Communication boosts Maori attendance to clinics, DHB finds

GREYMOUTH: The number of Maori patients who fail to show up for outpatient clinics on the West Coast has dropped to a historic low as a result of what staff say is an ‘‘embarrassingly simple’’ intervention.

The West Coast District Health Board Maori health team has been working for the past three months with the Te Nikau Hospital central booking unit in Greymouth on reducing the didnotattend (DNA) rate for tangata whenua.

At times that has been as high as 18% of Maori patients, and the rate has rarely dropped below 10%.

Hauora Maori portfolio manager Marian Smith said the noshows in October were down to a mere 1.5%.

‘‘We are so stoked about this result.

‘‘It’s something to be really proud of for all the staff involved and it shows you can make a big difference in health equity with a fairly small intervention, if you’re consistent, and diligent,’’ Ms Smith said.

Booking staff and the Maori health team had focused on communicating with patients to find out why they had not turned up and how they could help them get to appointments, she said.

‘‘The most common reason was whanau and social issues . . . If mum had to look after kids and couldn’t get to the hospital, or there was no money for petrol that week, or no car or credit on the phone.’’

Transience was another factor —17% of patients never received their appointment letter because they had moved, and 12% simply forgot.

‘‘But the key was talking to them . . . not giving up on them but following up and working out how we could make it happen, with help from a friend or a community organisation.’’

The project’s success had inspired the team to take the same approach with other noshows, although the DNA rate for nonMaori was much lower at about 3%4%, Ms Smith said.

The clinics with the highest number of noshows were usually ear, nose and throat; gynaecology; and paediatrics.

The Maori health team also reported progress in another equity indicator — the number of staff registering their ethnicity with the DHB.

DHBs needed to know how many of their staff were Maori and Pasifika, and how many had disabilities, to meet the Government’s equity targets.

Hauora Maori manager Gary Coghlan said at the DHB meeting in Greymouth last week the goal was to match the percentage of those groups in the health workforce to the numbers in the community by 2030.

‘‘We have had high numbers of staff whose ethnicity we don’t know for whatever reason, and some of that is down to people thinking it’s irrelevant, or not wanting to say. And if we don’t know, we can’t see how we are meeting the targets.’’

In the latest survey, those ‘‘don’t know’’ figures had dropped by 20%, one of the best results in the country, Mr Coghlan said.

Some 6.4% of the West Coast health workforce was registered as Maori, compared with about 14% of the region’s population.

The Maori health team’s Kia Ora Hauora programme, which gives Maori secondary pupils a week working alongside health professionals, was paying dividends, he said.

‘‘Twentyfive percent of those kids have gone on to careers in health — we have to make sure we retain them, make them welcome, show manaakitanga and connect them with other Maori staff.’’

West Coast DHB chairman Rick Barker said that was pleasing, but the board had to make more effort to grow that figure and would welcome any ideas for attracting more young Maori into health careers.

‘‘We have until 2030 to meet the target.

‘‘We could always up the numbers by hiring more Maori cooks and cleaners, but that is not the goal. ‘‘It takes time to get people through medical training; nine years is not a lot of time for that,’’ Mr Barker said.

❛ . . . you can make a big difference in health equity with

a fairly small intervention