Marys Medicine

January - February 2016
New $72m Outpatients facility for Christchurch
Bariatric Management Innovation (BMI) initiative
and news from around the nation
Information for readers, subscribers and advertisers
You'll notice some changes to New Zealand Health & Hospital during 2016. These changes have been
introduced to provide you with content that is more accessible and timely. Plus there is now no charge
for you to download your copies of New Zealand Health and Hospital from www.healthandhospital.
The low res pdf version that has become increasingly popular over recent years can be downloaded from the home page. Also available at no charge from the home page is a print-ready version for organisations who may wish to share an issue or issues widely. There is no limit on the number of copies that can be downloaded, forwarded or printed.
The contents page that has been published on the website for some time now also has live links to the articles. This means you can have easy access to the articles you are interested in and that you may wish to access on a mobile device.
Still want to receive hard copies of New Zealand Health & Hospital? That's fine too. The following rates apply: Annual rate within New Zealand
One copy: $60.00+GST
Five or more copies to the same address: $45.00+GST per subscription This will be for a minimum of 6 issues per publishing year. Please note there will be a delay of approximately two weeks between publishing the online versions and receipt of hard copies. This reflects the amount of time required for printing and the mail service.
If you would like to subscribe to hard copy during 2016 and have not already been contacted by us about this please email [email protected] (alternatively dmonigatti@xtra. Advertising
Our advertising rates have changed too, to reflect the new approach to publishing. The rates, which
have always been very competitive, have dropped slightly. There will also be an advertisers' tile on the
home page of which will provide easy access, direct links to the email
addresses of advertisers in the current issue. Please check the website for more information or email
[email protected] to discuss advertising.
Further changes
You'll also notice a small change to the masthead. The word Health has become more prominent,
reflecting a bigger sector focus on community initiatives. New Zealand Health & Hospital has been
published since 1948, initially as New Zealand Hospital, and the health landscape has changed
dramatically since those early days. In fact with changing demographics, advances in technology and
new ways of delivering services, change is happening so fast it's more important than ever to keep in
touch, share and learn from each other.
We welcome your contributions. We focus on the positive, not the negative, and present material in such
a way it allows the reader, rather than the editor, to decide what's important. All contributions must be
of interest to the wider health sector and have a New Zealand theme or link.

January - February 2016 New Zealand Health & Hospital New Zealand Health & Hospital
Volume 68 No 1, January - February 2016
Around the nation
Publisher and Editor
Debbie Monigatti, BA, BSc 4 New $72 mil ion Outpatients facility for Christchurch ISSN 0114 3727
4 Southern Cross North Harbour Hospital undergoes major expansion5 New sky bridge development in plan to expand patient care to Waitemata New Zealand Health & Hospital is published six times a year. Single annual subscription within New Zealand: 6 Good progress on quarterly health targets Five or more copies to one address: $45.00+GST per subscription 7 Waitemata DHB wins national award for patient experience programme Low resolution pdf and printable versions are available for no charge 7 Green light for loan for more LED light upgrades Overseas annual rate: 7 Free Wi-Fi now available at Northland DHB sites 8 Dargavil e Hospital celebrates 60th birthday Editorial, subscription and advertising contact
New Zealand Health & Hospital, PO Box 541, Wel ington 6140, NZ 9 Digital certificates make system simpler Phone+64 4 472 160 9 Organs donation and transplantation increased further in 2015 9 2015 delivers more births 9 Mobile surgical bus visits Whanganui Disclaimer: New Zealand Health & Hospital is a forum for discussion. The opinions expressed in New Zealand Health & Hospital are not necessarily those of the publisher. 9 Steady As You Go fitness programme a winner with Whanganui's elderly Independent professional advice should be sought as appropriate. 10 Final stage of Wel ington, Kapiti and Hutt Val ey modernised school dental 10 New ‘virtual medical receptionist' service to help South Westland10 Children in therapy receive generous community donations Personalised information booklets published for patients with colorectal, 11 Orion Health secures major French contracts melanoma and breast 11 Orion Health partners with Cognizant, the largest US health insurance cancers have been welcomed 12 Orion Health boosts offerings to UK's largest health board by those receiving them, says 12 Victim support turns to technology to help those in need fifth-year medical student 12 McKesson ranks highly in health industry report Hoani MacFater.
Products and services
Mr MacFater recently 1 New Zealand's first EASIE Living Centre opened in Palmerston North completed a 10-week 1 New watch saves diabetics' time research project for the 1 A tilt in the right direction Whanganui District Health 14 App makes low salt and gluten-free shopping easy Board's Surgical Services team, who designed and Pharmacy & pharmaceuticals
published the 8-page 15 Better care for people on multiple medications15 GSK first in New Zealand with new business model for the pharmaceutical booklets last year.
16 Initiative launched to support very large patients
16 National Science Chal enge tackles childhood obesity, learning and mental
17 Contact between children monitored in world-first infection study17 Revolutionising heart disease diagnosis18 Slow global progress on stil birth prevention18 Antipsychotic drug clozapine found to have significant gastrointestinal side 18 Fracture risk more important than bone density19 First study of South Island Pasifika heart health 19 One in five lie to their doctor19 How and who you exercise with affects your mental wel being19 Better nutrition policies needed for children20 Dads can help boost immunisation rates20 Can blood pressure medication stop breast cancer?20 Summer students trial wearable fitness technology in surgical ward and assess satisfaction with mental health crisis service People 21
Publications & resources
22 Agencies need to change response to family violence: Report
22 Data shows continuing disparity between gout prevalence and treatment
2 New online tool supports healthy food in schools2 Scholarship student explores response to Whanganui DHB cancer information booklets New Zealand Health & Hospital January - February 2016 around the nation
New $72 million Outpatients facility for Christchurch
An artist's impressions of the new outpatients facility.
The Government has given the green light to a new $72 million Southern Cross North Harbour
Outpatients facility to be built in Canterbury. Hospital undergoes major expansion
The new building will be located in the health precinct on St Andrew's triangle directly opposite Christchurch Hospital, which is close to the CBD and on public transport routes.
Spanning five storeys and 10,500m2 the new building will provide outpatient and other clinical services including diabetes, endocrine, ophthalmology, and dental.
"Patients and staff will benefit from having so many key services brought together in a purpose-built facility," says Health Minister Dr Jonathan Coleman. "Clinical leaders are having a high level of involvement in the design to help ensure the space is well utilised.
"While the final design and construction timeframes are expected to be confirmed in the coming months, the Government has made up to $72 million available for the project and the new facility is Southern Cross' North Harbour Hospital on Wairau
expected to be completed in 2018.
Road. New post-operative patient recovery facilities and
"The approval of the new Outpatients facility is a significant two state-of-the-art theatres are being added. An artist's
milestone in what is already the largest hospital redevelopment impression of the hybrid operating theatre.
project in New Zealand's history. In total close to $1 billion is Southern Cross' North Harbour Hospital on Wairau Road is programmed to be spent in coming years on a range of new and/or expanding for the fourth time in its 24 year history – to keep pace redeveloped health facilities in Canterbury." with resident demand for elective surgery. The new hospital at Burwood is expected to be completed around In 1991, Southern Cross opened with four operating theatres, the middle of this year and the new Acute Services Building at servicing ,000 patients a year. The Hospital now accommodates Christchurch Hospital is scheduled to open in 2018.
90 specialists across eight theatres and cares for 7,000 patients The new Outpatients building is being funding through the Christchurch Hospital Redevelopment Project and Canterbury DHB's Programme of Works funding. The design and construction of the New post-operative patient recovery facilities and two state-of-the- facility overseen by the Hospital Redevelopment Partnership Group. art theatres are now being added.
Outpatient services will continue to be provided from the Hagley One of these is a hybrid theatre, equipped with advanced medical building and other sites on the campus until the new facility is imaging devices, allowing pre and post-operative imaging to be done in theatre instead of having to move patients between rooms. Hybrid January - February 2016 New Zealand Health & Hospital theatres also allow treatments from relatively low risk procedures of scale and efficiencies which can be re-invested into frontline right through to open surgery to be performed in the same place.
"The investment we're making will allow us to expand the range "The transition to the new service went smoothly with the new of surgical specialities we can offer to patients and allow medical integrated workforce, facilities, IT system, and equipment performing specialists already on the campus to offer more complex spinal, as expected since the service went live in November 2015.
orthopaedic and upper gastrointestinal surgery," says Jeanette Kini, "Each day 4,500 patients are seen and 18,000 tests are processed North Harbour Campus Hospital Manager.
by a combined workforce of over 400 working in multiple sites. "We're very excited about the benefits of the hybrid theatre. Our Twenty-eight collections centres across the region have remained hybrid theatre will function as a conventional operating theatre open. There has been no change to the existing fee structure for tests with the benefit of state of the art imaging, usually only found in funded by the DHBs. radiology facilities. With the movement towards minimally-invasive "We now have a new purpose built laboratory facility at Wellington surgery aimed at reduced pain, trauma, blood loss and recovery Regional Hospital and laboratory equipment has been upgraded time, this is a welcome development to our service offering." at Hutt Valley Hospital, and will be upgraded at Kenepuru and The current phase of redevelopment is scheduled to finish no sooner Wairarapa hospitals as required.
than July 2016.
"It's been the biggest laboratory integration project in New Zealand. Hawke's Bay mental health inpatient
It was important to engage with clinicians, and the three tier governance framework which was put in place worked well. I'd like unit opens
to thank all those involved." A new $22 million mental health inpatient unit, Ngã Rau Rãkau, in Over the last 15 years, nine regions have adopted integrated Hawke's Bay is now open.
laboratory services - Southern, South Canterbury, Nelson Ngã Rau Rãkau means a collective of trees, and this new purpose- Marlborough, MidCentral, Wanganui, Tairawhiti, Bay of Plenty, built facility at the Hawke's Bay Fallen Soldiers' Memorial Hospital Lakes and Wairarapa DHBs.
in Hastings will better support both patients and staff.
Previously Capital and Coast and Hutt Valley DHB operated their The 2-bed unit is made up of 16 inpatient beds and seven sub- own hospital laboratories and privately-run community labs. acute beds. The unit is light, modern and as home-like as possible, The new integrated service involved merging a workforce from the and includes a gym to help patients to get active. previous provider Aotea Pathology with hospital laboratory staff in Later in the year, an intensive day programme will also be run from the three regional DHBs. the unit for both inpatients and those who are acutely unwell in the The Southern Community Laboratories Group has provided laboratory services in New Zealand for more than 50 years.
Whangarei Hospital's new $9.8m
New sky bridge development in plan
to expand patient care to Waitemata
Whangarei Hospital's new $9.8 million Te Kotuku maternity unit, community
officially opened by Health Minister Dr Jonathan Coleman on 24 February, has brought the hospital's maternity services together into the one place.
The purpose-built unit includes eight birthing rooms, 18 beds, four antenatal clinic rooms and a high dependency unit. It also includes a central staff base which will help to further improve collaboration and communication. It begins taking patients from early March 2016.
Wellington/Wairarapa region lab
An artist's impression of the sky bridge which will link
the Elective Surgery Centre (ESC) with the main hospital

Health Minister Jonathan Coleman has officially opened a new purpose-built regional laboratory at Wellington Hospital.
Waitemata District Health Board is constructing a sky bridge linking The new facility, run by Wellington SCL, provides integrated the Elective Surgery Centre (ESC) with the main hospital tower as community and hospital laboratory services for Capital and Coast, Hutt Valley, and Wairarapa DHBs. part of plans to further integrate and expand services on the North Shore Hospital site. "The three lower North Island DHBs have adopted a region-wide approach to provide integrated community and laboratory services," The bridge creates a covered link between the main hospital tower says Dr Coleman.
block and the ESC, allowing the DHB to perform more complex surgeries as facilities continue to expand, including plans under "As well as the benefits of improved, streamlined testing processes, better IT systems and new laboratory facilities, the three DHBs development for an additional ward on the ESC site. expect to save over $10 million a year from increased economies Waitemata DHB Chief Executive Dr Dale Bramley says the sky New Zealand Health & Hospital January - February 2016 North Shore Hospital campus.
bridge will allow increased staff and patient-transfer flow between Good progress on quarterly health
the main hospital and the ESC as the DHB's facilities grow to meet the demands of our rapidly rising population. Health Minister Jonathan Coleman says good progress has been "In the short-term, the bridge will allow the DHB to maximise the made in the quarterly health targets with improvements across all use of its state-of-the-art Elective Surgery Centre, increasing the volume and complexity of surgeries undertaken at the facility in time "The health targets are not just about numbers – they are about for winter 2016.
delivering better faster access to services," says Dr Coleman.
"This weather-proof link between the two buildings will become all "The latest quarterly update shows improvements in elective the more important as we further develop the ESC site to meet the surgery rates, shorter stays in ED, faster cancer treatment, increased needs of our community. It will be a critical piece of infrastructure immunisation, better help for smokers to quit, and more heart and for delivering high-quality patient care.
diabetes checks. "These results are a credit to health workers throughout New "The bridge will provide direct access to the High Dependency and Intensive Care Units in the main hospital, enabling an expanded range of complex procedures to be provided at the ESC." "Progress towards the new faster cancer treatment target improved six per cent, up to 75 percent - the biggest quarterly increase to The bridge forms part of a wider strategy of providing covered links between key facilities on the North Shore campus, including "Delivering better cancer services is a top priority for the Government. the access way linking the new inpatient adult mental health unit He We've made significant progress since 2008 and patients are getting Puna Waiora and the main hospital building. better faster cancer care. "Developing our hospital facilities in this way promotes an integrated "The more heart and diabetes checks target was met for the second approach to patient care, with faster patient transfers and an consecutive quarter. Around 1.2 million people have had their improved experience for those undergoing treatment in various cardiovascular disease risk assessed in the past five years.
hospital buildings," says Dr Bramley. "The elective surgery target has again been achieved with 98,870 "Construction of the bridge has just commenced, with some roads elective surgical discharges provided for the year to date – 4,890 on the hospital campus closed to accommodate works. Diversions more than planned. will be in place and we thank the public in advance for driving with "The Government is committed to delivering year-on-year increases care and demonstrating patience around the hospital site." in elective surgery. We have delivered around 50,000 more surgeries over the last seven years - a 42 percent increase." The sky bridge is a key project in the DHB's Waitemata 2025 10-year plan to meet the increasingly diverse health care needs of the fastest- The results for Quarter Two 2015/16 (October-December) also show: growing DHB population in the country. • The better help for smokers to quit primary care target covers Waitemata 2025 continues the Board's focus on growth in services all PHO enrolled patients. This is the second time the new target and facilities, including the recently completed 46-bed mental health has been reported – the national result was 85 percent, up two services inpatient unit, He Puna Waiora and Hine Ora, a 15-bed dedicated women's health unit., both at North Shore Hospital. An • 94 percent of patients were admitted, discharged or transferred expansion of Waitakere Hospital's emergency department, which from the ED within six hours, up two percent on the previous will see it almost double in size, is scheduled for completion in August 2016 and there are plans for a new 15-bed villa development • Immunisation coverage for eight-month-olds increased to 94 at the Mason Clinic. January - February 2016 New Zealand Health & Hospital The new childhood obesity health target will replace the more heart Authority (EECA) loan as a continuation of its lighting upgrade in and diabetes checks target from 1 July 2016. Heart and diabetes the kitchen and Clinical Services Block, where light fittings are at the checks will remain an accountability measure for DHBs to ensure end of their life and are constantly failing.
the gains made are not lost.
The loan comes with a set-up fee of around $20,000, but this would be more than offset by the expectant energy savings of $57,165 a Waitemata DHB wins national award
for patient experience programme
MidCentral DHB has regularly accessed EECA loans, and some Waitemata District Health Board (DHB) has been nationally grant funding, for energy saving projects over the past 20 years. recognised for its work linking the experiences of its patients to the Management has maintained regular energy audits of its facilities growth of its staff and services. and as a result identified such projects to reduce utility costs. These The DHB won the award for Talent Development and Management include: building management system upgrades, chilled water at the New Zealand HR Awards for an extensive programme metering and optimisation, upgrading heating ventilation and air connecting its organisational values of everyone matters; with compassion; conditioning systems, hot water and heating systems.
connected and better, best, brilliant with the experiences of staff and Group Manager Commercial Support Services Jeff Small says MidCentral DHB is embarking on a number of infrastructure projects, including the upgrade of Information Systems which Waitemata DHB Chief Executive Dr Dale Bramley says the award will contribute to a four percent increase in our overall electricity is underpinned by an organisation-wide commitment to growth and consumption of around $1.25 million a year.
positive change from the perspective of our patients. "This energy project will help offset some of the energy usage "We are immensely proud of the accolade as the awards are judged increases created by these types of infrastructure projects," says Mr across private and public sectors, making it a significant achievement for our nearly 7000 staff who have worked extremely hard to put the experiences of our patients at the forefront of their daily work," Free Wi-Fi now available at
says Dr Bramley. Northland DHB sites
Since the programme first began in 2011, the DHB has worked Patients and visitors who bring in their portable devices can access consistently to make understanding how patients experience its the internet, download files, watch video content, and send and services a priority within the organisation. receive emails from providers such as Gmail.
The DHB collects data from an ongoing ‘In Your Shoes' programme, The objective is to make the hospital experience more pleasant by gathering real-time feedback from patients and whãnau in each allowing patients to maintain communication with their whanãu, service. Over 1000 responses from across the organisation are friends and business contacts, and also to access sources of captured each month.
The feedback is then collated in an innovative report which maps Wi-Fi networks are initially available at three of the four Northland the patient feedback received to standards and behaviours. The District Health Board hospitals (Whangarei, Dargaville and Kaitaia), reporting is made available to each ward and allows teams to focus with the service to be expanded over the coming months.
their attention on specific improvements to the service they provide. The service is provided by specialist provider Internet Kiosk Specialist Ltd (IKS), Northland DHB and healthAlliance. Brochures "By involving staff and patients in developing our standards, we explaining the service know that by living up to them we are meeting staff and community have been distributed expectations of their health service," says Dr Bramley. around the sites.
The programme allows the DHB to tailor improvements to the The network has content areas that are most important to patients and families. One example showed that staff being welcoming and friendly was most significant which may block certain in patients having a positive experience. As a direct result, a websites (including those campaign was commenced to become ‘the most welcoming DHB with adult content) in New Zealand '.
and user allocation of "This award recognises that our focus on patient experience has bandwidth may be both improved our service design and delivery and inspired staff to provide the best possible care to each and every person who walks through our doors," says Dr Bramley. Green light for loan for more LED
light upgrades
MidCentral District Health Board has approved raising an interest-
free loan for about $260,000 to continue its hospital LED lighting
upgrade project.
The board plans to use the Energy Efficiency Conservation New Zealand Health & Hospital January - February 2016 Dargaville Hospital celebrates 60th birthday
Sixty balloons were released to mark Dargaville Hospital's 60th anniversary.
Sixty balloons were released by staff and well-wishers to mark the 60th anniversary of the opening of Dargaville Hospital.
The official opening of Dargaville Hospital took place on 25 February 1956, with local dignitaries and a brass band in attendance.
Other key events in the history of Dargaville Hospital include the opening in 1971 of a maternity annex at Dargaville Hospital, following the closure of the maternity ward at Te Kopuru Hospital.
In 1988, Dargaville Hospital was temporarily cut off by flooding in the wake of Cyclone Bola, which delivered some of the heaviest rainfall totals for a single storm in the history of New Zealand. Other floods since then have also made it a struggle for staff to get to work.
In 1994, surgical services at Dargaville Hospital were closed, resulting in community concern. Then-mayor Peter Brown went to Parliament and obtained a suspensory loan to purchase a 46 percent share in a number of the hospital's key buildings to ensure it Images from the official opening of Dargaville Hospital
remained as a hospital, providing reassurance to the community.
on 25 February 1956.
A joint venture board was formed, with the Kaipara Community to an average length of service by staff at the hospital of more than Health Trust representing the community's 46 percent share and providing a consumer voice alongside Northland DHB's 54 percent The two cakes at the ceremony were cut by the longest-serving staff member, enrolled nurse Heather Carter, who began working at the Dargaville Medical Centre relocated from the centre of Dargaville hospital in 1966 when it was just 10 years old, and the most recent to the hospital site in 2000, strengthening the integration between starter, clinical head Dr Scott Wilson, who joined late last year.
the two providers. Dargaville Hospital Operations Manager Jen Thomas says this is a great example of the ‘one-stop shop' model of healthcare which has led to a number of new initiatives. Iwi provider Te Ha Oranga and Hospice Kaipara's offices and nursing staff are also based on the site.
The hospital is made up of single-level buildings and patient rooms have windows and doors that open out on to terraces overlooking gardens. Ms Thomas says the atmosphere, along with community facilities and strong fundraising support for new hospital, contribute January - February 2016 New Zealand Health & Hospital Digital medical certificates
make system simpler
Health Minister Jonathan Coleman and
Social Development Minister Anne Tolley
say 72 percent of all medical certificates
for Work and Income clients are now being
lodged electronically.
"There's been a great uptake in GPs using the new secure electronic system to lodge work capacity medical certificates," says Dr Coleman. "It's meant that 1,200 clients per day no longer have to hand-deliver certificates to Work and Income offices.
"This is a good example of agencies working together to make dealing with government The mobile surgical bus on its visit to Whanganui in 2002.
easier and less time consuming." donated a kidney or a part of the liver to continued to drop in each year since 2008. The Ministry of Social Development is 78 recipients.
In 2015, the rate for women aged 15–19 currently focusing on how it can further years was 19 births per 1,000 women improve its interactions with clients.
As a result of both deceased donors and live – down from  in 2008.
donors, the number of New Zealand organ "As a result of the new electronic medical transplant recipients rose to 22 in 2015 certificate system, Work and Income Mobile surgical bus visits
(the largest number ever) from 214 in 2014 staff are able to devote more time to – an 8 percent increase.
one-on-one support for beneficiaries and Whanganui has hosted the mobile surgical superannuitants," says Mrs Tolley.
2015 delivers more births
bus to help the Whanganui District "With increased use of online options, there In 2015, 61,08 live births were registered Health Board provide more timely care is less need for clients to visit offices to fill in in New Zealand, up ,796 (7 percent) from for Whanganui residents requiring dental forms. It also means that dealing with Work 2014, according to Statistics New Zealand.
and Income becomes simpler for clients." "Higher fertility rates and population The bus has a particular focus on providing Work and Income handles over 400,000 growth led to more births in 2015," says surgery for children living in rural areas. certificates each year, completed by ,500 Population Statistics Manager Jo-Anne However, on this occasion, it sat on the Skinner. "The rise in births in 2015 follows Whanganui Hospital campus where dental Introduced in July 2015, the secure decreasing birth numbers in the preceding staff spent two days operating on patients electronic service allows GPs to lodge who would normally have their operations medical certificates which include client in one of the hospital's four theatres. It has Women aged 0–4 years have had the details on medical conditions, their ability been 14 years since the surgical bus visited highest fertility rate of all age groups since to undertake work related activities, and 2002. In 2015, there were 125 births for how long they are expected to be unable every 1,000 women aged 0–4 years, "Whanganui Hospital was the first in the up from 119 in 2014. This increase in country to have the bus onsite and now the proportion of women having a baby, we've reached out and asked if it could be Organ donation and
together with an increase in the number of brought here again to help us reduce the transplantation increased
women aged 0–4 years, resulted in 1,95 waiting time for patients requiring dental further in 2015
(8 percent) more births to women in this age surgery under general anaesthetic," says There were 5 deceased organ donors group compared with 2014.
Whanganui DHB Oral Health Clinical in 2015, the largest number ever in New Manager Barb Dewson.
In 2015, compared with 2014, births Zealand. This is a 15 percent increase from increased in all age groups over 20 years, Mrs Dewson says they were lucky to get the 46 donors in 2014 and a 47 percent including women aged: the bus within a week of asking – due to a increase from the 6 donors in 201.
• 25–29 years – up 1,17, largely due to These 5 deceased organ donors donated population increase organs (heart, lungs, liver, kidney or Steady As You Go fitness
• 5–9 years – up 696, largely due to pancreas) to 158 transplant recipients in increased fertility programme a winner with
2015, a 14 percent increase from the 18 • 20–24 years – up 544, due to slightly recipients in 2014.
higher fertility and increased population.
Age Concern Wanganui is delighted In 2015 there were also 78 live donors who In contrast, teenage fertility rates have with the level of interest older people are New Zealand Health & Hospital January - February 2016 showing in the new Steady As You Go fitness on upgrading and running school dental now be answered by Homecare Medical services since 2010 in this region," says receptionists who will be able to book While most participants are in their 80s, Dr Hope. "In total 1 clinics have been appointments. This service will be offered one ‘class' member is aged 100 and Age refurbished and 11 dental vans visit most Monday to Saturday from 8.0am to 6pm. Concern Wanganui manager Tracy Lynn schools that don't have a clinic.
"Homecare Medical registered nurses will says another recently celebrated their 101st "The launch has been the culmination of continue to provide support outside those several years' work to modernise the Bee hours and, when appropriate, transfer the The focus of the once-a-week, hour-long Healthy Dental service which provides free call through to one of our South Westland class is strength and balance with stretching, school based dental services and make sure nurses. During the trial we will be assessing sitting and standing exercises, weights on it is accessible and sustainable for many the possibility of further extending the time ankles, and eye exercises to improve people's when people can book appointments." peripheral vision. Having the opportunity Dr Hope describes it as another example of to socialise and form friendships is an added the two DHBs working together to provide Children in therapy receive
the most efficient service and getting the generous community
Steady As You Go was developed and best value for money for our communities. implemented 1 years ago by Age Concern "The six fully refurbished hubs have the Children receiving treatment at Taranaki Otago who are believed to have enrolled latest in modern equipment, are child DHB's Child Adolescent Community hundreds of participants during that time.
friendly and staffed by a talented team of Centres (CACC) in Taranaki have a reason Aware of how effective it's been in helping dental nurses who provide an excellent to smile, thanks to the donation of more to reduce falls among the elderly, ACC service, free of charge to the community." than 70 teddy bears from customers of has contracted Age Concern New Zealand These six new dental clinics that open Calendar Club in Centre City. to pilot Steady As You Go in Whanganui during term one 2016 are located at: Petone In the weeks leading up to Christmas, and Tauranga where it's creating a lot of Central Schoo, Hutt Central School, customers at Calendar Club were given the interest in both cities.
Raumati Beach School, Paraparaumu option of adding an extra five dollars to Age Concern Wanganui's Steady As You Go School, Miramar Central School and Selby their purchase in exchange for a teddy bear, coordinator Janet Lewis uses a prescriptive House in Newtown. which they could either keep or donate to Steady As You Go CD to guide the classes children receiving treatment at the CACC. and those she hopes will take up the offer New ‘virtual medical
Sue Tipler, Taranaki DHB CACC Clinic to become a peer leader at the end of the receptionist' service to help
Coordinator said, "The bears received so 10-week programme. Peer leaders will do South Westland
far have been given out to children at a First Aid course and receive ongoing A new service offering greater access to both New Plymouth and Hawera clinics support, she says.
booking general practice appointments in and have been very well received. The To help prevent themselves and others South Westland will become operational on kids' eyes lit up and the teddies received from falling while out walking, Steady As You 21 March when a three month trial begins.
immediate hugs with huge smiles all round. Go members are being encouraged to call People sometimes struggle to contact services Thank you to everyone who made the kind the Whanganui District Council to report in South Westland to book appointments at uneven footpaths.
a time convenient for them. South Westland Child Adolescent Community Centres are The programme is currently running in area staff receive thousands of phone calls run in both North and South Taranaki, with Marton and Bulls. Mrs Lynn and Mrs a year, and sometimes have to deal with patients ranging from newborn to 18 years Lewis hope to start a class in Hunterville multiple callouts at night and on during of age. A multi-disciplinary team provide a the weekend, for health matters that are coordinated therapy service for all children and adolescents with extra needs, such as Final stage of Wellington,
The West Coast District Health Board developmental delays, physical disabilities, Kapiti and Hutt Valley
has contracted tele-triage services provider intellectual disabilities, sensory disabilities, modernised school dental
Homecare Medical to support local staff coordination problems and low birthweight and communities. (in newborn babies). The final stage of a multimillion makeover "It's important we look after both patients "Referrals to these services come from of the school dental service in Wellington, and staff," says DHB General Manager GPs, Plunket nurses, Paediatricians, Special Kapiti and Hutt Valley was launched on Grey/Westland Mark Newsome. "The Education Services, schools and ACC. February 11 when Dr Virginia Hope, Homecare Medical virtual medical Children are assessed and treated at home, who chairs both the Capital & Coast and receptionist phone service will mean school or at the centre itself and appropriate Hutt Valley DHBs, officially opened Selby greater access for our community to book specialist equipment is arranged for them," House in Newtown. This is one of six fully appointments, and reduce the after-hours says Mrs Tipler. refurbished, modern school dental clinics to burden on our staff. Calendar Club is an annual pop up kiosk open in the region during 2016.
"How it will work is that people will continue that operates in Centre City from the "These final six clinics are part of a plan to ring their local clinic number or 0800 first Monday in November until the first that has seen more than $12 million spent SWHealth (0800 794 2584), which will Monday in January.
January - February 2016 New Zealand Health & Hospital Orion Health secures major French
hospitals, primary care and social care in the south of Burgundy.
The 15-month contract is with Groupement de Coopération Orion Health is contributing to the transformation of the French Sanitaire e-Santé Bourgogne (GCS). The build phase is currently healthcare sector as it embarks on two major projects in France.
scheduled to run until March 2017 in an initial territory covering 00,000 residents, after which there will be a generalisation phase Orion Health CEO Ian McCrae says the contracts represent a aimed at covering the full population of Burgundy and Franche- significant milestone for the company, as it is the first time it will Comté – a population of three million people.
deliver its solutions in France.
José Godfroy, director of GCS says the CSC/Orion Health proposal "These are landmark contracts for Orion Health. We are entering was selected based on the ability of the Orion Health platform to be the French market with our strategic solutions and are in a great deployed rapidly, and its extensive flexibility. position to leverage our experience and platform for other projects as France transforms its health system," says Mr McCrae.
Orion Health's solutions will be used in the roll out of eight main services, including the Information and Orientation Centre Jonathan Selby, Orion Health Executive Vice President for Europe, for patients and healthcare professionals, care coordination, e- Middle East and Africa, says the company is playing an integral role prescription and immunisation, patient education and e-learning, in France's shift from a hospital-centric model of care to a patient- and administration of the Regional Information System.
In order to find the right model of care, the French Ministry of Orion Health partners with
Health is funding a nationwide programme called TSN (Territoires de Cognizant, the largest US health
Soins Numériques – Digital Care Regions). The TSN has pilot projects insurance software vendor
in five regions and Orion Health is participating in two projects – the TerriSanté project in Paris and the eTICSS project in the Burgundy Orion Health has signed an agreement with the Cognizant Group, a global provider of information technology, consulting, and business process services, enabling Cognizant to deploy Orion Health's open In both contracts, the Orion Health solutions chosen have been built on an open data platform that scales to aggregate and manage data platform Amadeus. In addition, Cognizant will be a preferred different types of health-related data. systems integration partner of Orion Health in the United States.
"They will enable coordinated and personalised information to "Under the agreement Cognizant will OEM Orion Health's be shared across different groups of healthcare professionals and Amadeus Precision Medicine platform and other products such as organisations that are involved in these ground-breaking projects," its Rhapsody Integration Engine. It is a global arrangement but the says Mr Selby.
major focus of the partnership will be the US healthcare insurance market," says Ian McCrae, Orion Health CEO.
TerriSanté project in Paris
As part of a consortium led by Accenture, the TerriSanté project
Mr McCrae says the partnership is a significant opportunity for will see Orion Health provide solutions that enable better, more Orion Health. "Cognizant is deploying an impressive suite of new coordinated health treatment for residents in the Ile-de-France applications for the US market and we are excited to be the preferred region, which includes Paris and its surrounding urban area. partner to provide an underlying platform for this initiative." The five-year contract is with Groupement de Coopération Sanitaire "The US health system is moving to the practice of precision pour le Développement des Systèmes d'Information en Santé medicine because the current model of healthcare is unsustainable. partagés en Ile-de-France (GCS D-SISIF). The build phase for This creates a significant opportunity for both Orion Health and the contract is currently scheduled to run until March 2017 in an Cognizant to bring innovative solutions to the market.
initial territory covering 50,000 residents, after which the GCS D- "Orion Health is well-placed to take advantage of this transformation SISIF will look to extend the pilot across the Ile-de-France region, in healthcare with the launch of the Amadeus platform, as this potentially reaching a population of over 12 million people. relationship with Cognizant demonstrates. We look forward to Professor Eric Lepage, Director of the Innovation Programme working with Cognizant to help healthcare organisations to address and head of the TerriSanté project for GCS D-SISIF, says the complex challenges around improving quality, lowering costs, and Accenture/Orion Health proposal was chosen because it most delivering a differentiated consumer experience." closely met the region's vision of healthcare, and for the ability of Mr McCrae says the combined solution will be sold as a subscription the platform to incorporate care pathways that allow for improved service, increasing the company's recurring revenue, which will lead communication between health professionals. to greater ongoing cash flow. Orion Health's solutions will be used as part of a platform to "Currently Orion Health's software manages over 90 million patient provide services that include care coordination via pathways, health records worldwide. This includes 44 million US patient health patient scheduling, lab and radiology results, pre-admission records, which makes up around 14 percent of the US population. administration, online payments for patients, e-orders, e-referrals It is our stated goal to manage over 20 percent of a country's patient and e-prescription.
health records in strategic markets as we believe this cements our eTICSS project in Burgundy
position in that market. The Cognizant partnership will enable In partnership with CSC, the eTICSS project will see Orion Health us to fast-track our goal in the US much sooner than previously deliver the solution platform to develop shared services for patients, New Zealand Health & Hospital January - February 2016 Orion Health boosts offering to UK's
"We were able to share with the Dimension Data team our largest health board
experiences of what victims are looking for when dealing with our service," says Victim Support's Contact Service Manager Chris Orion Health has significantly increased its offering to the United Kingdom's largest healthcare provider, the NHS Greater Glasgow and Clyde Health Board (NHS GGC).
"The solution from Dimension Data has improved our business continuity and recovery systems so that in a local disaster we not only The publicly-funded NHS GGC is one of the largest scale users have the infrastructure in place to continue providing our systems of Orion Health technology with over 25,000 users. Located in but to also scale up the service as needed.
west central Scotland, it delivers services through 5 hospitals, 10 specialised units, and 50 healthcare centres and clinics.
"It was also essential that Victim Support found a solution to provide it with accurate reporting on call statistics. With the new solution we Orion Health has expanded its offering within the NHS GGC to can now analyse call patterns down to 15 minute intervals. This has deliver two new modules, Medicines Reconciliation and Problem been invaluable when it comes to aligning staffing numbers within List. In addition, the NHS GGC is extending its use of Orion the contact service." Health's Coordinate solution by adopting Healthcare Pathways to Victim Support has a team of 760 people, 640 of whom are its support care coordination and patient transfer and handover.
dedicated base of volunteers.
Jonathan Selby, Orion Health Executive Vice President for Europe, "Victim Support is looking for new volunteers to join the team. Middle East and Africa, says the new solution will provide healthcare Anyone interested can call on 0800 865 868 to find out more." professionals with a comprehensive picture of an individual's care needs and help reduce the potential for any medication related McKesson ranks highly in health
industry report
"It will allow authorised users to understand a full list of patient allergies and problems, and enable them to keep track of medication McKesson was recently recognised as a ‘Best in KLAS' software changes that occur during an inpatient episode of care. After the vendor in the US-based ‘KLAS' software and services report.
patient is discharged from hospital it will provide a summary of these The annual Best in KLAS report, based on extensive feedback from changes to other care professionals," says Mr Selby.
customers, identifies providers shown to be outstanding in helping "NHS GGC has acted as a beacon site for others and has driven healthcare professionals deliver better patient care. The Best in forward the integrated health information agenda in Scotland, as KLAS designation is reserved for vendor solutions that lead the well as acting as a reference study for health regions across the UK software and services market segments with the broadest operational and internationally." and clinical impact on healthcare organisations.
"What we really appreciate about the KLAS rankings is that they Victim Support turns to technology
aren't simply about the performance of software products, it's about to help those in need
the ‘customer experience', from selection to implementation through to adoption and meaningful use," says McKesson's Director of Sales Victim Support has employed a new Contact Centre system to & Marketing, Australia & New Zealand, Kimber Rothwell.
help it meet the growing demand for services. Victim Support is an independent incorporated society in New Zealand that provides "Meeting client expectations right through that life cycle is very free 24/7 community response to help victims of serious crime and important to us, it maximises the opportunity for us to deliver an trauma. It assists those impacted by natural disasters, such as the Christchurch earthquakes and people returning from Cyclone Pam Two healthcare solutions offered by McKesson in the Australian and in Vanuatu as part of its work for the Ministry of Civil Defence and New Zealand markets were highly ranked in their specific categories of the KLAS report.
The new Contact Centre system, provided by Dimension Data McKesson Performance Visibility, a new generation bed management based on Cisco technology, will help Victim Support to keep up with solution, was ranked second in the ‘Patient Flow' category, as was the nearly month-on-month increase in the demand for its services.
McKesson ANSOS One-Staff in the staff/nurse scheduling section. "The number of calls we are getting is continually increasing, last The company's other offering in the Australia-New Zealand region, year we received 77,000, up from 6,000 the previous year," says McKesson Capacity Planner, was not rated by KLAS as it does not Victim Support New Zealand Chief Executive, Kevin Tso.
yet have a capacity management category.
"Our telephone system is at the heart of our administration – it KLAS is an independent research firm focussed on improving is where most of our referrals come from, but it was struggling to healthcare delivery by working with thousands of healthcare handle the increase in volume.
professionals and clinicians to gather their impression on software, "We are the only national provider of free support services and services and medical equipment.
advocacy for victims of crime and trauma, and these people are relying on us at their most vulnerable time." Victim Support contracted Dimension Data to ensure it is equipped to help all clients and to meet the growing demand. Mr Tso says Victim Support chose to work with Dimension Data because of the tailored solution it offered and the high level of the support it could provide.
January - February 2016 New Zealand Health & Hospital products & services
New Zealand's first EASIE Living Centre
see, touch and try out different gadgets and equipment in a real life opened in Palmerston North
environment to see how these supports might work at their home." New watch saves diabetics' time
An innovative monitoring system for diabetes sufferers designed
by a Victoria University of Wellington
student was one of the top 20
international entries in the prestigious
James Dyson Award.
Sub-Scope, designed by Industrial Design student RuiFeng Yeo, is a glucose monitoring system primarily designed for type one diabetics.
The system consists of a waterproof watch, a small implant which sits beneath the skin, and a smartphone app. Palmerston North Mayor Grant Smith tries out a mobility
The implant monitors the user's blood glucose levels and relays data scooter after he officially opened the EASIE Living and
to the watch and smartphone app every two minutes.
Demonstration Centre, in Palmerston North.
The watch displays this data through colours and animations, with New Zealand's first EASIE Living and Demonstration Centre, blue representing the safe zone and blinking red representing the which displays exciting and innovative high and low tech living options for people with disabilities, and the elderly, has opened in If users need to know their exact glucose level a simple swipe across Palmerston North.
the watch screen will display a reading. This feature can also be For the first time customers, and those working in the health and accessed in the smartphone app. disability sector, will have a range of services encapsulated within the Mr Yeo says he wanted to design a device that would allow type one EASIE Living brand, under one roof - ‘a one-stop-shop'.
diabetics to exercise without interrupting their momentum to check EASIE (Equipment, Advice, Services, Information, Education) their blood glucose levels. Living Centre is the latest innovation from Enable New Zealand, "Subdermal implants which sit beneath the skin allow us to peer which has been providing disability support services for over 40 into our bodies in order to understand them better. The system years, and now reaches 50,000 people a year.
allows users to monitor what's happening inside their bodies, without "Throughout its life Enable New Zealand has looked to deliver having to disrupt what they're doing." value for its funders and clients, and is always seeking to break down The James Dyson Award is an international competition that is open barriers and foster an enabling community and society," says Diane to current and recent design engineering students in 20 countries, Anderson, Chair of Enable New Zealand's governance group. with a prize pool of more than $50,000.
"The EASIE Living Centre is its latest innovation and I see its success as being its strong community base. This is a gathering place A tilt in the right direction
for people with a disability and the elderly - it is their centre. They A group of Victoria University of Wellington alumni has developed have helped shape its development, and they will shape its future. an interactive gaming system to help take the chore out of Here they can gather to share and seek information, test products physiotherapy exercises. and supports to help them do what they want to do and have control The system-a lightweight balance training board called ‘Tilt'-allows of their lives.
the user to play games by standing on and tilting the board, while "The EASIE Living Centre reflects MidCentral District Health at the same time strengthening their muscles and improving their Board's strategic direction, which is all about improving the health overall balance. and wellbeing of its communities through partnership, innovation and excellence." The developers, a team of engineering and design alumni -Swibo's Benjamin Dunn, Lukas Stoecklein, Connor Broad and Zac Bird The centre is a collaboration with the private sector.
- formed the idea for Tilt at Victoria's annual Entrepreneur "We see the centre as a ‘gateway' where we will work alongside people to assist them to find the best outcomes possible, which at "The system uses any smartphone to connect the board to a times is not always about spending money, for example how we computer running the games. The phone can then record the board's can utilise natural supports," says Enable New Zealand General movements and measurements, which are analysed by computer Manager Scott Ambridge.
software. This helps physiotherapists and sports trainers track the "The real strength of the centre is you can find everything under one user's improvements and provide tailored training as time goes on." roof from information and advice about community services through "We wanted to make it easier for people to carry out their to specialist advice on equipment and housing modifications.
physiotherapy exercises and recover properly, and realised playing "Our demonstration centre offers the opportunity for people to games can be an incentive," says Mr Dunn.
New Zealand Health & Hospital January - February 2016 "The system is already used In New Zealand FoodSwitch has been downloaded more than by professional sports trainers 75,000 times since its launch in August 201.
and could extend beyond Lead researcher on the initiative at NIHI, Dr Helen Eyles, said the new filters to the FoodSwitch app would help people with high blood "A lot of people can benefit pressure, coeliac disease or gluten intolerance to make healthier food from these kinds of exercises, including the elderly, children "Food choices can be really difficult for people managing high or those with disabilities. It's blood pressure or with gluten intolerance," she says. "Many fresh very helpful for preventing or unprocessed foods are low in salt and gluten free, but in reality injuries before they occur. It's many of us choose packaged foods for reasons such as convenience also for people who just want to be a little bit more active and have fun gaming." "And even if you can find a gluten-free alternative it's often very hard to know how healthy it is. GlutenSwitch addresses both these The current three games problems," says Dr Eyles.
- NeoZen, Hexile and Unbearable - see users "We know only a small number of New Zealanders read and race their friends in space understand food labels." rockets, solve puzzles in an FoodSwitch and its new filters make it simple for shoppers to identify island adventure or fight back the best options for their heath and reduce the risks of our biggest against deadly bears.
killers – heart disease, stroke and cancer," she says.
The team is already developing more games and hopes to begin "Since the launch of FoodSwitch we've had several requests for a bulk manufacturing of the boards through their recently launched version for people concerned about heart health and for a gluten Kickstarter campaign. add-on, highlighting unmet needs of consumers." "We see the potential to make a real difference with Tilt and are Bupa New Zealand's Managing Director, Grainne Moss, says it has excited for people to start using it and seeing its benefits," says Mr become clear since the first release of FoodSwitch that there were large communities of people looking for some extra help when it The Bootcamp is run by Victoria University and Viclink, the came to healthy food choices. University's commercialisation office, in partnership with The "Having something without gluten doesn't automatically make it BizDojo, Deloitte Private and Chapman Tripp.
healthy and as with processed foods in general, some gluten-free "The Victoria Entrepreneur Bootcamp brought our team together, products may be high in sodium or saturated fat," says Ms Moss.
and the combination of our different backgrounds encourages and "This isn't about chasing a fad," she says. "GlutenSwitch helps facilitates collaboration," says Mr Dunn. "That collaboration is what consumers who need to maintain a gluten-free diet choose the best fuels the creativity you need for entrepreneurship." options for their health." App makes low salt and gluten-free shopping
Users can scan the barcode of packaged food using their smartphone camera to receive immediate, easy to understand nutritional information on close to 0,000 New Zealand supermarket Low salt and gluten-free food products will be easy to identify using an updated smart-phone app that helps New Zealanders to shop When a product is scanned using the phone's camera, the SaltSwitch filter indicates whether the product is low in salt and if there are The revised app enables shoppers to look out for hidden salt in healthier, lower salt options. products when they are grocery shopping thanks to a new filter The GlutenSwitch filter indicates whether a product is declared - SaltSwitch.
gluten-free (by the manufacturer), is gluten-free by ingredient (doesn't contain wheat, spelt, barley, rye and oats, triticale), or People with coeliac disease or gluten intolerance can also assess gluten contains gluten. It automatically provides suggestions for similar, but content when food shopping with the addition of GlutenSwitch to healthy gluten-free options.
New Zealander's leading food label-scanning app, FoodSwitch.
The updated version of FoodSwitch with Salt and Gluten filters is GlutenSwitch can instantly identify if a scanned food product is available as a free download from the New Zealand App Store for likely to contain gluten. It also recommends alternative gluten-free iPhone™ GS/4/4S/5/5C/5S/6/6S and iPad 2 devices or the items, listed by order of healthiness. Google Marketplace for an Android version.
At the same time, the app shows consumer-friendly traffic lights Apple mobile devices that have a camera with auto-focus require (red/amber/green) for total fat, saturated fat, sugars, and salt, and iOS 5.0 or later. Android devices need to be running version 4.4.4 information about energy content.
FoodSwitch was developed in Australia by Bupa and The George Institute for Global Health and tailored for New Zealand shoppers by the nutrition team at the National Institute for Health Innovation (NIHI) at the University of Auckland in partnership with Bupa New Zealand.
January - February 2016 New Zealand Health & Hospital pharmacy & pharmaceuticals
Better care for people on multiple
1. Increasing peer-to-peer discussions with GSK medics: As
technical experts on our medicines and vaccines we're responsible A feasibility study is being carried out of a new Medication Therapy for explaining them. We have increased the number of our Assessment (MTA) Service in Canterbury. This service is an extension medical team to provide educational support.
of Canterbury's Medication Management Service (MMS) which has 2. Moving to independent medical education: Medical
been successfully running for the past four years. Through MMS, education will continue to be supported by GSK where educational the pharmacist aims to improve understanding of and adherence gaps are identified and independent third parties have robust to medicines regimens; identifying and addressing factors linked to propositions to address them. The main change is that this support non-adherence as well as minimising pharmaceutical waste. will now be at ‘arm's length' via medical education partners with MTA involves an accredited pharmacist performing a systematic, no involvement from GSK.
patient-centred clinical assessment of all the medicines currently . Stopping direct payments to healthcare professionals:
taken by a patient, identifying, resolving and preventing medication- GSK has now phased out direct payments to healthcare related problems as well as optimising the effectiveness of medication professionals to speak on GSK's behalf about our prescription medicines and vaccines or the diseases they help to treat or "I was noticing medication issues that needed correcting and picking prevent. Instead GSK medical staff, as experts on our products, up things that we could have been doing something about, but we will have an increased role in external communication.
couldn't. Now we can," says Lyttelton pharmacist John Thrupp.
According to Dr Ian Griffiths, Medical Director of GSK New Zealand Pharmaceuticals, these changes are the latest steps in a "Following a 45 minute consultation with the patient, the GP and I talk for 15 or 20 minutes about a particular patient and we come up decade long journey to renew GSK's business model.
with a joint plan together about how we're going to move forward "In order to make informed decisions about patient care, doctors over the next , 6, 12 months with that patient. I think it's a win- want access to high quality information. When it comes to GSK win for everyone. It really helps us in our work and it really helps medicines and vaccines, and particularly new medicines and the patient as well to feel they're getting a real holistic approach to vaccines, the subject matter expertise and therefore the responsibility to communicate lies with us.
Gareth Frew, Clinical Leader at Canterbury Community Pharmacy "Whilst we implement innovative ways to meet the information Group (CCPG), which is delivering the MTA programme in needs of doctors we need to be mindful that information provided Canterbury, says successes like these are credit to the continued by industry may be perceived as conflicted. We have found support of the Canterbury District Health Board to enable that, whenever questions are raised about healthcare practitioners community pharmacy to deliver more services closer to home and receiving money from pharmaceutical companies, there is a keep people well and out of hospital. perception that inappropriate prescribing may result. We believe that "LEAN principles have been used to free up time and facilitated every patient should get the right medicine for their condition. We meetings with other health providers have enabled relationships to want as many healthcare professionals as possible to have access to develop and more patient-focused care to be delivered. the most current, fair and balanced information they need to choose "For MTA to work well it needs true collaboration and communication the right treatment for their patients. between the Community Pharmacist and GP. " "Strengthening the GSK medical team is an important step in Mr Thrupp has freed up .5 hours of time he would previously responding to this concern. Increased transparency around GSK's spend on administration and avoidable tasks every week, which he promotion of product or third party independent medical education now spends collaborating with the local general practice to better are further steps in the right direction.
care for patients with long term conditions and high needs. "In all of our interactions with healthcare professionals, our priority He says prior to the most recent integration project and the MTA is to be transparent, operate with integrity, and always put the pilot, the general practice and his pharmacy "were two separate interests of patients first," says Dr Griffiths.
places that didn't really communicate much. "In addition, from July 2014, no GSK medical representatives "I was sort of out of the loop but now we communicate regularly to have been financially incentivised on individual sales targets. Our complete MTAs, MMS and other patient centric activities. medical representatives are now incentivised based on their technical "GPs have loved it, patients have loved it. It seems to work so far." knowledge, the quality of service they deliver to doctors to support improved patient care and a broader set of business performance GSK first in New Zealand with new business
model for the pharmaceutical industry
"Healthcare professionals will remain valuable partners for GSK GSK is first in the New Zealand pharmaceutical sector to introduce in the long term in our endeavours to bring new medicines to New a new framework for its medical education program and interactions Zealand patients. We will continue to work with and to pay fair with healthcare professionals to increase transparency.
market remuneration to doctors and academics for non-promotional The three key changes, which come into effect on 1 January, activities such as clinical research, provision of expert advice or represent a fundamental shift in the GSK business model.
insights via market research." New Zealand Health & Hospital January - February 2016 Initiative launched to support very large
National Science Challenge tackles childhood
obesity, learning and mental health
A new National Science Challenge - A Better Start: E Tipu e Rea -
aims to reduce obesity and improve learning skills and mental health
in New Zealand children.
The Challenge, launched by Science and Innovation Minister Steven Joyce, is one of 11 National Science Challenges designed to find solutions to large, complex issues facing New Zealanders. Chal enge Director Professor Wayne Cutfield of the Liggins Institute at the University of Auckland says a healthy weight, good learning skil s and sound mental health are key to a child's health and success. He says A Better Start's mission is to find better ways to predict, prevent and treat obesity, learning and mental health problems in children and teenagers.
Professor Cutfield says A Better Start's research strategy is new for From left Dr Caz Hales, Todd Bishop and Lesley Gray at
New Zealand because it will target the children most in need as the launch of Bariatric Management Innovation (BMI).
early as possible in life, engage their families and communities, and For the first time in New Zealand there is a platform that focuses on draw together experts from different disciplines and institutions. The science leadership team will also take a holistic view of obesity, the needs of people who are very large and require health services.
learning and mental health, which are usually studied in isolation.
Bariatric Management Innovation (BMI) is a collaborative initiative He says the Challenge will use state-of-the-art big data tools to developed by obesity researchers from Victoria University of understand problems, identify risk factors, test solutions and quantify Wellington and Otago University, Wellington in partnership with their costs and benefits over a child's lifetime. It will also work with the health care industry. Launched on February 22, the BMI international researchers on data from studies on large groups of initiative will engage in research and innovation that supports the children around the world. development and management of safe, appropriate and equitable "Our children are our future and our job is to make science work for care for very large patients. them. Some of the biggest difficulties they can face are with obesity, The researchers are Dr Caz Hales, a lecturer at Victoria University's
learning and mental health. There is a big overlap among those at Graduate School of Nursing, Midwifery and Health, and Lesley
risk in each area, and each can influence the others. We're aiming Gray, a senior lecturer from the University of Otago, Wellington.
for practical, evidence-based solutions that make a measurable They are supported by Todd Bishop, CEO of Essential HelpCare, difference for our tamariki," says Professor Cutfield.
who is providing secretariat services.
"Problems that begin in childhood often get worse in adolescence and get ingrained in adulthood. The costs to the child, their community BMI will provide independent, industry-supported research relating and the nation only multiply as life goes on. The earlier we tackle to service provision, the education of healthcare professionals and these problems, the greater the benefit to the child throughout his or will also examine the perspectives of people who use the services. her life, and to the country." Early initiatives include looking at the perceptions health professionals Professor Cutfield says one in three of all New Zealand children have and the language used in relation to size, stigma and the quality is overweight or obese, one in three children is not meeting the of healthcare for large people.
National Standard for reading in their first year at school, and one in three young people will have had a significant mental health problem Asscoiate Health Minister Peter Dunne, who launched BMI, said by the age of 18. he applauded partnerships such as this one, which demonstrate the benefits of collaborative efforts between health, academia and "We will target children as early in life as possible, when we can communities to address major health and social issues, improving make the most difference, and focus on those most in need, to reduce the inequities for Mãori, Pacific and poorer children. Mãori and outcomes for New Zealanders. Pacific communities will help us design, execute and interpret our "The Government considers that science and research will research in a way that's culturally right for them. increasingly play a vital role in developing knowledge that can help "Scientists specialising in paediatrics, education, psychiatry and address our particular environmental, health and social advantages psychology will collaborate with health and education experts, and challenges.
epidemiologists, big data analysts, software designers and economists. "Collaboration between researchers and those that deliver health We wil have over 75 researchers from institutions across New Zealand. services is important, as it will increase the likelihood of research Our team wil include Mãori and Pacific researchers. Our science being translated into ways that improve health outcomes and health leaders wil col aborate with other leading international experts." system performance." Challenge Co-director Professor Barry Taylor of the University of Otago says the big data team will offer scientists, policy makers and Being oveweight or obese is expected to overtake tobacco as the community groups a new depth of information and understanding. leading preventable risk to health in New Zealand within the next 12 months.
"We will be analysing the links between anonymous health and January - February 2016 New Zealand Health & Hospital sociodemographic data sets for new insights. The tools we are • Professor Barry Taylor - Big Data Leader, Co-director,
developing will also tell us when our solutions are working." University of Otago • Professor Angus Macfarlane (Te Arawa) - Mãori Research
Challenge Co-director Professor Gail Gillon of the University of Leader, University of Canterbury.
Canterbury says Mãori scientists and communities are integral to A Better Start's Mãori name, E Tipu e Rea, means ‘grow and the research strategy.
branch forth'. It is the opening phrase of a passage written in a "Our research will be designed in line with kaupapa Mãori principles, schoolgirl's autograph book in 1949 by Mãori leader and scholar Sir Ãpirana Turupa Ngata, of Ngãti Porou, to express his vision for to braid together indigenous and Western scientific understandings Research Outline – A Better Start: E Tipu e Rea Contact between children monitored in
world-first infection study

Obesity research goals are: Christchurch primary school students have been wearing sensors • to develop tools to predict which infants are at risk of becoming tracking contact with each other in a world-leading study to better obese by the age of five - using sociodemographic and research understand diseases caused by the staphylococcus bacterium. Very data, body measurements and biological samples little is known about who passes the bacterium to whom in the community.
• to develop strategies to prevent or treat obesity in children and teenagers at risk.
University of Otago, Christchurch researcher Dr Pippa Scott
is testing levels of the bacteria in Linwood Avenue pupils and, in
Research will include investigating environmental factors such a world first, monitoring contact between them using ‘proximity as food, activity, sleep and gut microbiome, as well as genetic sensors' to better understand how staphylococcus is passed from inheritance and epigenetics – the way the environment can change person to person.
the behaviour of a child's genes.
Dr Scott says school-aged children often spread flu and other Learning research goals are: disease so could be important to the spread of staphylococcus in the community.
• to develop strategies to help children at risk of literacy problems succeed from their first year at school – using the best techniques "We asked a lot of schools if they would take part in the study and Linwood Avenue School Principal Gerard Direen came back to us and services in the education and health sectors quickly and said the school would be really keen to help." • to support children who are emerging as bilingual in English and Dr Scott says 70 children aged between eight and 11 were given the either Te Reo Mãori or Samoan, as they move from preschool to proximity sensor to wear clipped to their shirts for around two weeks. primary school.
The sensors are not GPS devices and can not pinpoint a child's Research will include investigating the best ways to teach vocabulary whereabouts but rather record when children come in contact with and phonological awareness – the ability to read a word by sounding each other. They have never before been successfully used in a study linking infectious disease spread to contact in the same individuals. out the letters in it, and the best ways to integrate health and education services to support children and their families.
The study is ongoing but early analysis found almost every child was carrying the bacterium at some stage during the seven times they Mental health research goals are: were tested. More than half the children carried the bacterium at • to develop next-generation online self-help tools for teenagers any one test session.
and those around them to help detect common mental health Almost all strains the children had were susceptible to commonly prescribed drugs for the condition.
• to use these tools to offer help to at-risk teenagers, first with an Revolutionising heart disease diagnosis
evidence-based online treatment programme, and then, if needed, Christchurch researchers are playing a key role in a new company with access to mental health services.
aiming to revolutionise the accurate diagnosis of heart conditions.
Research will include designing the next generation of behavioural Upstream Medical Technologies [UMT] is a partnership between intervention technologies - developing rigorous tests of their the University of Otago and Powerhouse Ventures Ltd. Researchers effectiveness, and presenting them in an engaging way. from the University's Christchurch Heart Institute are developing a Learning and mental health researchers will also explore new range of tests to speed up the diagnosis of potentially deadly heart methods of detecting and treating young children with developmental conditions. These will be patented and ultimately sold to hospitals worldwide.
and behavioural disorders. The lead researchers are Associate Professor Chris Pemberton
A Better Start: E Tipu e Rea's science leadership team is: and Professor Mark Richards.
Professor Wayne Cutfield - Obesity Leader, Director – Liggins
Associate Professor Pemberton says Christchurch Heart Institute Institute, University of Auckland researchers were first to identify the importance to heart health of • Professor Gail Gillon (Ngãi Tahu) - Literacy Leader, Co-
protein fragments in the blood known as signal peptides. "These director, University of Canterbury protein fragments, once identified, can be monitored for medical • Professor Sally Merry - Youth Mental Health Leader,
diagnostics relating to heart health.
University of Auckland "UMT has developed a world-first test to potentially speed up the New Zealand Health & Hospital January - February 2016 diagnosis of unstable angina, a serious cardiac condition that is it was first available in New Zealand in 1988. This is the first study of difficult and time consuming for doctors and is a major area of its kind to measure the degree to which the drug slows the gut. unmet clinical diagnostics." Professor Pete Ellis, Head of Psychological Medicine at the
University of Otago, Wellington, says clozapine is a valuable
Slow global progress on stillbirth prevention
antipsychotic drug that can be effective when other treatments have Maternal and child deaths have halved globally while stillbirth remains a neglected global epidemic, according to a report just "For many people clozapine can be life-changing. Overall, these published in The Lancet.
people live better and longer with clozapine than with other Four University of Auckland academics were involved in writing the treatments, but it does have considerable side effects, which we need fourth paper in The Lancet Series on ‘Ending Preventable Stillbirths' that is intended to focus attention at a policy and research level on "Although clozapine is well known to cause constipation, the rare, reducing the global burden of stillbirths.
but potentially severe consequences of this are not widely recognised. More than 2.6 million stillbirths continue to occur globally every These study results mean we can now start exploring its mechanism year with very slow progress made to tackle this ‘silent problem', of action, with the hope of finding effective treatments to reduce or according to the new research.
prevent this impaired gut motility, and help make treatment with clozapine much safer." Despite significant reductions in the number of maternal and child deaths, there was little change in the number of stillbirths (in the third The researchers tracked the movement of small markers, which trimester of pregnancy) even though many may be preventable.
could be seen on X-ray, through the gut of people taking clozapine and other antipsychotic medications to measure the speed at which World-wide, half of all stillbirths occur during labour and birth, food was moving. usually after a full nine month pregnancy, and the research highlights that most of these 1. million deaths globally could be prevented "Our study shows that that clozapine slows bowel function quite with improved quality of care, especially in developing countries.
considerably, causing constipation. This ranges from moderate to severe. If it results in complete bowel obstruction, this can have This fourth paper in the series looks at what is going on in high potentially fatal consequences," says study lead author Dr Susanna
income countries and examines the stillbirth rate from 2000 to 2015 Every-Palmer, from Capital & Coast DHB.
"In the past 20 years, this impaired gut motility has contributed to New Zealand with 2. stillbirths (after 28 weeks of pregnancy) per at least four deaths and 11 other serious or life-threatening events 1000 births in 2015, is doing better than many countries, including (like bowel obstruction) in people using clozapine in New Zealand, Australia (at 2.7 per 1000 births). New Zealand has also had a so it is important to increase our understanding of how this occurs," reduction in the stillbirth rate in recent years.
One of the co-authors, the head of Obstetrics and Gynaecology at "We found that in patients using clozapine, the markers took four the University of Auckland, Professor Lesley McCowan, says
times longer moving through the gut compared to those on other "New Zealand is doing quite well and is tenth best in terms of our antipsychotics, or in people on no medication," says Dr Every- stillbirth rate for babies after 28 weeks with a small reduction in that rate in recent years. But we can still do better with research aimed to identify modifiable risk factors for stillbirth here." "Four out of every five people taking clozapine were affected in this way, irrespective of their gender, age, ethnicity or length of clozapine Professor McCowan provided New Zealand input into the global treatment. Therefore we are recommending that everyone starting research along with fellow University of Auckland academics, on clozapine should be prescribed laxatives, to try to reduce this Professor Frank Bloomfield (Director, Liggins Institute),
Professor Cindy Farquhar (Post-graduate Professor, Obstetrics
This research was funded by a grant from Capital and Coast DHB and Gynaecology and Dr Lynn Sadler (Population Health).
and was published online in EBioMedicine.
"In New Zealand we are fortunate to have very good national data collection, (provided by the Perinatal and Maternal Mortality Fracture risk more important than bone
Review Committee, PMMRC) that started in 2006 and gives us detailed information about babies that have died from stillbirth. From this we can try and identify any groups more at risk and ways Low bone density is very uncommon in patients with coeliac disease, to reduce those risks," says Professor McCowan.
according to new research from the University of Auckland.
The Ending Preventable Stillbirth Series was developed by 216 experts In a study published the New Zealand Medical Journal, bone researchers from more than 100 organisations in 4 countries and comprises five Associate Professors Mark Bolland and Andrew Grey noted
papers. It follows the research group's 2011 series on stillbirths also that average bone density in a group of adults suffering from coeliac published in The Lancet.
disease was normal.
"This suggests bone density measurement is not routinely indicated Antipsychotic drug clozapine found to have
in coeliac disease, but can be considered on a case by case basis for significant gastrointestinal side effects
individuals with strong risk factors for fracture," says Dr Grey.
New research from the University of Otago, Wellington, and Capital "Most of the people with coeliac disease referred for the test (17 and Coast Health District Health Board shows that the antipsychotic adults with an average age of 47 years) were in an age group where drug clozapine dramatically slows bowel function. Rarely, this can fragility fractures are very uncommon.
lead to serious or life-threatening consequences. "When coeliac disease is treated, it usual y results in improved nutrition About 10,000 New Zealanders have been prescribed clozapine since and the fracture risk declines. The clinical recommendation from this January - February 2016 New Zealand Health & Hospital work is that for wel -nourished people with this disease, there is no cholesterol levels, blood sugars and markers linked with kidney compel ing reason to order a bone mineral density measurement." function, gout and heart failure. He says this work aligns with another study conducted by their research team that assessed the recommendations of clinical One in five lie to their doctor
guidelines for managing bone health and was published recently in Do you smoke? How often do you drink? Do you exercise often? And how much do you spend on takeaways? These are just some of the routine questions one in five Kiwis lie to their doctor about because "In that work, we found that guidelines from non-osteoporosis they're ashamed of their unhealthy lifestyle.
specialist medical organisations strongly encouraged the measurement of bone density, but didn't discuss the risk of fracture, when fracture A recent Southern Cross Healthcare Group survey showed that: is the important outcome," says Dr Grey.
• 22 percent of people lie to their doctor • of those who lied, 5 percent admitted they could be in better "We think a lot of referrals for bone density testing are from clinicians responding to these guidelines, which should be focusing more strongly on fracture risk.
•  percent didn't want to own up to their bad behaviour• 0 percent were embarrassed or uncomfortable talking about their "An important point when considering whether to request a bone density scan in a patient with coeliac disease is the natural history • 25 percent were afraid of the response of bone density changes following diagnosis. Longitudinal studies of individuals with treated coeliac disease show that body weight and • 17 percent didn't want to disclose personal information.
bone density increase.
The Southern Cross survey was conducted by TNS online amongst 2002 randomly selected New Zealanders and was carried out in "If body weight and bone density are likely to increase fol owing November 2015. Responses were weighted to be representative of diagnosis and treatment with a gluten-free diet, and low bone density is the New Zealand over 15 population by age, gender and region.
both uncommon and unlikely to be clinical y significant, the justification for routinely measuring bone density at diagnosis is weak." How and who you exercise with affects your
A small proportion of individuals with coeliac disease have low bone mental wellbeing
density - 12 percent of this cohort.
How you exercise - indoors versus outdoors - and whether you "For younger individuals with no clinical risk factors for fracture, exercise alone or as part of a group can impact your wellbeing. whose bone density is likely to increase over time, the short-medium 'The Sovereign Wellbeing Index – Exercise and Wellbeing in New term fracture risk is low and knowledge of the bone density, even Zealand' report examines the relationship between wellbeing and if it is low, is unlikely to lead to a change in management," say the exercise including the contexts in which it is undertaken. The report used four key wellbeing outcomes – awesome (used to For such people, measuring bone density is unnecessary. For older describe the highest levels of wellbeing), depressed mood (measured people or those with strong clinical risk factors for fracture, the short- using the internationally recognised CESD-8 depression scale), term risk of fracture is higher and measuring bone density could be happiness (a single item measure of positive affect) and high energy considered on a case-by-case basis.
(a single item measure of vitality). The findings of the study might help to reduce unnecessary testing. Professor Grant Schofield of AUT's Human Potential Centre,
"For example, if bone density measurements in our cohort had been says the report reveals important insights into the relationship restricted to those with BMI <20 kg/m2 or those aged >50 years between exercise and wellbeing. with BMI <25 kg/m2, 69 percent of those with low bone would "The findings suggest that there may be two groups of exercisers: have been identified, and 69 percent of the total number of scans those who engage in active recreation for health, fitness, and would have been avoided," say the authors.
enjoyment and those who engage in structured exercise to achieve specific performance or health goals. First study of South Island Pasifika heart
"We all know exercise is an important part of overall wellbeing – delving deeper into this, the report is indicating that consideration It's well known that New Zealand's Pacific population suffers higher of how we are exercising can further benefit happiness, vitality rates of heart disease than the general population. But until now, and overall wellbeing. Exercise shouldn't be a chore – it's about evidence has been based on data gathered in Auckland. University understanding what's working best for each individual and ultimately of Otago, Christchurch researcher Dr Allamanda Faatoese
making you happy." is changing that with the launch of the Pasifika Heart study of Who you exercise with:
Christchurch Pacific people.
• Exercising with friends, family or colleagues is shown to be "Pacific communities living in Auckland have vastly difference more beneficial than exercising alone – just 1 percent of those environments than those in Christchurch. We know little about the exercising with social networks were associated with depressed heart health profile of Pasifika people in Christchurch," she says.
mood, while almost a third (27 percent) reported happiness, and almost half (47 percent) had high energy and 1 percent were The Heart Foundation-funded Pasifika Heart study will for the first time measure heart disease risk factors in 200 Pacific Island • Prevalence of high energy was greatest among those exercising with participants, both healthy people and those suffering from illness. Dr a team and a group of people and lowest among those exercising Faatoese is based at the University's Christchurch Heart Institute but on their own (although still higher than non-exercisers). will study participants from across the South Island.
• Interestingly, 5 percent of exercisers who train with a personal Each participant's personal and family medical history, blood trainer or instructor had high energy, but 26 percent also reported pressure and body composition will be recorded along with their having a depressed mood. New Zealand Health & Hospital January - February 2016 Better nutrition policies needed for children
"As another whooping cough epidemic is expected in New Zealand Most early childhood education services strive to encourage healthy later this year or in 2017 it is particularly important that we look for eating among children, but need stronger and more detailed nutrition ways to improve immunisation timeliness right now." policies to support change in everyday staff and parent behaviours.
The study found that more than one in five future fathers remain These findings are revealed in new doctoral research from the undecided during pregnancy whether to immunise their child or not, University of Auckland's Centre for Longitudinal Research.
compared to one in eight future mothers.
An online survey of 257 licensed Early Childhood Education (ECE) "The reason why almost twice as many fathers than mothers are services was carried out in 2014 in Auckland, Manukau and the undecided about immunisation could be that they are not having as many opportunities to engage with health professionals during pregnancy. They could be missing out on personal advice and The survey found that most services promoted healthy eating recommendations from doctors and midwives, and on information behaviours by maintaining edible gardens (90 percent), not using material distributed through maternity health clinics." food in punishments and rewards (96 and 95 percent respectively), and serving family-style meals with adults seated alongside children Can blood pressure medication stop breast cancer?
(80 percent).
The spread of breast cancer may be prevented by well-known drugs The survey showed other common practices may encourage children commonly used to treat high blood pressure, research funded by the to eat too much or develop preferences for unhealthy foods.
Australian and New Zealand College of Anaesthetists (ANZCA) will These included serving more than the recommended amount of sugary, salty and fatty foods at celebrations (26 percent), selling Dr Jonathan Hiller, researcher and anaesthetist from the Peter unhealthy food at fundraisers (7 percent), hurrying children to MacCallum Cancer Centre, supports increasing evidence that finish eating (61 percent), and not checking with children if they are chronic stress and sympathetic nervous system activity (the system full before offering more food (60 percent).
responsible for the "fight or flight" response) influenced the behaviour Forty percent of ECE services said they faced barriers to promoting of breast cancer cells.
healthy nutrition to children. The most commonly reported barriers Laboratory research by Dr Erica Sloan at the Monash Institute of were a lack of support from parents and families (21 percent) and Pharmaceutical Sciences has shown that sympathetic nervous system concerns about food intolerances and allergies (10 percent).
changes breast cancer progression to increase metastasis (the spread "Eating behaviours and preferences for certain foods, such as those of cancer), says Dr Hiller.
high in salt and sugar or vegetables and fruits, develop early in "Understanding and managing increased sympathetic nervous life, so early childhood is an opportune time to teach the basics of system activity during the stress patients experience before, during nutrition and healthy eating," says PhD student Sarah Gerritsen,
and after their operation may improve long-term survival after who conducted the survey with the support of GRAVIDA* and the breast cancer surgery." University of Auckland's Centre for Longitudinal Research.
Dr Hiller says beta-blockers, often used to control hypertension, may offset the harmful changes stress induces in breast cancer cells.
Dads can help boost immunisation rates
"In animals studies we have seen that beta-blockers can prevent the Aiming immunisation campaigns specifically at fathers-to-be could spread of breast cancer and, in human breast cancer studies, better be a promising new approach to get more New Zealand children outcomes are linked to patients who have breast cancer and have immunised on time suggests new research by the Growing Up in New been simultaneously treated for hypertension with beta-blockers." He says the beta-blocker associated with the most consistent benefit The paper published in Vaccine showed that a child whose father for patients with cancer is propranolol, a drug currently used to treat made the decision during pregnancy that his child would be fully mild hypertension and anxiety. immunised was three times more likely to be immunised on time than the child of a future dad who had decided on partial or no "We want to see if the benefits of propranolol seen in pre-clinical immunisation, independent of the mother's intentions.
studies of breast cancer are also seen post-operatively in women with breast cancer," he said.
If both parents agreed on full immunisations their infant was between two and three times more likely to be immunised on time The study will also help anaesthetists learn whether propranolol compared to the child of parents who disagreed. Yet only 77 percent effectively manages pre-operative anxiety and whether propranolol of mothers and partners in the study agreed on their intentions limits the body's stress response to surgery.
for immunising their child, with only 65 percent deciding to fully "Research, conducted in animals, shows that stress worsens cancer. In immunise their child.
humans, stress is associated with progression of breast cancer – not its To find out about parents' intentions regarding immunisation, the occurrence. Stress appears to worsen the progression of the disease." Growing Up in New Zealand study interviewed 6822 women and 4404 The research received funding from ANZCA's Anaesthesia and of their partners during the last trimester of pregnancy, and asked Pain Medicine Foundation. The foundation supports research questions about parents' plans to immunise their child. Infants projects across the fields of anaesthesia and pain medicine. ANZCA were considered to have been immunised on time if each of the established the Anaesthesia and Pain Medicine Foundation in 2007 recommended six-week, three-month and five-month vaccines were to support medical research and education.
given within 0 days of their due date.
"Our research showed that both parents are involved in the Summer students trial wearable fitness
decision-making process, and that fathers play an important role in technology in surgical ward and assess
ensuring that children get their childhood immunisations on time," says Growing Up in New Zealand Associate Director and Starship satisfaction with mental health crisis service
paediatrician, Associate Professor Cameron Grant from the
Trialling whether data from a wearable sports monitor could predict University of Auckland.
a patients' decline and assessing a new crisis mental health service January - February 2016 New Zealand Health & Hospital were two of the research projects tackled by this year's University of In May 2015, Pegasus Health began a telephone-based brief Otago, Christchurch's Summer Students.
intervention service where enrolled patients, known to be smokers, The annual mentoring programme allows young scientists to get are called and offered cessation advice. experience working on health-related projects for 10 weeks between Summer student Anna Hulme measured how satisfied general
early November and January. They are supervised by some of the practice teams involved with the programme were, and whether it country's leading researchers and clinicians.
was helping more people attempt to stop smoking. She found the Four of the projects undertaken by this year's Summer Students majority of general practice teams were either satisfied or extremely satisfied, with 91 percent of survey respondents saying they would recommend the service to their colleagues. Early detection of deteriorating patients using wearable
fitness technology

More than 1,000 people were contacted by the service and offered Medical student Fraser Jeffery and his supervisor intensive care
brief advice, with 1,800 referred on to a cessation support service. specialist Professor Geoff Shaw fitted wearable sports heart
General practices who engaged with the service were more likely rate monitors to the chests of patients recovering in the Surgical to have increased in-house smoking cessation support to patients Progressive Care Unit in Christchurch Hospital. They studied compared to those not involved with the telephone service. General heart rate variability data to see if there was a connection between practice staff surveyed were generally supportive of extending the ongoing heart rate variability and a deterioration of the patient's service to include routine re-calls such as cervical screening. Anna was supervised by Leigh Aston and Dr Ruth Savage. The
Professor Shaw says early results from the small-scale, preliminary project was sponsored by Pegasus Health.
study (less than a dozen patients were involved) showed heart rate Measuring a ‘good death'
variability recovers quickly in patients who are progressing well. Canterbury District Health Board has developed a tool to record and However an improvement in variability was not clearly seen in sicker analyse aspects of care received by people in their final days. The patients with more complex conditions.
tool, thought to be the first of its kind in New Zealand, focuses on aspects of care that have been identified in scientific literature as being Professor Shaw says leveraging technology developed for the sports important, including good symptom control, identification of cultural industry could provide an inexpensive way to improve patient and spiritual needs and family involvement and support. The goal is care. He hopes to extend this preliminary work to larger groups of to ultimately apply the audit to al deaths within the Canterbury DHB hospitalised patients. and identify services or wards where patients and families are looked The project was sponsored by the New Zealand Federation of after particularly wel so others can learn from their success.
Graduate Women.
Summer student Claire Whitehead assessed the tool's ability to Satisfaction with the Canterbury DHB's new Crisis
determine a ‘good death' by reviewing the notes of more than 10 deceased people, about 100 in hospital and the remaining in Needing urgent psychiatric care is typically a stressful situation for hospice or aged care. She found the tool worked well at measuring individuals, their families and often for those, such as GPs, who refer the quality of a person's death, and developed a user guide so non- them to Specialist Mental Health Services. At the end of 2014 the medically trained people can use it to do assessments. Canterbury District Health Board introduced the Crisis Resolution Ms Whitehead was supervised by Dr Kate Grundy. The project
Service, which provided a new way of delivering care to people with was sponsored by the Canterbury District Health Board.
urgent mental health needs. This service aims to provide care that is more accessible and better integrated with other support. One example of a change is that where feasible consumers can be seen in their own homes.
Chief executive appointed to NZ Health
Summer Student Maddie Weston evaluated the satisfaction of
patients, their families and referrers such as GPs with the service. A Megan Main has been appointed Chief Executive, NZ Health
novel aspect of her evaluation was that families and referrers were Partnerships Limited, the Crown subsidiary that works in asked how they found the service.
partnership with district health boards to identify, collaborate and The majority of people (88 percent of the 11 people that took part) build shared services for the health sector. were satisfied with their care and would recommend the service. Participants who were dissatisfied were more likely to be family Megan comes from Health Purchasing Victoria, where she has members, which highlights the importance of asking their opinion. held the role of Chief Executive since 2008. Health Purchasing More than 80 percent of people using the service responded Victoria is responsible for the procurement and management of positively to questions addressing how easy it had been to access over 40 contract categories (clinical, indirect materials, services help, how quickly they received help, whether they were asked if and equipment streams) for the 80 independent health services they wanted family involved, how straightforward the assessment organisations servicing a population of just under 6 million process had been, and if their needs had been met. The survey gathered suggestions about how the service could be She was previously Director Supply Chain at Alfred Health in improved, with better publicity of the service and more options for Victoria. Prior to joining the public health sector, Megan held people who were both intoxicated and requiring crisis care raised. various consulting and line management roles across a range of The Specialist Mental Health Service will develop and incorporate industries, focusing on supply chain, process improvement and some of these suggestions into its services where possible.
Ms Weston was supervised by Dr Frances Carter and the project
She holds Degrees in Engineering and Science, an MBA from The was sponsored by the Canterbury Medical Research Foundation.
Melbourne Business School and a Diploma in Leading Change & GPs positive about telephone-based intervention for
Organisational Renewal from Harvard Business School. New Zealand Health & Hospital January - February 2016 publications & resources
Agencies need to change
NGOs have a crucial part to play in Justice, the Ministry of Social Development, reducing family violence in New Zealand, response to family violence:
the Ministry of Health, New Zealand but they are not currently as effective as Police, Te Puni Kûkiri, the Department they could be.
of Corrections, the Ministry for Women, The Family Violence Death Review "Some of the thinking around family the Office of the Children's Commissioner, Committee (the FVDRC) says agencies violence leads to ineffective responses from the Judiciary, the National Collective of must take more responsibility for the safety services to both victims and those using Independent Women's Refuges, and other of family violence victims, rather than violence," she says.
family violence NGOs.
expecting victims to keep themselves safe from abusive partners. "Treating abuse as a problem that can be Professor Wilson says the current cross- remedied solely by giving victims advice government focus on family violence is also Women in New Zealand experience a and leaving them to take action alone, or very encouraging.
higher rate of violence from their intimate treating abusive people as being beyond partners than women in 14 other OECD "The Ministerial Group on Family Violence saving, doesn't work. Family violence is a countries. Over a 10 year period there and Sexual Violence, led by Ministers Adams pervasive problem in our society that has were 12 family violence deaths in New and Tolley, is committed to improving the the potential to destroy the lives of both the systemic response to family violence. The direct victims, and indirect victims (usually group has launched an ambitious cross- The FVDRC's fifth report calls for a number children), and also the lives of those using of changes to how both government and government work programme." violence. We need to work together and non-government organisations (NGOs) improve our responses considerably if we Data shows continuing
respond to family violence, to reduce the are going to bring about change." rate of violence, abuse, and deaths. disparity between gout
Professor Elder says agencies still see the prevalence and treatment
victim as having the ability to walk away if The latest Atlas of Healthcare Variation • there is a need to stop asking victims she wants to; this kind of thinking further shows a continuing gap between populations to keep themselves safe from abusive entraps victims and their children in the with the largest prevalence of gout and partners - practitioners need to proactively abusive situation.
those being prescribed the most effective make sure victims are safe "Victims do ask for help – often repeatedly drug for its treatment.
• practitioners need to provide long-term – but our FVDRC reviews indicate that assistance to victims rather than one-off The updated gout Atlas has been released by they often need to get a more helpful the Health Quality & Safety Commission, and informed response. There are many building on data which was published in • there must be more focus on the person barriers to help-seeking that need to be using violence, in addition to the victim identified and understood." – changing the behaviours of those using The data shows Mãori and Pacific peoples Some organisations also still don't see the violence is the most effective way to are more affected by gout, with at least link between intimate partner abuse and prevent family violence twice the rates of other non-Mãori, non- • violence must be recognised as being not Pacific groups. However, they are less likely just physical – it is also carried out through "If a person is abusing a child, FVDRC than these other groups to receive effective control, coercion, and intimidation. reviews have found they are likely to be These behaviours trap victims.
abusing the child's primary carer as well. Professor Nicola Dalbeth, Chair of the The report also identifies how the family Also where there is intimate partner abuse Commission's expert advisory group on violence workforce – including the justice, and children are present in the home, then gout, says that while the most common and child protection, and mental health and by definition there has been exposure to well-tolerated medicine for gout prevention addiction sectors – can be strengthened and emotional abuse and the children are at is allopurinol, Mãori and Pacific peoples work together better.
increased risk of being physically abused as receive it less frequently. well. These are entangled forms of family FVDRC co-chair Professor Dawn Elder violence and must always be identified and "Patients who take allopurinol regularly says it is time to change our collective addressed together." don't need as many other medicines to understanding of how we should address treat gout and have lower rates of hospital family violence.
FVDRC co-chair Professor Denise Wilson admission. We don't know how many says in spite of the needed changes in "We need to think differently about family people should be taking allopurinol but thinking, the FVDRC is encouraged by the violence and understand it is not a series data suggests there are people for whom willingness of agencies to work in a more of isolated incidents affecting an individual taking it would improve their health.
integrated way.
victim. Rather, family violence is a pattern "On average, 41 percent of people with gout of abusive behaviour used by an individual "The report has been drafted in consultation received allopurinol regularly. However, and between individuals that can have with many of the agencies responsible for among those populations with the highest multiple victims – both children and adults policy around family violence and we are rates of gout that number is lower – 9 – in the past, present and future." working closely with them." percent for Maori and  percent of Pacific She says government organisations and These agencies include the Ministry of January - February 2016 New Zealand Health & Hospital "This is similar to 2011 data which showed Childhood obesity was highlighted last year Scholarship student explores
allopurinol use was inversely related to gout as a key health target, in a statement by response to Whanganui DHB
prevalence and Pacific peoples received the Health Minister, Dr Jonathan Coleman. cancer information booklets
least amount of the drug.
"Many Kiwi children consume one or two Personalised information booklets published "The data shows there is no ‘one size fits all' of their daily meals at school, so the school for patients with colorectal, melanoma and approach to the management of gout – but food environment is the key to establishing breast cancers have been welcomed by we hope clinicians can use the information healthy eating patterns from a young age," those receiving them, says fifth-year medical to improve outcomes for patients living with says Professor Swinburn.
student Hoani MacFater.
Lisa King and Chef Michael Meredith, Mr MacFater recently completed a 10-week New online tool supports
founders of ‘Eat My Lunch', which research project for the Whanganui District healthy food in schools
provides lunch to kiwi kids in need, are also Health Board's Surgical Services team, who supportive of School-FERST.
designed and published the 8-page booklets Schools will have a new online tool to assess last year. Funded by a Ministry of Health and improve the food and beverages they ‘Eat My Lunch' is based on the principle grant, the project aimed to follow up the have available for students.
that every child deserves a healthy and impact the booklets have had on patient The new online tool - School Food nutritious meal at lunch time. recall and satisfaction.
Environment Review and Support Tool "We all know that kids struggle to Patients spoken to have told Mr MacFater (School-FERST) - will enable schools to concentrate and learn on an empty stomach that besides finding the distinctive covers self-review the healthiness of the food so in order for them to succeed our lunches and beverages they have available and easy to spot, they appreciate the level of focus on a wholesome lunch with less sugar support them in improving their food detail they're given about their cancer and more veggies – nothing from a packet," diagnosis, the operation performed, their says Ms King.
post-operative treatment and answers to The tool was developed by the INFORMAS* Research has linked healthy eating with many questions they, their family members team from the University of Auckland and positive body weight, better mental health and their GPs might have.
is designed to enable schools to assess and and educational outcomes. continue to contribute positively to their "The response I've had from patients has food environments by capturing important St. Mary's School in Avondale (Auckland) been very positive," Mr MacFater says. "As indicators and best practice examples.
also recognised the link between healthy soon as I mention the booklets with the eating and improving student engagement green foliage on the front of them, they These include foods and beverages provided which led to them creating their own garden know what I mean and they're happy to talk and sold on the school premises, use of and developing a healthier canteen menu. about how useful the booklet has been.
school gardens, participation in food and nutrition programmes and the school's food Their efforts were recognised with a Heart "From the start, the booklets were designed and nutrition policy.
School Award from The Heart Foundation to improve the follow-up process for which runs several programmes that Whanganui DHB cancer patients. Aware School-FERST will also highlight the that patients don't always remember what's efforts of schools that are taking positive facilitate healthy food environments in said to them in a clinic, the Whanganui steps to improve their food and nutrition schools. The INFORMAS team is keen DHB's Surgical Services team wanted to environments and promote them as role to build on this success with the launch of find a way to improve communication and put the focus on the patient and their needs. It will enable schools to better link their School-FERST will provide detailed, Making patient input an important part of nutrition education curriculum to mirror individual feedback to schools on various the design process appears to have really the food and beverages offered.
aspects of their school food environments, and will also be able to see how they fare "The data gathered using School-FERST in comparison to schools in their decile, "Besides giving people ownership of their will provide an important snapshot of food information, the booklets also provide them and nutrition environments in schools in region, and across the country.
with the tools to help identify if they have Aotearoa," says INFORMAS Co-ordinator, "Schools will be able to easily identify a problem that could need to be reviewed Professor Boyd Swinburn. "It's vital we act areas where they excel, and areas for now to better understand and improve the improvement," says Professor Swinburn. Feedback from the patients and groups food environments of our children." "Those with exceptionally healthy including the Cancer Society, Whanganui The Childhood Obesity Plan announced environments will be identified and DHB's Mãori Health Services, the Cancer by the Government in October 2015 promoted as role model schools, to offer best Psychology Service and DHB staff will now includes a focus on education and the practice examples for others to follow." help the Surgical Services team produce a school environment.
School-FERST will also provide resources second, updated version of the booklets. The lead agency for this work, the Ministry to guide those schools working toward Over time, additional booklets may be of Health, supports the use of School- improving the healthiness of their food published for patients with other types of FERST by schools.
The equipment can arrive before they do.
Ask about our 24/7 rapid resonse equipment service on the contact details below Earlier Mobilisation Phone 0800 331 332 Shorter Length of Stay Reduced Re-admission


Journal of the academy of rheumatoid diseases vol. 2

Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment. this theory was incorrect, the treatments developed from it have The Journal 2. To contract with professional scientific and medical organi- Academy of zations for research and develop mental studies related to the cureand/or remission of Rheumatoid Diseases;

Prednisolone or pentoxifylline for alcoholic hepatitis

Prednisolone or Pentoxifylline for Alcoholic Hepatitis Mark R. Thursz, M.D., Paul Richardson, M.D., Michael Allison, Ph.D., Andrew Austin, M.D., Megan Bowers, M.Sc., Christopher P. Day, M.D., Ph.D., Nichola Downs, P.G. Cert., Dermot Gleeson, M.D., Alastair MacGilchrist, M.D., Allister Grant, Ph.D., Steven Hood, M.D., Steven Masson, M.A., Anne McCune, M.D., Jane Mellor, M.Sc., John O'Grady, M.D., David Patch, M.D., Ian Ratcliffe, M.Sc.,