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Health Service Development and Planning

Respite requirements for children and young people with high level, complex, health-related support needs
Funding Body: Nurse Maude Campbell Ballantyne Foundation
Project Description/Update: This project was designed to quantify and qualify the respite care requirements of families caring for children and young people with high-level, complex, health related support needs. The project also aimed to identify and describe the current service gaps in meeting these needs.
Project Outcomes: The research identified that for families there is a need for a tailored respite plan, however, the focus groups and environmental scan highlighted the difficulties families have accessing appropriate respite services. In particular their preferred option of flexible, funded, home-based respite care with suitably trained, qualified and experienced carers is currently not available to most families.

The report recommendations include:
  • Urgent attention is paid to improve current assessment and identification of children and young persons with high level complex health related needs.
  • Work with urgency to establish accessible, appropriate, individualised respite options in Canterbury to meet the needs of families caring for a child or young person with high level complex health related needs.

The report is available from http://www.nursemaude.org.nz/about/publications

Further Information: Contact the NZICHC on institute@nzichc.org.nz
Continence: a service of last resort. Profiling the role of a nurse continence service
Funding Body: Ministry of Health
Project Description/Update: This report provides a case study illustrating the role of the specialist paediatric continence service at Nurse Maude. It highlights the assessment, education and treatment plans that are tailored to each child's needs, as well as the inter-disciplinary partnerships necessary to help a child achieve continence.
Project Outcomes: Ministry of Health (2009). A service of 'last resort': the outcomes of a specialist paediatric continence service at Nurse Maude, Christchurch. Wellington: Author. Available from: http://www.moh.govt.nz or contact the NZICHC on institute@nzichc.org.nz
Further Information: Contact the NZICHC on institute@nzichc.org.nz
Exploring the impact of dementia on community-based health service delivery
Funding Body: Nurse Maude
Project Description/Update: The aim of this project was to provide recommendations for service development activities that could meet the needs of this client group in the community.
Project Outcomes: A report with recommendations based on a literature review, environmental scan, service overview and gap analysis was provided to Nurse Maude.
Further Information: Contact the NZICHC on institute@nzichc.org.nz
Future-proofing Care Co-ordination Services
Funding Body: Nurse Maude
Project Description/Update: The aim of the project was to provide the funder with:
  • A better understanding of new development technologies in care co-ordination and any indications of the future direction of care co-ordination, both locally and nationally
  • An overview of how Nurse Maude is currently positioned to meet future needs
  • Recommendations for care co-ordination service delivery
Project Outcomes: A report with recommendations based on a literature review, environmental scan, service overview and gap analysis was provided to Nurse Maude.
Further Information: Contact the NZICHC on institute@nzichc.org.nz
Development of an NGO's profile and project national client base
Funding Body: Smoke Change (http://www.smokechange.co.nz/home)
Project Description/Update: This NGO was responding to a Ministry of Health request for proposal (RFP) for services and needed to have information on their service potential. To achieve this, the Institute collected statistical data on both the population profiles and the current midwifery workforce profiles of each District Health Board. This information was also mapped against the organisation’s current service delivery model. A current state was identified for them. This data was then used to develop potential service delivery models in discussion with the Institute until a model was developed that could meet service requirements using the least resources while likely to meet the areas of most need. The Institute peer reviewed the RFP for Smoke Change.
Project Outcomes: The Smoke Change proposal was successful and the Institute has subsequently advised the organisation on how best to evaluate the service from the start.
Further Information: The programme outline is available on: http://www.smokechange.co.nz/midwives
Development of the service delivery model for Whangarei Maternity Services
Funding Body: Northland District Health Board
Project Description/Update: The DHB were in the process of building a new maternity base hospital in Whangarei http://redevelopment.northlanddhb.org.nz/index.php/stage-1a-mental-health-inpatient-unit/maternity/maternity-project-background/. They wanted to plan for the transition from the old hospital to the new. Over a 3 month period, the Institute Director, Dr Chris Hendry, worked with clinicians, managers and consumers to develop firstly an optimal woman’s journey through the service, then a service delivery model and physical design that could best enable that journey.
Project Outcomes: An agreed best practice maternity service delivery model was designed and contained in a report for the DHB to inform the development of the maternity hospital.
Further Information: http://redevelopment.northlanddhb.org.nz/index.php/media/newsletters/
Planning for maternal and child health services integration in Rotorua and Taupo
Funding Body: Lakes District Health Board
Project Description/Update: The DHB were invited by the Ministry of Health to submit a proposal as a demonstration site for the integration of maternal and child health services. The Institute Director, Dr Chris Hendry, worked with the DHB, clinicians and the communities in Rotorua and Taupo to initially identify the current state of health and social services and then to work out a plan for services to co-locate and work more collaboratively so that there was no duplication of services and more clarity for consumers over access.
Project Outcomes: Following extensive consultation with a range of key stakeholders an initiative was proposed that supported a long term, sustainable maternal and child health service integration programme planned to address current service duplication and gaps as well as streamline consumer navigation through the services.  Lakes DHB proposed the establishment of a service referred to as Te Whanake: Lakes DHB Maternal and Child Health Integration Programme.  This proposal was successful and the Maternal and Child Health Integration Service commenced early in 2014 with the first new service established in Turangi.
Further Information: http://www.lakesdhb.govt.nz/Article.aspx?Mode=1&ID=3003&ESID=8356
A national audit of student nurses in community health settings
Funding Body: AKO Aotearoa Regional Hub Projects Funding Scheme
Project Description/Update: This research project was undertaken to explore the exposure student nurses, the largest group of health professionals, have to Primary Health Care (PHC) and community nursing in New Zealand during their undergraduate Bachelor of Nursing (BN) programme. The project consisted of two components: a review of the international literature surrounding the issue of clinical placement provision for undergraduate health care professionals with a focus on both nursing and PHC and community settings; all New Zealand tertiary institutions providing BN programmes were invited to complete a short questionnaire.
 
The goals for this project were to
 
  1. gather baseline information on the range of PHC and community settings used in offering clinical experience to Bachelor of Nursing students
  2. identify barriers to providing quality PHC and community clinical placements
  3. identify areas of innovation in providing PHC and community placements
  4. make recommendations for ensuring BN students gain appropriate exposure to PHC and community based nursing.
Project Outcomes: The report from this project is available at:
http://akoaotearoa.ac.nz/download/ng/file/group-7/student-nurses-exposure-to-primary-health-care-nursing-issues-and-innovations.pdf
Further Information: gill.coe@nzichc.org.nz
Evaluation of the Nurse Maude Total Care Service
Funding Body: Nurse Maude
Project Description/Update: The Nurse Maude Complex Restorative Care Service (TotalCare) commenced in May 2011 with the main aim of providing a responsive community based health service to clients who would otherwise have required hospitalisation and/or admission to a rest home. The Canterbury District Health Board (CDHB) funded this service which was based on the Integrated Community Services model, with care coordinated by a registered nurse who assesses and case manages the client’s service care needs, and then oversees support workers who provide the majority of personal cares for the client. Clients also had access to:
  • Occupational therapy and Physiotherapy services
  • Respite beds for crisis care
  • Laundry services
  • Meal services.
The institute completed a 360° evaluation of the service by obtaining information from providers, referrers, family and service consumers.
Project Outcomes: This evaluation was completed by the New Zealand Institute of Community Health Care . The evaluation provided useful evaluative benchmarking information on TotalCare in order to identify if it is meeting the goal of enabling those assessed as rest home/hospital level care to remain in their own home safely.
Further Information: Information from this evaluation was presented by the Nurse Maude Director of Nursing at the NZ Home Health Association Conference in 2013:
http://www.nzhha.org.nz/conference/presentations/Nurse_Maude_Stretching_the_Limits.pdf
An article was also published in Nursing Review:
http://www.nursingreview.co.nz/issue/july-2013/rest-home-in-the-home/
Profiling the development of a nurse-led wound management service
Funding Body: Ministry of Health
Project Description/Update: This project looked at the development of a nurse-led wound management clinic at Nurse Maude, a large community support service provider (Christchurch, New Zealand) and the impact on patient outcomes and service delivery.
Project Outcomes: Ministry of Health (2009). A vision for a nurse-led wound management service: innovating from the inside out. Wellington.  Available by contacting: institute@nzichc.org.nz
Further Information: Cathy Hammond, Clinical Nurse Specialist Wound Care, Nurse Maude.
catherine.hammond@nursemaude.org.nz
Patient dependency and workload in community nursing
Funding Body: NZNO District Nursing Section and the Institute
Project Description/Update: This literature review summarised published literature from 1999-2009 on the measurement of patient dependency, workload and workload allocation within district/community nursing.
Project Outcomes: The report was published by the District Nursing Section and is available for public access on the NZNO website.
Further Information: gill.coe@nzichc.org.nz
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