Co-design of youth appropriate services for young people with rheumatic fever/rheumatic heart disease in Counties Manukau District.

AIM: To co-design a rheumatic fever service model which enables young people with acute rheumatic fever/rheumatic heart disease (ARF/RHD) and their families to access the health and wellbeing services they need. METHOD: Co-design, a collaborative and participatory approach, was used to gather experiences and ideas from 21 consumers and 30 health professionals. Thematic analysis was undertaken. RESULTS: Maori and Pacific patients and their whanau/aiga identified the importance of whanau/aiga support and involvement throughout their ARF/RHD journey. They described that the way care was delivered was often frustrating, fragmented and lacked effective communication. Participants expressed the need for information to improve their understanding of ARF/RHD. Health professionals identified the need for better continuity of care and felt that they were currently working siloed from other professionals with little visibility of other roles or opportunity for collaboration. The ideas for improvement were grouped into themes and resulted in development and prototyping of peer support groups, patient and staff education resources, clinical dashboard and pathway development, and an enhanced model of care for delivery to patients receiving penicillin prophylaxis. CONCLUSION: The co-design process enabled consumers and staff of ARF/RHD services to share experiences, identify ideas for improvement, co-design prototypes and test initiatives to better support the needs of those delivering and receiving ARF/RHD services.

Facilitators, barriers and opportunities in workplace wellbeing: A national survey of emergency department staff.

INTRODUCTION: Emergency department (ED) staff face daily exposure to the illness, injury, intoxication, violence and distress of others. Rates of clinician burnout are high and associated with poor patient outcomes. This study sought to measure the prevalence of burnout in ED personnel as well as determine the important facilitators of and barriers to workplace wellbeing. METHOD: An anonymous online survey including six open-ended questions on workplace wellbeing was completed by 1372 volunteer participants employed as nurses, doctors, allied health or nonclinical roles at 22 EDs in Aotearoa, New Zealand in 2020. Responses to the questions were analysed using a general inductive approach. RESULTS: The three key themes that characterise what matters most to participants' workplace wellbeing are: (1) Supportive team culture (2) Delivering excellent patient-centred care and (3) Professional development opportunities. Opportunities to improve wellbeing also focused on enhancements in these three areas. CONCLUSION: In order to optimise workplace wellbeing, emergency departments staff value adequate resourcing for high-quality patient care, supportive and cohesive teams and professional development opportunities. Initiatives in these areas may facilitate staff wellbeing as well as improving safety and quality of patient care.

Health literacy of Samoan mothers and their experiences with health professionals.

INTRODUCTION Patient and health professional engagement is a crucial factor for the effectiveness of service delivery and the management of care. Low health literacy amongst Pacific peoples is likely to affect their engagement with health professionals. AIM To explore the health literacy of Samoan mothers and their experiences with health professionals in primary care. METHODS Twenty Samoan mothers and caregivers living in Auckland were interviewed about their experiences when engaging with health professionals. Semi-structured interviews guided by open-ended questions were conducted with individual participants in either Samoan or English. The interviews were recorded, transcribed and analysed. RESULTS A key finding was the significance of the health professionals' role, in particular general practitioners, in providing resources and information to participants. Many participants recognised their general practitioner as their primary source of information. The findings revealed the negative experiences participants faced while engaging with general practitioners and shared how this affected their ability to manage care. Themes about enablers of open communication with health professionals included mothers understanding their rights as patients and being acknowledged as an expert on their child's health. Themes about barriers to open communication with health professionals included limited consultation time, language barriers, medical jargon, closed answers, power relations and the shame associated with not fully understanding. DISCUSSION This research can inform health care engagement practices with patients. This study is relevant to health-care providers, development of health resources, health researchers evaluating health-care communications between providers and patients, to inform culturally appropriate and effective health-care delivery. The importance of shared responsibility in addressing issues of health literacy is noted, shifting the focus to everyone involved in providing and receiving information and in making decisions and managing care.

Workplace wellbeing in an urban emergency department in Aotearoa New Zealand.

OBJECTIVES: Staff wellbeing is important for individuals and considered integral to the development and maintenance of high performing health systems. Unless baseline parameters of wellbeing are known, the effects of any interventions to improve staff wellbeing will remain uncertain. By clarifying staff perceptions and objective measures of important factors related to wellbeing, our primary goal was to assess the baseline wellbeing of staff in our central city ED. METHODS: A survey template, the WoWe@AED (Workplace Wellbeing at the Adult Emergency Department) was developed from several sources. Burnout was measured using the Copenhagen Burnout Inventory. Inclusion in the survey required that participants worked in our ED, all staff groups were eligible. The electronic survey was conducted between 22 January and 5 February 2018. Quantitative and qualitative data were analysed. RESULTS: Two hundred and seventy (71.1%) of 380 potential participants participated. All staff groups were represented. About 72.4% agreed/strongly agreed that Adult Emergency Department was an excellent place to work, 80.7% found their work meaningful. About 42.0% felt well informed regarding important decisions. One hundred and eighty-three (48.2%) out of 380 completed the Copenhagen Burnout Inventory. Overall, personal burnout was 42.1% (n = 77), work-related burnout was 35% (n = 64) and client-related burnout was 27.9% (n = 51). Females were significantly (<0.05) more likely to have burnout in some or all domains. Four key themes were identified: supportive teamwork and relationships; providing high quality patient care; resourcing; and workload issues. CONCLUSIONS: Baseline indices of wellbeing of the frontline staff in a central city ED have been documented. These have informed wellbeing interventions. Future measures can be compared against these data.