Dot triumphant: Dot has had o dizzying rise through the corporate ranks at her district health board. And her son-substitute Kone has carved out a highly successful career there too. They're both truly inspirational and are enjoying the fruits of their success. MUSING ON NURSING

Kai Tiaki: Nursing New Zealand, August, 2008 by Chris Cottingham

"You want complaints? Try lumbago."

-- Old stand up comic joke

Those of you who can be bothered will remember the story of Dot. (1) She's Louise the Lecturers Mum, who has risen from Manager, DHB Spatial Resource Services to Manager, DHB Projects, Innovations and Support Systems (PISS).

The Te Henga Section of the Nurses' Marxist Union has occasional Field Trips to explore the results of our viciously exploitative capitalist socio-economic systems on the down-trodden proletariat.

Dot was kind enough to show us round the DHB PISS Suite. "We call it the urinal", she joked, "but not when the CEO is around--she signed off on the name the PR Consultants came up with."

Dot described her rise through the corporate ranks. "The DHB supported me to do some study at the University. Gosh, those universities are wonderful. They gave me an "A" for attendance and another "A" for saying "kia ora" at the lecture roll call--it showed cultural safety, they said. I didn't really understand what the assignments were about, but since it was a business studies course, I used phrases like "roll-out", "going forward" and "optimal resource allocation and utilisation" and popped in a few conjunctions. I passed with honours!"

Management course

Dot then passed us on to her Projects Manager for the Integrated Community Epicentre Department. Kane used to rule up Dot's Room Booking Book. Then he did the same management course and now runs his own department. Dot was very proud--"he's less a protege than a son-substitute, with a daughter like Louise, I need one."

Kane took us around his floor. "We used to be called "Complaints", he said, "but we got a series of focus groups and they consulted widely and contracted out community surveys, and after we put the name change through our Quality Team, Policy Work Group, Consumer Consultative Committee and received input from Women's, Pacific People and Iwi collectives, fono and hui, we came up with the new name.

"It is 'gold standard', we believe and it certainly is evidence based and conforms to best-practice principles" Kane paused and allowed himself a moment of quiet self congratulation.

Innovative change strategies

"Actually, we think this name change process is really cutting edge and represents innovative change strategies. We included the DHB Men's Co-operative Consultative Group in our decision making process for the first time ever, anywhere. This is realty radical, and my interaction with this group gave me, personally, a great deal of satisfaction."

Kane told us that the DHB thought so highly of this strategy, that they sent him and the Men's Group to all sorts of conferences to give papers on the process. "We went to Prague and Acapulco," he said, "Milan and Madrid. Our favourite was San Francisco, where we were received with typical American enthusiasm.

"We were a bit worried about the cost, but Dot has a sister-in-law in DHB asset management and somehow things got sorted out." Kane said something about selling a redundant out-patient clinic to Hanover Finance ... "but gosh, those sort of things go fight over my head".

Kane told us that his Department mostly manages complaints. He explained that in this, again, the Team operated on evidence-based principles.

"If the complaints or incidents are internal--and gosh, don't those DHB employees often just refuse to see how fortunate they are working for us--then there is the "Feedback" sub-site on the ICED website. They need a personal password to get on, of course. This changes every week for security reasons. When they do get through, we allow for an 18-month response time. Research shows this is the optimal timeframe which is directly co-related to a reduction in Employee complaints.

When the public ring in--and gosh, don't they want the jolly world sometimes!--we put them on hold and play "Fields of Gold" by Sting or anything by Nora Jones. We've measured huge satisfaction rate increases since we started. We measure satisfaction ratings by the number of phone-in complaints. The fewer the phone calls, the better the satisfaction levels. Sounds simple, but the most sophisticated systems often are. We believe in quality, we believe in community contact and we believe in upgrading our working environment. The painters are now working on the mauve theme and we're replacing the wire coat hangers."

Kane asked if we had any questions. We hadn't. He really had said it all, don't you think?

Reference

(1) Cottingham, C. (2007) Ka Pai, Te Roro Hiko. Kai Tioki Nursing New Zealand; 13: 2, 5.

Chris Cottingham, RN, BA, MEd, DipSocSci, PGDip (Hlth Sci), is a staff nurse working for a district health board which prefers not to be identified. In his spare time, he writes a bi-monthly column of alternative (sometimes amusing or irreverent but always challenging) musings on our profession.