General Practice teams supported within the Capital and Coast + Wairarapa districts
enrolled patients within the Capital and Coast + Wairarapa districts
total General Practice consultations
permanent fulltime/part time + fixed term Compass Health staff
Compass Health casual staff
of 8-month-olds fully immunised in the Wairarapa District
clinical practice development sessions
funded radiology interventions
free sexual and reproductive health consults
funded visits for 2,100 people requiring mental health interventions
enrolled patients in care plus + guided care to manage their Long Term Conditions
outreach nurse referrals + consults
Pacific navigation referrals
Data Source: Compass Health Reporting Services.
Compass Health Board Chair Dr Richard Tyler
During 2013/14 year our broad strategies have been supporting the integration between primary and secondary care, empowering patients, continuous quality improvement, making Compass a great place to work, improving Pacific outcomes and implementing our Māori strategy Ka Pō, Ka Ao, Ka Awatea.
A lot of effort has gone into our relationship with the DHB and the roll out of the Integrated Care Collaboratives (ICC). Many people in primary care and within the hospital have put a lot of time and effort into this. Relationships have developed well and the first tangible fruits were the roll out of the Cellulitis & DVT packages of care. The DHB purchasing of the Canterbury pathways boosted the clinical pathway development and these are being collaboratively worked through and customised for Capital & Coast needs. We are also working closely with our Hutt Colleagues at Te Awakairangi Health network on cross DHB initiatives.
Following the successful launch of the Shared Care Record in the Wairarapa this has now been rolled out in Capital and Coast and is being used in the hospital and at After Hours. The record is regularly viewed by Emergency Department doctors and nurses and is also used by Outpatient Clinics to check they have the correct information on patients. It is also used by CCDHB pharmacists to assist with medicine reconciliation for inpatients.
Also, we are working with willing Practices to enable patient’s access to parts of their Medical Records.
As part of the continuous quality improvement a number of practices have taken part in the patient satisfaction surveys where they can benchmark themselves against other practices.
Within Compass we have introduced Kaizen improvement training which has been well embraced by the staff and is continuing.
Our Pacific outcomes target has focused on the Pacific Navigation Service which has had an independent evaluation which found that the service was well regarded by the Pacific community. The end of year data found that the Ambulatory Sensitive Hospital admissions for Pacific children aged 0-14 reduced by 12% in the year to June 2014 while the rates for Māori and other ethnicities increased. Admissions for cellulitis dropped from 40 to 25 per year.
Ka Pō, Ka Ao, Ka Awatea is a comprehensive program to improve Māori health. Over the past year the team have focused on developing cultural resources for practices to use – particularly when seeking Cornerstone accreditation. The resources are being trialled in practices now.
This will be my last report as Chair as I am not seeking a further term.
I would like to thank all those Board members who have supported me and contributed to the Compass achievements. I would like to especially thank the wonderful and dedicated staff at Compass who worked so hard for many years and contributed to making Compass Health what it is today.
It has been a pleasure to have been Chair of the organisations in their various forms over a number of years. I am pleased to be leaving the organisation in very good shape and well prepared for even more challenges ahead.
Compass Health Board Chair
Richard is a Wellington based GP. He has a long history of involvement in organisations supporting GPs and general practice. Richard has expertise in the management and governance of primary health and primary health care organisations.
Larry has lived and practised as a family GP in Porirua for 30 years. For much of this time he has been involved in the development and governance of primary care services including After Hours medical services. Larry chaired the Tumai mo te Iwi PHO.
Dale has a degree in Tupunga Hapu from Te Wananga-o-Raukawa. She also has a Masters Degree in Education from Massey University and a background in policy. Dale enjoys applying her knowledge of policy as a problem-solving process when making decisions in her Board work.
Don has been a Partner GP Newtown Medical Centre for the last six years. Prior to that he was a Partner GP in Queenstown Medical Centre for 20 years. His current interests include meeting the challenge of the increased expectations being placed on primary care.
Elaine has a variety of roles that give her opportunities to engage with many different people and aspects in the community. Amongst her roles she is currently serving her sixth term as an elected Councillor, now Deputy Mayor for Carterton. Her skills have come from life experiences of growing up in a seven day a week grocery dairy business, working as a bank clerk and dairy farm partner, fostering children for 20 years and long term involvement in many community organisations.
Gordon has many years’ experience as a Chairman, Director and Manager in the commercial sector and has had a continuing interest in health and community activities over many years, being recognised for this in the 1998 New Year Honours with a QSO.
Lynn is a GP practising in suburban Wellington for over 24 years and Senior Lecturer in General Practice and Primary Health Care at the University of Otago Wellington. Her role at the medical school involves undergraduate medical student teaching and primary care research. She has extensive experience in clinical governance.
Mano’o has over 30 years of senior management experience in governance and management with national and international organisations including the United Nations Economics Commission for Africa; Local and National Government as an MP and Cabinet Minster; Training institutions; the Business sector; and non-Government organisations sector. Mano’o has been involved in governance and management of primary health care for over 15 years.
Melissa is the Clinical Manager at the Island Bay Medical Centre, with 20 years' experience in primary health care nursing and a Post Graduate Certificate Primary Health Care. Melissa has a supportive teaching role with Otago School of Medicine.
Simon lives in the Wairarapa and works in Wellington at the commercial law firm Bell Gully, where he has been a partner since 2000. Simon heads Bell Gully’s Government, Health and Climate Change practice groups. Much of his work involves public sector contracting and procurement, including in the areas of ultra-fast broadband, ICT projects and public private partnerships. He also advises Crown entity Boards on public sector governance. During 1997 and 1998 Simon was seconded as Legal Counsel to PHARMAC. He continues to advise PHARMAC as well as DHBNZ and DHBs on their collective procurement activities, individual DHBs and Health Benefits Limited.
Trevor lives in Mahina Bay, and is currently the Chief Executive Officer for Outward Bound Trust of New Zealand a position he has held since December 2001. Prior to Outward Bound Trevor spent 20 years in senior line management position in the energy sector. Trevor is a Member of the Institute of Directors in New Zealand and a Member of New Zealand College of Chartered Accountants (CA). Trevor has held a number of governance positions in the private and public sectors and is currently Chair of the Wellington Free Ambulance Trust, Deputy Chair of Life Flight Trust and a Board Member of Outward Bound International, Surf Life Saving New Zealand and the New Zealand Olympic Committee.
The Finance and Audit Committee provides Compass Health with an independent interface with the external auditors and an advisory committee to the CEO and the General Manager - Finance; and assists the Compass Health Board in discharging its corporate governance duties to meet the statutory requirements of Directors and Trustees as outlined in the Companies Act (1993), the Financial Reporting Act (1993) and other relevant legislation.
The Māori Health Committee is an advisory committee of the Compass Health Board. The purpose of the Committee is to ensure that Compass Health commits to Iwi, Hapu, and Māori primary health services by providing direction, advice and leadership in response to Māori primary health care at a governance level.
The Pacific Health Committee is an advisory committee of the Compass Health Board. The purpose of the Committee is to provide advice and recommendations to Compass Health on Pacific health issues; to provide feedback and reports on performance and service delivery effectiveness for the Pacific Community; and to communicate Compass Health's health programs and other relevant information impacting Pacific people to the Pacific Community.
The purpose of the Clinical Quality Board is to monitor quality in primary health care within Compass Health; provide clinical leadership and oversight to the Compass Health committees and advisory groups; report clinical quality activity and risk to the Compass Health Board; and to act as the conduit of Clinical Quality information between relevant DHB Quality Boards.
The Clinical Information Reference Group has been established as an Information and Communication Technology (ICT) ideas and information sharing group, which is able to make recommendations to Compasss Health ICT and senior management for discussion. The group is able to provide leverage for system change by providing a collective voice.
The General Practice Strategy Group has been established to develop and guide implementation of a short, medium and long term strategy to ensure continuity of care for patients within its geographical region. This strategy promotes models which address clinical excellence and business sustainability issues and may include Compass Health taking an equity stake in General Practice businesses.
The Nurses Committee supports the development of Primary Health Care Nursing models and the delivery of nursing services to the highest possible standards; provides a framework for the workforce to be supported; and assists in the development of nursing leadership in primary care.
The purpose of the Radiology Oversight Committee is to act as the Clinical Governance Group of the Community Referred Radiology Scheme. The functions of the Committee include providing oversight to the community radiology services for the greater Wellington region; monitoring and reporting findings on radiology service demand in greater Wellington; suggest and/or make recommendations for changes to the Clinical Guidelines for funding in line with best practice in the context of the programme; audit and report GP use of the Radiology Referral Guidelines as endorsed by the committee; identify, document, and monitor clinical risk and ensure appropriate mitigation strategies are implemented; monitor the income and expenditure under the contract by reviewing full financial reports on a quarterly basis; and ensure that the services are delivered according to the DHB Service Specification.
The purpose of the Mental Health Advisory Committee is to provide leadership and to advocate for primary mental health service delivery; and support, promote and monitor service quality and the development of primary mental health within Compass Health and within the PHO supported by Compass Health management services.
This committee supports the pursuit of excellence in the practice management, function of practise and supports the development of the Primary Health Care management workforce in the Greater Wellington Region. Management services include those services delivered from general practice/provider sites, as well as other relevant primary care services.
Working together, towards healthy and flourishing communities
Navigation: Improving the quality, safety and experience of care for our patients
Empowerment: Strengthening general practice capacity and capability
Success: Gaining the best outcomes from the resources available
Wellbeing: Improving the health and equity of our enrolled population
Trust: Maintaining open and honest relationships
Respect: Embracing diversity, uniqueness and ideas
Unity: Valuing strengths and skills
Accountability: Working in a transparent and responsible manner
Courage: Participating with confidence and enjoyment
Compass Health is a primary care network and not-for-profit social enterprise providing quality primary health care services to an enrolled population of 289,487 people across the Wellington, Porirua, Kapiti and Wairarapa areas. We employ 122 people and contract with 60 member practices. We also provide corporate services to Central PHO and a number of general practices.
Provide approximately 1,467,000 consults
Administer approximately 190,000 immunisations
Deliver 350 clinical practice development sessions to 4,000 participants (1,500 individuals)
Provided over 7,000 specialist sexual health visits to approximately 2,600 unique patients
Fund nearly 25,000 radiology interventions
Provide 6,000 retinal screens
Provide over 25,000 free sexual and reproductive health consults
Deliver 1,500 podiatry visits
Arrange 8,700 funded visits for 2,100 people requiring mental health interventions
Enrol 16,000 people in care plus/guided care to manage their Long Term Conditions
Provide 1,600 outreach nurse referrals/consults
Respond to 1,300 Pacific navigation referrals.
Data Source: Compass Health Reporting Services.
|Strategic Aims||Five Year Goals||Annual Plan Strategies||Improvement Projects||Targets /
avigation:improve the quality, safety and experience of care for patients
uccess:gaining the best outcomes from the resources available
mpowerment:strengthening general practice capacity & capability
ellbeing:improving the health and equity of our enrolled population
In 2013/14 we focused on integration and patient and community voice, and we:
Our goals here included staff engagement, environmental sustainability and financial management. We:
General practice development is aimed at improving GP quality and sustainability – so that general practice will be able to support future generations.
The key focus has been in the preventative and proactive care domains – aimed at keeping people well and picking up problems early.
Data Source: Compass Health Reporting Services.
Data Source: Compass Health Reporting Services.
Data Source: Compass Health Reporting Services.
Total Revenue, per the Statement of Comprehensive Income, of $64.0m is represented in the below chart by Capitation Income, $45.3m (per note 2 in the Financial Statements), Provider and Community Health Services Income of $18.5m (Revenue from Services, less Capitation) and Interest Income of $0.2m.
Total Expenses, per the Statement of Comprehensive Income, of $63.9m is represented by Capitation Expenses, $44.7m (per note 3), Provider and Community Health Services Payments of $12.9m (Project Direct Expenditure, less Capitation) and Operating Expenses of $6.3m.
Total Revenue does not equal Total Expenses by $0.1m, being the operating surplus for the financial year ended 30 June 2014.
For a more detailed breakdown of our Financial Statements, please download from the PDF below the charts.
Dr Lynn McBain
Clinical Quality Board Chair
Compass Health Board member
In July 2011 a new oral anticoagulant, dabigatran (Pradaxa®), became available throughout New Zealand. Although working in a different way from warfarin, it was approved for use in some of the same conditions.
An advantage of dabigatran is that those prescribed it do not need regular blood tests.
There is, however, no treatment available yet that can reverse the effects of excessive dabigatran anticoagulation. In addition, kidney function must be monitored so the dose can be adjusted accordingly.
Because of dabigatran’s newness, the need to regularly check renal function and reports of it being used for unapproved conditions, the Compass Health Clinical Quality Board (CQB) decided to do a Clinical Quality Improvement audit in all its PHO’s medical practices in 2013.
The purpose of the audit was to check how this medicine was being used against a set of standards. After feedback, if any standards are not met, the medical practice will plan how to achieve them.
It was an important achievement by the Pharmacy team that the audit was carried out in all 60 of the Compass Health practices. At the time of the audit there were 941 patients prescribed dabigatran.
Most people were prescribed dabigatran for an appropriate condition and a very high proportion of patients had their kidney function checked as recommended. General practitioners were very good at reducing the dose of dabigatran in patients when needed.
Recommendations of some kind were made in just over 50% of records audited. These included recommendations about other medications the patient was prescribed not just dabigatran. This was an additional benefit of the audit.
Further work is required in some practices to ensure that all patients taking dabigatran have their kidney function checked at least annually, or more often in some cases.
There were a large number of recommendations made, but not all were directly related to dabigatran. Only some of the interactions for example involved dabigatran.
In some instances, dabigatran was being used for unapproved conditions, often initiated by specialists. An education session, with a specialist speaker, was held in September 2014 to clarify some of these issues.
This was the first time that an audit relating to a particular medicine has been carried out throughout Compass Health PHO. It enabled our organisation to gain an overall picture of how this new medicine is being used and identified some issues that require clarification or improvement.
Whaiora Medical Centre nurse Donna Holmes gives a baby boy his three month immunisations. He was previously immunised on time for his six weeks immunisations.
Since August 2007, increased childhood immunisation has been a national health target. The current health target focus is for 90% of 8-month-olds to be fully immunised by July 2014, and 95% by December 2014.
For the 12 month period ending June 2014 the Wairarapa exceeded the national target with 95% of 8-month-olds fully immunised, with an amazing 96% for Māori, 100% for Pacific, and 95% for Deprivation levels 9-10.
The Wairarapa Immunisation working group has adopted a collaborative team approach to achieve high percentage rates throughout the district. The team consists of the District Immunisation Facilitator and National Immunisations Register (NIR) Administrator (Compass Health), Whaiora Outreach Immunisation Service OIS (a local Māori provider), a representative from each of the seven practices, Occupation health, Population Health Unit, and Wairarapa's first and only vaccinating pharmacy.
The NIR administrator ran a report to determine all children that were not fully immunised by the set dates. From this a child was identified with whom all immunisations had been declined, and for whom we had incorrect details. The NIR administrator contacted the mother to update our records, and asked the mother if she would like to speak to the District Immunisations Facilitator (DIF) regarding immunising her child.
The family consisted of a Māori couple in their mid-20s, and two children aged six months and two years.
The mother had declined immunisation for both of her children due to comments heard from friends and on social media. The DIF discussed all of these concerns with the mother, giving correct immune, disease and vaccine information verbally, as well as sending out some information for the parents to read.
Following this, the mother stated she would really like to have both of her children immunised now, although they only had one car which her partner took to work, and they lived just out of town so transport was an issue for her.
DIF therefore discussed the option of Outreach Immunisation Services (OIS), and offered to refer her to OIS to have the children immunised at home, for which she was thankful for.
DIF made the referral to OIS, who have since vaccinated both children, and have kept them on their service to give all subsequent vaccines until they are up-to-date as per the Immunisation Schedule.
Data Source: NIR BC CI Overview - Milestone Ages PHO/Clinic (Final Dose including PCV).
Compass Health Practices completed 31,413 Cardiovascular Disease Risk Assessments (CVRAs) in the 2013/14 year, 3,607 more than the previous year. High needs CVRA coverage also increased. A total of 21,759 people received brief advice to stop smoking. These activities are likely to make a significant difference to population health in the Capital Coast and Wairarapa areas. In fact, Ministry of Health data shows that myocardial infarcts (heart attacks) declined by 20% in CCDHB and 50% in the Wairarapa over the past three years.
The highly successful campaign of last year meant large volumes of smoking brief advice codes fell due at the same time resulting in a coverage decrease from 80.1% to 76.9% in the Capital Coast DHB for all eligible patients and a decrease from 81.5% - 76.1% for high need populations.
Janice and Dr Philip Wong are proud to be Cornerstone Accredited.
Dr Philip Wong with his emergency spills bucket.
The time, effort and cost to gain Cornerstone Accreditation have been a focused and concentrated investment in the future for the Hataitai Medical Centre.
Practice owner and GP Philip Wong and practice manager Janice Wong say the Cornerstone status places their practice in a strong position and signals it operates at the highest standard.
"We saw it as another long term investment in the practice."
Janice says the practice met 35 indicators to gain accreditation and the process has benefited it through the development of robust and standardised policies and procedures.
"We have tidied up a lot of areas. I think the doctors and clinicians needed more guidelines on how we do things, so I spent a lot of time discussing with our team members how we wanted to do it, and how we were to standardise it.
"We weren’t doing things wrong, but we now have it written down on pieces of paper for people to go to. Patients will benefit from better procedures around the clinical practices in areas like follow-ups, repeat prescriptions and with consenting forms for things like smoking, cervical screening and immunisations."
She says staff were supportive of the decision to gain accreditation and were active in the process. "We had lots of little micro-meetings during the day and as a result we work better together as a team."
The practice was extensively renovated to assist its accreditation developing a paraplegic toilet, wheelchair access and a wall to enable records to be locked away at night. An electrician tested every power plug and special RCD plugs were installed. Equipment has been upgraded and there are clear labels on all supplies and practice features.
"It’s been a huge effort and we gave it 100% commitment. But we know we can give ourselves and our staff a pat on the back and say we are doing our best at what we do," Janice says.
Island Bay Medical Centre Clinical Director Melissa Simpson enjoys the patient-centered approach to primary care, made possible with the flexibility of the new programme.
The flexibility of funding in the Long Term Conditions (LTC) programme is enabling Island Bay Medical Centre to develop a care plan that is more patient centred and better meets patient needs.
Clinical Manager Melissa Simpson says the flexibility has also had positive benefits for the practice and its staff.
"We are definitely seeing the benefits with funding flexibility. Patient treatment and care is more timely, as we are not restricted to rigid time frames."
As an example Melissa says the practice is doing at least two insulin starts each week for patients that don’t have optimal control of their diabetes. "The longer you leave initiation of insulin therapy the potential for complications is increased, so patients are getting more timely intervention, leading to better control of their diabetes."
To develop its practice plan, Island Bay Medical Centre reviewed its whole population and aligned the service to those that have the greatest need. Melissa expects each practice will do it differently, but Island Bay stratified LTC patients into four groups.
The first group is those self-managing well. They are funded for an annual visit and can pay if they wish to visit more regularly. The second group receives two free visits each year and the visits aren’t fixed. The third group is similar to the former Care Plus model and receives four visits a year of which two are funded, and again the visits aren’t fixed. The final group is for patients that might need to visit often for a short period of time, such as those discharged from hospital or patients starting on insulin that need to be seen more frequently. For those that can afford to pay a little there can be a co-payment option, or funding could come from the diabetes plan.
"The idea behind it is we can target individual care. It is more patient centred and better meets their needs."
She says the practice plan covers three areas – LTC, diabetes and SIA (services to improve access) – and Island Bay has champions to oversee each area.
"We still offer all our diabetes patients a free annual check, but most of those patients also have another LTC, so we make the visits longer and also incorporate their annual review for their LTC."
The practice plan has brought together the patients, funding, practice and improvement performance targets and associated actions for the whole practice team. "In terms of the whole team approach, it’s been invaluable."
The programme flexibility enables the practice to fund additional services for patients such as prescriptions, vaccines, minor surgery and the removal of co-payments for patients with high needs or financial difficulties.
One year on, after revising its plan, Island Bay will use funding for innovative projects such as nutrition and lifestyle consultations targeting those at risk of developing a LTC.
Melissa says practice nurses are empowered and enthusiastic as the consults are tailored to patient need and are becoming increasingly nurse led. "Island Bay supports a collaborative model that involves patients co-producing care plans with their GP and nurse. Patients feel confident that their care is well co-ordinated and it’s a real strength."
Island Bay is preparing a questionnaire to ask its LTC patients what they think of the programme changes, with the results incorporated into its next care plan as a quality improvement activity.
The new layout ensures the fax/printer hides the computer screen.
A young person's confidentiality was inadvertently breached when their name was viewed on a clinic appointment screen by another young person while waiting to be seen. Information was then circulated on social media. A complaint was lodged with Compass Health that confidentially and privacy of a person's information was breached.
Investigation into the incident prompted two questions:
A patient complained to the Health and Disability Commission (HDC) about a staff member promoting the use of complementary and alternative medicines during a consultation. One of the recommendations by the HDC was that Compass Heath needed to have a policy on the Use of Complementary and Alternative Medicines in place.
Investigation on the use of complementary and alternative medicines in New Zealand highlighted that the Medical Council of New Zealand and Nursing Council provide statement documents giving guidance to practitioners and nurses.
The links to the two statement documents were added to the Compass Health Code of Conduct Policy with the documents circulated to staff for signing. Signed copies are held in staff records.
The issue of emailing patient information was raised through an event reported.
Investigations took place as to what guidance can be given on communicating with patients via email or using other electronic methods. We reviewed Statements written by the Medical Council of New Zealand on the Use of the Internet and Electronic Communication and the Use of Telehealth and decided to promulgate these as useful guidance.
The links to the two statement documents were circulated to the Compass Health General Practice Team, internal staff and they were added to the Compass Health Social Media Policy.
This section describes the adverse events that were reported to Compass Health during the year. All reported events are summarised and reviewed by the Clinical Quality Board and learnings promulgated to the primary care network.
|Reportable Events||Key Learnings/Actions|
|Immunisation administration related incident|
|Eight immunisation related events were reported:
|Patient complaints about access/cost|
|Four access/cost related events were reported:
|Privacy related incidents & complaints|
|Four privacy related events were reported, including:
|Infomation Communication Technology related incidents|
|Two events were reported, including:
|Other incidents & complaints|
|Three miscellaneous events were reported. All three were complaints about staff behaviour. One complaint about advice regarding alternative medicines came via the Health and Disability Commissioner (HDC), but the HDC was satisfied with information received from Compass Health and no further investigation was held.||Organisational guidelines updated to include Medical and Nursing Council statements on the Use of Complementary and Alternative Medicines.|
|Health & Safety related incidents|
|Three health and safety related incidents were reported:
surgical site infections
|Four surgical site infection/sterilisation events were reported:
|Medication related incidents|
|Three medication related events were reported:
|Complaints regarding Mental Health Referral delays|
|Three complaints were received by Compass about delays in accessing primary mental health services.||Compass has reviewed processes and is putting in place a new model of care with practitioners based at larger GP practices. We are now monitoring access timeframes weekly.|
Compass Health Māori and Population Health.
Whānau Self Assessment Tool.
Our Population Health approach aligns with Whānau Ora and focuses on a broad range of factors both inside and outside of the health care system that can influence health. These factors include early childhood development, health promoting communities and healthy lifestyles, education, income, housing, and accessto healthcare. We seek to involve individuals, communities, schools, workplaces, local and central government.
We have specific responsibilities for ensuring Compass Health delivers on our commitment that Māori enjoy the same health status and access to primary health care services as non-Māori. To achieve this, we need to work both within Compass Health, with Practices and all health providers, Iwi, Hapu and Whānau and across sectors. The team brings tikanga me ona kaupapa skills and knowledge to the organisation through strategic thinking, application of policy, and development of sustainable relationships with iwi and Māori.
During 2013, the Māori and Population Health team designed a WWhānau Self-Assessment in using Whānau Ora approaches, Te Pae Mahutonga and Population Health principles.
This was developed in response to our observation that there was not a simple way for Whānau to signal their wider health and social needs and to be able to access support through a straight forward process.
Our resulting assessment is a visual interactive tool. Supporting the assessment is a one-page flow diagram with referral contacts for each item on the self-assessment form.
Masterton Medical Centre; 6:40pm Tuesday 25th February 2014.
Within 16 hours of suffering a devastating fire, Masterton Medical was operating out of temporary premises seeing patients.
"We are the largest practice in the country. We have 23,000 patients, just over 50% of the Wairarapa population and we were seeing about 500 patients a day. No one could pick up that workload so we had to get up and running quickly," General Manager Paul Cocks says.
There were two critical factors to the response. There was another facility with capacity to operate consultation rooms and the centre’s computer servers with patient records had been saved by the fire service. "So we had the site and access to MedTech."
Other matters around phones, clinical suppliers and messages to stakeholders were resolved with support from the DHB, Compass Health and the local community. The centre’s business interruption and other insurances were also up-to-date.
"One of the key messages we needed to get to our 72 staff on day one was that you were going to get paid and no one was going to lose their job. Many thought that if they weren’t working they wouldn’t be paid. We were running half the staff at any given time as we didn’t have the room for all of them, but we paid them as normal."
Paul says managing and supporting the team has been the hardest challenge in the wake of the fire. "The adrenalin lasts for so long when you have change upon change. It does get weary and tiring."
He says they were also concerned for their patients’ welfare. "We knew there would be patients trying to do the right thing by not coming to see us and when they did present they could be quite complex, so we needed to get our general appointments going. By day four we were up to 70% of normal capacity, although patients were not necessarily being seen through our GPs."
Other GP practices in Masterton helped by taking on some of the centre’s patients, a situation made easier with access to the shared care records.
Now operating out of more permanent yet temporary facilities, Paul says the experience has taught them to accept what they have and to make the most of it. The fire has presented Masterton Medical with an opportunity to redesign its model of care and plans for a new purpose-built centre will follow within two years.
The fire highlighted the centre’s business continuity plan was "rubbish and too generic". Masterton Medical is now establishing a more realistic Co-ordinated Incident Management System (CIMS) and Paul - who was the only member of the practice with any CIMS training - recommends CIMS to all practices.
CIMS is a command co-ordinated process, about an initial response, then management and then recovery. It is used by emergency services.
"If you just have a power outage you can follow your business continuity plan, but when you have no power, no security, no water, no clinical suppliers and you don’t have a building your plan quickly becomes very difficult to implement."
There have been other learnings from the fire. Masterton Medical now carries more clinical supplies and stationery, and its business interruption insurance policy has been extended from six months to two years. Changes have also been made to its rent protection insurance to increase its level of cover.
The team at Tawa Medical Centre
For the first time Compass Health has offered all Practices the standardised and validated New Zealand General Practice Assessment Questionnaire (NZGPAQ) Patient Satisfaction Survey this year. The NZGPAQ offers the benefit of being able to compare Practice results with the National Benchmark as well as the PHO network sample. It is widely used across New Zealand in General Practice and has been determined to be a reliable patient survey tool. It is delivered in New Zealand by Health Services Consumer Research (HSCR) in Auckland.
The NZGPAQ is a useful practice development tool as it is repeatable and will show changes over time. It helps to identify areas for improvement and also fulfils some requirements for Cornerstone Accreditation. Compass Health has also offered an online version of the NZGPAQ questionnaire, a popular option for many patients who can choose to easily complete the questionnaire on their mobile device.
The first PHO network level report was completed by HSCR in June 2014, based on 1,421 responses from 16 practices, the following were highlighted:
A further 12 practices have now implemented the NZGPAQ Patient Survey since the initial PHO report. HSCR will deliver a final 2014 PHO report in November this year.
Following the 6.5 magnitude earthquake that rocked the city at 5.09 pm Sunday 21 July, Compass Health continued to operate with minimal disruption while a structural engineer's report was completed on the Willis Street site.
Increased Immunisation 97%, Better Help for Smokers to Quit 98% and More Heart and Diabetes Checks 98%.
Kim Lund, Compass Health Clinical Nurse Specialist and Clinical Manager, presents the process behind the "Who Are You?" collaborative project at the ANZTSA Conference in Hobart, Tasmania.
Accessible via the Compass Health Provider Portal for Compass practices, and via the Compass Health website for non-Compass practices.
New Zealand General Practice Assessment Questionnaire (NZGPAQ), provides a comparative view of patient experience across practices.
More diabetes and heart checks, immunising 8-month-old babies, and helping smokers to quit.
Totals 132 responses: Overall satisfaction rate 7.5/10 with a goal of 9/10.
Distributes 1,000 healthy skin packs to Porirua medical practices, pharmacies and the Work and Income Community Link to support people to clean and cover cuts and care for their skin, and 4,000 bottles of liquid soap to 30 primary schools in Porirua
An official launch of the Shared Care Record was held in the Wellington Hospital Emergency Department on April 7 2014, attended by Minister Ryall. Ministry data shows a 20% reduction in MIs in Capital and Coast and 50% in the Wairarapa.
Compass Health, along with the Porirua City Council, YAG, Mai FM, Opportunities Centre organise Porirua Youth Expo. Providers’ stalls at the event were well resourced and effectively directed youth to services available to them when they have left school.
POAC is a stream of funding for services provided to the patient in the community where the service is intended to avoid the need for an ED attendance, outpatient visit or hospital admission. Currently there is POAC funding for IV antibiotics for the management of adult cellulitis where there has been high dose antibiotic failure and Clexane administration for the management of lower limb DVT.