Magazine article Public Sector

From Vision to Reality - Building an Integrated Health System in Canterbury

Magazine article Public Sector

From Vision to Reality - Building an Integrated Health System in Canterbury

Article excerpt

David Meates is a man on a mission. While he's been in the role of chief executive at Canterbury District Health Board since 2009, he still talks and acts like a leader who is set to transform the way healthcare is delivered in the region. Of course, looking at the unique position Canterbury DHB has been in, particularly since the 2011 Christchurch earthquake, it's clear that change has by necessity become the norm. It's also clear that "improving" and "evolving" are paramount to his personal and professional philosophy.

When Meates stepped into his role, he came into a region where the healthcare system had been very fragmented.

"Primary and community health organisations were extremely isolated, patients were being bounced around between providers and there wasn't a focus that everyone could collectively make it better for our patients and community."

In short, the system wasn't working. If things didn't change, Canterbury was looking at needing an additional hospital the same size as Christchurch Hospital, and would have required an additional 2000 agedcare beds and 20 per cent more general practices to serve its population.

"Even if we had the money to fund those increases, we would not have sufficient staffand health professionals to run the additional facilities."

While the system needed to be fixed, it was apparent that using the same old approaches was not going to resolve the underlying issues.

"We needed to connect our health system in a way that worked for providers and, more importantly, for Cantabrians. Healthcare can be very inwardlooking, so the first thing we did was observe other sectors to see if there were things we could learn about building an integrated system. We immersed health professionals and managers into an environment where they were exposed to travel and tourism, customer-focused hotel management, elite sporting teams and Air New Zealand - anyone who might be able to give us some fresh insights and to challenge our thinking.

"From there we asked, 'How do we solve this problem?'. We engaged with about 2000 people across Canterbury's health system who collectively helped create our vision."

Picturing success

David Meates says by working together and engaging communities and health professionals in shaping what an integrated health system should look like, the vision became apparent quite quickly: An integrated health system that keeps people healthy and well in their own homes by providing the right care and support, by the right person, at the right time, in the right place, with the right patient experience.

"It's a vision that reducespressures on the health system, but more importantly it's focused on keeping people healthy, productive, and independent as much as possible."

Meates says as soon as the vision could be articulated, it was important to create a visual representation of it.

"We needed people - from patients, to admissions staff, to specialists, to general practitioners, to accountants - to understand where they fit within an integrated health system.

"Equally important was using language that was inclusive when explaining the vision. We talk about the Canterbury Health System not providers, we talk about 'our health system' and 'how we can make it better'."

He says they also worked to develop strategic criteria that guide everything they do within the system. The criteria include:

* actively supporting people to stay well within their own homes

* making primary health providers the first port of call for most health problems

* when people are in hospital making it a priority to enable them to return home as soon as possible - sometimes with a range of services provided in their home while they recover and regain independence.

"We work within a complex system, but we are working with extremely bright and capable people. Because people feel vested in the vision we have been able to achieve remarkable things. …

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