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Home / Hawkes Bay Today

Simple change in process proves transformational

By Nicki Harper
Reporter·Hawkes Bay Today·
1 Dec, 2017 10:00 PM4 mins to read

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Registered nurse Julia Glentworth (left), Dr Elaine White, and Communities, Women and Children service director Claire Caddie receive their Hawke's Bay Health Awards supreme award. Photo / Duncan Brown

Registered nurse Julia Glentworth (left), Dr Elaine White, and Communities, Women and Children service director Claire Caddie receive their Hawke's Bay Health Awards supreme award. Photo / Duncan Brown

This year's Hawke's Bay Health Awards supreme winners have not stopped smiling since being recognised for their achievement at last week's award ceremony.

Dr Elaine White and registered nurse Julia Glentworth work in Hawke's Bay Hospital's gynaecology department and received the Royston Hospital, Acurity supreme award for a simple, cost-effective innovation, which has sped up the diagnosis of the women referred to them, bringing piece of mind to many.

There was a certain amount of No 8 wire, Kiwi ingenuity involved in the process, said Dr White, who hails from Scotland, and supported by Mrs Glentworth, presented a proposal to pilot a rapid access outpatient hysteroscopy clinic at the Hawke's Bay DHB in May last year.

About 900 women were referred to the DHB's gynaecology service with abnormal bleeding each year and of those around 100 were prioritised as "see immediately, high suspicion of cancer" requiring an initial specialist appointment within two weeks, said Mrs Glentworth.

Traditionally referrals to the service were waiting weeks to be seen and faster cancer treatment targets were not being met due to high risk urgent referrals requiring priority over others.

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Dr White said the women faced potentially four appointments - the referral, undergoing a general anaesthetic, a pre-operation anaesthetic clinic review, and at least one day off work or from their normal lives.

That was where the innovative thinking came in.

"After discussions with the company representative that serviced our existing colposcope we realised we could use the colposcope camera, light source and screen and the only piece of equipment we needed to buy was the hysteroscope itself," said Dr White.

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At a cost of $15,000, it was a saving on what could have potentially cost between $45,000 and $60,000 and it had radically improved the experience of the patients referred to them.

"The patient feedback has been really positive," said Mrs Glentworth.

"The patient turns up on the day of the appointment, and through using the hysteroscope we are able to reassure them within half an hour that everything will be okay and they are discharged, or we make a more formalised plan if things need more investigation."

Dr White added that friends and whanau could come into the examination room as well if the patient wanted that.

For the minority of women who had something abnormal detected, they were able to see the screen themselves during the examination and discuss what they were seeing, and prepare themselves for a potential cancer diagnosis.

"When they get the results in a week to 10 days they are already anticipating what's coming and are more ready to discuss further treatment," Dr White said.

The cost savings for the DHB had been significant, saving $2177 per case, and as of July this year, the team had performed 60 outpatient hysteroscopy procedures at a cost saving of $130,000 to the DHB.

The only unit in the country to have employed such a procedure, Mrs Glentworth said it had already caught the attention of two other DHBs who were keen to come and see for themselves how the system operated.

Communities, women and children's directorate service director Claire Caddie, who oversaw and supported the process, said the team was excited and stunned to receive the supreme award.

"What it showed was how a small change of practice could have a significant impact on the women who come to this service."

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Hawke's Bay DHB chief executive Kevin Snee congratulated the team, and said that while he was not a judge of the awards, he could see the innovation was transformational for the hundreds of women involved.

This was the seventh year that the Hawke's Bay Health Awards had been held, and it was a great way to recognise the hard work being done in the health sector, especially this year, he said.

"People in the wider health system have worked pretty hard all year.

"We have had problems with the Havelock North water crisis, junior doctors' strikes, and a few fiscal constraints - basically the worst things we have faced for a while, so it was particularly good for us to showcase some of the really good things that have been going on locally."

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