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Participants of the Gemba workshop – 27, 28, 29 April 2011

Participants of the Gemba workshop – 27, 28, 29 April 2011. Rere atu, rere mai, taku manu e rere ki tua, rere ki kō, kia whetūrangitia e As we take up new challenges plant your feet strongly upon mother earth with eyes towards the stars for light and inspiration. Proposed future state;.

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Participants of the Gemba workshop – 27, 28, 29 April 2011

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  1. Participants of the Gemba workshop – 27, 28, 29 April 2011

  2. Rere atu, rere mai, taku manu e rere ki tua, rere ki kō, kia whetūrangitia e • As we take up new challenges plant your feet strongly upon mother earth with eyes towards the stars for light and inspiration

  3. Proposed future state; • High level future state developed during the Gemba three day workshop for people in South Taranaki.

  4. What was our goal? • The goal was to design future services that can be provided by an appropriate range of skilled staff, making good use of technology and equipment in the best locations for patients.

  5. How we did it We designed a future state around four elements; • Prevention and screening • Assessment, triage, emergency • Diagnostics & specialist assessment • Treatment rehab and follow up

  6. Prevention and screening • Main aim: • Screening • Prevention • Early intervention Utilise existing & effective initiatives/programmes & enhance them Investigate delivery models in other similar areas • Whole community approach • Annual strategy & planning • Hub & spoke • Expansion of outreach • Programmed engagement • Whanau Ora Assessments • Extensive holistic approach defining risk factors across health/social streams • Community support / resource for Maori/mental Health/CAMHs (non-clinical) • Enhancing community facilitating/identification • ie. of kaiawhina/etc • Enhanced MDT processes • Free up 2⁰ educators to work across entire community Integrated Care Centre • Database • Back office functions • Recalls • Admin / clinical • Scheduling • Focus on Targets through joint planning

  7. Assessment, triage, emergency Protocol-driven transfer (non-doctor) Does this need to be open during working hours? 24/7 Dr on site – 0800 2200 Dr on call – 2200 0800 Healthline F2F / Phone 111 Community/Kai awhina Procedural A & M plus 24/7 1⁰ facility Co-payments Voucher system / LCF fee Must have I2 lead ability combined with TK4 until St John have training, equipment & funding to do this Triage Prime 2-tier transfer system Bypass protocol Transit lounge Appropriate staffing On call (dedicated South Taranaki) Crisis MH on call & support • Available daily • Bookings • Records • Meds • Results • IBA • Radiology Security Mental health help line Dental health A&D Base hospital

  8. Diagnostics & specialist assessment FSA • Orientation • Where in Hawera <->Base? • Health professional • Patient • Navigator • Community • Main Requirements • Recruitment • Retention • Training • Labs • Onsite 8-5 (already there) • Collection • POCT (after 1pm weekends) • Reduction in staffing cost • Mobile • Echo? (car, lease clinic, increased FTE) • Lab screening • Radiology • Easier accessibility • Onsite U/S - plain film • Mobile U/S? • Mobile CT / MRI (future) All together -Pooling resources - One IT Site critical • Support • Telemedicine (in patient names, laptops, video) • E-mail • Phone call • Standardized template “R” • Increased / intensified local one programme • Specialist • 1x Cardio, 1x Ortho etc • Onsite visits by all • “One local champion” specialist • Education & support of local Everyone together

  9. Treatment rehab and follow up • Maori Advocacy • Support? • Intervention? Hawera Health Base (South Heath Integrated) Rehabilitation/Intermediary Care(@ home or residential care) • Day Procedure Unit • Nurse lead • Blood transfusion • Ex ECGs • A&M • Observation/assessment beds (numbers ?) Need a central hub Community Team OP clinics – increase Complex care managers • Daytime Crisis Team • 1x member South Gen Team • 1x staff CPT (to cover general) • After Hours Crisis Team • Rostered staff (x2) based in Stratford GPs Mobile bus – enhance Public Health Minor procedures: bumps, scopes, local anesthetics, Oral health • Mental health • Up skill to crisis trained Maternity (currently under review) • Resources needed: • Staff • Mental health • Up-skilled/multi-skilled, more mobile • More allied health ( physio, OT, social worker, geriatrician) • Restorative/Intermediate Care team (Splice-related) • Transport • Diagnostic primary • Paeds • Respiratory • Diabetes Need to be linked to screening / prevention early intervention Psychiatric nurse within Intermediary Care team

  10. Common themes • Mobile services • Central hub and spoke • Pooling resources • One IT site/system • Building single team focus • Recruitment, retention, training

  11. Key Enablers • Transport • Policy & Governance • IT – shared information • Funding • Workforce • Health literacy/education • Facilities

  12. Meet with Hawera Hospital staff Meet with GPs Develop proposal Community consultation Where to from here?

  13. Rere atu, rere mai, taku manu e rere ki tua, rere ki kō, kia whetūrangitia e • As we take up new challenges plant your feet strongly upon mother earth with eyes towards the stars for light and inspiration

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