting with staff representatives in coming weeks. We will also be setting up an intranet site so that you can easily see a schedule of meetings, forums and regular updates, including answers to frequently asked questions. We are only going to achieve this if we do it together as a team so your support and input is hugely appreciated.

To segue from finance to our environment, you may be aware of the work our organisation is doing around Environmental Sustainability and our recent accreditation with CEMARS (Certified Emissions Measurement and Reduction Scheme). I’ll be talking more about this next week but for now I want to share with you a recent insight from David Grayson, the Clinical Lead of our 20,000 Days Campaign. Not only have we saved 13,551 bed days to date but, using a template developed by the UK’s National Health Service, David has calculated that this bed days saving equates to a reduction of over 1 million kilograms of carbon dioxide emissions (thanks to changes in patterns of patient demand, reduction in travel etc).  A number of factors contribute to our carbon footprint but it’s great to see that our work in other areas is helping reduce the environmental impact of our organisation.

This week I also want to remember several of our valued and well-respected colleagues who have passed away recently, including Kathy Walker. I was speaking earlier to our Director of Nursing, Denise Kivell, who had these thoughts to share after attending Kathy’s funeral: Kathy started as a student nurse 47 years ago, spending the majority of her career at Middlemore Hospital in a variety of nursing, managerial and Needs Assessor roles. Whilst Kathy’s extensive experience and networks were amazing, it was this remarkable nurse’s personality, passion and professionalism which has left her ‘Middlemore family’ with such positive stories and memories. The large turnout at her funeral included all professions from Middlemore, testament to the strong working relationships she had forged with her colleagues across the board. She is one of Middlemore’s irreplaceable treasures who helped shape where we are today. She touched our hearts and leaves a lasting legacy.

We have recently lost a few wonderful people who will be sorely missed by many. I know you’ll join me in passing on our sympathies to their family and friends at this time.

On a personal note, I’d also like to thank everybody who passed on their best wishes for my recent wedding. It’s yet another example of the wonderful sense of ‘family’ we have at CM Health and the way we care not only for our patients, but also for one another.

Geraint

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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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