Health Matters EBOP November 2018

Better care coordination of staff leads to shorter stay in hospital A project focused on having the right health professional see patients in a timely way at Whakatāne Hospital is leading to in some cases faster treatment and a shorter hospital stay. Since June the ALPHA team which includes a broad range of health professionals such as physiotherapist, occupational therapists, podiatrists, pharmacist and nurse specialists has been working closely with doctors and nurses in the Emergency Department (ED), quickly identifying patients whose treatment aligns with their profession. The team attend three whiteboard rounds in ED a day, meeting with the ED nursing and medical team, identifying patients who’d benefit from the team’s health skills. Whakatāne Hospital ED Clinical Lead Dr Tamsin Davies says, “They pick up a broad range of things such as fitting appropriate splints, reviewing medications and coordinating care in the community for patients with complex health needs. “It’s a shift from the traditional way of doing things where those patients were only seen by those health professionals once they’d either been admitted to a ward or from an ED referral. “For patients picked up by the ALPHA team what we’re finding is that they are getting the healthcare they need much sooner. Particularly our older patients (75 plus), faster treatment means a better recovery and less time spent in hospital.” Dr Davies says some patients are also avoiding a hospital stay altogether by being connected with the right health support they need in the community. The ALPHA team is part of a wider programme underway at Whakatāne Hospital this year to improve the care treatment pathway, making better use of hospital resources and saving our patients time. Service Improvement Programme Manager Fiona Burns says, “We’re constantly looking at ways to improve the timeliness and quality of care provided at the hospital, we don’t want patients waiting unnecessarily when there’s no good medical reason to do so.” “We have been monitoring progress closely and since the programme began approximately 7 out of 10 patients are going home a day earlier.” Globally research shows just a few days in bed can reduce muscle strength and increase the risk of complications, particularly for our frail older patients. Getting older patients up and moving has been shown to reduce falls, and reduce their length of hospital stay by up to 1.5 days. ‘EndPJParalysis’ is something the hospital fully ED Clinical Lead Dr Tamsin Davies with part of the ALPHA team, Occupational Therapist Ellise Robinson, Nurse Practitioner Theresa Ngamoki and Podiatrist Amanda Johnstone. supports. As part of our improvement progamme we’ve designed activity plans for patients. Where appropriate, patients can expect to be encouraged to get up and get moving. “PJs say you’re unwell, clothes say you’re getting better,” says Fiona. Eastern Bay people and lifestyle attract new doctors This month six new doctors start their medical careers at Whakatāne Hospital. For three, it’ll be a chance to reconnect with the Eastern Bay people and lifestyle they experienced as students. Each year the New Zealand Resident Doctors’ Association (NZRDA) ranks the nation’s hospitals in order of where final year medical students would like to work after qualifying. For the 2019 year Whakatāne Hospital took top spot as most preferred employer, with twice as many applicants as positions. Three of the intern doctors may be familiar faces to some Eastern Bay people. Kip Mouldey, Eleanor Harvey and Alice Hunter were previously on the Whakatāne based Rural Health Interprofessional Programme (RHIP), a joint student placement initiative between the BOPDHB’s Clinical School, the University of Auckland and Health Workforce New Zealand. Established six years ago, the five week student placement initiative brings together students from a range of health disciplines including medicine, nursing, pharmacy, physiotherapy, social work, paramedicine, speech pathology, midwifery, occupational therapy and podiatry. The students live together in student accommodation and learn together looking at health through a rural lens. Staying on local marae listening to kaumatua about the history of local iwi and how this relates to health as well as visiting local industries are just some of the things students are exposed to on RHIP. For this trio of intern doctors, it’s the hospital’s supportive working New doctors starting their medical careers at Whakatāne Hospital. Pictured left to right: Mercy Moxham, Alice Hunter, Anahera Herewini, Eleanor Harvey, Ben Keren and Kip Mouldey. environment, a desire to improve the health status and reduce disparities within the community and the great outdoor Eastern Bay lifestyle that’s attracted them back. Kip Mouldey says he considers it a privilege to start his medical career at Whakatāne Hospital. “As a student I got an up close look at the health issues facing people living in rural areas on placement at the Te Kaha Medical Centre. “It really broadened my outlook and cemented my passion for rural health, and improving the health status of Māori.” The first year doctors will be here for two years. In their first year they will work 13 week rotations across most specialities as they work towards gaining full registration.