Great to be Back

As always, it’s great to be back at CM Health and to know that the organisation has been in such good hands while I’ve been away. Thank you to everybody who has held the fort for me, both with my blog and my other work. I’d particularly like to thank ‘Ron Ball’ (our Deputy CEO and Director Corporate & Business Services, Ron Pearson) for his honest yet positive reflections on the treatment he received at MSC and Middlemore as an anonymous patient. As staff who commented on the post pointed out, it really was a great read.

Over the last couple of weeks I have been fortunate enough to have a short sabbatical overseas, during which time I’ve been looking at how other health systems are transforming through better integration and how they are making themselves fit for the future. I’ve had some fantastic experiences and met some wonderful people. Both in this blog and in person, I’ll be talking a lot about what I’ve learned over the next couple of months as we think about putting some of it into practice at CM Health.

Although I was fortunate enough to meet amazing people doing some extraordinary things, I became very clearly aware of how much we in New Zealand are at the leading edge of change. There are very few systems in the world which are as focussed on creating future healthcare, or which are grappling with some of the serious issues associated with chronic disease, in the way that we are in New Zealand. Too many systems are focussing only on one or two aspects of what they need to do. The fact that we in New Zealand, and particularly in Counties Manukau, are seeking to achieve a balanced, system-wide transformation which is tailor-made to the demands of the 21st century, makes us world leaders.

And yet we have so much to learn from others. I’ve been quite humbled over the past few weeks by the amount of time, effort and excitement fellow healthcare professionals have shared with me. One initiative that has really inspired me is Project Echo, originally founded in New Mexico, Albuquerque. I’d urge you to watch this TEDxABQ presentation by Project Echo lead, Dr Sanjeev Arora, about this exciting initiative. Believe me, when you finish watching it your mind will be thinking of 4 or 5 ways in which this initiative could be used here at CM Health to truly transform how we work.

Wherever I’ve been, I’ve been constantly reminded that the answers don’t just lie in becoming technically more efficient, however important that is. Especially for us in Counties Manukau, some of the more profound answers lie in realising the importance of patient literacy and how we communicate with our patients to teach them how to manage their diseases. Sometimes we don’t feel we have the time or feel that it’s not our forte to communicate with patients. And sometimes as a patient (and I speak here from personal experience) when a doctor does talk to you, you find yourself only taking in 5% of what is said. These hunches are reinforced by learnings from our 20,000 Days Campaign.

Yet it’s become increasingly clear to me how important it is that we find ways to better communicate with our patients. We could provide the best healthcare system in the world, but if we don’t take a moment to work with our patients to find out how they can use it and look after themselves to the best effect, then we aren’t going to get the results we seek. Because the consequences are so profound, I really do believe we need to think about how we build better communication with patients into how we work. As always, I’d be grateful for your thoughts: ceoblog@middlemore.co.nz.

A number of places I’ve visited on my travels have achieved it by having community health workers or buddies working alongside patients. These people in dedicated roles often come from the patient’s own community and can support them on their journey, allowing clinicians like doctors and nurses to focus on the more technical aspects of their roles. There are, however, many other ways of doing it. I also visited one community which uses You Tube to link patients up with the information they need. They have a bi-lingual You Tube channel where patients can connect with other patients to seek their advice, suggestions and support. For this community it proved to be a very useful tool.

This is not a perfect science and what works in one place may not work elsewhere. The important thing is that we begin to think not so much out of the box but into a new box about this issue. Using You Tube certainly does not replace face to face contact but, to quote Dr Sanjeev Arora in his TEDxABQ presentation, it is helping to ‘de-monopolize’ knowledge and ‘force multiply’ the impact of that learning. The challenge for us is to think about what would have the same effect in our setting.

Speaking of using modern technology to communicate, I want to finish by sharing with you a brief story about Lottie, my pet Border Terrier. While I was away we Skyped the family and I would howl into the computer to encourage Lottie to howl back at me. It was a good laugh and elicited a great response from my dog via the internet. Unfortunately, it also encouraged dogs in the neighbouring apartments where I staying to join in. Suffice to say, my American neighbours were not so impressed with my antics!

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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