Page 59 - Regional Services Plan 2016/19
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Line of Sight
Waikato DHB Annual Plan – section 2.5.2; Taranaki DHB Annual Plan – section 2B.2.15; Bay of Plenty DHB Annual Plan – section 2B.1.5.2; Lakes DHB Annual Plan – section 2B.1.3.2, and Hauora Tairāwhiti Annual Plan - section 2.3.3
Initiative
Health Literacy - Stroke /TIA (as per the FAST campaign) education for the community as well as the primary and secondary workforce.
NZ Health Strategy strategic themes alignment: People powered
What are the identified root-causes to be resolved?
Lack of awareness of signs and symptoms of Stroke/TIA (as per the FAST campaign)
Lack of resources regarding Stroke/TIA
Lack of appreciation of specialisation of Stroke care What does success look like?
Implementation of the Stroke/TIA Map of Medicine pathway
Communities are more aware of FAST message
Increased presentation for TIA
Increased presentation for Stroke within the 4 hour time frame.
Increased awareness in the ARC sector
What will have changed for you to know that you have achieved the objective?
Increase in presentations for Stroke and TIA
Confident, competent workforce.
What are the steps to achieving the objective?
1. Establishing monthly webinar sessions / video conference across the region
2. Support of Stroke study days: national, regional and local days.
3. Support NZ Stroke Foundation awareness raising campaigns.
4. Explore linking Stroke prevention services with existing Cardio-vascular and other health
promotion services.
5. Increase consumer/ whānau participation in Stroke service development and delivery
1: Improve Māori health outcomes
2: Integrate across continuums of care
3: Improve quality across all regional services
4: Build the workforce
5: Improve clinical information systems
6: Efficiently allocate public health system resources
Initiative
Milestone/Date
Responsibility
Rehabilitation - Ensure rehabilitation services for stroke patients across the region aligns to the “NZ Organised Stroke Rehabilitation Service Specifications (in-patient and community)” that have been prepared by the National Stroke Network (aligns also with the joint Ministry and ACC Hospital to the Home project).
NZ Health Strategy strategic themes alignment: Closer to home, one team, value and high performance
What does success look like?
People being discharged home
Improved functionality (Driving, working, less dependence on others)
Improve psychological well being
Improved quality of life
What will have changed to know that you have achieved the objective?
Community supported discharge service
Under 65 have access to community resources following discharge
Reduced number of direct admissions to ARC following a stroke
Reduced readmissions following a stroke
What are the steps to achieving the objective?
a. Gather the data for the rehabilitation indicators
b. To complete a current state stocktake of ambulatory Allied Health and nursing
rehabilitation and identify any gaps in service and compare against best practice
c. Develop a clear vision and care pathways for rehabilitation patients, based on ESD
evidence and best practice for patient clinical complexity
d. A clear time-bound plan (including models of service delivery ie. who to deliver what,
where and when) is developed based on the findings of the stocktake and regionally
agreed care pathways
e. Hold a Midlands region rehabilitation study day
f. Standardise expectations around post discharge follow up (linking with indicators -
objective ‘a’), for example, access to all disciplines / timeframes to be seen / return to
work programs/ return to driving programs
g. Develop regional business cases for the implementation of ESD teams for chronic / long
term conditions
1: Improve Māori health outcomes
2: Integrate across continuums of care
3: Improve quality across all regional services
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4: Build the workforce
Milestone/Date
Monthly
At least one regional professional development session offered per year by a DHB Stroke Team Ongoing
Ongoing
Ongoing
5: Improve clinical information systems
Responsibility
HSL with MSN MSN
MSN/ DHBs MSN
MSN
Q1 2016/17 Q1 2016/17
Q1 2016/17 Q2 2016/17
Q2 2016/17 Q2 2016/17
Q3 2016/17
MSN and DHBs MSN and DHBs
MSN MSN
MSN MSN
Midland DHBs
6: Efficiently allocate public health system resources
