J. Kay Poulsen, MBA (dist), BA, Dip Sec Tchg Help4U Ltd (Friday, 9.30, General 2)

1. Finding Meaning in Despair
Using the Omaha System to
document disaster recovery efforts
Kay Poulsen, BA, MBA, DipSecTchg, PRINCE2 Practitioner
HINZ, 25 November 2011

2. A Tale of Two Cities
• Setting the scene and the links to HINZ
• The Omaha System
• Beyond 22/2/11
• The public health warning

3. How did we get here?
A Timeline
• HINZ November 2009
“To ensure that correct decision making occurs at
the right time, at the right place, and that services
provided are at the right level in a
consistent, coordinated way, this clinical
information must be valid, reliable, but most of all
present”.
Brent McGrath (1960 – 2010)
Changing the way nurses and allied health professionals document and communicate
care in community clinical practice : a community care clinical data set.

4. Unique features of
Omaha System
• Problems at family or community level
• Potential problems
• Opportunities for health promotion
• Evaluation of problem rating over time:
– Knowledge –do they understand the problem?
– Behaviour – are they compliant with the plan?
– Status – are signs/symptoms present?

5. • Holistic evaluation of problems in the setting
of a person’s life
• Measure the impact of interventions on
consumer awareness and consumer
engagement as well as clinical outcomes.
www.omahasystem.org

6. Checkpoint 2010:
Where are we?
• Omaha System
• CADI data dictionary
• Project GAIN
• PLAIN WORDS taxonomy
• IT architecture
• International partnerships

7. Life Interrupted…
4.35am, 4 September 2010

8. Delivering the vision
• HINZ, November 2010 – Sheree East
“The key thing is, understanding the
landscape in which you are operating
is constantly shifting. And when the
ground shifts beneath you – systems
need to be flexible and sustainable.

9. • “We are now ready to embark upon the trial
and implementation of the dataset using 21st
century documentation and communication
technology” (Sheree East, HINZ November
2010)
Transforming Clinical Practice through Terminology

10. Life interrupted
• 2
• 10
• 20
• 1000
• 3000
• 10,000
• 12,000
• 38,000
• 45,000

11. 12.51pm, 22 February 2011

12. The Help4U timeline
• Stocktake of agencies
• Set up a Facebook page
• Linked student welfare division with existing agencies
• Commenced coordinating suburban welfare enquiries
• Earthquake services A-Z
• The lightbulb project

13. Immediate Aftermath
• 100 tertiary care beds
• 600 residential care beds
• 122 NGO health groups

14. Student Volunteer Army
• Established a ‘welfare
division’
• Lodged a request for
help on Facebook

15. Social Media
• Facebook here:
– Red Cross
– CDHB
– Plunket
– Christchurch City Council
– St John
– City Mission
• And overseas
– Katrina experiences
– Omaha System colleagues

16. Operation Suburbs

17. In the suburbs
• 2000 portaloos
• 27,500 chemical toilets
• 400 disposal tanks

18. Activities, Events, Services &
Outcomes Planning

19. Problems encountered
35 Nutrition
03 Residence
02 Sanitation
38 Personal care
06 Communication with community resources
12 Mental Health
41 Health care supervision
07 Social contact
04 Neighbourhood/ Workplace safety % of all cases
01 Income % of all requests
42 Medication regimen
36 Sleep and rest patterns
14 Caretaking/parenting
27 Neuro-musculo-skeletal function
11 Grief
30 Digestion-hydration
09 Interpersonal relationship
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

20. Interventions

21. Case Studies
• A solo mum, recovering alcoholic, who had been
given a bottle of wine in a food parcel
• Elderly couple (one dementia, one hearing
impaired, both with mobility issues), hadn’t seen
anyone for 3 weeks, no portaloo in street, had
food laid out on floor and were rationing it
• Teenage boy, living alone in condemned house
while parents were in Wellington with daughter
who had leg amputated at hip due to quake
injury. Auntie (mother’s sister) died at CTV.
• ‘The Rat Problem’

22. Where to from here?
• TotalCare service
– Hospital in the Home
• Nurse Practitioner service
– Older Persons’ Health
• AESOP clinical documentation tool

23. Hospital in the Home
Problems

24. Hospital in the Home
Baseline Rating
Substance use
Residence
Healthcare supervision
Physical activity
Urinary function
Status
Social contact
Behaviour
Nutrition Knowledge
Oral health
Interpersonal relationships
Personal care
Medication regimen
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5

25. NP problems

26. NP interventions

27. Teaching, Guidance &
Counselling

28. Treatment & Procedures

29. Case Management

30. Surveillance

31. Questions
Acknowledgements
Sheree East, RN, DoN
Nurse Maude, Christchurch NZ
Karen A. Monsen, PhD, RN
University Of Minnesota, Minneapolis, MN, USA
Amy B. Lytton, MS, RN
St. Paul-Ramsey County Public Health, MN, USA
Sara Avery
Massey University, Nursing Programme
Wellington, NZ
Ashleigh Peck
CPIT School of Midwifery
Christchurch, NZ