New patient and family escalation pathway to be rolled out at Dunedin and Invercargill hospitals

A new patient and family escalation pathway will soon be available at Dunedin and Invercargill hospitals.

Kōrero Mai is a three-step process that a patient or their whānau can use if they are worried that they or their loved one are becoming more unwell.

The service is in place in some other hospitals around New Zealand and will be launched at Dunedin Hospital on Monday and Invercargill Hospital on Tuesday.

Health NZ Southern Director of Quality and Clinical Governance Solutions Dr Hywel Lloyd says the service will strengthen existing processes in place to escalate care when required.

However, this service, which was co-designed alongside health users, community groups, and hospital staff, will give a greater voice to patients and their whānau.

“We are continuously looking at how we can improve our quality processes and to have systems in place that give patients and their families a voice in their care,” Dr Lloyd says.

“This service is focused on the condition of patients who may be deteriorating and listening to the people who know them best – their family.”

Dr Lloyd says the new service acknowledges the important role of whānau in recognising changes in a person’s health condition.

“It is our hope that people will feel comfortable using Kōrero Mai and assist in identifying deteriorating conditions in patients.”

The first step for escalating care is relaying concerns to the nurse who is caring for the patient.

If the patient or family member do not feel they have been heard, and there are still concerns about a patient’s condition, this can be escalated to the nurse in charge of the shift.

Finally, a Kōrero Mai call can be made to the hospital’s 24/7 Patient at Risk team, who will assess the patient and decide on appropriate next steps.

Kōrero Mai was developed as part of the Health Quality and Safety Commission’s Patient Deterioration Programme.

It is co-designed with communities and hospital staff to meet the specific needs of respective areas.

The process to introduce Kōrero Mai to Invercargill and Dunedin hospitals began following a Health and Disability Commissioner report released in early 2022, that looked into the passing of a patient in Dunedin Hospital in 2019. That patient’s daughter, Tania Henwood, has been heavily involved in this process.

At the time of the report’s release, Kōrero Mai was only in place in the Waitematā, Canterbury, and Capital and Coast district health board areas. It has since been introduced in various other hospitals across New Zealand.

It was introduced in Dunedin and Invercargill following extensive consultation with community groups, health users, and hospital staff, as well as trials of the new system and education for health professionals on how to use it.

Henwood says being involved in the co-design process was bittersweet, but she is delighted the service will soon be rolled out locally.

“It’s so important family members know that what they know, matters.”

Henwood says the hospital setting was unfamiliar and confusing when she was there with her mum.

“I had no idea what was best for my mum, but I knew her best, and that was critically important information.

“My hope is Kōrero Mai is an avenue for patients and whānau to voice their concerns, and for health professionals to be able to take a step back, see the wood from the trees, and understand why whānau are concerned, because ultimately, I truly believe we all want the same thing, to give and receive the best care possible.

“Being part of this group has been very cathartic, and allowed me to gain an appreciation of the importance of trying to make this as accessible as possible for everyone, and accepted as an important tool in a health professional’s tool bag.”