Jacqueline Schmidt-Busby - Middlemore Hospital, New Zealand - The Re-Working of Mainstream ACP...
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Transcript of Jacqueline Schmidt-Busby - Middlemore Hospital, New Zealand - The Re-Working of Mainstream ACP...
The Re-Working of Mainstream ACP Guidelines and Resources for Pacific Island Populations
Jacqueline Schmidt-BusbyKo Awatea
Counties Manukau District Health Board
Advance Care Planning ConferenceSydney Australia
2-3 May 2016
Contents
• Overview
• Background
• Re-working the Guidelines
• Re-working the Resources
• The Bigger Picture
Overview:
Asian (including Indian)Pacific
Māori
Guidelines for Northern Region
Overview:
of the Counties Manukau population are Pacific
16%
21%63%
Māori
Pacific
NZ Euro / Other
Population Profile
Overview:
16%
21%63%
MāoriNZ Euro / Other
76%
of the Pacific population live in severe deprivation
Population Profile
of the Counties Manukau population are Pacific
Pacific
Overview:
48%
16%
21%63%
MāoriNZ Euro / Other
76%
29%
23%
15-44 Yrs
65 + Yrs
45-64 Yrs
of the Pacific population have one or more LTC*
*Diabetes, gout, CVD, COPD, CHF, Asthma, Bronchiectasis
Population Profile
of the Counties Manukau population are Pacific
Pacific
of the Pacific population live in severe deprivation
Overview:
Manukau Surgical Centre
Localities
CMDHB
Middlemore Hospital Ko Awatea
16 Collaboratives
Manaaki Hauora Supporting Wellness
Campaign
Organisation Chart
Overview:
Manukau Surgical Centre
Localities
CMDHB
Middlemore Hospital Ko Awatea
16 Collaboratives
Manaaki Hauora Supporting Wellness
Campaign
Organisation Chart
Background:
Cook Island Niuean Samoan Tongan
2012 1 1
2013 5
2014 3 1 10 9
Number of advance care plans: Pacific Baseline data: Jan 2012 – Dec 2014
30
Baseline Data
Background:
Cultural factors play an important role on how conversations andactions surrounding death and dying are carried out.
Despite cultural similarities - each Pacific culture is unique;
different languages, customs, rituals and familial expectations
Cultural Differences
Background:
Current Advance Care Planning does not accommodate culturalperspectives, customs or traditions
…for Pacific peoples both as a collective groupand as individual island nations...
Inadequate Resources
Background:
To:
1. Define ACP for Pacific peoples
2. Improve experiences of Pacific patients and families
3. Re-position conversations within Pacific culture
Overall Aim
Background:
By:
1. Providing health workers with relevant information andguidance on cultural concerns relating to death and dyingfor Pacific peoples.
2. Increasing the conversations and awareness of AdvanceCare Plans within Pacific communities.
Overall Aim
Re-working the Guidelines
Re-working the Guidelines
• Which Pacific orientation?
• Cultural competency
• Framing of conversations
• Importance perception: conversation or documented plan?
• The audience
Considerations
Re-working the Guidelines
Which Orientation?
Re-working the Guidelines
An understanding and appreciation of cultural factors that allow effective clinical care
Cultural Competency
Re-working the Guidelines
Who are you?
Framing of Conversation Structure
Re-working the Guidelines
Conversation? OrDocumented plan?
Importance Perception
Re-working the Guidelines
Experienced, committed health workers
The Audience
Re-working the Guidelines
“All speech, written or spoken, is a dead language,until it finds a willing and prepared hearer”
Robert Louis Stevenson
Re-working the Resources
Tonga
Cook Islands
Niue
Samoa
For Who?
Re-working the Resources
What is Advance Care Planning?
Re-working the Resources
Simple Translation?
Re-working the Resources
Which Orientation (again)?
The Bigger Picture
Tongan Versions
Cook Island Versions
Samoan Versions
Niuean Versions
Advance Care Planning: Pasifika
Enabling conversations relies upon cultural awareness, sensitivity, communication and the inter-relationships between patients, families, communities and health workers.
Re-working guidelines and resources makes an important contribution to the provision of information and guidance for health workers, and the choices of treatment and care at the end of life for Tagata Pasifika – Pacific People.
Soifua ma ia manuia lavaJacqueline Schmidt-Busby
Advance Care Planning
(Pasifika)
Collaborative Team:
Expert Group: Fuimaono Karl Puloto-Endemann, Dr Margaret Southwick, Fakavamoeatu Lutui,To’a Fereti, Meg Goodman, Karlynne Earp, Suzanne Joseph, Sitela Vimahi, Jacqueline Schmidt-Busby
Working group: Fakavamoeatu Lutui, Karlynne Earp, Suitupe Sorensen, Meg Goodman, Sierra Faitua, Fakaola Otuafi, Kola Fue, Margaret Tuala,Vainakali Fonohea, Sorrel Renton-Green Jacqueline Schmidt-Busby
Sponsor: Geraint Martin / Denise Kivell
Clinical Lead: To’a Fereti
Project Lead: Jacqueline Schmidt-Busby