2015 Winners Gallery

Kathryn Chrystal and team

Excellence in clinical care

Kathryn Chrystal and team - It takes a team 

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Multidisciplinary team meetings (MDM) are the cornerstone of modern cancer care. MDM also underpin initiatives such as the National Standards, and Ministry of Health Faster Cancer Treatment (FCT) targets, which are intended to improve outcomes for patients with gynaecological cancers.

Auckland DHB hosts the MDM for Gynaecology, and referral numbers have doubled in the past five years. The existing MDMs could not cope with the workload, and the result was fragmented care.

Patients attended multiple appointments for treatment and follow-up care. A whole service review was undertaken to streamline the patient pathway.

A supra-regional MDM with live video links to eight referring DHBs was established. This provided the opportunity for real-time discussion and decision-making across regions.

Combined medical and radiation oncology and nurseled follow-up clinics now provide more cost-effective, efficient, patient-centred care. Timelines across the patient pathway have reduced, contributing to an improvement in FCT target performance.

Finalists for this category:

Paul Birch and teamExcellence in community health and wellbeing

Paul Birch and team - Transforming the way we care for children diagnosed with coeliac disease in Auckland

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The Auckland regional outpatient model for children with coeliac disease was identified by Starship Hospital as being avoidably expensive and resource intensive. It was agreed that a patient-centred approach was required to reduce the need to bring patients into Starship while delivering the best modern support closer to home.

The current medical model was analysed, including an evaluation of cost and volumes in Starship. A proposed ideal regional clinical pathway was mapped out that would shift management from the tertiary service into primary care.

As the management of coeliac disease is essentially the avoidance of gluten, an educational, self-management approach in primary care was determined to be the best approach, with Starship Children’s Hospital becoming the diagnostic centre only. It was also agreed that a more formal partnership between Coeliac NZ and Starship would ensure better self-management for these patients in a way that was sustainable.

Finalists for this category:

Joe McDermott and teamExcellence in process and systems improvement  

Joe McDermott and team - Improving histology report turnaround

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The timeline of treatment for cancer patients is an important issue within the New Zealand health sector. Both the government and the DHB have made it a key priority to reduce waiting times for patients with cancer. The histology turnaround time is a significant part of the patient’s journey, supporting faster diagnosis, and the improving histology report. A turnaround project utilised a cross-functional LabPlus project team that challenged its current processes and the way they worked together to deliver a successful project.

This project has achieved a 40 per cent reduction in histology reporting time, creating significant benefits for patients and clinicians within Auckland DHB.

Finalists for this category:

  • Putting order into menstrual disorder: Development of a care pathway for women presenting with Abnormal Uterine Bleeding – Kathy Dryden and Women’s Health team - view the video (external link)
  • Review of the Medication Administration processes in Buchanan Rehabilitation Centre – Diane Bartlett and team (Mental Health) - view the video (external link)
  • Turning vision into reality: Reducing waiting times at the Northern Hub GHSNZ – Kimberley Gamet and team (Women’s Health) - view the video (external link)

Alan Barber and teamExcellence in research

Alan Barber and team - Endovascular therapy for ischemic stroke with perfusion-imaging selection

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This research study focused on endovascular therapy for ischemic stroke patients. It was presented at the International Stroke Conference (ISC) 2015 in February and published simultaneously online in the New England Journal of Medicine.

The Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-arterial (EXTEND-IA) trial showed convincing evidence of benefit for endovascular therapy in selected stroke patients. The investigators, led by Bruce Campbell, MD, Royal Melbourne Hospital, note that, until recently, trials of endovascular therapy for ischemic stroke have not managed to show a benefit of this approach. But these latest studies have changed that by selecting patients with advanced imaging techniques, using the latest stent retriever devices, and performing the intervention earlier.

Dr Bruce Campbell commented to Medscape Medical News that tissue plasminogen activator (TPA) does not work well on its own for this group. This is because the clot is too large to be completely dissolved with thrombolysis. He said: “In our study, 40% of patients had a good outcome with TPA alone. This was almost doubled when endovascular therapy was added in,” he said. “This is a huge benefit. “We are talking about transforming the outcome from severe paralysis to patients being able to care for themselves at home.” This paper has been cited over 130 times.

Finalists for this category:

  • AVERT (A Very Early Rehabilitation Trial) – Anna McRae and team (Adult Community and Long Term Conditions) - view the video (external link)
  • Use of an electronic adherence monitoring device with audio-visual reminder function to improve medication adherence and asthma outcomes in children with asthma – Amy Chan and team (Pharmacy) - view the video (external link)

Julie Helean and teamExcellence in the workplace

Julie Helean and team - Values project

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In March 2014 Auckland DHB launched a project to refresh its organisational values. Tim Keogh of UK-based April Strategy, led a process that had proven successful overseas and at Waitemata DHB.

Values Week was held in July 2014 and included workshop sessions with patients, staff, and stakeholders, as well as leadership values training. Considerable care was taken to ensure the values project was appropriate for children and those from a Māori, Pacific and Asian backgrounds. Mental health consumers were also engaged with, and the whole process was as inclusive as possible.

Attendees at the Values sessions identified behaviours that contribute to a good experience. Four clusters of behaviour were identified. Over 12 months these behaviours evolved into the new DHB values: Welcome-Haere Mai, Respect-Manaaki, Together-Tūhono, and Aim High-Angamua.

The values are now being integrated into the organisation. This piece of work was assisted by a steering group, our Chief Adviser Tikanga, and Waitemata DHB.

Finalists for this category:

Julie Helean and teamChief Executive Award

Julie Helean and team - Values project

Finalists for this category: