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Video transcript: Improving Together - Improving physical health - Tangata Whaiora

English, 5 min 41 seconds.

Marie White - Registered Nurse

My name is Marie White and I work at Stanford House and I’ve been working here for 5 years as a registered nurse

The title of this project is Our Tangata Whaiora and Improving their Physical Health.

[Footage of staff working with clients]

The project's about develolping the emphasis around metabolic monitoring and how to improve it.

The purpose of the project is to include clients in a program with co-design and this includes our staff and clients working collectively together and learning how to work effectively with programmes and education and this is to be part of their recovery journey and moving on in the future, having hope.

The problems we wanted to solve at Stanford House included the increasing weight and obesity of clients, now this is generic to mental health for some patients and we actually looked at our clients and what best methods to reduce their weight.

[Footage of Stanford house both internal & external]

Peter De Roo - Clinical Nurse Manager

My name is Peter De Roo. I'm the clinical nurse manager here at Stanford House in Whanganui. So we’re situated on the hospital site, we are a 15 bed unit.

Right at the beginning of releasing time to care when we sat down with the clients and staff and we asked them what did they think of Stanford house? What did they think we do? Because that’s what our vision statement needed to reflect.

We had 3 meetings, the one that we ended up with was a safe place, we live, learn and grow in the wider community.

Marie White: Joe is a Maori and Samoan client at Stanford house. For this case study he has actually willingly come on board as a role model and he has been participating in the weight competition and the diabetes foot check for over 2 years now and he has had significant change.

[Footage of Joe working with staff]

The PDSA cycle is actually a tool and a cycle in itself is plan, do, study, act. The PDSA cycle was used to implement and change programmes and this is something I used as a quality initiative, and I linked them to 2 areas I thought required considerable change.

Joe has weight reduction of significant amount over the last 2 years and being a case manager I’ve actually included him in geneogram and meeting with his family, talking about his whole life and his family life and how we can best effectively work with him within the complex of this unit.

[Footage of Joe walking in the community, cooking his own meal and swimming at the acquatic centre]

He’s actually more motivated, more interested in activities, he’s walking – he now leaves the unit. Before when he arrived in this unit 3 years ago he actually didn’t want to leave the unit.

He is now able to walk more than 7 laps of the courtyard. That was his 1st stage and now he’s walking out in the community  for 30 minutes a day and effectively interested in swimming at the splash centre, moving around doing programmes of his choice  -and that can include singing, photography group, education, maori  learning and language.

So he’s actually participating in a wide range of aspects of education and cooking and learning about his diet which includes cooking his own meals now. And these are all part of his learning and improving his health and taking responsibility for his daily care.

The foot checks for clients just like Joe is because he’s high risk and concerns are these must be monitored and he’s jsut 1 of a unit of 15 clients and we actually check every single client and become part of that assessment on a 3 monthly check and then we can bring in the podiatrist.

The things that went well from the PDSA – change. The key issues were around our quality improvements. The weight reduction happened, the weight competition was successful, it’s become annual. The diabetes foot check, we brought about photography which wasn’t used ever before and this is actually showing change from those feet from a baseline taken to a change, and if they were issues we can address them straight away.

[Footage of staff and clients riding bikes]

The only thing I can say about going wrong, there was an odd occasion where a client would gain some weight slightly because they might be on unescorted leave, they go off on their bike to town and have their time, which they are allocated, and they’d come back after eating unhealthy foods and they’ll come back, they’d realise they made a mistake and they'd learn to fix it because it shows in due course on their weight graphs that they’ve been doing things wrong. Education comes in and they become more aware that it isn’t working for them so they have to change their own behaviours.

[Footage of graphs showing progress made]

The things that brought about change, and it brought about the act side, I want it to continue because I believe it works and I can see the results not just in the clients, the way they look physically, they lost weight, they’re actually checking their feet, I can see results in graphs and trends and changes and they’re all in the positive direction.

We can record that and share that within our quality team meetings the clients representatives attend them, they can tell us how they feel and they can see benefits of what we’re doing.

In this unit it’s about change, it’s about recovery journeys, and it’s about success and hope.

We think we’ve delivered that within our programmes and quality initiatives and improvements.

I would recommend the PDSA cycle, it’s important and to other services I’d recommend it by looking at what we’ve done and it’s worked.

Those things we’ve implemented, whether it be about weight competitions or diabetes and foot checks - we've given education - I think that’s priority and being able to look at the learning styles of our clients. Whatever the learning styles are, we work with those of each client and built it around there recovery care journey, their portfolios and that’s made the difference. 

[Footage of Joe and Marie walking down the driveway]

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