Turanga Health is an iwi health provider delivering services to more than 3000 whānau. Its vision is ‘kia whai oranga-a-whanau mo nga whakatipuranga’ or ‘building family wellness for future generations’.
Its Tū Mahi Workplace Wellness programme offers on-the-job health checks, flu vaccinations, smoking cessation and other wrap-around services to the area’s primary industry workers.
Turanga Health Chief Executive, Reweti Ropiha, says many of the largely seasonal, mainly Māori, workforce are disconnected from the health system and their first contact is often with secondary or tertiary care.
‘During our workplace visits we saw that we could improve our services if we extended our consults into the home for those who were screened as being at risk, particularly for cardiovascular disease.’
The project was undertaken as part of the 2018 Whakakotahi quality improvement programme, which aims to increase quality improvement capability in primary care. Successful providers are supported by the Commission to implement quality improvement projects about an area of patient care that is important to their patients/community and to them as providers. Equity, consumer involvement and integration are key focus areas for Whakakotahi.
The Commission’s primary care programme team supports and mentors participating primary care teams through site visits and group learning events, and a member of each project team is offered a position on the primary care quality improvement facilitator course delivered by Ko Awatea and the Commission’s primary care and leadership capability programmes.
About half those at two workplaces who were identified as at risk agreed to home visits by Turanga Health nurses and kaiāwhina.
Project manager, Dallas Poi, says the home visits meant clients and their whānau were able to be linked into services they may not otherwise have accessed.
‘As well as ensuring that they were connected to their GP, the home visits meant we were able to introduce the whānau to things like the Healthy Homes Initiative, Turanga Health’s lifestyle programmes for those with long-term conditions and, for the wider whānau, antenatal services or Well Child/Tamariki Ora providers.’
All the home visits generated the need for at least one wraparound service.
‘We identified that involving the whānau meant there was a better chance of achieving a good health outcome, because we were speaking with them in their own environment rather than in a medical one, and at a time that suited them.’
Continuing the home visits alongside the workplace visits, provided a valuable opportunity to follow-up where connections to other services had been made.
Dallas says she appreciated the support provided by Commission’s Quality Improvement Advisor, Jane Cullen. ‘I also enjoyed the group learning sessions, which were an opportunity to hear how others in the Whakakotahi programme were putting the quality improvement tools into practice.’
Reweti says the Tū Mahi programme is now engaged with 17 workplaces and the home visits will continue to be offered to at-risk clients.
‘While we still need to perfect the way we go into the whare, because every whānau is unique, this project has shown us that there is an appetite for this approach.
‘We want to ensure there is real, evidence-based rigour to all of our programmes so that they are sustainable and have really appreciated the opportunity to turn this idea into tangible results. It has given us a lot of new tools to authenticate the work we’re doing and we’re already applying them to other Turanga Health projects.
‘One of these is looking at the whānau voice through three different lenses – customer satisfaction, improvement and intelligence – and we’ll be using the tools and experience gained through Whakakotahi to unlock that.’