National Forum 2-3 November 2017 Quality, Timely a



Improving Quality of care in Cancer and Electives

Patient centred, safe, efficient, effective, timely and equitable

National Forum 2-3 November 2017

Day One: Thursday 2 November

NZ Health Strategy, direction, integration and partnerships

Jill Lane, Director of Service Commissioning, Ministry of Health

Working across systems and priorities to improve patient care

Lyn Horgan, I Operations Director, Hospital Services I MidCentral Health

Equity: Current evidence regarding cancer inequities for Māori

Dr Jason Gurney | Kairuruku Matua (Senior Research Fellow), Associate Director, Cancer and Chronic Conditions (C3) Research Group, Research Portfolio Leader, Department of Public Health, University of Otago, Wellington

Māori New Zealanders experience an unequal and inequitable burden of cancer: in short, Māori are more likely to get cancer, and once they have cancer they are less likely to survive it. This presentation will describe current evidence regarding incidence and survival disparities between Māori and non-Māori cancer patients, and discuss some of the potential drivers of these disparities.

Using a health equity and quality lens to improve delivery of Electives and National Services

Assoc Prof Sue Crengle, Department of Preventive and Social Medicine, Otago Medical School and General Practitioner, Invercargill Medical Centre

Faster Cancer Treatment & National Cancer Nurse Coordinator Initiative - Addressing the Equity Gap

Natalie James - National Nurse Lead - Cancer Nurse Coordinator Initiative

This presentation will consider the national cancer programmes efforts to support equity in cancer care, recognising the role consumer can take when designing programs that support high quality and timely care for people with cancer.

A new Cancer Strategic Action Plan 2018-2025

Vanessa James, Principle Advisor, Ministry of Health and Dr Scott Macfarlane, Clinical Advisor, Ministry of Health

Cancer Services are developing a new strategic action plan to follow the current New Zealand Cancer Plan 2015-2018. In this session Vanessa James will outline the approach to developing the plan and how people can have input into the process.

Patient Flow: balancing the flow

Dr Chris McEwan, Clinical Leader Prioritisation, Electives and National Services

Dr Suzanne Beuker, Faster Cancer Treatment Target Champion, Cancer Services

Dr Kim McAnulty, Radiology, Waikato DHB – Clinical Lead during the National Radiology Service Improvement Initiative

Respective leaders from the Electives and Cancer programmes will provide an overview of their programmes and how they link together to support patients in receiving timely and equitable care. Diagnostics are an enabler to supporting both the Elective and Cancer patient pathways and are an important step in a patient’s journey, hear how radiology can support patients in their journey. Have the opportunity to ask your questions to the clinical leaders in a panel discussion.

Patient Flow: Applying the acuity index

Allan Cumming, Improvement Advisor, Southern DHB

An interactive session which discusses a solution to the question of 'who should be booked next?'. The acuity index is a simple calculation which combines the urgency of individual cases and the amount of time people have been waiting. It takes into account routines and urgents and can be applied across follow ups, FSAs and treatment. It provides the order in which services should be delivered to patients. Allan will discuss the theory behind the acuity index, get the audience to experience using it and present the results of implementing the index across two services in Southern DHB.

National Forum 2-3 November 2017

Improving Quality of care in Cancer and Electives Patient centred, safe, efficient, effective, timely and equitable

Day Two: Friday 3 November

An integrated system

Clare Perry, Group Manager, Integrated Service Design, Ministry of Health

Building sustainable patient flow

Candice Togia, Team leader Central Bookings Unit, West Coast District Health Board

Maria Petrovics-Edens, Endoscopy Nurse Coordinator, West Coast District Health Board

Andrea Reilly, Clinical Nurse Specialist, Cancer Nurse Coordinator, West Coast District Health Board

An overview will be provided of the changes the West Coast DHB team implemented to their diagnostic colonoscopy and colorectal cancer services. Improvements discussed will include production planning routines, multi-disciplinary meetings and the transalpine referral process.

Consumer engagement: Waikato DHB experience based co-design projects

Mo Neville, Executive Director of Quality and Patient Safety, Waikato DHB

Wendy Entwistle, Team Leader - Consumer Engagement, Quality and Patient Safety, Waikato DHB

Experience Based Co-Design (EBD) is an adaptable, qualitative approach that focuses on gathering patient and staff experience and emotions to identify opportunities for service improvement. It looks at the actual experience of people rather than detached measures of customer satisfaction or proxy measures of performance such as waiting time. Waikato DHB have recently completed eight projects and will discuss the benefits and learnings from this approach.

What gets in the way of faster cancer treatment? A review of factors that cause patients to delay and decline treatment

Reynolds, L. M., James, F., Garcia-Hoyos, V., Young, M., Jansen, K., Chadwick, J., Small, R., Edmondson, A., Weeks, T., & Jackson, L.

Lisa Reynolds will present recent research conducted at Counties Manukau Health which investigated the reasons behind patients failing to meet the Faster Cancer Treatment 62-day timeline between August 2015 and January 2016. The research included a quantitative comparison of people who met the target with those who did not, 2) a clinical audit of reasons for delay documented in clinical records, and 3) a qualitative investigation of individual experience for 15 individuals who did not meet the FCT targets for patient factor reasons. Research findings and implications will be discussed.

Bariatric Surgery and equity

General Surgery Department, Counties Manakau DHB

Carolyn Watts, Director, Quigley and Watts Ltd

A discussion of equity in relation to bariatric surgery at Counties Manukau DHB. The team will discuss the results of their analysis into the level of equitable access to the bariatric surgery programme. They will also discuss strategies that are being put in place to move closer towards equity.

Prostate Decision Support: Raising Awareness in Priority Populations

Homecare Medical

Prostate awareness and treatment in NZ shows significant disparities across ethnic and socio-economic groups, with those at highest risk to their life outcomes having the lowest rate of checks, diagnosis and treatment. Those being underserved have low engagement with the health system, and therefore are difficult to reach. The chosen strategy is to use digital and offline communications to provide information, awareness and advice to these people, so as to increase their likelihood of checks, and improve the advice given based on the results of that check.

This presentation will discuss the journey towards creating this tool, and the challenges and opportunities in creating a tool targeted specifically at priority population individuals.

Poster Presentations – Friday 3 November

K’aute Pasifika Trust Mobility Action Programme (MAP)
K'aute is a Pacific Island Organisation based in Hamilton providing health education and social services predominantly for Pacific peoples living in the Waikato Region. The team will be presenting on their innovative early intervention community based programme for people with Osteoarthritis in the knee and /or Gout

Active + Remote Engagement and Community Health(REACH) Mobility Action Programme
Active + will be presenting on their REACH programme, an innovative technology supported multi-disciplinary approach to providing early intervention programmes for people living in the Hokianga region with low back pain and osteoarthritis of the hip and knee. This programme is a collaboration with Northland DHB, Active+, Hokianga Health Enterprise Trust (HHET), Te Tai Tokerau PHO and AWA Films Ltd

Bay of Plenty DHB
Determine, test and implement viable ways of improving Faster Cancer Treatment

Capital & Coast DHB
Emergency presentation of colorectal cancer

Southern DHB
Pathway entry – ED presentations and other route to diagnosis

Southern DHB
Diagnostics – Fast Track Clinics

Nelson Marlborough DHB
Improving the cancer pathway for Māori (Phase 2)

Waitemata DHB
Patient initiated follow up, a self-referral of symptoms approach

Bay of Plenty DHB
Just Book It – providing surety of follow up requirements and appointments at the time of discharge

Whanganui DHB
Review of orthopaedic clinic planning, resource utilisation and patient experience

Southern DHB
Pathway entry – referrals – improving the standard of primary referrals