Wairarapa Community PHO EOI - New Zealand Doctor

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3.5.4 Key Performance Indicators SECTION 3.5 – LONG TERM CONDITIONS Year 1 Year 2 Year 3 Health System Implement the Guided Care System Increased flexibility of funding streams Organisation and Design Decision Support Clinical Information Systems Quality Framework developed Clinical leadership and governance structures developed and implemented Re-designing clinical pathways to allow for integrated patient care Create a framework for clinicians to work to best practice standards Internal referral system established Facilitate multi-disciplinary models and team work Develop single patient record across all service provision Systematic programme of combined clinical audit and quality assurance Establish integrated Information Management/PMS systems Merge Practice Management Systems and databases Support for self management Implement tested and evaluated self management programmes Facilitate a framework for the delivery of self management education Ongoing self management education for patients delivered across the sector 34
3.6 Whānau Ora "Whānau Ora is the way forward to achieving a future where Whānau determine what is in their best interests.” 8 The foundation of Whānau Ora is to empower Whānau to maintain or improve their own wellbeing through their own values and needs. In principle self management and Whānau Ora have many similar themes. The point of difference is Whānau Ora moves the emphasis away from the individual and illness and widens considerations to the family and environment. The model below is an expression of the Wairarapa translation of a Whānau Ora Model Māori World View Crown World View Political Variables Values Te Arawhata Tōtika MOH Whānau ora Funder Māori Whānau Providers ora Whānau ora Whānau ora DHB Values Iwi Hapu WHĀNAU ORA Marae Community Providers Matauranga Māori Tipuna Knowledge base Policies Processes /Procedures Crown Knowledge Te Arawhata Tōtika – The Wairarapa District Health Board Cultural Competency Framework 8 Tariana Turia.2009. Whānau Ora Taskforce announced :Māori Party 35
Page 1 and 2: TRANSFORMING PRIMARY HEALTH CARE IN
Page 3 and 4: Contents 1.0 Lead Organisations det
Page 5 and 6: Executive Summary Better, Sooner an
Page 7 and 8: Background and Development Process
Page 9 and 10: 1.3 Legal Structure Wairarapa Commu
Page 11 and 12: 2004 Q3 2004 Q4 2005 Q1 2005 Q2 200
Page 13 and 14: 3.0 The Proposed Initiative / Packa
Page 15 and 16: The Wairarapa Integrated Family Hea
Page 17 and 18: health services, as well as selecte
Page 19 and 20: Immunisation Outreach (1 FTE curren
Page 21 and 22: Local delivery of as much service a
Page 23 and 24: Whānau Ora approaches are infused
Page 25 and 26: Practice Decision Support modules (
Page 27 and 28: 3.3.4 Key Performance Indicators SE
Page 29 and 30: patients transported to ED and redu
Page 31 and 32: 3.5 Patients with Long Term Conditi
Page 33: visible to all providers working wi
Page 37 and 38: Māori Mental Health positions, Wh
Page 39 and 40: Te Rūnanga Hauora o Wairarapa AOD
Page 41 and 42: WCPHO/CH will continue to support a
Page 43 and 44: A shared approach to service improv
Page 45 and 46: WEEK CLINICAL PATHWAY COLLABORATIVE
Page 47 and 48: Practice performance monitoring pro
Page 49 and 50: Figure 1: The Business Unit Model I
Page 51 and 52: Alongside the business and operatio
Page 53 and 54: o o Direct primary care referrals f
Page 55 and 56: 3.8.4 Key Performance Indicators SE
Page 57 and 58: Enhanced collaboration across the c
Page 59 and 60: 3.9.3 Pharmacy Our Goal: Action Com
Page 61 and 62: Medicines Management will be implem
Page 63 and 64: 3.9.3.2 Decision Support and Clinic
Page 65 and 66: 3.9.4 Older Persons Services Our Go
Page 67 and 68: The following organisations have be
Page 69 and 70: 3.9.4.2 Decision Support / Clinical
Page 71 and 72: 3.9.5 Urgent Care We are working th
Page 73 and 74: 3.9.6 Primary Mental Health Service
Page 75 and 76: The Integrated Family Health Model
Page 77 and 78: 3.10 Access Our Goal: Improve acces
Page 79 and 80: 3.10.2 Decision Support / Clinical
Page 81 and 82: o assessment for FSAs in Primary Ca
Page 83 and 84: Meaningful effective linkages betwe
Page 85 and 86:
SECTION 3.12 - VULNERABLE POPULATIO
Page 87 and 88:
Expanded workforce through better u
Page 89 and 90:
MSD has already developed the Commu
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CHWT currently has a Board of 5 Tru
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Associated partners of WCPHO: This
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excellent relationships with the tw
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good track record of issuing media
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Funding model for new integrated se
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4.7 Clinical Leadership Our Goal: M
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Mentoring and support for emerging
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4.8.2 E-Referrals Compass Health ha
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The unit could establish a regional
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when dealing with Long Term Conditi
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The Practice Liaison team forms an
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meet the needs of the workforce. Th
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achieving a systematic approach to
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Secondary funding is not able to be
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Rural Funding and Kimberley 71,000
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Funding sources for capital items w
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The organisation’s financial syst
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7.0 References 1. National Health C
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Appendix 2 - Letters of support for
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Appendix 4 - Terms of Reference of
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number of national forums and organ
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Alison Appleton Manager, Human Reso
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Appendix 6 -Compass Health Staff li
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Hancock Tui Mobile Nurse Hart Nicky
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Gartrell Stephanie Operations Manag
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Wairarapa Community PHO EOI - New Zealand Doctor

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