E22 A4 Annual Report 2010 FP.indd - Northland District Health Board

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24 comment to shift some secondary services to primary health care. This policy direction stems from a signifi cant body of evidence which indicates that some ambulatory services can be better provide in local community settings rather than hospitals and that this has the potential to improve service quality, access and patient outcomes. Northland DHB had made commitments to secondary to primary devolution prior to the Government’s announcement, the largest of these being the introduction of the Primary Options Programme. Primary Options Programme Northland (POPN) is a scheme to enable primary care providers to provide treatment for people with selected acute conditions who would normally have been treated by secondary services. Primary providers are able to access up to $300 for each patient who meets POPN access criteria. Northland DHB has entered into a three year agreement with Manaia Health PHO, as the lead primary health organisation for the provision of the POPN programme. Manaia Health PHO has appointed a primary options coordinator who will coordinate and manage the programme. In addition, Northland DHB intends to invest in a minor surgery initiative. Previously piloted within Northland, this initiative involves a review of secondary services waiting lists to identify patients whose conditions can be treated in primary care. Patients are then referred to general practitioners (not necessarily their own) who have previously been identifi ed as skilled and available for providing the appropriate surgery. Consolidation of Primary Health Organisations When primary health organisations were established in Northland, they formed around historical alliances. This approach led to the formation of six primary health organisations within Northland, namely Te Tai Tokerau, Whangaroa, Hokianga, Tihewa Mauriora, Kaipara and Manaia PHOs. These primary health organisations range in size from 3,000 to 80,000 enrollees. The collective Northland primary health organisations recognised the benefi ts of cooperating by sharing resources and infrastructure early after their formation, and established Northland primary health organisations (NPHOs) as a separate entity with the purpose of supporting back-offi ce function around capitation and data requirements. More recently there has been an increasing recognition within the district of the need for primary health organisations to merge into larger, more effi cient organisations. This process of consolidation has already been initiated with the merger of Tihewa Mauriora PHO into Te Tai Tokerau PHO from 1 April 2010. Northland primary health organisations have indicated their intent to reduce the number of primary health organisations further. Northland DHB has already supported the merger of Tihewa Mauriora PHO and Te Tai Tokerau PHO, and has applied a process similar to that described within the Ministry of Health PHO Confi guration Process Requirements and Timetables. It is Northland DHB’s intent that any merger process should be made as simple as possible to facilitate ongoing provision of primary care to enrolled populations with minimal disturbance. Further devolution currently under consideration includes ultrasound, orthopaedic steroid injections and rheumatologic primary care management, outpatient orthopaedic fracture follow-ups and chronic pain primary care management. HOSPITAL AND SPECIALIST SERVICE ACTIVITIES BreastScreen First Digital Mobile Arrives in Northland New Zealand’s fi rst digital BreastScreen mobile unit arrived in Kaitaia with a special blessing in February 2010. The arrival of the state of the art digital mobile technology means Northland women’s images can be viewed at the time of screening. The technology is not restricted to Kaitaia and Kerikeri women will be able to access the service from July 2010. Previously, women in Kerikeri have been offered free breast screening at a fi xed site utilising analogue technology. Newborn Hearing Screening Initiative The fi rst six months of a baby’s life is a critical period for learning communication. Lack of exposure to language during this time can affect a child’s development, communication skills, educational and career achievements. The early detection of hearing loss, and the application of early interventions, has been demonstrated to signifi cantly improve longterm language skills and cognitive ability. Newborn hearing screening is becoming the standard of care internationally, with programmes being established or already implemented in the United Kingdom, the United States, Canada, Australia and a growing number of other countries. As a response to the success of newborn hearing screening programmes in other countries, the New Zealand Government announced in 2006, that it would fund a universal newborn hearing screening programme for all eligible New Zealand children. Each year, it is estimated that between 135 and 170 babies are born in New Zealand with mild to profound permanent congenital hearing loss. This represents a birth incidence of approximately three babies with a hearing loss per one thousand births. In Northland this translates to approximately fi ve babies born with mild to profound permanent congenital hearing loss every year. The universal Newborn Hearing Screening and Early Intervention Programme (UNHSEIP) is being progressively rolled out in New Zealand and from May 2010, Northland DHB began offering newborn hearing screening free of charge, to every eligible baby born in Northland, whether they are born in hospital or at home. Northland DHB commenced newborn hearing screening in May 2010. As at 30 June 2010 380 babies have been screened, with sixteen referred for targeted follow up. Four of the sixteen have been referred to specialist assessment services, with one baby found to have sensory neuronal (hearing) loss. Information Services Much has been happening in the information services division with the implementation of the clinical workstation and the development of the Clinical Knowledge Centre. • Clinical Workstation Project The aim of the Clinical Workstation Project is to deliver a front-end user interface to display patient information stored in other systems. It is a three-year programme of work incrementally adding features to a new user interface. The business case to replace our old clinical patient information system (iHealth) with a new clinical workstation (Concerto) was approved late last year. Implementation is well underway and we are in the process of building a new clinical data repository with all the laboratory results and radiology reports recorded in Northland DHB systems. • Clinical Knowledge Centre Launched in June 2010, the Clinical Knowledge Centre (CKC) is a single portal that allows clinical staff to access clinical resources, databases and documents. It contains only information relevant to the delivery of clinical services and it is envisaged that all clinical documents within the current DHB intranet and all hard copy documents residing in a collection of folders across various clinical areas will be available within the CKC by the end of 2010. • JADE Co-ordinated Care (Access Pilot JADE Co-ordinated Care (JADE) is an electronic patient record system used by Northland District Health Board’s mental health service. It allows authorised clinicians to access a complete health record from the point of care. It offers an integrated case management model enabling the delivery of co-ordinated client care within a multidisciplinary service. The JADE access pilot has been launched at Northpoint Services Trust, a non-government organisation (NGO) in the Mid North. The aim of
the pilot is to improve the integration of care between the NGO and the district health board’s mental health service, and to explore the potential of NGO reporting to the Ministry of Health being undertaken by the district health board via JADE. • Picture Archiving and Communications System (PACS) Expansion Inpatient and outpatient radiology services are provided at four Northland DHB’s sites – Whangarei, Dargaville, Bay of Islands and Kaitaia. Radiological services for patients referred from the community are also provided at these sites. PACS was introduced in June 2008 to Whangarei, Dargaville, Bay of Islands and Kaitaia Hospitals and has seen the use of fi lm processing becoming obsolete. Recently, the PACS link to the Auckland DHB was extended to Kaitaia Hospital, improving clinical access to x-rays for patients transferring to Auckland City Hospital or Starship for treatment. • Regional Information Strategy In December 2009, the northern district health boards, together with a wide range of sector stakeholders, developed the Regional Information Strategy for 2010 to 2020 (RIS10-20). The strategy supports the transformation to new models of care and underpins the development of a person-centre model to achieve better, sooner, more convenient health care. Safe Medication Management Programme Medication is one of the most common therapeutic interventions used in the health care system, and medication errors in hospitals or the community are common. Approximately 1.6% of people admitted to hospital may experience an adverse medication event. Of these events, the majority are preventable and occur inside hospitals. Preventable adverse events have a signifi cant impact on consumers. About 3.1% result in death and 8.3% in permanent disability. Northland DHB has introduced strategies proven to be effective for reducing the rate of errors in medication management. They include: pharmacy software; reconfi guration of medication rooms and implementation of a new patient medication chart on 6 April 2010. Value for Money (VfM) and Productivity Increase Northland DHB established a VfM steering group to oversee and support VfM projects, report benefi ts and ensure ongoing benefi ts are imbedded into the organisation. Launched in 2009, the aim of the group is to encourage staff to submit cost savings and effi cient project and ideas. Working through a number of great ideas in areas including electricity consumption, use of motor vehicles and procurement reviews, the district health board has saved over $1,200,000. Violence Intervention Programme The violence intervention programme screening project is currently being implemented at Whangarei Hospital’s emergency department and maternity service and Kaitaia Hospital. During the next two years, the programme will be rolled out within all areas of the district health board. Family violence intervention training is now mandatory for all district health board services and departments. Whangarei Hospital’s Site Master Plan Strong progress continues with the Whangarei Hospital development following the Minister of Health’s approval of our stage one business case to build a new mental health inpatient unit. Principal consultants for the multi-million dollar building programme have been selected. The developed design for the new 25 bed mental health unit at Whangarei Hospital was approved by the Northland DHB Board at its meeting held on 21 June 2010. The main building contractor is expected to be appointed in late September and works will commence on site at Whangarei Hospital in October 2010. The building is expected to be completed and operational by December 2011. PUBLIC AND POPULATION HEALTH POINTS Emergency Planning and Disease Outbreaks Following the World Health Organisation declared H1N1 pandemic infl uenza event, Northland DHB successfully contained and managed the H1N1 outbreak in Northland during the winter of 2009. Work is continuing on the development of the Maori component of the Northland DHB pandemic plan. A tornado hit Kaitaia Hospital on Saturday, 4 July 2010. It damaged roofi ng on the old boiler house and shattered glass in the building. The boiler room roof landed on the main hospital roof, damaging it. The general practitioner waiting room areas had considerable damage done to the ceiling tiles. The glass panel in the fi rst exit doors next to the cafeteria was damaged along with the windows at the front entrance to the hospital. There were patients and children in the waiting area, but fortunately no one was hurt. On 30 October 2009, all theatres were closed as a result of a signifi cant power cut experienced through out Northland and Auckland. All elective surgery was cancelled as a consequence and patients were rescheduled. In January 2010, dry conditions prevailed in Northland causing less than average monthly rainfall resulting in low river and stream levels and extreme soil moisture defi cits. Drought conditions continued to worsen and the Far North District Council placed area water restrictions in Kaitaia directly affecting Kaitaia Hospital. Northland DHB activated its incident management team to monitor community health concerns. The team stood down on 1 June, following the lifting of water restrictions by the district council. In March 2010, Northland DHB’s medical offi cer of health notifi ed Northlanders of a measles outbreak in Northland area. There had been thirty two reported cases of measles (fi ve laboratory confi rmed) in the Hokianga since the middle of February 2010. All cases, except for one, were directly associated with an extended family group in the Hokianga whose children are largely unvaccinated and are home-schooled. Most cases were unwell, with one child admitted to hospital. High Five for clean hands In 2007, the Northland District Health Board with support from representatives from Northland’s schools and early childhood centers launched a Northland-wide project for children aged 0 – 12 years focusing on the lifelong importance of good hand hygiene. The goal of the programme was to effectively spread the message throughout Northland that thoroughly washing and drying hands is one of the most signifi cant things that children and their families can do to prevent the spread of illnesses. In August 2009, the Ministry of Health adopted the programme and rolled it out over 6,000 schools and preschools throughout New Zealand to support hygiene activities in local communities and in response to Novel A H1N1 09 pandemic. In response, Northland DHB’s public health promotion unit launched the second phase of the programme involving the unveiling of vehicle signage and billboards. Each vehicle and billboard incorporates the vibrant ‘High 5 for Clean Hands’ theme. SCHOOL AND COMMUNITY FOCUSED ACTIONS Health Assessment of Year 9 Children in Decile 1 and 2 Schools The new school based health assessment programme for Year 9 children in Decile 1 and 2 schools began in May 2010. The overall purpose of the programme is to identify health issues, improve students’ access to primary health care and to ensure that appropriate and timely referrals are made in order to improve youth health and reduce inequalities. The programme’s objectives are to appropriately plan for, resource and 25
Page 1 and 2: 2009 2010
Page 3 and 4: Contents INTRODUCTION NORTHLAND DIS
Page 5: Our Role Northland DHB, established
Page 9 and 10: Our Vision, Mission & Values Our Vi
Page 11: The Board Chair and Chief Executive
Page 15: Our Services Health Portfolio No of
Page 18 and 19: 18 NATIONAL: Health Workforce New Z
Page 20 and 21: National Health Targets Health Targ
Page 22 and 23: 22 ASSOCIATED HEALTH TARGET ACTIVIT
Page 26: 26 implement a comprehensive health
Page 31 and 32: Our Health Priorities Northland DHB
Page 33 and 34: Financial And Audit Reports Content
Page 35 and 36: Northland District Health Board Boa
Page 37 and 38: Northland District Health Board Boa
Page 39 and 40: Northland District Health Board Aud
Page 41 and 42: Northland District Health Board Sta
Page 43 and 44: Northland District Health Board Con
Page 45 and 46: Northland District Health Board Not
Page 75 and 76:
Northland District Health Board Sta
Page 77 and 78:
Page 79 and 80:
Page 81:
Page 84:
NORTHLAND DISTRICT HEALTH BOARD Mau
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E22 A4 Annual Report 2010 FP.indd - Northland District Health Board

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