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Nurse Maude is leading the way in community-based collaborative care in Christchurch. Its nurse-led model could become a blueprint for other community-based services in New Zealand.
For 117 years, Nurse Maude (NM) has been delivering community nursing services in Christchurch, supporting people to stay out of hospital and remain living as independently and as long as possible in their own homes, with an emphasis on self-care.
When Matron Sybilla Maude left Christchurch Hospital in 1896 to establish a district nursing service within two parishes in the city - the very first community nursing service in New Zealand - she could never have imagined how big the service was destined to grow.
Today, says director of nursing Sheree East, NM employs more than 1100 staff, including 100 district nurses (DNs)and 600 support workers in its home-care service; runs a 40bed aged-care hospital and an 11-bed hospice; has developed a variety of specialty nursing services (eg continence, stomal and wound care, diabetes and school-based nursing); has contact with around 14,000 patients a year and provides 700,000 episodes of care. Forty per cent of patients are aged over 85 and more than half have multiple co-morbidities. Nearly a third of patients are involved with three or more NM services.
"The community patients we care for are increasingly older, sicker and more complex to look after," East said. "This has meant developing new service models to help them remain safely in the community and to avoid unnecessary hospital admissions."
NM prides itself on its autonomy and public health perspective which, staff say, are the keys to its success. It also claims to have developed a more comprehensive spectrum of community nursing services than anywhere else in New Zealand. Service collaboration is another key focus for the organisation. The not-for-profit service has a real commitment to working in partnership with general practices, hospitals and other health and homecare providers.
"Canterbury District Health Board [DHB] expects all services - hospital, primary and community - will work together for the benefit of patients, avoiding unnecessary admissions and managing acute patients without duplicating services," said East. "Key to this collaboration is the Canterbury Clinical Network through which multi-health providers work on various integration projects targeted at DHB priorities. Much of this work...