August 2017: Korowai Aroha Health Centre is a kaupapa Māori service, and this shapes many aspects of the way it operates. However, Korowai is similar to many other providers in that its nurses are playing increasingly diverse and skilled roles in healthcare, contributing to improved patient outcomes and freeing GPs to concentrate on acute cases. Korowai staff say they feel as though they are weaving together their collective strengths and building trust with each other as they cooperate in increasingly varied aspects of patient care.A team of nurses run their own nurse-led treatment clinic and form an important part of the general practice team. But that’s just the start of the centre’s nursing approach.Korowai has a nurse covering kura kaupapa schools, providing general nursing services with special attention to acute illness. There’s a dedicated community nurse for asthma/Chronic Obstructive Pulmonary Disease (COPD) and another for diabetes. Yet another nurse covers CVRAs and the Tane Takitu Ake men’s wellness programme.Project coordinator Jane Lane supports the nurses with data extraction, system reviews, documentation, reporting and a host of other tasks. Jane has been involved with nursing for 40 years, and she says that nurses’ roles have grown immensely from the days in which most tasks were delegated by GPs.

“It’s the nurses doing the first line of work now,” she says. “Patients are now booking directly with our nurses, and our diabetes programmes and cardiovascular risk assessments are being done by nurses first. Nurses can do ACC – all kinds of things.”

This change in the way treatment is given has led to improved patient outcomes, and in that respect Korowai can point to some healthy figures.The cervical screening rate for Māori women has doubled in three years to 73 per cent, and is still climbing. The BSA enrolment rate has also improved, hitting 90 per cent. The 95 per cent immunisation target for 8-month pepi has also been met. These results have been achieved despite the challenges of providing for a population that is 80 per cent Māori and 93 per cent high-needs.This means that, rather than waiting for patients to walk through the door, Korowai uses a pro-active approach to connect with the community and achieve its health goals. For example, the service employs a health care assistant to undertake recalls and cold calls to homes, and has contracted a Hapū Mama nurse for home visits to support the immunisation targets. Internal systems have also been tightened, allowing better identification of patients who are overdue for contact. These methods are part of a “whānau ora” approach to healthcare that Jane greatly appreciates, describing the centre’s atmosphere as “really lovely”.Change has clearly brought benefits, and Jane predicts that nursing will develop to become even more highly-skilled. Skills do not develop by accident, and key to progress is education. Korowai’s managers recognise this by freeing staff for training events.Korowai CEO Hariata Vercoe says the centre is fortunate to have such a highly-skilled nursing team. “They provide a high standard of nursing assessment,” she says. “They are passionate and thoughtful about the care they provide to whānau, and their contribution ensures we provide a high-quality service.”