PATIENT JOURNEY Author : Hemaima Reihana Tait ADON May 2015

HISTORY Johnny is a 68 year old gentleman. For 20 years between 1991 and 2011 he enjoyed a very productive lifestyle as the Manager of a 10,000 acre sheep and cattle farm in Turangi with 9 other staff. In 2004 while holidaying in Maroochydor, Australia he contracted Legionnaires disease which would start a journey of health decline, eventually precipitating early retirement. From 2004 – 2011 Johnny would endure Four Cardiac arrests Develop Type 1 Diabetes Develop changes in Kidney function and circulation Gangrene to R foot resulting in 2 ½ toes amputated

SOCIAL AND MEDICAL HISTORY 2011 Johnny’s severe decline in health meant leaving his livelihood on the Turangi cattle station and moving to Balclutha in the South Island to his son and daughter-in-law Two years later the cold of the South drove Johnny and his wife back to Northland where they had originated more than 30 years ago June to 2015 …opened the door for a raft of unexpected challenges in a community where he was still finding his feet…..footing????

FOCUS ON MOST RECENT HEALTH CRISIS Amputation of half my Left foot June 4 toes and a big hunk out of my foot Sept Big toe amputated

SYMPTOMS Feb- March -I kicked my foot in the shower and skinned 2 toes 2-3 wks before the infection showed up in my foot Visit to GP Antibiotics didn’t work – 2-3 months of repeated courses of antibiotics without change Referred to Podiatrist by GP Podiatrist referred to specialist Time frame – 4 months before specialist review and amputation

TREATMENT

SERVICE TOUCH POINTS Where the patient interacts with services Identified service points that impact on the patients healing journey

FEELINGS How the patient felt at different times during his treatment and recovery

CONTACTS Regular contacts Significant clinical support people

IMPROVEMENT ACTIVITIES Activities that made a difference to the treatment and recovery journey

THINGS THAT REALLY HELPED Services Free shuttle bus from Whangarei to Auckland everyday for my wife to visit me (7.30 am leave Whangarei, return at 6 pm – that was perfect) Pain management support And services supporting learning to walk again My Podiatrist The District Nurses were fantastic Personal, self management Things that boosted my mental health and emotional recovery – fishing and getting away from the house, the vege garden, and regular exercise

AREAS FOR IMPROVEMENT 1. It would have been good to have the operation sooner … ? Delays or opportunities 2. Prefer appointments rather than to ‘drop in’ – to minimise waiting for DN to turn up

QUESTIONS Identify the gaps in Primary health Care Where are the areas for improvement? What are the factors affecting the care received ? Barriers ? Primary Health Care issues ? Data : Past and Future measures Self help / management Health Literacy Touch points number Time frame