March 2008

Emergency PlanningClinical Quality Management

T h e N O VAAwards were

introduced in2005 as one

w a y w e c a nr e c o g n i s e

employees andteams whose own

values align with thefour ADHB adopted

values : Integr i t y,Respect, Innovation

and Ef fec t iveness.

The NOVA Award worksby nomination – anyone

can submit a story aboutan individual or team who

has demonstrated ourvalues ‘above and beyond’ that expected in theworkplace. Nominations are then reviewed by acommittee, and worthy nominations are putforward to receive an award at one of the six-monthly State of the Nation addresses.

By encouraging stories to be told, ADHB hopes touncover the stars that glow within our midst.NOVA is the name given to a star when it is born,and its Maori translation Te Whetu Marama means‘Bright Star’.

For more information on the Nova Awards, or to make anomination, visit the Nova Awards page under CEO News

on the Intranet.

Comment from thechief executive

Integrity

Innovation

Respect

Effectiveness

“Kia u ki te tika me te pono”

AWARD

Te whetu - Marama

Values Recognition

ADHB’s progress andperformance is highon my mind at themoment, prompted byrecent or upcomingevents.

As you may haveheard in the media, theQuality ImprovementCommittee released anonymised details in late February on allreported serious and sentinel events which have occurred in the21 DHBs over the past few years.

This is the start of creating a national reporting system for adverseevents and the ADHB welcomes any work to decrease adverseevents in New Zealand’s health system. ADHB has taken significantstrides in improving quality systems including online risk reportingand clinical effectiveness programmes. Inside the pages of this issuethere is more information on the processes we’ve put in place toimprove our clinical quality and performance.

The half-yearly State of the Nation event is coming up, where welook at what has been achieved against our objectives, how we areperforming and where we are going. I would recommend all staffto attend this event, if possible.

Both these events have prompted me to ponder how we got toour current position, which is extremely positive. We are experiencinga significant reduction in staff turnover, an increase in productivity,improvements in efficiency, better management of our waiting lists– and perhaps most notably, the imminent elimination of our deficit,with a break-even position forecast this year.

The Quality Framework is being implemented to embed clinicaleffectiveness in everything we do. We are continuing to see thebenefits of strong clinical leadership and expertise such as thatprovided by the Clinical Practice Committee.

Similarly, we have addressed the root causes of the deficit. We havereceived recognition for the additional costs of providing nationalservices. Our procurement team have negotiated high qualityproduct at fair prices. Productivity has been improved by an increasein efficiency as well as by the performance of staff, who havemanaged increasing patient throughput with staff numbers stayingrelatively stable. The Operational Efficiency Programme will continueour improvements in this area. We have also introduced an accountmanagement concept to assist in managing referrals from otherDHBs and ACC, who are now acknowledged as ‘customers’.

All of these factors have played a part in getting to the positiveposition we are in today. But I believe the fundamental reason forour success is that so many of you show a passion and commitmentfor what we are here for: the patient and the health of AucklandCity population.

I look forward to meeting with you at the State of the Nation seminarsoon.

ISSN 1178-5373 (print) ISSN 1178-5381 (online)

Quality AwardA two-year project streamlining quality policies betweenOperating Rooms, Anaesthesia and the Central SterileSupply Department culminated in a Quality Improve-ment Award for consultant nurse Annie Wilkinson.

“My first job was to build relationships with peopleworking in the various areas. Their initial reaction was‘Who is this nurse coming in here and telling us whatto do?,’” says Annie.

Annie spent a huge amount of time at staff in-servicesessions to produce forward progress. This was helpedby recognition and support from senior staff.

She worked slowly, using a multi-disciplinary approachto achieve standard practice and buy-in from workersacross five separate operating rooms (OR). Therelationship between the department and widerorganisation was better aligned and six hundred policieswere reduced to a mere ninety six.

But that was not all. Annie researched and consultedto establish best evidence-based practice for our localsetting and these policies are now available on theIntranet at:http://adhbintranet/ADHB_Policies_and_Procedures/Policies/OR_Anaesthesia_and_CSSD/Index.htm

“The process set up and used by Annie is an excellentexample of how appropriate consultation and co-operation between all groups, can bring about change,even when there are deeply held opposing views.” Thisquote by Annie’s manager Vanessa Beavis, Director ofOR, underlines the enormity of the task Annie hasachieved, and makes her success all the more impressive.

On my mind

Lifting the health of the ADHBClinical Quality and Professional Governance Model

So is clinical quality simply a questionof creating an environment ofaccountability?

“The Clinical Quality and ProfessionalGovernance model is dependent onan environment of openness andtransparency, and this includes a “noblame” culture,” says David. It is alsoabout clinicians being accountable forclinical outcomes.

“Accountability underpins ADHB’s values ofintegrity, respect, innovation andeffectiveness. If the structure and culture ofan organisation create a workplace wheremistakes can be admitted you are half-way there. The governance modelemployed by the ADHB also ensures thatthere is someone in place to provide theresources and implement the relevantsystems to promote clinical quality,” he says.

As a recent article in the New ZealandMedical Journal states:

“…it (the Clinical Quality and ProfessionalGovernance model) requires clinicians toaccept transparent accountability,teamwork rather than individualism…..Inreturn, they must be given the autonomyto do the job that they are trained for andthe resources necessary for that job.”(Perkins, Pelkowitz & Seddon 2006)

Professional GovernanceProfessional standards &development

Setting clinical and culturalcompetency requirements andethical standards

Performance monitoring

Compliance with credentialingstandards & processes

Professional developmentthrough ongoing education &training

Workforce development

Quality/ Clinical Effectiveness cycleClinical quality, efficiency, safety, & value formoney

Clinical audit management, planning &monitoring

Measuring efficiency, safety & value formoney of clinical interventions

Learning through research & audit

Teaching/ collaboration with academicinstitutions to support evidence basedclinical practice

Integrated information managementsystems

Policy & Risk ManagementPatient, staff and organisational riskmanagement

Statutory regulation &compliance

Ensuring safe work environments

High quality employmentpractices

Consumer involvement

Ongoing review of policy,systems, processes & guidelines.Service contracts, specificationsand accreditation

Research & DevelopmentBest practice based on evidence

Research guidelines

Transparent research governance &financing

Integrated approach to the learningand clinical effectiveness cycle

Health service research

If the ADHB is to meet our goal ofcontinually lifting the health of thepeople of Auckland, it follows that wemust continually look at ways to en-hance the quality of the work we do.

In short, it is a simple relationship: if weimprove the health of our organisationwe will improvethe health ofA u c k l a n d e r s .

an easy equationt o p u t i n t owords, and a principle that is understoodand used across the globe. However, inpractice, improving clinical quality is acomplex issue - especially in anenvironment as dynamic as the ADHB,where technology, best practice and thevery diverse of the population we serveare changing all the time.

So how does the ADHB seek to effectivelyand continually enhance the health ofthe one of the largest and most complexorganisations in New Zealand?

Firstly, it is important to understand what‘clinical quality’ means as it can bemistakenly seen as just a reference tothe work undertaken in the operatingtheatre or in a consultation room. Thework done by our doctors, nurses andallied health and technical staff does nothappen in isolation. The quality of whatthey are able to achieve is not just downto their skill and expertise, but is also aresult of the effectiveness of ourorganisational structures, supportsystems and processes and the ADHB’sculture and values.

In essence, we all have a role to play inimproving clinical quality as it is the endoutput of everything we do.

A key element to ensuring everyone isworking towards clinical qualityimprovement is a DHB’s clinical qualitymodel, says the ADHB’s Chief MedicalOfficer David Sage.

“Clinical governance is not just aboutclinical process. It is also about drivingquality improvement by creating anenvironment in which excellence inclinical care will flourish,” says David.

This philosophy underpins the ADHB’s‘Clinical Quality and ProfessionalGovernance’ model where differentservices are managed in partnership byclinicians and a manager.

“The belief is that this partnership willhave all the attributes to drive clinicalquality improvement,” says David.

Two corollaries emerge: Firstly the logicof having clinicians in partnership with

managers at all levels in the organisation.

Secondly, all clinicians dealing withpatients have a connection through eachmanagement layer to their professionalhead.

Janice Mueller, Director of Allied Health,says that this modelapplies to all clinicalstaff, irrespective ofclinical profession,level of experienceor seniority.

“For example, the Chief Medical Officer,the Executive Director of Nursing and Ihave a partnership with the ChiefExecutive. General Managers have anumber of clinical partners, and so it goeson,” says Janice.

The model also is the framework for theADHB’s working relationships withorganisations within the provider armand those contracted to the ADHB viaservice contract agreements.

“Our Planning and Funding PortfolioMangers work closely with the expertsin our primary health care services andcommunity advisory groups to ensurethat not only are targets set and achievedbut also the best patient experiencepossible is provided,” she says.

We all have a role to play inimproving clinical quality as it is theend output of everything we do.

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ADHB Participation inExercise Ruaumoko -

Auckland RegionVolcanic Exercise

November 2007 - March 2008

In 2005 Cabinet directed the Ministry of Civil Defence Emergency Management (MCDEM) to conduct two national disasterexercises to test New Zealand's all-of-nation preparedness for a major disaster. The first of these, Exercise Capital Quake,took place in November 2006 and tested response to a Wellington earthquake. The second, Exercise Ruaumoko wasdesigned to test the all-of-nation preparedness for a volcanic eruption in Auckland, commenced in November 2007 andran through until the middle of March (the main exercise days being 10th-14th March 2008). Auckland District HealthBoard (ADHB) as part of the New Zealand health sector participated in Exercise Ruaumoko (a Tier 4 - national-level exercise),throughout this five month period in order to improve its ability to respond to a volcanic eruption in the Auckland regionby continuing to develop and practice its respective roles and responsibilities at district, regional and national levels asset out in National Health Emergency Plans.

The exercise was led by the Department of the Prime Minister and Cabinet, the Ministry of Civil Defence & EmergencyManagement, and the Auckland Civil Defence Emergency Management (CDEM) Group. It was supported by approximately100 local and national agencies, in addition to ADHB the regional health sector participation included Waitemata DistrictHealth Board (DHB), Counties-Manukau DHB, Northland DHB, St John Ambulance, and Auckland Regional Public HealthService.

The scenario was based on a possible volcanic eruption somewhere in the wider Auckland metropolitan area. The exercisecommenced with the identification of precursor activity in the form of seismicity in the Auckland region in November2007, such that planning meetings were required. In early March 2008 unusual and sustained seismicity in the Aucklandregion prompted further attention. As the source of seismic activity grew shallower, it became clear that a volcanic eruptionwas imminent. Exercise Ruaumoko focused on the lead-in to a volcanic eruption; it allowed current inter-health and inter-agency communication to be further developed and reaffirmed - with particular emphasis on key decision making processes.

The aim of Exercise Ruaumoko 2008 for ADHB was: “To trial, develop and improve the ADHB co-ordinated response to avolcanic eruption.” To facilitate this response the Incident Management Team (IMT) and IMT Support Team were activatedwith the ADHB Emergency Operations Centre being operational on 13th and 14th March. As the debriefing and reportingprocesses for the exercise commence it is anticipated this improvement will come about through: having tested the healthsector’s systems and procedures, and the familiarisation of ADHB staff with these systems and procedures. In addition thedevelopment of closer working relationships with other government agencies, and the refinement and improvement ofADHB’s systems and procedures will be reviewed, based upon feedback and evaluation.

The events that may lead to the evacuation of the ADHB hospitals and associated sites for which ADHB has legal responsibilityare many and varied but may result from a natural disaster, such as a volcanic eruption (Exercise Ruaumoko), severe weatheror due to other hazards such as fire, explosion and utility failure. Part of the ADHB all hazards approach to EmergencyManagement requires that plans be put in place to address the issue of evacuation. There are several critical issues whenconsidering the evacuation of a hospital site and smaller sites for which ADHB is responsible across the city. For example,the nature and severity of the threat will define the urgency of evacuation required and determine the risk to patients andstaff and the ability to function during the evacuation, as tested in Exercise Ruaumoko.

The ADHB evacuation planning process commenced in October 2007 with the formation of a Steering Group to map theplanning process. This process involves evacuation strategy, the development of an evacuation plan (including the decisionto evacuate) along with its evaluation for refinement and improvement. A draft version of this plan was used to assist theIncident Management Team in their decision making processes during the exercise. The plan project will continue to beconducted over the coming months, with consultation across all ADHB sites at all levels being key to its successfuldevelopment. The evaluation reports produced from Exercise Ruaumoko will further inform the Steering Group’s planningprocesses; in addition the scoping of the ADHB Evacuation Plan project has been instrumental in initiating an AucklandRegion Health Evacuation Plan Working Group.

ADHB’s participation in Exercise Ruaumoko, which was the largest Civil Defence Emergency Management lead exerciseever conducted in New Zealand provided a unique opportunity to look at its roles and responsibilities at all levels whilsttesting planning arrangements embed in its standard processes. It confirmed the connections between ADHB and local,regional and national agencies (internal and external to health). This included introducing health-specific issues into theexercise scenario and practicing the Civil Defence Emergency Management (CDEM) Health Liaison role when working withlocal CDEM Group organisations as part of exercise play.

Emergency Management Services as part of its activities to assist ADHB to prepare and manage any emergency or majorincident are facilitating the Evacuation Plan project. The contacts are Justin Rawiri – Emergency Management Coordinatorextn: 27589 and Debra Ellis - Emergency Management Advisor extn: 26310.

-Deborah Ellis investigates

ADHB Travel Plan gets into gear

Nov - Dec 2007Scoping and development plan

Jan – Mar 2008Tender awarded

Information gathering begins

Apr – May 2008Patient, visitor and staff surveys on travel behaviour

June 2008Analysis of data and recommended actions

July 2008Develop ADHB agreed actions.

Recommendations for ACC and ARTA

Plan finalisation

On-going reviews

ADHB Travel Plan project time-frame

The Travel Behaviour Survey is your chance to ensure thatyour travel issues and views are taken into account. AllADHB staff will be given the opportunity to participate.

In addition to the staff survey, patient and visitor surveysare being carried out by dedicated personnel on bothsites. Those conducting the surveys will be easilyidentifiable by their blue bibs and identification tags.

“We’re keen for asmany of our staff tohave input into theADHB Travel Planand I’d encourageeveryone to takea few minutes toc o m p l e t e t h esurvey.”

Once the survey and reviews have been completed, the datawill be analysed and recommendations on possible coursesof action will be submitted to ADHB, Auckland City Counciland Auckland Regional Transport Authority. This is likely tobe towards the end of June.

“The recommendations will be discussed and developed intoa plan to be rolled out across the sites,” says Reg.

Auckland City Council and the Auckland Regional TransportAuthority are already working on a number of transportimprovements which will make passenger transport and ‘active’options easier and safer. These include the Central Connectorproject, commencing this month, which involves thedevelopment of a dedicated busway connecting Britomartwith Newmarket via key locations, including Auckland CityHospital (further information is provided in the article on pageXX); and the DART project which involves the upgrade of railservices, including a new railway station on the corner Park &Kyber Pass Rd .(an article detailing the project will feature innext month’s NOVA).

Auckland Distr ictH e a l t h B o a r d ,Auckland City Coun-ci l and AucklandRegional TransportAuthority partner toimprove travel forADHB staff, patientsand visitors.

Auckland is one of thousands of cities around the worldexperiencing increasing pressures on its transport networkand parking facilities, with drivers facing heightened congestionand commuting times.

Combined with an increasing focus on environmentalsustainability - cities, governments, organisations andindividuals are increasingly examining their daily routines toreduce their environmental impact.

“Transport has a huge impact on Auckland District HealthBoard (ADHB) and affects the provision of the health careservices it provides to its population in a range of ways – fromstaff travelling to and from work each day, to patients andvisitors being able to park or use other suitable methods oftransport,” says Roger Jarrold, Chief Financial Officer, ADHB.

“Working in partnership with Auckland City Council and theAuckland Regional Transport Authority, ADHB is embarkingon a Travel Plan. This involves a series of actions thatwill improve access to, and provision of, health care.”

The plan will address key issues affecting the Greenlane andGrafton sites and will focus on staff, patients and visitors.

“In order to develop these actions we must first understandwhat factors affect how and why people travel to ADHB sitesin the way that they do,” says Ian Harper, ADHB’s FacilitiesManager.

“We must find out what could make sustainable travel optionseasier and safer.”

With this in mind the plan involves a comprehensive researchand information gathering stage including:

A detailed review of pedestrian, mobility and cycle accessand safety in and around both sites with the aim ofimproving walkways, way-finding signage, cycling facilities,disabled/mobility access to transport options and clinics.

A parking management review addressing car parking issuesat each site.

An information and marketing review with the aim ofimproving and promoting travel options to staff, patientsand visitors.

An ADHB Travel Behaviour Survey of staff, patients andvisitors.

The Travel Behaviour Survey is a core component of the ADHBTravel Plan. Commencing in the first week of April, the staff,patient and visitor surveys will inform the project, determiningthe current usage of each type of travel and where peopletravel from, identifying common issues and potential solutions.

“The ADHB Travel Plan is important to the whole organisationespecially with increased emphasis on environmentally friendlytransport modes and the impact of foreseeable petrol pricehikes,” says Reg Prasad, Project Manager ADHB.

Improving our QualityQIC plans to release the national serious and sentinel eventsfigures annually from now on. This work on clinical qualityindicators is being referred to as the “Sixth Stream” of QIC’snational programme. After its establishment, QIC consultedwidely and presented business cases on the five highest-priorityprojects to the Minister.

The projects included arrangements for leading andcoordinating the work of DHBs and the Ministry of Healthalong with appropriate mechanisms for oversight.

Five streams were subsequently established, after the Ministryof Health approved $20 million for their funding under theNational Quality Improvement Programme. The ADHB is thelead DHB for the Infection Prevention and Control project.

Project

Optimising thepatient’s journey

Management ofhealthcare incidents

Infection preventionand control

Safe medicationManagement

National mortalityreview systems

Lead DHB

Counties Manukau– Geraint Martin

Waikato – Craig Climo

Auckland – Garry Smith

West Coast – Kevin Hague

Hutt Valley – Chai Chuah

Joint DHB &Ministry of Health

Funding

$2m over 3 years

$1.15m over 2 years

$0.75m over18 months

$10.2m overa multi-yearperiod

$5.5m over 3 years

Quality improvement is an integral party of health planning.The work of the committee is building on the strong supportcommitment of DHBs and providing the opportunity tocoordinate the efforts in this field and reduce the chance ofduplication. It also consolidates and builds on the work thatmany DHBs have already been doing in this area.

More information on QIC’s work can be found atwww.qic.health.govt.nz

Level 2 Atrium at ACH turns into Disaster ZoneMajor Incident and Disaster Management are key functions for emergencydepartments in every hospital. The ability to change the daily routine and accept amass influx of casualties is important. The Adult Emergency Department at AucklandCity Hospital had a practice exercise recently.

After staff education, updating and briefing, the Atrium on Level 2 was convertedinto an area to receive and manage minor category patients. Portable stretchers,mobile trolleys, whiteboards, desks and chairs all came out of the Major IncidentStore. Pretend patients were processed from entry, to treatment, to discharge.

Approximately 30 ED staff were involved and included ED specialists, nurses, healthcare assistants, orderlies, friendsof the emergency department(FEDS), medical students andeven the department secretary.The chaotic environment waseffectively managed by MargaretC o l l i g a n , a n e m e r g e n c ydepartment nurse practitioner.She calmly organised resourcesand movement of patients.Overall it was a fun time andheightened the knowledge andskills of all ED Staff involved.

The nationwide release of details of serious and sentinel eventsreported by the 21 District Health Boards created a largeamount of media attention in February. It was the first timethis sort of information had been released on this scale in NewZealand and, as Quality Improvement Committee chairman(and ADHB chair) Pat Snedden said, it may be the first timeinternationally that this has been done.

The Quality Improvement Committee (QIC), which releasedthe information, was established in February 2007 to provideindependent advice to Parliament to make and implementrecommendations on national quality improvement.

The figures released by QIC showed that in 2006 -2007, 182people treated in New Zealand hospitals were involved inactual or potentially preventable clinical incidents that resulted– or could have resulted in –serious harm or death. Of these,40 died as a result. Over the same period, more than 834,843people were treated.

The ADHB recorded 26 serious or sentinel events in that period,during which time it treated more than 100,000 patients whowere in for day stay or longer. Waikato DHB reported 24 seriousor sentinel events, and Waitemata and Canterbury DHBs bothreported 22.

There are large differences in classification between hospitalsso it is not possible to make any comparison based on thenumber of incidents reported by different hospitals.

Mr Snedden says the Health & Disability Commissioner issuedthe sector a challenge to come up with a system to report onand measure these events and provide comparative statisticsas part of the process of making patient care safer.

“Hospitals have always collected this data, but this is the firsttime it has been done like this with detailed summaries. Thislevel of transparency could be a world first. We’ve still got away to go with the system – but the endorsement of the HDCand the Ombudsmen confirms we’re on the right track.”

The next phase of work for QIC on this project is to look at asystem to make real time information about serious and sentinelevents available on-line to clinicians.

From the professional partners

Monitor Pro running I have seen noevidence of censure at all. Issues ofindividuals’ competence arise veryrarely and are dealt with via acompletely different process fromthose used here for qualityimprovement. These improvementscan only be made by voluntaryreporting of events that givesopportunity for Root Cause Analysis(RCA), centralised awareness ofrecurrent and organisation-wideproblems that can be remedied,exporting quality and improvementopportunity outside the confines ofdepartmental PQAA activity. RCA isalso a process beyond the resourcesof most departments, is non-judgemental of the individualsinvolved, and provides a structuredanalytical framework suited toidentifying multiple contributorycourses for a single accident.

As we expected, this OIA has hadbeneficial results. It has catalysedinter-DHB collaboration on howbest to capture and compare “thecentral ised awareness” thatpowerful databases can produce,and provides strong support forvoluntary reporting by individuals clinicians of all medicalevents they see that are serious or sentinel.

In recent times, within our own organisation a number of bigprojects have started for quality improvement as a result ofevent reporting, notably “time-out” patient identity andlaterality checks in operating theatres, the large radiology /reconciliation project and various prescribing projects.Reporting serious and sentinel events including those “nearmisses” is now mainstream in your duty of care not just to thepatient or consumer in fr ont of you – but the next ones as well!

Why Risk Monitor Pro is not PQAA’ed

The annual influenza vaccination campaign iscoming to ADHB in April. There are now morereasons than ever to get your flu vaccination:

Your responsibility as a health professionalIf you pass on influenza to patients they may getmore severe disease and experience thecomplications associated with influenza. Plus ifyou’re off sick with the flu, that’s one less hand ondeck for the busy winter period. By gettingvaccinated you’ll protect yourself, your patients andyour family – don’t take home hospital bugs.It’s FREE to all ADHB staff.

Win prizes! By getting an influenza vaccine thisyear you’ll go into the draw to win some excitingprizes.

The 2008 campaign also aims to address some ofthe myths surrounding influenza vaccination.

Top to bottom:- Chief Medical OfficerDavid Sage, Director ofNursing TaimaCampbell, and Directorof Allied HealthJanice Mueller.

Last year, along with all the other DHB’s, we receivednewspaper requests under the Official Information Act (OIA)to produce our file of Serious and Sentinel Events. We lookedat Risk Monitor Pro where these are stored and we thought“how can we release these files that contain identifying patientdetails, and use a lot of technical jargon”.

Other DHB’s had the same issues so we invited the Healthand Disability Commission and the Ombudsman for OfficialInformation to meet us at Auckland City Hospital to adviseus on how to approach the request. On the one hand wehave to completely respect individuals’ privacy, on the otherhand the OIA asks for full and frank disclosure. With thoseexpectations clarified for us we edited out personal detailsand jargon and produced 14 pages of case summaries thatwe released to the newspapers.

We had realised at the outset that this OIA request could turnout to be beneficial if presented in public with the explanationof why the cases are recorded and individually investigated,the basis for a blame-free quality improvement cultureincreasingly a reality in our hospitals. Commentary by nationalexperts with the release of the information confirmed thatview, and the public discussion has been thoughtful andsupportive rather than sensationalising to any great extent.

Thus it is highly significant that we have successfully put inthe public arena the most serious and sensitive casesummaries from our reportable events database (“Risk MonitorPro”). Significant because I believe it vindicates our decisionnot to make reporting to this database a “Protected QualityAssurance Activity”. Otherwise known as “PQAA” this is amechanism available to doctors under the Health PractitionersCompetency Act 2003 (HPCA) to enable them to discussclinical cases and outcomes confidentially, with protectionfrom legal discovery. Many of our clinical departments havetheir clinical meetings, morbidity / mortality discussions etc“PQAA’ed” for this purpose and it has huge benefit foruninhibited discussion at departmental level especially whenthings have gone wrong. Medical staff particularly have beendistrustful of additionally reporting various sentinel eventsto the reportable events database either through fear of beingcensured or a belief it has no value. Since we have had Risk

PROTECT YOURSELF AND YOUR PATIENTSGET IMMUNISED 2008 FLU VACCINATION CAMPAIGN COMING SOON

MYTH BUSTING:MYTH: Natural immunity is better.

FACT: The types of influenza viruses circulating in the communitychange from year to year. Immunity to influenza viruses only lasts fora year, so it is important to get vaccinated against influenza every year.

MYTH: The flu vaccine can cause the flu.

FACT: The flu vaccine cannot cause the flu. It takes up to two weeksto provide full protection. If you get the flu after you have had the fluvaccine you may have contracted the flu before the vaccine kicked in,or you may have caught a strain that was not in the vaccine. Alternatively,you may have experienced symptoms from a virus other than the flu.

MYTH: The flu vaccine does not work.

FACT: The flu vaccine is 70 – 90% effective in healthy adults under 65years of age.

Two new simulators donated to Starshipphysiotherapists – in fact, any staffmembers involved in clinical work atStarship as well as parents and caregivers.

There is a huge scope of use andapplication for both of these manikins.

The prime factor, however, is thatsimulated scenarios using the SimBabyand Megacode Kid will not compromisepatient safety but will ensure that clinicalstaff members do have the skills andconfidence to manage a wide-range ofemergency situations effectively.

HIV Screening for Pregnant Women hascommenced in Auckland Region

recommend an HIV test along with the first antenatal bloodswith each pregnancy.

Three Auckland HIV coordinators will work together to educatehealth care professionals on the specifics of the policy change.Training sessions will cover the screening pathways andguidelines for positive results and the support systems in placefor health professionals and for HIV positive women within theAuckland and Northland areas as well as to answer anyquestions people may have.

HIV screening in pregnancy is something we want to beconsidered as part of normal practice. Pregnant woman canexpect to offered an HIV test along with there first antenatalbloods as training rolls out this year.

For more information please contact:Donna Raymond ADHB, phone: 021 983 468

Seniorlinekeep a disabled visitor safe during their stay. Hiring is an optionin this situation and Seniorline staff can list local hire outlets.If the person visits regularly but family do not want to buyexpensive new equipment, staff might direct them to a websiteoffering second-hand equipment for sale.

Transport is another regular topic for callers; staff can provideinformation on how to access mobility parking permits orreduced taxi fares for people unable to use public transport.

“We find callers are often surprised to get a real personanswering the phone”, says Deborah. “We also attend a numberof Health Expo type events so that we can talk face-to-facewith older people.”

The Seniorline service began in May 2007. It is funded byAuckland District Health Board and is available to people livingin the Health Board area. You can contact them the followingways:

Phone: 375 4395 or 0800 725 463Email: seniorline@adhb.got.nz

Counties Manukau, Auckland and Waitemata District HealthBoards announced the commencement of training sessionson Antenatal HIV Screening in March 2008.

The aim of screening is to identify HIV infection in pregnantwomen. Since 2000 approximately 14 children in New Zealandhave contracted HIV because it was undetected duringpregnancy in their mothers.

If women are diagnosed and treated in pregnancy, the risk ofvertical transmission to the baby can be reduced from (up to)30% to less than 1%. In fact no babies have been born in NewZealand to identified HIV positive women who have beenappropriately treated in pregnancy. There are also benefits tothe mother for early detection of HIV, with new treatmentsimproving life expectancy and quality of life.

Training sessions are being provided to ensure all health careprofessionals are updated on the need to routinely offer and

Ever wonder how to access mobility equipment or home carefor that older friend or relative? Seniorline, a new service offeredby Auckland District Health Board could help.

Seniorline is an extension of telephone information serviceResidential Care Line which holds data on retirement villages,rental accommodation, home care, activities, day care, resthomes, hospitals and finances for same. The expandedknowledge base includes information on transport, equipmentand a range of disability services.

“We aim to help older people navigate the health system,” saysco-ordinator Deborah Duncan. “People often don’t know whereto start, but after discussion we can provide them with theinformation they need to begin making decisions. If we don’thave that information we will find it, or identify someone whocan help.”

Equipment is a popular caller question; how to get it, or whereto return gear once it is no longer needed. Sometimes a familyrealise that a piece of equipment like a shower chair will help

Mattel Children’s Foundation hasgenerously donated the monies toenable the Starship Foundation topurchase two new simulators for usein the Clinical Skills Centre (CSC).

Simulation training is becoming anincreasingly vital part of clinical andresuscitation skill development and thenew simulators will allow for basic andadvanced training in a number ofsettings. The simulators can beprogrammed to deliver set scenarioseither in the CSC or be transported bythe CSC team to wards and departmentsin Starship or other areas for ‘on the spot’simulated scenarios.

The SimBaby manikin - a high fidelity,computer-driven simulator - is the sizeof a 3 month old baby. Simbaby canbreath, cry, wriggle, choke, pulses can befelt and lips turn blue. It can be intubated,

defibrillated, routine and invasivemonitoring can be displayed and IVfluids & drugs administered. TheSimbaby simulator can be ‘operated’ on,anaesthetised or be used to enact outthe role of a baby in any ward ordomestic situation.

The second simulator, Megacode Kid, isa resuscitation manikin approximatelythe size of a 6-7 year old child. Using ahand-held device the operator ofMegacode Kid can generate pulses, heartrhythms and heart, lung and bowelsounds. The manikin can be defibrillatedand has both intravenous andintraosseous access.

SimBaby and the Megacode Kid will beinvaluable teaching and learning toolsfor the all Starship and other staff -nurses, doctors, health care assistants,operating room personnel and

Kids Domain, the staff child carecentre at Auckland City Hospitalhas acquired a reputation inrecent years as a centre ofexcellence noted for goodbusiness practice and qualityinitiatives.

Manager of 13 years JulianneExton confesses that at first shefelt she would stay in the joba couple of years and thenmove on. Clearly this has nothappened!

that she wanted the centre tobe “the best child care centre inNew Zealand,” by combiningbest business practice with theheart of a not-for-profit. With“fabul-ous support” from theirgovern-ance committee, KidsDomain works hard at achievingthis vision.

Childcare in the 1990’s was a place of low status and low pay.Winning several business development quality awards for theAuckland Hospital Staff Preschool (as it was then named),started to change perceptions.

The centre continues to focus on improving quality and bestpractice. While Ministry of Education grapples with the issueof how to attract male teachers, Kids Domain employs two,well above the norm for early childhood education.

Staff and kids both enjoy the balance male teachers bring tothe centre. Julianne explains they have noticed with interesthow men have different strategies for managing difficultbehaviour in a group; female staff members deal with it, butspend time considering context and possible triggers for thebehaviour, while male staff simply deal with it and move on.

Atsushi Ukito, a five year veteran of the centre attended thefirst “Men in Early Childhood Summit” at Christchurch in 2007.There are Ministry of Education project plans for him to speakin schools and help recruit more young men.

“Growing teachers” is another passion for Julianne; “I feel it is

Welcome Graduate Nurses

preceptorship, clinical skill development, and ongoingtheoretical and academic education.

This recent group of graduates is the first intake for 2008 andrepresents the largest intake in recent years.

Recruitment consultant, Darren McLean, says that the numberof applications received for this intake of ADHB graduate nurseprogrammes far exceeded expectations with students applyingfrom as far as Whangarei and Invercargill. This, Darren says,probably reflects the seemingly growing belief amongst thestudent population that ADHB is seen as the employer of choicefor new graduate nurses.

To all our recent graduates, we trust that this will be thebeginning of a very rewarding career in nursing. We welcomeyou and wish you well.

Welcome to the 104 graduate nurses who commenced work at ADHB

Kids Domain noted for excellence

something we do really well,” she says. Anyone wanting towork at the centre must agree to study and they are supportedthrough to full registration as an early childhood teacher.

Kids Domain staff are about to participate in a research projectwhich will engage them in collective story-telling of their ownchildhood experiences. Shared stories from the diverse staffpopulation will be captured in audio-visual format and usedas a training aid to increase awareness and understanding ofdifferent cultures.

The 30 childcare staff includes members of the followingnationalities: Indigenous Fijian, Fijian Indian, Malaysian, Filipino,Romanian, Japanese, German, New Zealand Maori, Cook IslandMaori, Indian, British and Pakeha New Zealander.

Final word on Kids Domain should go to families who use theservice. “It’s great to be able to get on with my work knowingthat Samara is happy and well cared for. She just loves it here,I can’t praise them enough,” says Shelley Sebastian, whose fouryear old daughter who has attended the centre for almostthree years.

ADHB warmly welcomes 104 graduate nurses whocommenced work with us in January this year. Graduateswere employed in a wide range of areas across adult health,child health, women’s health and mental health services.

“This is a significant step in their career. We wish to embraceour new talent, and wish them all the best,” says VanessaGraham, Recruitment Manager.

“For the new graduate nurses the transition from student tothe professional working world can be a challenging, evendaunting, experience at times. We seek to help them make asmooth transition through two essential graduate nurseprogrammes: the Nursing Entry to Practice (NETP) Programme,and the New Graduate Mental Health Nursing: Entry toSpecialty Practice Programme.”

Both programmes support the graduate nurse through

Staff and kids from Kids Domain.

Auckland City Hospital:getting there faster and safer

Commencing work:It has been confirmed that work willcommence on April 8 on two main sites:Customs Street / Anzac Avenue (from thebottom end heading uphill) and from theend of Grafton Bridge heading past theHospital towards Khyber Pass.

All work will be completed in key stages andinclude a ‘dig once’ approach to ensureminimum disruption to traffic, local residents,businesses and the hospital.

Key facts:2,600 bus trips carrying 65,000 passengers

Up to 14 minute shorter journey time

Increased bus trip reliability

24-hour operation

Safer, more attractive route for pedestriansand cyclists

Three new bus canopies for increased shelter

Work is set to begin on Auckland City’s Central Connectorproject.

Travelling to and from Auckland City Hospital by sustainablemeans is set to become quicker and easier for staff, patientsand visitors with construction of the Central Connectorbeginning this month.

The Central Connector, a key Auckland City Council transportproject due for completion in 2010, is a dedicated buswayconnecting Britomart with Newmarket, via key locations, whilealso providing a safer route for cyclists and pedestrians.

“Auckland City Hospital is one of the key locations on theroute and this project will provide faster and safer sustainabletransport options for our staff and visitors,” says Reg Prasad,ADHB’s Project Manager.

The Central Connector will start at the Britomart transportcentre and continue along Custom Street and Beach Road, upAnzac Avenue and Symonds Street, across Grafton Bridge andalong Park Road, linking-up with existing bus lanes on KhyberPass Road.

As part of the project there is a range of other work beingcarried out to make bus travel easier and more efficient,including:

New bus stops being installed at key locations

Improved and coordinated traffic signals

Dedicated 24-hour bus lanes ensuring buses are not held-up in traffic

Improved lighting.

Improvements for pedestrians include ten new pedestriancrossings, marked with raised mats for the visually impairedand easily accessible to the mobility impaired; new paving;and newly designed glass canopies and bus shelters.

“The new canopies and shelters will provide effectiveprotection from the weather while people wait for their bus,”said Graham Long, Central Connector Project Manager,Auckland City Council.

In addition to public transport users and pedestrians, cyclistsare also a priority in the Central Connector project.

“Where possible lanes have been designed to allow buses andcyclists to safely pass each other and mountable kerbs will becreated where bus lanes narrow, so cyclists can safely andeasily move onto the footpath,” said Graham.

“Cycle advance boxes will be positioned at traffic lights, whichwill benefit cyclists in giving them a head start on other traffic.”

A major part of the Central Connector project is a structuralupgrade of Grafton Bridge to provide earthquake resistanceand additional load-carrying capability. The structural andseismic upgrade is not going to change the way Grafton Bridgelooks or change its heritage status.

“No allowances were made for earthquake resistance in theoriginal design of Grafton Bridge. As the Central Connectordesign has developed, so too has the need to bring the bridgein line with modern earthquake design standards. The bridgewill be strengthened to withstand a one in 1000 yearearthquake,” said Graham.

Once the Central Connector is complete, Grafton Bridge willoperate like any Auckland city bus lane, between 7am and

...contd. on page 10

Eat together as a family as often as you can.

Drink water and milk instead of sugary drinks.

Provide a jug of water on the table for the whole family to shareduring meal times.

Involve your kids in choosing a meal and then get them to helpyou prepare it, such as peeling, chopping, cooking or serving.

Keep a variety of fresh vegetables and fruit on hand for quickhealthy snacks.

Try and make fruit and vegetables a part of every meal.

Snacks don’t need to come in packets – choose home-made,healthy foods. They can be tasty, low-cost and easy to prepare.

To encourage kids to eat more fruit and vegetables, try cuttingand presenting them in different, easy-to-eat shapes. Also trydifferent cooking methods.

Kids learn a lot from how their parents eat. Lead by example –make sure you eat and enjoy different vegetables as a regularpart of your diet.

Try making meal times enjoyable and a happy whanau time.

patients and visitors are informed of all aspects of the CentralConnector work affecting them.

Reg praised the project, saying it is a great development forstaff and visitors of Auckland City Hospital, providing safer andeasier transport solutions.

“The Central Connector is part of the council’s plan to provideAuckland City residents and workers with better and moresustainable travel choices. It’s going to provide our staff andvisitors with more efficient and sustainable ways to get to work.”

Reg Prasad will be providing updates to ADHB staff on anydisruptions specific to the hospital via the transport update inthe weekly Nova Noticeboard staff email.

Park Road first to receive new design bus shelters“This canopy is part of a 45 metre long shelter and allows fora much larger waiting area and increased shelter from theelements,” said Graham Long, Central Connector ProjectManager, Auckland City Council.

“It will also have timetable and route information attachedto reduce footpath clutter.”

The canopy is being installed early to allow time to confirmthe design and build before the remainder of the sheltersare manufactured and rolled out along the route.

Two further canopies will be installed along Park Road thisyear, one adjacent to the medical school and the other outsidethe Grafton shops, east of Seaview Road.

“The new shelters will improve the appearance and functionof the existing furniture protecting staff, patients and visitorsto Auckland City Hospital from the Auckland

One of the features of the Central Connector project forAuckland City is the new 45 metre bus shelters and canopies.

Park Road will be the first street to receive the newly designedbus canopies, with installation beginning on the corner ofPark Road in late March.

Top 10 Tips for parentsHere are the top 10 tips for parents to achieve healthy eating for kidsfrom the Feeding Our Futures Campaign.

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9

8

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5

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7pm, Monday to Friday. This means traffic will be restricted topedestrians, buses, bikes, motorbikes and emergency vehiclesduring these hours.

The structural upgrade of Grafton Bridge will mean it will beequipped to carry increased bus traffic, and be future-proofedto handle new transport technologies, for example light rail.

Graham explained that disruption will be minimised whereverpossible.

“All work that needs to be carried out on each section of theCentral Connector project, including utility work, will be doneat the same time, with the aim of reducing disruptions to thoseusing the roads and footpaths,” he said.

Reg Prasad, who has worked with the council on the design ofthe route, will work closely with Graham on ensuring staff,

For more information on the Central Connector project visitwww.aucklandcity.govt.nz/centralconnector

...contd. from page 9

A day in the life of the StarshipFoundation team

NOVA takes time out to visit the Foundation

Waitakere City Probus club about the work of the StarshipFoundation and how they can help.

In the same office, the Marketing Communications team IrmaRavagli and Cindy Carleton are busy organising theFoundation’s street appeal on Friday 11th April. They need torecruit 600 volunteers to make it a success – raising funds toboost the national air retrieval service which transports over200 patients each year from all over the country to Starship’sintensive care unit.

It is a huge effort but well worth the reward!

Sponsorship Manager, Rachel Gardiner is working with a newcompany who has shown an interest in supporting Starshipto identify a suitable sponsorship opportunity within thehospital. This could be a piece of equipment or healthprevention initiative in the community. She’ll also help themwith marketing the relationship and leveraging the relationshipthrough PR opportunities.

Recently she’s been working with Barfoot and Thompson, aStarship Foundation Five Star Sponsor who’ve committed tohelp fund the Starship Heart Unit’s needs for the year.

Grateful heart surgeon Kirsten Finucane says, “Many thanksfor your huge fundraising efforts which have provided us withworld class equipment and allowed our cardiac team to providethese children and their families with the best chance at life.”

It’s been a busy day but for the Foundation there is a greatdeal of job satisfaction in seeing the result of our fundraisingaround the hospital and the smiles on the faces of staff andpatients. You can find out more about the Starship Foundationand what they do by visiting Room 3.101 in Starship orwww.starship.org.nz/foundation.

Steve Williams with children from Starship Hospital

The Starship Foundation is a busy hub of activity on level 3 ofStarship. The charity has been providing additional equipment,support and help to patients, families and staff at Starship forthe past 16 years.

The small staff of eight raised nearly $6 million last year takingthe total to $45 million since its inception in 1992. Each day isa busy stream of meetings with sponsors and donors whosesupport helps make Starship a better place.

Liaine Warneford is the smiling face of the Foundation and thefirst point of call for visitors. She’s busy processing donationsfrom individuals, companies and community groups that arrivein the mail and via the website.

Occasionally a visitor arrives with donated gifts for patientssuch as knitting, clothing, toys and crafts which Liaine distributesto the wards and services. Each donation is recorded on thedatabase and acknowledged with a personalised thank youletter.

At the next desk, Direct Marketing Manager, Esther Bruning isworking on the upcoming annual appeal letter to theFoundation’s 40,000 donors around the countr y.Communicating with and making our most loyal donors feelvalued is an important task as they’re the cornerstone of ourfundraising.

Next door Andrew Young, the Chief Executive is meeting withStarship's General Manager, Kay Hyman to agree on suitablefundraising projects for the Foundation, chosen from acrossADHB’s child health services. These may include lifesavingpieces of equipment, comfort items for patients and parents(parent beds, breast feeding chairs, murals and artwork),paediatric research grants, staff travel to conferences, wardupgrades as well as community-based prevention projects.

Later on he meets Steve Williams, Tiger Wood’s caddy, to discusshis six figure donation towards the rebuild the StarshipOncology Ward. A lot of work has gone into the written proposaloutlining the need for the rebuild and the benefits to patientscare and recovery. Andrew takes Steve and his wife Kirsty ona tour of the ward accompanied by Charge Nurse Natalie Jameswho outlines the downfalls of the current configuration ofrooms.

Along the way they meet many patients and their families. “Itwas impossible not to get emotional”, says Steve.

“I couldn’t imagine what it would be like to have a childdiagnosed with cancer and then have to go through the longtreatment process. As a father, making the donation to theStarship Foundation feels like the right thing to do.”

Fundraising Director Bobbie Brown spends much of her daycommunicating with our top level donors and making themfeel appreciated. “Saying thank you is very important to theFoundation and ensures that our supporters continue to helpus in the future,” she says. Today she’s also working onapplications to various Trusts and Foundations for an endoscopyvideo for the operating theatres and a haemodialysis chair forWard 26B. This afternoon she’s doing a community talk at the

Introducing Justin Rawiri – Emergency Management Co-ordinator

Empowering Emergency Management

“As I’m new to the health sector, it’s anexciting challenge to get to grips withthis large organisation - what it doesand the services it provides to thecommunity.

“I’m impressed that everyone knowswhat we do. There are time-slotsdedicated to emergency managementduring staff inductions and resourcessuch as emergency response flip chartsand Emergency Preparedness andResponse Manuals (EPARMs) areavailable in every department.

“Emergency management is not just ourteam’s job, it’s for everybody. If a situationstarts small then it can be handled atward or hospital level. ADHB staff havethe experience and tools to deal withthe bulk of incidents.”

Alumni service keeps past staff in touch with ADHBThe Auckland District Health Board’s Alumni is attracting former staff from Aucklandand around the world and encouraging dialogue, ongoing learning and informationsharing.

The ADHB Alumni was set-up to forge and strengthen relationships between pastemployees by offering them opportunities for involvement with the ADHB.

Clinical Associate Director and facilitator of the ADHB Alumni Dr John Henley saysthe aim was to create a worldwide network of alumni members who couldcontribute to the continuing advancement of ADHB and its current and futureemployees.

“The service also showcases current job opportunities and provides contactinformation to members wishing to seek opportunities off-shore,” he says.

Past ADHB employees, from support staff to medical and clinical staff, are eligibleto become members of the programme, which was formed in 2006.

Members are also invited to participate in a number of events and social activitiesincluding Celebration Week and Round the Bays.

“The Gathering of Retired Doctors is one ADHB Alumni event which takes placeduring Celebration Week where retired doctors can visit the hospital, receive atour of new facilities and information about new procedures. They have a morningtea and are invited to join the Grand Round, a regular clinical meeting whereregistrars present on a chosen clinical topic,” says Dr Henley.

Members of the alumni can apply for an ID card which offers a range of benefits- from a shuttle bus service between the hospitals to recruitment opportunities.The ID card also entitles members to discounts at a range of retail, insurance andhealth facilities.

The alumni programme also allows members access to the ADHB Alumni website,www.adhbalumni.co.nz, which includes a discussion forum and calendar of events.

For further information or to join the ADHB Alumni visit: www.adhbalumni.co.nz.

Justin Rawiri

What’s happening inMarch/April

March 200821 Race Relations Day

24 World Tuberculosis Day

30 - 1 April Guide Dog Appeal RNZFB

April 20084 - 6 Red Puppy Appeal

7 World Health Day

CALENDARCALENDAR

Threats of terrorism, mass casualties andpandemics might seem a world awayfrom daily life in Auckland. However,with the appointment of Justin Rawiri,Emergency Management Co-ordinator,planning for these events will continueto be a major focus for the AucklandDistrict Health board (ADHB).

Justin, who arrived back in Aucklandfrom the UK on Waitangi day, will overseethe ADHB’s Emergency ManagementTeam. He will play a crucial part in majorincident management planning and willco-ordinate and manage a range ofprojects such as the recently completedRuaumoko exercise – an Auckland-widedrill which trialled the ADHB’s responseto a potential volcanic eruption inAuckland.

“I feel privileged to work for ADHB andfeel as though I have come into anemergency management service teamwhich is already in very good shape. Theteam has done a great job in getting themessage across that emergencymanagement is everyone’s business,”says Justin.

Formerly a police officer, Justin spentnearly four years in a wide variety of rolesincluding six months with the America’s

Cup operation in Auckland beforeleaving the force to travel throughEurope and work in the UK.

Like many Kiwis, Justin took an extendedOE and spent four years living in London.Career-wise a highlight was working asan emergency planning officer for a localauthority.

“This position gave me the opportunityto work on a range of projects includingflooding, pandemic flu, mass evacuationand mass casualty planning, as wellas the threat of terrorism whichLondon was facing. As a result of this Ideveloped an excellent understandingof emergency management processes,”he says.

While enjoying life and work in London,Justin had his sights set on continuingin a similar field upon his return to NewZealand. As a result he kept up-to-datewith local policy, trends in emergencym a n a g e m e n t a n d d e v e l o p e dknowledge of the New Zealand CivilDefence Emergency Management Actas well as the New Zealand InfluenzaPandemic Action Plan.

Justin is looking forward to applying thisknowledge to his new role at the ADHB.

ADHB EventsState of the Nation

ACH – Clinical Education Centre,Level 5Monday 31st March: 4.00 pm – 5.00 pmThursday 3rd April: 8.00 am – 9.00 am

GCC – Liggins Theatre, Level 1,Cornwall Complex, Building 15Friday 28th Mar - 8.00am – 9.00 amThursday 3 Apr – 1.00pm - 2.00 pm

Flu Vaccination Campaign7th – 24th April 2008

RECRUITMENTNEWS

Are you recruiting the ADHB Way?Careers Centre facilitates a monthlyworkshop on recruitment policiesand procedures for recruitingmanagers within ADHB. Theworkshop is conducted by a seniorrecruitment consultant who guidesyou through the requirements of theADHB procedures for recruitment.

Hiring Managers will:

Find out about ADHB recruitmentpolicies and procedures

Find out what the Careers Centredoes

Be able to discuss any issues youmay have faced while recruitingfor your department.

Meet a few recruitmentconsultants

Meet an HR consultant and findout how they are different fromrecruitment consultant

Learn more about how ourrecruitment practices affect ourbusiness.

Feedback from our previousworkshops:

“…This course has confirmed I’ve beenfollowing correct process”

“I’ll be more confident when askedquestions by my servicemanagers/team leaders onrecruitment process.”

What did they learn – “knowing whoto deal with and what documentationis required in recruitment process”

If you are a recruiting manager andwant to be more knowledgeableabout recruitment or just want toconfirm that you are following theright processes, enrol yourself nowon the Learning and Developmentintranet website. The course is calledADHB-Leadership and ManagementDevelopment- Recruiting the ADHBWay.

We look forward to meeting with youat future workshops.

Next course date:16th April

All staff were encouraged to wear green today. Our two Irish Staff NursesHelena King and Liz Langdon visited the ward and all patients with a decoratedtrolley of green coloured “treats” accompanied by Irish music.

Pictured from left to right are Staff Nurse Helena King, Clinical Charge NurseBernie Lightbourne(nee Kelly) Staff Nurse Liz Langdon and Staff Nurse JanetPellech (our Canadian supporter.)

Celebrating St Patrick’s Day in Ward 42

March Grand Prize letters: Y and S

What are the dates for the ADHB fluvaccination campaign?

Air New Zealand will provide two economy class tickets to either Pacific Islands –Samoa, Tonga, Fiji or Rarotonga or Sydney, Melbourne or Brisbane for the Grand Prizefor Nova for 2008. There may be peak periods when seats are not available i.e.Christmas. To be in the draw, each month simply collect the letter (supplied at thebottom of this column) and at the end of the year correctly solve the simple anagram.Then send your answer to the address supplied in the November edition.

Part 2: Switzerland, here I come

Gretchen Strid former Senior Consultant at Orbit Corporate TravelFollowing her OE Journey:

This month, be in to win 2-day Budget Car Hire.

Budget Rent a Car Limited New Zealand is wholly owned by AvisBudgetGroup. Budget operates as an independent brand with over 3,500worldwide locations.

Budget in New Zealand is staffed by a professional, enthusiastic groupcommitted to a philosophy of providing car, truck and four-wheeldrive product with the highest possible levels of customer satisfaction.

In New Zealand, Budget Rent a Car operates a network of locations,which includes outlets at all major cities and provincial locations.Every major New Zealand airport is serviced by Budget Rent a Carwith in-terminal rental facilities.

To enter, simply answer this month’s questionand send your entry to , subject line “monthlycompetition”, or mail to the CommunicationsDepartment, Level 1, Building 10, GreenlaneClinical Centre.

Entries must be received by 15 April 2008.

Conditions of entry: Tickets are not exchangeable for cash; tickets will not attract air points; tickets are not upgradeable; winnermust be an employee of ADHB (show employee number) at the time of the prize draw. Valid until 30 June 2009. Travel is notpermitted 20 Dec 2008 – 15 January 2009.

it wasn't too bad, at least it didn't rain the whole time - verycold though. We checked into our 4 bedded dorms which wehad to ourselves. Dinner was included in the price, so we haddinner and then headed back into town to have a wanderaround. In the morning we even saw a clear view of theMatterhorn.

The following day we caught the Glacier Express train fromZermatt to St Moritz. It is a 7 1/2 hour train ride, however beingin first class made the train journey more bearable and thepanoramic scenery even more so. The views are so spectacular,it is amazing scenery, surrounded by mountains and valleysand little towns along the way - definitely worth doing althoughI think it would be even more amazing during winter wheneverything would be covered in snow. We arrived into St Moritzin the afternoon and caught a bus most of the way to thehostel.

Next morning we caught the train from St Moritz to Zurich viaChur, we arrived early afternoon, so was able to do a few thingsin the afternoon. The gentleman at the information desk wasfantastic and he advised of a really good walk through thetown. We saw the 13th century Fraumunster (Cathedral) atMunster platz and St Peterskirche (St Peters Church). We walkedto the highest point where we could see views over Zurich.This was a great walk as it only took a couple of hours and wehad a number of stops and sightseeing along the way.

Next morning the journey from Zurich to Milan. Then onto toGreece and the Greek Islands.

See Part 3 in the April Nova.

The first week of July was spent travelling through Switzerland.It is such a pretty country, although the weather wasn't thatgreat. It rained pretty much everyday and was so cold, if I shutmy eyes I could have been in Auckland! We spent the first twonights in Montreau, which is a cute little town.

On the morning we left, we visited Chateau de Chillon, whichis a 13th century castle overlooking the lake and surroundedby mountains. After this we caught the train to Zermatt. Thelast hour of the train trip is through the mountains which arejust amazing, the scenery is fantastic and there was even snowon the mountains. Before checking into our hostel we storedour luggage at the train station and booked a ticket on thecog train going up to the Matterhorn as we only had one nightin Zermatt. The trip up to the Matterhorn was amazing; wewere overlooking Zermatt on the way up and were able toview more mountain scenery. I don't think we were expectingit to be quite as cold as it was though and we probably weren’tdressed properly for the temperatures up the top - it was -4degrees on the mountain. We were only able to stay up therefor about 30 minutes and we caught the next train back down.When back at the train station we picked up our packs andstarted the walk to find our hostel.

There are no cars in Zermatt, people either walk, bike or travelin small taxi cars. I loved Zermatt. It is a gorgeous little town ina valley of mountains. Not long after we had started walkingto find the hostel we could hear bells behind us and look-ing back there were goats! They were just moving the goatsthrough the main street! So we had to wait until the 15 or sogoats passed. The weather still wasn't great here although

Bringing us together to look to the future

Did you know?We are on target to break even this yearThat ADHB is developing a travel planOverall patient discharge average 10,000 per month,up 4% on last year

Come to hear all this and more at State of the Nation, an organisation-wide update onour progress, achievements and future direction delivered by chief executive Garry Smith.

Chat with the CEOWe’ve allowed more time for discussion, so come along and put your burning questions to the CEO

ACH – Clinical Education Centre, Level 5Monday 31st March: 4.00 pm – 5.00 pmThursday 3rd April: 8.00 am – 9.00 am

GCC – Liggins Theatre, Level 1, Cornwall Complex, Building 15Friday 28th March: 8.00 am – 9.00 amThursday 3rd April: 1.00 pm - 2.00 pm

Feedback from the last State of the Nation event suggested that staff members found theseminars interesting, relevant and worthwhile. Choose a session that interests you and come

along to hear about your organisation.

Do you know what’s next for ADHB?Come along to these presentations and learn moreabout ADHB, our successes and our plans for the future.

State of the Nation 2008State of the Nation 2008

ISSN 1178-5373 (print)ISSN 1178-5381 (online)

This year, the seminar will focus onPerformance to date – results and challengesActivity updates including facilities and capital plansQuality improvement