20 May 2015


New Zealand’s world-leading approach to system-wide innovation and new patient pathways initiatives

nurse holding elderly patients hand

System-wide collaboration has enabled New Zealand’s Canterbury District Health Board (CDHB) to provide new patient pathways that incorporate both primary and secondary health providers, with better outcomes for patients.

After witnessing the early success of Canterbury’s ambulance service Lightfoot pilot, CDHB started with a prototype Lightfoot project to assess one area of secondary care. At the time, there was no joined-up robust data, so when analysts were able to provide insights to managers it typically led to more questions, and hence more analysis.

‘With Lightfoot in place we can now work cooperatively with the managers,’ says Simon Berry, Lead Analyst, Planning and Funding at CDHB. ‘In a single morning workshop we can dig in and find the detail to answer any questions on the spot – using current data. We can explore every aspect of an area, see the linkages and know the disease areas to target by the end of the workshop. Analysis like that used to take us days or even weeks to complete.’

- So far, we’ve cut 1.5 million days of patient waiting time, met the six hour ‘discharge or admit’ government health target in 95 percent of cases and are leading in the OECD for screening mammograms


Carolyn Gullery, CDHB’s General Manager for Planning and Funding, says the Canterbury vision is a connected health system, centred around people. ‘By operating collaboratively with all healthcare providers – including ambulance, general practitioners, clinicians and administrators – we can deliver the right care in the right place at the right time,’ she says. ‘Our initiatives and planning are evidence-led using Lightfoot, not only boosting confidence in the way forward being the right one but allowing us to see a system and its opportunities.’

One strategy targets people with Chronic Obstructive Pulmonary Disorder (COPD), to ensure they will be safely supported to stay well at home, using a plan agreed with their general practitioner. This approach is being supported by pathways for ambulance staff to decide to leave patients in their own home with follow-up acute nursing, or deliver them to acute community medical centres or Emergency Departments based on clinical need.

‘So far, we’ve cut 1.5 million days of patient waiting time (in just four areas we have measured), met the six hour ‘discharge or admit’ government health target in 95 percent of cases and are leading in the OECD for screening mammograms,’ says Ms Gullery. ‘The feedback from patients has been overwhelmingly positive and our admission rate is the lowest of any large metropolitan area, with the length of stay also steadily reducing.’

In the past year almost 20,000 patients have been cared for in community settings – avoiding a hospital stay altogether.

‘We’re excited by the results our people-centred approach has already achieved, but are even more excited by what else we believe we can accomplish in the future with the added power that Lightfoot brings to our evidence-led thinking and our collaborative way of working,’ concludes Ms Gullery.