title: Knowing when we get there: An investigation into measuring success in new health service interventions for older people in Te Whatu Ora – Waikato region

authors: Guy, Graham

subjects: Success

abstract: Background: Health services are dynamic and undergo significant and ongoing changes.  The delivery of services to older people are no different and in many ways the changes are more dramatic as a consequence of the ageing population.  Monitoring whether health services meet the needs of the individuals that they serve is important as without such knowledge, it is not possible to determine the success of the interventions.  This research explores what does success look like from an older person’s perspective, the health professionals delivering that care, through to operational and executive managers.
Objective:  To explore the concept of success within health services for older people at Te Whatu Ora – Waikato.
Participants: One-to-one interviews were held with stakeholders, from executive and operational management and operational health professionals (n=7); focus groups with needs assessor service coordinators (n=10) and home care support services (n=6); and patient surveys with older participants (n=67).
Methods: Mixed methods research involving interviews and focus groups with stakeholders and surveys with older people receiving services.  Interviews and focus groups were transcribed verbatim and later analysed using a general inductive method of enquiry to generate key themes.  Surveys were analysed with descriptive statistics.
Results: The strategic direction of the health services and anticipated outcomes were well communicated and widely consulted and consequently there appeared to be alignment of views from those health professionals involved.  All believed that they were making a difference and felt personally rewarded by the role that they do and the contributions they make to the community, population in their care and individual patients.  Measures of success focussed on the assessment of quality of life and wellbeing for the older person.  This contrasted with the consumer perspective, who generally reported dissatisfaction with the services they received and on the whole their current quality of life. 
Conclusions: The research showed that health services tended to focus on an acute response and hospital services dominated conversations.  There was little awareness of the need to assess the broader aspects of service delivery.

text: Knowing when we get there: An investigation into measuring success in new health service interventions for older people in Te Whatu Ora – Waikato region Background: Health services are dynamic and undergo significant and ongoing changes.  The delivery of services to older people are no different and in many ways the changes are more dramatic as a consequence of the ageing population.  Monitoring whether health services meet the needs of the individuals that they serve is important as without such knowledge, it is not possible to determine the success of the interventions.  This research explores what does success look like from an older person’s perspective, the health professionals delivering that care, through to operational and executive managers.
Objective:  To explore the concept of success within health services for older people at Te Whatu Ora – Waikato.
Participants: One-to-one interviews were held with stakeholders, from executive and operational management and operational health professionals (n=7); focus groups with needs assessor service coordinators (n=10) and home care support services (n=6); and patient surveys with older participants (n=67).
Methods: Mixed methods research involving interviews and focus groups with stakeholders and surveys with older people receiving services.  Interviews and focus groups were transcribed verbatim and later analysed using a general inductive method of enquiry to generate key themes.  Surveys were analysed with descriptive statistics.
Results: The strategic direction of the health services and anticipated outcomes were well communicated and widely consulted and consequently there appeared to be alignment of views from those health professionals involved.  All believed that they were making a difference and felt personally rewarded by the role that they do and the contributions they make to the community, population in their care and individual patients.  Measures of success focussed on the assessment of quality of life and wellbeing for the older person.  This contrasted with the consumer perspective, who generally reported dissatisfaction with the services they received and on the whole their current quality of life. 
Conclusions: The research showed that health services tended to focus on an acute response and hospital services dominated conversations.  There was little awareness of the need to assess the broader aspects of service delivery.

year: 2023

title: "I wonder if we should even be doing it at all": An exploratory study of Family Violence Restorative Justice in cases of intimate partner violence

authors: Redman, Kelly Adelle

subjects: Family Violence Restorative Justice

abstract: The introduction of Restorative Justice as an adjunct to the criminal justice system is often seen as a progressive step, but its extension to cases of intimate partner violence is more controversial. Internationally, feminist academics have presented concerns related to the use of power and control within violent relationships, and how the dynamics of such relationships are inevitably re-enacted within Restorative Justice processes, potentially endangering women and denying them justice. This study was conducted in New Zealand to explore key informants’ perspectives of the use of Restorative Justice in cases of intimate partner violence. Semi-structured interviews were used to canvas women’s safety before, during, and after a Family Violence Restorative Justice conference.

The findings of this research mirror international arguments against the use of Restorative Justice in cases of intimate partner violence. Concerns were largely related to the psychological harm an abusive relationship imposes on women, and how this restricts a woman’s ability to be an active participant in a conference. Most of my key informants had significant concerns about the way Family Violence Restorative Justice is currently practiced and expressed serious doubts about whether this initiative should be continued.

text: "I wonder if we should even be doing it at all": An exploratory study of Family Violence Restorative Justice in cases of intimate partner violence The introduction of Restorative Justice as an adjunct to the criminal justice system is often seen as a progressive step, but its extension to cases of intimate partner violence is more controversial. Internationally, feminist academics have presented concerns related to the use of power and control within violent relationships, and how the dynamics of such relationships are inevitably re-enacted within Restorative Justice processes, potentially endangering women and denying them justice. This study was conducted in New Zealand to explore key informants’ perspectives of the use of Restorative Justice in cases of intimate partner violence. Semi-structured interviews were used to canvas women’s safety before, during, and after a Family Violence Restorative Justice conference.

The findings of this research mirror international arguments against the use of Restorative Justice in cases of intimate partner violence. Concerns were largely related to the psychological harm an abusive relationship imposes on women, and how this restricts a woman’s ability to be an active participant in a conference. Most of my key informants had significant concerns about the way Family Violence Restorative Justice is currently practiced and expressed serious doubts about whether this initiative should be continued.

year: 2019

title: Māori and medications: What happens when the pills go home?

authors: Nikora, Linda Waimarie

subjects: Māori

abstract: Chronic illnesses are a feature of many Māori homescapes. These illnesses are often managed at home through the use of health technologies, particularly medications. This article explores the meanings given to medications and the use of this health technology in four Māori households. We use a range of qualitative methods to engage with householders and to document how medications are acculturated into Māori homescapes and everyday lives. From our discussions with householders about the procurement, storage, emplacement and administration of medications emerged five culturally patterned orientations to treating with medications. They are: 1) storage and administration practices that corresponded with the Māori hygiene practices of tapu (prohibited) and noa (permitted); 2) reminder strategies, or ngā pūrere whakamāharahara; 3) the enactment of the value of manaakitanga (kindness) in care relationships; 4) pōharatanga, or attitudes towards medication procurement and administration in households textured by low socio-economic status; and 5) rangatiratanga, the right of people to manage and make decisions about their own lives and health status. This study presents a view of how medications are acculturated into Māori homescapes, relationships and daily routines. The use of health technologies by health professionals to interrupt illness and improve quality of life must be cognisant of the cultural contexts into which medications are prescribed.

text: Māori and medications: What happens when the pills go home? Chronic illnesses are a feature of many Māori homescapes. These illnesses are often managed at home through the use of health technologies, particularly medications. This article explores the meanings given to medications and the use of this health technology in four Māori households. We use a range of qualitative methods to engage with householders and to document how medications are acculturated into Māori homescapes and everyday lives. From our discussions with householders about the procurement, storage, emplacement and administration of medications emerged five culturally patterned orientations to treating with medications. They are: 1) storage and administration practices that corresponded with the Māori hygiene practices of tapu (prohibited) and noa (permitted); 2) reminder strategies, or ngā pūrere whakamāharahara; 3) the enactment of the value of manaakitanga (kindness) in care relationships; 4) pōharatanga, or attitudes towards medication procurement and administration in households textured by low socio-economic status; and 5) rangatiratanga, the right of people to manage and make decisions about their own lives and health status. This study presents a view of how medications are acculturated into Māori homescapes, relationships and daily routines. The use of health technologies by health professionals to interrupt illness and improve quality of life must be cognisant of the cultural contexts into which medications are prescribed.

year: 2011