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Kia āta kōwhiri Choosing Wisely

The Choosing Wisely campaign seeks to reduce harm from unnecessary and low-value tests and treatment.

Measuring is about checking how effective improvements have been. Some Kōrero mai teams have connected with other teams, such as the quality team, to help with measurement. Kōrero mai teams have used many different data sources to compare the situation before and after the co-design improvements:

  • regularly collected data, for example, from routine consumer and family satisfaction surveys and analysis of early warning score activations
  • repeating the data collection done when at the ‘Capture’ stage, such as observation of staff interactions with consumers and family and whānau, and interviews with staff and consumers
  • data from use of the call bell, and the daily log of any consumer, family and whānau escalations made directly to the charge nurse manager or nurse in charge.

Because some of the data will have been generated by the improvement there will not be a baseline.

What other hospital Kōrero mai teams have found

‘You can talk to me’ stickers and face-to-face communication have been the most effective tools for promoting the Kōrero mai escalation process to patients and their family and whānau. Posters and brochures have been the least effective interventions. For example, at one site, most people did not recall seeing posters. Of those who received a brochure, most could not remember the content. Audits of 0800 numbers and call bells showed few escalations of concern over the measurement period (often four weeks).

From these findings, Kōrero mai teams have developed improvement strategies. These include a focus on face-to-face communication about Kōrero mai and the services available in the hospital. For example:

  • training nurses, reception staff and volunteers to communicate how patients, family and whānau can escalate concerns
  • putting written information about Kōrero mai in places where people may be more likely to read it, for example, in whānau rooms, lifts and bathrooms or when connecting to the DHB’s wi-fi
  • redesigning posters and stickers for better visibility
  • putting the Kōrero mai message on a business card for family and whānau to take away with them.

Downloadable examples and resources from Waitematā DHB’s case study

  • Waitematā DHB approach to measurement (pp 12-13)
  • Waitematā DHB call bell audit template & results (page 25)
  • Waitematā DHB Charge Nurse Manager escalation log template & results (page 33)
  • Waitematā DHB patient survey questionnaire (pp 26-28)
  • Waitematā DHB family/whānau survey questionnaire (pp 29-31)
  • Waitematā DHB call log template (page 32)
Last updated: 13th November, 2021