THO’s Achievements

Operating in high need and high deprivation areas of South and East Auckland, THO is a high performing PHO.

Here is a how THO measures on different best practice parameters internationally for high performing primary healthcare organisations:

Considered Best Practice	How do THO Providers measure up
Increase access, in particular reduce waiting times for appointments to same day if possible	No appointments necessaryAccess available from 8:00 am to 11:00 pm 7 days a week.
Undertake opportunistic provision of medical services/educationIdentify and treat as many conditions that a patient presents with as possible.	Opportunistic care for THO patients is fundamental to its operations.THO Offers a variety of programmes that meet the variety of conditions that a patient may present at its practices.
Empower the patient through self management education (SME)	THO has staff who have achieved SME Master Trainer status and a number of SME courses are available.
Utilise workforce other than the GP to work with the patient – team based care	THO Pathway of care includes – • Opportunistic care involving all of the primary care team including – CHW, Receptionist, Clinical Assistants, Nurses and GPs. • The patient visit invariably includes screening, education, health promotion, diagnosis, treatment, reinforcement of self care strategies, medication compliance
Phone/computer/web visits/group visits/follow ups	• Cell phone texting for follow ups and recalls is being trialled.• THO has the largest real-time LAN IT infrastructure for Electronic Record Management enabling superior service delivery to an enrolee population that is mobile. This infrastructure enables the complete visibility of patient flow/demands of all practices at any time. • Dedicated staff monitor and review the fluctuant patient flow and provide immediate clinical/management support from a resource pool of doctors, nurses and operations staff.

 

In 2008, THO underwent an independent audit by Health Share commissioned by the DHB. The auditors reported:

 

 

FROM THE EXECUTIVE SUMMARY

“Overview

All programmes delivered by THO were supported by comprehensive planning, including a documented business plan, health promotion plans and a Māori health plan. The Māori Health Action Plan had been developed in consultation with Māori. The Chairman of the THO Board was Māori and led the development of the plan in consultation with the General Manager for Māori Health, CMDHB.

 

THO staff represented a number of ethnic groups within the local community and spoke a number of languages.

 

Translation services were available. Additional cultural support was available by referral to community health workers and health promotion programmes at Otara Health Incorporated (OHI). Community health workers included people of Māori, Pacific and Indian cultures.

 

Robust monitoring processes were in place to ensure that patient outcomes met best practice requirements and that all programmes met or exceeded the requirements of the agreements.

 

Performance monitoring data was shared between CMDHB and the THO on a regular basis.

 

There were no high risk issues identified.

 

…… Total Healthcare Otara met the terms of the audited Agreements. It was evident that THO and its subcontractors had sound, active governance, business and healthcare management systems and processes, and worked closely with their community to ensure that services are safe, effective and accessible to their high needs population.

 

THO focussed on providing accessible, affordable primary health care to the majority high needs population in its catchment area. At the time of audit, THO had an enrolled population of approximately 81,000, of which, 54% were Pacific Island people and 15% were Māori.

 

The PHO demonstrated well developed governance, business and healthcare management systems and processes. Particular strengths were:

Strategies to remove barriers to access by low socio-economic people, such as:

·        Walk in service with no appointments required;

·        A three (3) stage triage and patient care system;

·        Low fee structure;

·        Clinics located in shopping centres with adjacent public transport;

·        An integrated patient register across all clinics so patients could access;

·        Subsidised care at any clinic in the group; and

·        Availability of cultural support provided by the Community Health Workers.

 

A collegiate model of care with nurses providing all first level assessment, care, and follow up, and doctors providing medical assessment, diagnosis and treatment, enabled reduced waiting times, opportunistic review of patients’ full health profiles and high through put through clinics.

 

Active community participation through OHI and its wide community networks.

Māori Health and Pacific Health Plans and strategies that address local population health needs.

 

·        50% community participation at governance level.

·        Strong administration and clinical support systems and networks.

·        Comprehensive integrated IT patient management systems.

·        Robust monitoring and quality improvement systems.

 

THO operated a sound financial and business management principles and practices evident with the number of sub-committees it had put in place to strengthen its governance and policy development aspects.     “

that all programmes delivered by its providers (ETHC) were supported by comprehensive planning, including a documented business plan, health promotion plans and a Māori health plan.

.

Robust monitoring processes were found to be in place to ensure that patient outcomes met best practice requirements and that all programmes met or exceeded the requirements of the agreements.

 

Performance monitoring data was shared between CMDHB and THO on a regular basis.

There were no high risk issues identified.

 

The report went on to state that Total Healthcare Otara met the terms of the audited Agreements. It was evident that THO and its subcontractors had sound, active governance, business and healthcare management systems and processes, and worked closely with their community to ensure that services are safe, effective and accessible to their high needs population.

 

THO (through ETHC) focuses on providing accessible, affordable primary health care to the majority high needs population in its catchment area.

 

At the time of audit, THO had an enrolled population of approximately 81,000, of which, 54% were Pacific Island people and 15% were Māori.

 

The PHO through its contracted providers demonstrated well developed governance, business and healthcare management systems and processes. Particular strengths identified included:

 

·        Strategies to remove barriers to access by low socio-economic people, such as:

o   Walk in service with no appointments required;

o   A three (3) stage triage and patient care system;

o   Low fee structure;

·        Clinics located in shopping centres with adjacent public transport;

·        An integrated patient register across all clinics so patients could access;

·        Subsidised care at any clinic in the group; and

·        Availability of cultural support.

·        A collegiate model of care with nurses providing all first level assessment, care, and follow up, and doctors providing medical assessment, diagnosis and treatment, enabled reduced waiting times, opportunistic review of patients’ full health profiles and high through put through clinics.

·        Active community participation.

·        Strong administration and clinical support systems and networks.

·        Comprehensive integrated IT patient management systems.

·        Robust monitoring and quality improvement systems.

 

THO and its Board are secure in the knowledge that ETHC operate sound financial and business management principles and practices and we wish them well in their application for a well deserved acknowledgement  “

 A recently released study presented to the CMDHB PHO and DHB Managers group (GPHO) undertaken by Sonia van Gessel Public Health Registrar Counties Manukau District Health Board, confirms that THO’s provider group (ETHC) is highly sought after by patients across the region.

 

It shows that our (Otara) practices cope with twice as many enrolled relative to its number of residents with a high number of patients attending from outside of Otara to access its services.

 

This is likely to be due to the fact it offers low cost ($10 for over 18s, under 18 free) after hours provision (8:am to 11 pm 7 days a week) and that we utilize a broad workforce to triage and treat high patient volumes (clinical assistants, nurses and GPs).

 

As you know, barriers to access are removed through –

·        Walk in service with no appointments required;

·        A three stage triage and patient care system;

·        Low fee structure;

·        Clinics located in shopping centres with adjacent public transport;

·        An integrated information technology system across all clinics so patients notes are accessible no matter which THO clinic they attend;

·        Subsidised care at any clinic in the group