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Collaboratives – making     best practice happen                       Silke Kuehl               Emergency Nurse Advisor  ...
Outline   • The collaborative − best practice     implementation approach   • Kiwi approach − whakawhanaungatanga   • The ...
Our collaborative   • Best practice – evidence-based guideline   • Best people – team with right experience     and knowle...
Self-harm and suicide prevention               collaborative    • Implementing guideline    • Mental health, Emergency    ...
Participating DHBs    Northland                                           Waitemata    Counties Manakau                   ...
We are using a best practice             implementation process    • Support from leaders and influencers    • Team approa...
Consumer pathway        Community                   ED, Mental & Mäori                           Discharge          Care  ...
NZ Flavour    Whakawhanaungatanga – what we do and the way      we do it…    • Connected like kin or whänau    • Shared re...
NZGG – Self-harm and Suicide Prevention Collaborative
Benefits of a Collaborative    • The collaborative process can achieve rapid      change    • Clinician driven process mea...
Benefits for Consumers    • Improved responsiveness    • Better referral and coordination between      emergency and menta...
Benefits for DHBs    • Opportunity to participate in national      quality improvement project    • Transferable skills   ...
Early Results    • Better understanding of consumer journey    • Changing attitudes in some EDs    • Better relationships ...
More collaboration    • Collaborative      methodology being      evaluated in NZ    • Opportunity to build      on skills...
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NZ Guidelines Group Self-harm and Suicide Prevention Collaborative: Progress in Implementing Change and Whakawhanaungatanga

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Silke Kuehl and Dr Nicole Coupe. SPINZ Symposium Presentation, Dunedin, 29 November 2006. http://www.spinz.org.nz

Published in: Health & Medicine, Spiritual
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  • Kia Ora. Thank you for invite. Emma Sutich. My name… My background: ED, Mental Health My experience: substandard delivery of care – lack of collaboration.
  • 1. Published 2003. Good feedback. 2. Sponsors – team consists of project coordinator, MH, Maori MH, ED (Dr, nurse), consumer, family (catt, cmht, adolescent, cbt)‏ 3. 4 targets, monthly documentation of targets, teleconferences
  • 1. Evidence-based, recommendations: risk factors, therapeutic alliance, whanau, triage, assessment/referral to MH, intoxicated people, discharge, follow-up. NICS.
  • Show maps.
  • CEO, clinical and nursing leaders, psychiatrists, charge nurses, - enthusiasm, commitment. Problems: people leaving, not committed, time pressures, MH, Maori Mental Health, ED. Challenges: Different ED’s, hard for ED at times to understand MH and vice verca. Different agendas. Process mapping: consumer journeys, challenge for services to accept what actually happens, PDSA’s: permanent change implemented, eg assessment tool. Website: research, teleconferences, encourage use website discussion board. Eg cultural assessment – waikato Target 1: 90% access within 1 hr begin process of assessment, 2: 100% documented assessment: assessment of psychosocial stressors, cultural assessment, screen for mental illness, subsequent risk assessment within 72 hrs. Target 3: Written discharge plan given to client and whanau and sent to others involved in their care. Target 4a: 90% have follow-up appt within 48 hrs of discharge. Target 4b: 90% of people not attending appt contacted within 48 hrs of not attending. Contact person at NZGG, visits, telephone, get expert involved, eg Maori, MH, ED.
  • Colette talk.
  • Transcript of "NZ Guidelines Group Self-harm and Suicide Prevention Collaborative: Progress in Implementing Change and Whakawhanaungatanga"

    1. 1. Collaboratives – making best practice happen Silke Kuehl Emergency Nurse Advisor Self-harm and Suicide Prevention Collaborative - WhakawhanaungatangaNZGG – Self-harm and Suicide Prevention Collaborative
    2. 2. Outline • The collaborative − best practice implementation approach • Kiwi approach − whakawhanaungatanga • The benefits & early results − for consumers & cliniciansNZGG – Self-harm and Suicide Prevention Collaborative
    3. 3. Our collaborative • Best practice – evidence-based guideline • Best people – team with right experience and knowledge • Best process – results focused supported collaborativeNZGG – Self-harm and Suicide Prevention Collaborative
    4. 4. Self-harm and suicide prevention collaborative • Implementing guideline • Mental health, Emergency Departments, Māori health • Consumer focus • Families focus • 12 months • 10 DHBsNZGG – Self-harm and Suicide Prevention Collaborative
    5. 5. Participating DHBs Northland Waitemata Counties Manakau Waikato Lakes Taranaki Midcentral Hutt Valley West Coast SouthlandNZGG – Self-harm and Suicide Prevention Collaborative
    6. 6. We are using a best practice implementation process • Support from leaders and influencers • Team approach working across services • Use key tools - process mapping, PDSA • Encourage learning from others – latest research, other DHBs • Rapid feedback on impact of change – 4 targets • Ongoing support and guidance - NZGGNZGG – Self-harm and Suicide Prevention Collaborative
    7. 7. Consumer pathway Community ED, Mental & Mäori Discharge Care Health Services Destination Presentation Assessment Management • Map client pathway at each of these phases of care • Identify a typical problem at each point of the process • Find examples of best practice • Identify measures to monitor improved processes • Test the changes National Institute of Clinical Studies © 2005NZGG – Self-harm and Suicide Prevention Collaborative
    8. 8. NZ Flavour Whakawhanaungatanga – what we do and the way we do it… • Connected like kin or whänau • Shared responsibility for one another • Common understanding • Cheerful cooperation • Corporate responsibility (Russell Bishop, Kathy Irwin and Louise Ihimaera)NZGG – Self-harm and Suicide Prevention Collaborative
    9. 9. NZGG – Self-harm and Suicide Prevention Collaborative
    10. 10. Benefits of a Collaborative • The collaborative process can achieve rapid change • Clinician driven process means that it is implemented using an evidence-base in a way that works for clinicians in their local situation • Implementing evidence-based proven methodology that can be used again & againNZGG – Self-harm and Suicide Prevention Collaborative
    11. 11. Benefits for Consumers • Improved responsiveness • Better referral and coordination between emergency and mental health services • Improved access to services • Improved follow up • Culturally appropriate services • Family/whänau and friends in the pictureNZGG – Self-harm and Suicide Prevention Collaborative
    12. 12. Benefits for DHBs • Opportunity to participate in national quality improvement project • Transferable skills • Cost effective • Professional development of staff • Manage service risk • Service improvement for consumersNZGG – Self-harm and Suicide Prevention Collaborative
    13. 13. Early Results • Better understanding of consumer journey • Changing attitudes in some EDs • Better relationships between Māori health, mental health and ED • Better idea of the number of people presenting with self-harm and suicide ideationNZGG – Self-harm and Suicide Prevention Collaborative
    14. 14. More collaboration • Collaborative methodology being evaluated in NZ • Opportunity to build on skills for other service areas • Contact NZGG for more information astewart@nzgg.org.nzNZGG – Self-harm and Suicide Prevention Collaborative
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