Surgical teams and clinicians are being called to address equity for Māori by the Perioperative Mortality Review Committee.
The committee reviews deaths related to surgery and anaesthesia that occur within 30 days of an operation. It advises the Health Quality & Safety Commission on how to reduce these deaths and makes recommendations to make surgery safer for patients.
Its eighth report, published today, analyses perioperative mortality on surgical outcomes for Māori following acute laparotomy.
Laparotomy is a surgical incision into the abdomen, for diagnosis or in preparation for major surgery. The procedure is required to deal with surgical emergencies and is associated with high mortality. Patients requiring this type of urgent surgery are at risk of complications.
The report makes recommendations on improvements to Māori surgical outcomes, including committing to Te Tiriti o Waitangi to achieve equitable outcomes for Māori.
The report also recommends surgical staff undertake training on Te Tiriti, anti-racism, cultural safety and competency.
Committee chair Dr Tony Williams says this is a situation that will require the collective effort of the whole health system to redress.
‘Surgical teams may feel there is little they can do – but the reality is we all share the responsibility to improve outcomes. I think we must all reflect on our own practice, because treating people as we always have done will lead to the results we have always seen.’
Dr Maxine Ronald (Nga Puhi and Ngati Wai), member of the committee, says whānau have an extremely important role to play in supporting the hauora of the patient.
‘Patients and their whānau should be listened to without judgement and be included in the management of their health care.
‘Advocate for a proactive health care management plan to meet your needs as the patient and whānau.’
She says patients and whānau can also request:
- an assessment before the surgery of the risks of the surgery and any risk of death
- surgery to be offered within an appropriate timeframe
- both a consultant surgeon and consultant anaesthetist provide input prior to surgery
- a senior clinician to be present during the operation especially if the patient is high risk
- the admission to a critical care facility following surgery
- being given the opportunity to discuss appropriate goals of care.
Consumer advisors to the committee, Rob Vigor Brown and Sheldon Ngatai, say it is the committee’s desire to drive change in the health system to achieve equity in the surgical health outcomes for Māori.
‘This will require ongoing and substantially improved culturally-safe communication from clinicians, alongside patients and whānau, so that all are connecting throughout the patient’s journey to wellness.’