By Helen Peterson

The percentage of cardiovascular disease risk assessment screening by Turanganui Primary Health Organisation and its general practices has exceeded national and regional targets. 
 
Turanganui PHO chief executive Keriana Brooking is delighted with the results which are directly attributable to staff.

“We are doing better than most other primary health organisations, and this is due to the efforts of GP clinic and HealthRight staff.”

Cardiovascular disease (CVD) risk assessment screening data is forwarded to Pinnacle, which then produces quarterly updates for each PHO region.

While Turanganui PHO has had regular access to Pinnacle’s assessment figures, staff at general practices within the area have not. Keriana said many have been unaware of the great results until now.

“Each quarter I have received a report showing how well we are doing and now the general practitioners and their staff will also get this information.”

Figures show 20.96 percent of the PHO’s total population have been assessed. The target set was 14.06 percent.

For the high needs population, which includes people of Maori and Pacific Island descent and others living in high needs or deprivation areas, the PHO figures show 20.75 percent have been assessed. The target was 12.78 percent.

Nationally 13.88 percent of the total population and 14.89 percent of the high needs population have been screened.

Turanganui PHO Nurse Practitioner Diane Williams says the organisation has made a great start and the effort within the practices is acknowledged.

“With regards to most of the 20 percent screened we already knew they had cardiac disease or diabetes,” she says. “Now we must ensure they have assistance to reduce their risk factors and general CVD score.”

Diane also stressed the importance of learning more about the remaining 80 percent of people so the true number of patients at risk was revealed.

CVD risk assessment screening is part of the national PHO Performance Programme focused on improving the health of New Zealanders. The assessment includes a questionnaire highlighting information about a person’s blood pressure, cholesterol level, smoking status and whether they have experienced a heart attack, angina or a stroke. Age and gender are taken into account.

The national aim is to get 80 percent or more of people deemed at risk in the PHO area screened within a five year period.

     
     By Helen Peterson

PHO’s Performance made public
Cervical Cancer screening in Turanganui Primary Health Organisation’s area is achieving top results, according to the latest Performance Management Programme (PMP) released online earlier this month

Results for immunisations of two-year-olds are also impressive, but there is room for improvement regarding breast screening.

This is the first time the PMP report has been available online and Turanganui PHO chief executive Keriana Brooking is excited by the innovation. She says the initiative will make the results accessible to the wider Turanganui PHO team and general public.

Previously the PMP figures were included in internal reports that went directly to primary health organisation boards and executives, but not the wider PHO family.

“This meant general practice staff may not have been aware of how well the PHO was doing and in most cases the promising outcomes were a direct result of their input,” said Keriana.

The national PMP, introduced in 2006, focuses on improving the health of people within primary health organisations. It measures performance against a range of nationally consistent measures. Key areas are cervical screening, breast cancer screening, influenza vaccinations and immunisation of two-year-olds.

Since July 2006 Turanganui PHO has been working hard to improve the health of its population and the results have been pleasing.

Cervical Screening
More than three quarters of eligible women in the Turanganui PHO area have been screened for cervical cancer in the past three years. This exceeds those screened nationally. Locally the targets set for cervical screening were 75 percent of the total eligible population and 70 percent of the high needs population. Both targets were exceeded - total population was recorded at 77.1 percent and high needs at 70.4 percent.

Keriana is delighted with the result but not surprised by the figures. While the doctors’ practices had done a great job screening the women and recording results, there was no doubt that Gisborne women were more proactive about cervical screening.

Two year old immunisation
Turanganui PHO had also recorded good results for immunisations of two-year-olds. The total population figure of 85.3 percent had exceeded the target of 84.3 percent and the high needs percent of 84.7 percent had almost broken even with the 84.8 percent target. 

“The importance of vaccinations was highlighted by the extensive Meningococcal B campaign but our midwives, outreach teams, Well Child nurses and general practice staff have all helped to achieve this great result.”

Influenza immunisation
The proportion of vaccinated people aged 65 years and older in this area was higher than that found nationally, but  local  targets for both total population and high needs population had fallen short by about three percent in each case.

Breast screening
Breast screening figures were a little disappointing but not surprising, said Keriana. Although more than half the eligible women in the area had been screened for breast cancer in the past two years the total population figures (60.6 percent) and high need population figures (52.7 percent) were marginally exceeded by national figures.

One of the main factors was that during last year Breast Screening Coast to Coast had been unable to secure a technician to do the mammograms, and so regular access was restricted. It is also worth noting the age for eligible women had been dropped by 10 years, therefore increasing the eligible population. It is hoped the figures will improve during the next quarter.

[Click here] to read the full PMP report].

     
     By Hayley Redpath

General practice and Turanga Health staff are asked to nominate patients to tell their story as part of a collection being created about the experiences of enrolled patients.

Can you think of a patient who would be perfect for this project?, asks Turanganui PHO Communications Coordinator Hayley Redpath.

“A patient or client who stands out for having a story to tell and an ability to tell it to myself and award winning photographer Brett Mead.”

Focus will be on patients who identify as Maori, and have used:

•         the Diabetes Annual Review Service, or
•         HealthRight Lifetime Lifestyle, or
•         received a Cardio Vascular Disease (CVD) risk assessment.

Each story will be told using the person’s own words, and the paper-based resource will include bold photographs taken by Brett Mead.  A sneak preview of the type of publication being prepared for the kete, or collection of stories, appears above.

Twelve people will be selected to have their story told, says Hayley.

Finding patients who identify as Maori, have used one or more of the three above services, AND, willing to tell their story will be a challenge! Hayley assured staff and potential story tellers that as always, obtaining permission from patients every step of the way, is part of the process.

She says the creation of the resource relies solely on the next step: staff ability to link with their communities and patients and find the 12 people needed.
 
“If you do know someone, please contact that patient or client, briefly explain the project, and seek their permission to have their contact details passed on to me. The protection, privacy and respect of anyone taking part will be paramount.”

Turanganui Primary Health Organisation Board chair David Scott encourages staff to nominate special patients to have their story told.

“Hayley and Brett are looking for the type of patient that makes it worthwhile coming to work for. A person you have seen respond to primary care and make a positive change for one reason or another.”

“It’s also a chance for staff to have their own efforts and that of their fellow staff, the general practice and or Maori health organisation, recognised.”
 
David said the resource is being created because Turanganui PHO wants to engage with more of its enrolled patients, particularly iwi, for the purposes of increasing the number of patients using specific services.

“It also wants to create a resource showing how Turanganui PHO is responsive to the needs of Maori. The resource will be for use by anyone engaging with iwi at a strategic and or operational level, in a variety of settings.”

Please forward the contact details of any appropriate patients by Monday 31 August 2009 to:
 
Hayley Redpath
Redpath@farmside.co.nz
(06) 862 4885 (weekdays)
027 44 795 88
(06) 863 2661 x 104 (PHO office)

The PHOnetic is running a series of articles introducing new practice nurses to readers. 

     By Helen Peterson

Former cardiothoracic nurse Karen Barrett can’t imagine a career other than nursing and loves her new job at City Medical.

The mother-of-two works at the practice two days a week and enjoys the continuity of contact with patients and their families. She also takes part in on-going personal development and says these opportunities are hugely beneficial.
 
“The City Medical team are wonderfully supportive - it’s a great place to work.”
 
Karen gained her nursing diploma in 1993. She spent three years working in Gisborne Hospital’s general surgical ward before moving to Auckland with husband, Andrew.

While in Auckland Karen had the opportunity to work in the cardiothoracic field and after two years the Barretts moved to Queensland, Australia. Karen continued her cardiothoracic nursing in Australia and broadened her experience by learning more about cardiac investigation.

She spent six months studying extramurally via the University of New South Wales to gain her nursing degree in 2000.

Four years ago the Barretts, now with two children, returned to Gisborne and the lifestyle they love. In February Karen joined the City Medical team and is enjoying her work.

“I am learning a lot about children’s primary health and am enjoying the up-skilling.” 

One thing Karen noticed about practice nursing was the sheer volume of patients she deals with on a daily basis compared with six patients in a hospital ward at any one time.

She says life is busy at City Medical. No two days are the same because and there are always new challenges, but Karen is enjoying the variety of work.