Published: 28 January, 2022
Today we resume our Best Practice Bulletins for the year, brought to you twice monthly. We have some great topics in store for you over the next few months and we are excited about some new products we have been working on behind the scenes. We would love to hear from our readers to see what topics you would like us to cover this year, what type of resources you would like to see more of and any other feedback you have. We are here to support you over the coming months as together we stride into uncharted territories for health care in New Zealand.
Email your feedback to firstname.lastname@example.org
COVID-19 Māori health protection plan
The Ministry of Health has published an updated framework to help guide the health and disability system actions for Māori for the next three to six months of the COVID-19 pandemic response.
The focus is on two key outcomes:
- Increase vaccine coverage among Māori
- Build the resilience of Māori health and disability service providers and Māori to respond to the changing environment of the pandemic and the "long tail" of the impact of COVID-19 on the health and wellbeing of Māori
This plan aligns with the broader COVID-19 pandemic response for New Zealand, including mitigating the social effects of the pandemic. The document contains strategies, insights and key Māori health statistics in relation to COVID-19 through to mid-December, 2020. N.B. The protection plan was published prior to the emergence of the omicron COVID-19 strain in New Zealand, and while the delta strain was most prevalent.
Read the full report here.
New Zealand Melanoma Summit
12th – 13th February, 2022
After the postponement of the Melanoma Summit in September last year, and due to the ongoing uncertainty around larger in-person events, the MelNet Executive Committee has made the decision to hold the Summit as a virtual conference.
The Summit will focus on the changing landscape of melanoma care in New Zealand and proactive, collaborative action to improve our high incidence rates. The two-day multidisciplinary meeting includes a line-up of internationally recognised experts, interactive workshops on prevention, diagnosis, clinical management and research, and the official launch of the Quality Statements to Guide Melanoma Diagnosis and Care in New Zealand. Primary care health professionals are encouraged to be part of this important conversation, improve your knowledge of best practice melanoma care and connect with other health professionals with the same interest.
Click here for further information and to register
For latest information on the prevention, early detection and follow up of people with melanoma, see: https://bpac.org.nz/cancer-care#skin
Reminder about patient privacy when sharing information electronically
You have a problem with your computer, the programme just won't load properly, what do you do? That's right, you remember you have that IT guy who always fixes things for you. You take a screenshot of the issue and flick it off to him via email and sit back and wait for the response. The IT guy gets your email but he hasn’t seen this problem before, so he forwards it to his colleague who then sends it out to his team to troubleshoot the issue. In no time, a solution comes back, and you are sorted and up and running again. The only problem is that when you sent that screenshot, it contained identifiable details of the patient on your screen, and now at least ten other external, non-clinical people have seen it too and this information is sitting in their inboxes, with no guarantee of where it goes next.
This is just one example of the many scenarios in which inadvertent sharing of patient information, or another breach of privacy, may occur. With our increasing reliance on electronic rather than face-to-face communication, more of these errors are likely to occur and we have to think carefully about the information that we are sending and who is receiving it. What is your practice policy on this?
The Medical Council of New Zealand has issued guidance for clinicians on use of the internet and electronic communications.
Key points include:
- Any health information transmitted electronically must comply with the Health Information Privacy Code 2020
- Be aware of information shared on social media that can be accessed by members of the public; in private groups, you should seek permission from the patient before sharing clinical information, even if non-identifiable
- You need to first seek permission from a patient if you wish to view their online profile or website, and verify any information before using it to inform clinical decisions or entering it into the patient's record
- If you agree to communicate with patients via email or other electronic means, set expectations for this, e.g. not to use email if urgent advice is required. Often people may have non-exclusive access to the email address they use – check before sending sensitive information via email that this is ok.
Medicine supply information in the NZF
It can be challenging to keep up to date with the myriad of medicine supply issues and changes to brands, especially in the current environment of pandemic-related shipping and manufacturing delays. The New Zealand Formulary contains up to date information on any PHARMAC supply issues affecting funded medicines. This is displayed in a blue box at the top of the relevant medicine monograph, with a link to the PHARMAC website for further information. So, if you are uncertain about the status of a medicine, enter it into the search bar on NZF and see what formulations are available to prescribe and if there is anything else you should know, including important interactions and dosing information for specific patient groups.
Minister of Health Volunteer awards
If you are looking for a feel-good story for the week, look no further! Profiles of the winners of the 2021 Minister of Health Volunteer Awards, which took place in August last year, have recently been added to the Ministry of Health website. The honourable title of Health volunteer of the year was awarded to Mr Hughie Hughes who has dedicated both his time and financial support to the St John health shuttle service on the East Coast for the past 60 years. When a local medical centre burnt down in 2017, he donated two cars to the community to enable patients to travel to neighbouring towns to receive healthcare – he even takes care of the registration, servicing and petrol! The team award was taken out by Buddies Peer Support Service who have been serving the Wellington and Hutt communities for the past 20 years. Buddies volunteers support people experiencing mental health crises and share their lived experience of recovery and coping strategies.
Click here to read more about these local heroes and all of the other outstanding award recipients.
Paper of the Week: Staying psychologically safe as a doctor during the COVID-19 pandemic
As we prepare ourselves for the onslaught of omicron throughout New Zealand, a group of primary care clinicians*, mostly from countries who have faced a larger burden of disease, share their insights and recommendations on how doctors, and indeed any front-line healthcare workers, can keep their mental health and wellbeing in check during the pandemic.
The article published in the BMJ Family Medicine and Community Health Journal in January, 2022, acknowledges that in the current environment doctors are at significant risk of burn-out due to large, often unmanageable workloads, lack of resources, increased responsibility and uncertainty. Burnout manifests as emotional and/or physical exhaustion, lack of ability or motivation to accomplish tasks and depersonalisation (i.e. feeling disconnected or a sense of detachment from yourself). Among those who manage to remain resilient at work, many may revert to this dysfunction at home and not be able to adequately provide emotional support to their family and loved ones.
"The COVID-19 pandemic is ‘not a sprint but a marathon’, and we need to ensure that our minds and bodies are healthy enough to endure".
The authors propose five principles of self-care that we have
summarised as follows:
- Preparation – it is difficult to suggest eight hours of sleep a night, a nutritious diet and plenty of exercise to build resilience, when in reality everyone is stressed, working long hours and run off their feet, but at the least, try to find a way to "switch-off" during the downtime that you do have and optimise your quality of sleep. Get a plan in place for any help you may need to juggle family commitments.
- Protection – you alone cannot control the spread of omicron, but take comfort in the things you can control, such as getting your booster vaccination, being vigilant with your personal protection strategies both during work and out in the community, and setting boundaries for where you choose to go and who you choose to see
- Professionalism – don't get caught in the rabbit hole, always maintain an evidence-based stance and respectfully correct any misinformation, try to avoid constant viewing of sensational news reports that make you fearful or anxious
- Promotion – be a role model for others, lead by example, work together and look after each other; promote hopefulness as hopelessness is contagious
- Pathway of care – if you are struggling with your mental health and wellbeing, be a patient, not a doctor, and seek assistance; if your patient is a doctor, run through the same things you would with any patient, reassure them about confidentiality, ask the difficult questions, share the decisions but maintain your stance as the treating doctor
* All but one of the authors are members of the World Organization of Family Doctors (WONCA) Working Party for Mental Health.
Read the full article here: Benson J, Sexton R, Dowrick C et al. Staying psychologically safe as a doctor during the COVID-19 pandemic. Fam Med Comm Health 2022;10:e001553.
This Bulletin is supported by the South Link Education Trust
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