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At the resilient health care hui in November 2021, the Commission was gifted a te reo Māori name that encapsulates the concepts of resilient health care in Aotearoa. Toki (Adze) is the metaphor for resilient health care. A toki represents strength, determination and courage in times of diversity. Ngao matariki (precision work) represents the relationship between the Crown and Māori to grow and foster strong partnerships.

He toki ngao matariki Aotearoa demonstrates how we have changed our focus over recent years to better reflect the many ways in which work is performed by humans, incorporating an understanding of human factors and ergonomics, and resilient health care principles. 

  • Health care is a complex adaptive system that operates in the setting of volatility, uncertainty, complexity and ambiguity. All levels of this system influence one other to create political, regulatory, financial, clinical and cultural outcomes. 
  • Safety arises from the ability to adapt flexibly to changing conditions, such as clinical demands, different contexts, innovations and new threats. 
  • People within the system are the key resource for this adaptability, building on the relationships and expertise from working within that setting that develop over time. 
  • System design should support the realities people face, whether in their work setting (health care staff) or in their daily lives. 

He toki ngao matariki Aotearoa is defined as the capacity to adapt to challenges and changes at different system levels and to maintain high-quality care where relationships are integral. Resilient health care recognises the whole system, the dynamic, independent and inter-dependent relationships that make up the system and the emergent behaviours within that system.  

The team works closely with Ahuahu Kaunuku (the Commission’s Māori health outcomes team), external experts and the health sector in the development of resilient health care in Aotearoa.  

Last updated: 9th March 2022