Keywords
Citation
(2012), "A vision for connected healthcare (New Zealand)", Leadership in Health Services, Vol. 25 No. 4. https://doi.org/10.1108/lhs.2012.21125daa.006
Publisher
:Emerald Group Publishing Limited
Copyright © 2012, Emerald Group Publishing Limited
A vision for connected healthcare (New Zealand)
Article Type: News and views From: Leadership in Health Services, Volume 25, Issue 4
Keywords: Emergency healthcare and natural disasters, Integrated healthcare systems, Demand management strategies in healthcare
On 22 February 2011 a 6.3 magnitude earthquake shook Canterbury and the devastation it caused made it one of the worst natural disasters in New Zealand’s history. Christchurch city and hillside areas were badly hit. With buildings and infrastructure already weakened by an earthquake the previous September, the February quake and aftershocks placed huge pressure on the Canterbury health system and led to a peak in demand. A number of facilities were damaged, some rendered unusable. Healthcare workers had to quickly find a new way of working against a backdrop of damaged homes, lost essential services and shell-shocked families.
The reason they were able to respond so quickly and effectively post-disaster was because the transition towards a more integrated way of working was already underway. New initiatives and plans were in place and working relationships were being strengthened to address the more everyday challenges of an ageing population, outdated facilities and increasing demand.
Their vision in Canterbury is for a connected health system, centred around people, where “the whole system needs to be working for the whole system to work”. By operating collaboratively with all healthcare providers, including ambulance, GPs, clinicians and administrators and using powerful “fact-only tools”, they could deliver the right care in the right place at the right time.
They have already seen fewer emergency department presentations and acute medical admissions, increased community care and are working towards improving health outcomes.
Initiatives include an acute demand management strategy specifically aimed at supporting people in the community and, where appropriate, avoiding unnecessary admissions. For example, providing acute nursing, general practice packages of care, acute diagnostics and community observation to ensure that people receive appropriate care, which in many cases is not a journey to hospital.
Another strategy ensures people with chronic obstructive pulmonary disorder will be safely supported to stay well at home, using a plan agreed with their GP. That plan could include advice on stopping smoking, ensuring they have sufficient medication for when they need it, giving a free flu vaccination, or arranging for visits from a community nurse. This approach is being supported by pathways for ambulance staff to decide to leave patients in their own home with follow-up acute nursing, or deliver them to acute community medical centres or emergency departments based on clinical need.
Another one of the initiatives provides in-home care to support patients discharged from hospital and helps to avoid re-admission. The feedback from patients has been overwhelmingly positive and the admission rate is the lowest of any large metropolitan area, with the length of stay also steadily reducing.
So far, they have cut 1.5 million days of patient waiting time (in just four areas measured), met the six-hour “discharge or admit” government health target in 95 per cent of cases, and are leading in the OECD for screening mammograms.
In the past year almost 20,000 patients have been cared for in community settings – avoiding a hospital stay altogether.
They are excited by the results the people-centred approach has achieved, but they are even more excited by what else they believe they can accomplish using evidence-led thinking and working collaboratively.
For more information: www.guardian.co.uk