Just another day at Counties Manukau Health – Part Two

A couple of years ago, I met with Intensive Care Specialist, David Galler, and Acute Care Clinical Director, Catherine Simpson, in the old Intensive Care Unit (ICU), which was then located in Middlemore Hospital’s Galbraith building. My visit followed some gang violence in the community, which ended with two gang members being shot and admitted to ICU. Unfortunately they belonged to rival gangs so, as you can imagine, visiting time was a little awkward during their stay with us.

I was reminded of that meeting this week when I attended the blessing of the new Clinical Services Building plaza and temporary Critical Care Complex (CCC) waiting room on Monday morning. As we gathered to bless parts of this magnificent new facility, it struck me how the evolution of ICU in the last few years is a metaphor for the journey CM Health is on.

As recently as 2009, ICU was located in a converted ward in the Galbraith building. We were providing high quality services but in conditions that can only be described as pretty poor. The environment was shabby and cramped for patients, visitors and staff alike. This all changed with the opening of the Edmund Hillary Building, which saw ICU move into its current home – a purpose designed and built facility. This upgrade also enabled us to open a High Dependency Unit for the first time, completing our CCC.

As significant as this achievement was at the time, we were already looking to the future, which brings me back to Monday morning and the blessing in the Clinical Services Building. When the Clinical Services Building was being designed, plans were made to enlarge the CCC and include it in the new facility. But any journey inevitably has setbacks that require compromise, and ICU’s development is no exception. Those original plans have had to be altered to accommodate the Neonatal Unit, which also requires more space.

Despite this, ICU continues to explore ways to develop and improve. In recent years, CM Health has become a national leader in eradicating CLAB (Central Line Associated Bacteraemia) infections from New Zealand hospitals and ICUs. Through Target CLAB Zero, insertion and maintenance bundles have been introduced to 19 district health boards and 24 ICUs. This initiative has helped reduce harm and improve outcomes for patients and as well as save an estimated $20,000 per each CLAB avoided. From April 2012 to May 2013, New Zealand was CLAB-free for seven non consecutive months with only 17 CLAB during that period. According to baseline data, 121 CLAB (costing an estimated $2.08m to treat) might have been expected during that same period had Target CLAB Zero not come about. It’s an extremely impressive improvement and one I’m so proud of CM Health for leading.

More than anything, I remain hugely impressed by our CCC staff – by their efficiency, compassion, pragmatism and ambition. They are a world-class team who embrace our Team Counties spirit to deliver an increasingly high quality service regardless of setbacks they encounter along the way. I really do think this is a microcosm for our organisation and how far we have come.

I’ve often been asked whether, given the choice, I’d prefer to be a patient in a New Zealand or British hospital. Unequivocally, I’d want to be admitted to a New Zealand hospital but more than anything, if I was ever seriously ill I’d want to be treated right here at Middlemore. Putting your life in someone else’s hands is a huge expression of the trust you have in them, but I have no doubt I would be expertly looked after should I ever require the specialist care you all provide.

Finally, I spent an extremely enjoyable Saturday night with David Clarke (who many of you will remember was CEO here from 1996 – 2002) watching the Lions beat the Wallabies. It was fascinating to watch Australian and British/ Irish teams compete head to head. When you realise that they were both coached by Kiwis you see just how well we hold our own on the world stage, both in healthcare and in rugby.

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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