One team, two hospitals and a natural disaster: Admin and IMT kept appointments going
An emergency, like the severe weather event the Nelson Marlborough region experienced this August, has a way of bringing the complexities of our health care system into focus. Healthcare’s many moving parts become clearer when they are disrupted, allowing us to better appreciate all that goes into the scheduling of surgical bookings and outpatient appointments — all the people involved, from the management team, administrative staff, radiologists, histologists, doctors, nurses, and of course, the patients and whānau.
Te Whatu Ora – Nelson Marlborough operates as one service across two hospitals. Clinicians frequently travel between Nelson Hospital and Wairau Hospital to provide care to patients in both locations. If a wait time for a ‘first specialist appointment’ is shorter in Wairau Hospital, a patient who lives in Nelson might be given the option of going over the hill. Similarly if there are opportunities in a specialist service in Nelson Hospital, a patient who lives in Blenheim may travel to Nelson for their surgery.
But when State Highway 6 between Blenheim and Nelson closed due to slips and flooding, many patients, whānau and staff literally found themselves on the wrong side of the flood.
To contend with this challenge and manage its impact, Te Whatu Ora formed an Incident Management Team (IMT). This is a team of Service Managers, Theatre Coordinators, and Charge Nurse Managers, among others, set up to manage the ongoing response and ensure that hospital resources were coordinated to best possible use.
Acting Clinical Appointments Manager within IMT Jess Ettema says the incident management team's job is to look after the day-to-day running of the hospital.
"We’re looking closely at patients and staff who are affected by flooding, road closures, and traffic congestion, and then navigating through those aspects.
“My role has predominately been the administration and planned care response. Our team was looking at our patients who were in flooded areas and patients who are in Blenheim but need treatment in Nelson, and what we needed to do to look after those patients and ensure we were still managing care.”
For every patient who had an upcoming surgery or outpatient appointment, Jess and the IMT worked through a series of questions and considerations with the goal of delivering care in a safe and timely manner, amid increased disruption including road closures, traffic and impossible travel routes.
“For both sides of the hill, because we did not want people travelling for non-urgent appointments, we asked ‘is it safe to turn the appointment into a virtual telehealth one?’ or ‘is it okay to defer for two weeks when the situation was better and we knew more about the road status on both sides?’”
If a switch to Telehealth was not appropriate and the appointment or surgery could not be delayed, Travel Services arranged for the patient to be flown to their appointment. In some cases, clinical staff were flown between the two sites as well.
The Secretarial Support administrative team not only called patients to reschedule appointments or change them to Telehealth – they also called patients to reassure them that their appointments or surgeries would go ahead as planned.
“Admin are always incredible,” Jess says. “They’re amazing how they’ll just step up and really get on with the challenge. I have no doubt that they’re exhausted and some will be dealing with their own stress of potentially being red stickered or dealing with the anxiety and trauma that comes with emergencies. But admin have been amazing and the Team Leaders have been great at keeping them going.
“As a collective it has been decided to acknowledge what is not always an acknowledged workforce about that extra response. This morning tea is really to celebrate them and the over and above job they have done in the last couple of weeks, because it is no mean feat what they do every day.”