2016 Winners Gallery

Excellence in clinical care

Photo of project team in the lab

Project team: Colleen Harvey, Dianne Webster, Keith Shore, Mark de Hora, Detlef Knoll.

Colleen Harvey and team -  Improving Follow-up in Newborn Metabolic Screening.

Newborn metabolic screening saves about 50 babies a year from death or disability. Samples of blood dried on paper are collected
throughout New Zealand and sent to the screening laboratory at LabPlus for testing. Communication with lead maternity carers (LMCs) over screening samples has, in the past, been problematic, resulting in delays in getting follow-up samples, and unnecessary requests for second samples. Some disorders kill babies within days, so timely testing and follow-up is essential. The introduction of text messaging has enabled more timely communications with LMCs, reduced miscommunications with the laboratory, and reduced anxiety for both LMCs and families. The programme has achieved a 20 per cent improvement in the number of follow-up samples received within 10 days, and the avoidance of up to 10 requests per month for follow-up samples. The next step is to build a module to track the outcome of positive tests, and to extend to antenatal screening, where text messaging could replace up to 300 phone calls annually.

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Finalists for this category:

Excellence in community health and wellbeing

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Project team: Carolyn Pye, Lucy Westbrooke, Jill Miller, Dr Cathy Pikholz, Sunil Kushor, Kim Olsen.

Carolyn Pye, Lucy Westbrooke and team - TeleDOT  Telehealth Programme.

The aim of the TeleDOT programme was to increase the number of patients with pulmonary tuberculosis receiving directly observed therapy (DOT), within current nursing staff levels. The programme has embraced evolving technologies to deliver TeleDOT on a secure video-conferencing platform. Initial use of video-phones was quickly replaced by video-conference applications on a patient’s personal computer. This application was later deployed on mobile devices – initially tablets and then smartphones. More cost-effective TeleDOTs have been achieved with the move to web-browser access and secure virtual meeting rooms. The recording function allows patients
the convenience of conducting TeleDOT at a time they choose. The public health nurse then views the recording within hours.The programme has achieved an increase in the number of patients receiving DOT within existing nursing staff resources, with improved treatment delivery and cost efficiencies. The number of patients with active TB receiving DOT has increased from 30 per cent prior to TeleDOT to 60 per cent. Comparing the six-month period prior to launch with the six months after has shown that the cost of TeleDOT is a quarter that of the regular DOT therapy; a figure that has decreased still further since the introduction of web-browser access.

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Finalists for this category:

Excellence in process and systems improvement  

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Project team: Paul Birch, Eletha Taylor, Mike Puttick, Paula Whitfield, Dr Jeremy Whitlock, Dr Robyn Oldfield, Gabby Ikitau, Dr Linda Ashley.

Paul Birch and team - Faster Cancer Treatment: Doing right by patients and letting the target take care of itself.

The Faster Cancer Treatment programme aims to improve the quality and timeliness of services for cancer patients. As a result of the project, the proportion of women with a high suspicion of breast cancer who received treatment within the Ministry of Health 62-day target, has increased from 71 to 90 per cent. No one with a confirmed cancer waits longer than the Ministry of Health target of 31 days, with the average wait being 15 days. Meanwhile, the proportion of women seeing a specialist within 14 days has increased from 25 to 88 per cent. Waiting times have reduced from an average of 22 days to just nine days by adopting a one-stop clinic approach and a sustainable new clinic template, and in future the team are aiming to treat 85 per cent of women within 50 days.

Project team: Paul Birch, Eletha Taylor, Mike Puttick, Paula Whitfield, Dr Jeremy Whitlock, Dr Robyn Oldfield, Gabby Ikitau, Dr Linda Ashley.

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Finalists for this category:

Excellence in research

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Project team: Dr Michelle Wise, Dr Premjit Gill, Sarah Lensen, Assoc Prof John Thompson, Prof Cindy Farqhar.

Michelle Wise and team – BEC1: Body mass index trumps age in decision for endometrial biopsy. 

The objective of this study was to evaluate the effect of body mass (BMI) on the risk of endometrial hyperplasia or cancer. A retrospective cohort study at Auckland DHB of 916 pre-menopausal women referred for abnormal uterine bleeding, who had an endometrial biopsy between 2008 and 2014, found that 4.9 per cent had complex endometrial hyperplasia or cancer. Women with a BMI of 30kg/m² or more were four times more likely to develop complex hyperplasia or cancer. Other risk factors were not having any children, and anaemia; age was not a risk. In conclusion, obesity was found to be an important risk factor in women with abnormal uterine bleeding. Considering that more than half the women with complex hyperplasia or cancer were under 45 years of age, deciding to biopsy based primarily on age, as is currently recommended, potentially misses many cases or delays diagnosis. BMI should, therefore, be the first consideration in the decision in whether to perform endometrial biopsy and to refer to secondary gynaecology services.

Project team: Dr Michelle Wise, Dr Premjit Gill, Sarah Lensen, Assoc Prof John Thompson, Prof Cindy Farqhar.

Watch the video (external link)

Finalists for this category:

Excellence in the workplace

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Project team: Santosh Parab, Leigh Donohue, Barbara Fox,Esther Bathula, Sonu Anand, Gina Cowper, Don Fulford, Stuart Almao.

Santosh Parab and team - Auckland DHB Nursing Bureau Project. 

The Auckland DHB Nursing Bureau employs more than 400 casual staff, consisting of registered nurses, midwives, healthcare assistants and mental health assistants. Due to the turnover rate and high demand, these roles need to be constantly filled, requiring the careers centre to run a proactive recruitment campaign. Under the existing process it was taking more than a month to recruit each new worker. Consequently, the bureau was dependent on agency temps. This resulted in additional costs, and existing staff were under increased pressure, having to work extra shifts. The project focused on reducing the time spent on various steps in the recruitment process. Improvements included using pre-screening questions and scoring techniques, obtaining candidates’ referee details as part of the application, and using text messaging to contact candidates. As a result, the time required to fill a vacancy was reduced from 43 to 26 working days, and the time to complete a reference check from eight days to three. The number of candidates providing referee details increased from 66 per cent to 93 per cent; and the average number of casual staff hired increased from 10 to 13 per month. 

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Finalists for this category:

  • Mindfulness-Based Stress Reduction – Nadav Avny and team (Te Whetu Tawera). Watch the video (external link)
  • Te Ama Workplace Health – Annemarie Dobson and team (Community Child Health & Disability Service). 

Chief Executive Award

Photo of project team in front of Spectrum Care poster

Project team: Adele Print, Judy Garriock, Ingrid Moody, Joe Monkhouse, Dr Anecita Lim, Ian Costello.

Adele Print, Judy Garriock  and team - Reaching out beyond hospital Walls: Optimising medicines for people with intellectual disability.

People with intellectual disability commonly have multiple and complex long-term health needs, and are significantly
more at risk of disease, ill health and early death than the general population. In 2015, Spectrum Care, an independent charitable
trust that supports people with disabilities, identified that 49 per cent of their residents were taking six or more medicines every day and were potentially at risk of medicine-related problems. In response, they partnered with the Auckland DHB Pharmacy Department to set up an innovative and collaborative review service to optimise residents’ medicines. Previously medicines reviews by specialist hospital pharmacists were available only to inpatients. The Spectrum team developed an assessment tool to prioritise the people who require a health and medicines review. A clinical pharmacist has completed 12 months of medication reviews for residents identified as being
high-risk and are currently tracking five per cent above expected completions. The pharmacist identified real or potential medicine-related problems and recommended a number of medicine changes to the GP. The success of the project is largely due to the excellent
communication and information sharing by the pharmacist, working closely with the Spectrum Care interprofessional health team.

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Finalists for this category: