Whānau-centred care in Whanganui

Whanganui District Health Board places whānau at the centre of service delivery. In the story below, they discuss the benefits of working with their regional health network and whānau navigators to improve Māori health outcomes. It’s a great example of a district health board working in innovative ways towards effective service delivery.

In May 2015, staff from the Māori Health Business Unit spoke with Rowena Kui, Director Māori Health Services for Whanganui DHB. Rowena talked them through some of the ways they have been working in partnership with the Whanganui Regional Health Network (WRHN (PHO)) and others to improve Māori health outcomes and to tackle specific issues like immunisation.

‘Our approach to immunisations in the region has been led by WRHN. They take the lead and we have a multidisciplinary group from across the sector that overseas our approach,’ Rowena explains.

‘Getting all the interested parties around the table – from nurses to planning and funding managers – and openly sharing all the information has been key. It’s a community-led initiative. The need has been driven by the community and, as providers, we’ve worked together to find ways to remove barriers and respond to those needs.’

In a practical sense, this has meant the team focus strongly on working together, including what Rowena calls ‘opportunistic vaccinations’ – checking the immunisation status as tamariki come into the Emergency Department and After Hours Care, and providing vaccinations on the spot for tamariki and other family members where appropriate.

‘We also check all children that are admitted into pediatrics against the National Immunisation Register and administer opportunistic immunisations where needed there as well. It’s about capturing tamariki at all of the points where health services intersect with their whānau. We’ve taken a multi pronged approach to achieving this and the team track it closely, keeping their finger on the pulse. It’s worked really well.’

‘It’s not unknown for members of the immunisations team to go and visit a household after hours or when Mum and Dad get home from work. You need to be really tenacious. The team are really committed to promoting this and working with families to understand immunisation better,’ Rowena adds.

‘Health literacy is one of the key barriers – there are still a lot of misunderstandings. I think the key though is being able to access immunisation on the family’s terms – being able to provide the vaccination in many different spaces and places, removing those physical and practical barriers.’

‘The WRHN and the community providers deserve a lot of kudos for the work they are doing and the contribution this work makes to improving the health status of our whānau.

This is really just one example of the overall whānau-centred/family-centred approach that is being taken in the Whanganui region.

‘We began implementing a much more family-centred care approach within our DHB services 12–18 months ago. The Te Hau Ranga Ora service was born then,’ Rowena explains.

‘One of the key components that’s worked really well is the Haumoana (navigator) service that’s been put in to support families and staff. The service provides support to families as they navigate their way through the DHB services and links them with community providers on discharge. It also provides support to our staff, assisting and building their confidence working with Māori families in terms of tikanga and cultural practices.’

‘We’ve had some very positive responses from staff where they feel much more supported and some great feedback from families. The latest figures show that over the last three months, of the families using the service, 60% have identified as Māori and 40% non-Māori.’

‘Anyone is eligible. The service is based on Te Whare Tapa Wha – the Māori concept of family - and is there for any family that comes through our doors with complex health and social needs. It’s been a huge shift in the way we work with families and embodies the DHB’s decision to adopt family/whānau-centred care as one of our core operating values,’ Rowena adds.

The service is delivered by experienced non-clinical Māori staff, working alongside experienced clinicians and health professionals, and is available 24 hours, 7 days a week.  Another key element of success is the fact that the DHB has embedded the support into service teams in an integrated way, rather than located their navigators in an isolated Māori health unit.

The Haumoana team also manages the Te Whare Whakatau Matea whare on the DHB campus for whānau/families who experience the sudden death of a whānau member in the community.

‘The whare has been in place for a number of years as a collaborative initiative between the DHB, the Police, the Coroner, local funeral directors, and Iwi – all of whom work closely with whānau in these instances,’ Rowena explains.

‘They also manage and facilitate whānau into Mauri Ora the emergency temporary accommodation for whānau in the DHB grounds. Mauri ora has been recently refurbished to be more welcoming for whānau.’

‘All in all, this has been a great change for us over the last year and a half. Really, these are all just examples of supporting the DHB’s goal and are in line with He Korowai Oranga moving from whānau ora to Pae Ora.’

‘I’d like to see all of us talking more about Pae Ora and making He Korowai Oranga a living strategy in our services and communities. As directors of Māori Health, that’s part of our responsibility. It’s a fantastic document that’s complemented well by the new Equity in health Care for Maori framework,’ Rowena adds. 

Our thanks to Rowena and the team for sharing the great work they are doing.

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