EDWWIN

A network of frontline health care workers (HCWs), consumers, and other stakeholders who aim to build and share knowledge, attitudes and skills to assist with the implementation of best practice for improving wellbeing at our emergency departments (EDs) throughout Aotearoa New Zealand (NZ).

We believe workplace wellbeing in our EDs is complex, that often requires complex solutions including a scientific approach exemplified by quality improvement (QI).

We believe that our passion, lived workplace experience, and generalised awesomeness means we are in a strong position to implement meaningful informed improvements, and need to be wise in our application of time, energy, attention, and other resources, to achieve our aims.

EDWWIN is multidisciplinary, and we aim to have representation from all stakeholders involved in ED care in NZ.

Improving the quality of healthcare, including healthcare worker wellbeing, can be challenging. Scientific methods, such as QI, are sometimes required.

Evidence suggests that in the area of improvement in NZ EDs, there is room for improvement. We need to improve our ability to improve. EDWWIN aims to reduce the gap between our current ability to use QI to what is ideal.

QI may be used to directly improve workplace wellbeing, by working on topics that are intended to improve HCW wellbeing. QI may also indirectly improve workplace wellbeing, by working on issues related to care quality that are not directly related to wellbeing of HCWs but that cause frustration to those staff. By reducing these frustrations, HCW wellbeing may indirectly be improved, alongside other areas of care quality.

This video, based on James Reason’s Swiss Cheese model of error and harm in healthcare, illustrates that workplace wellbeing is complex, and influenced by many factors. One way of viewing this complexity is using the IGLOO model (Individual, Group, Leadership, Organisation, Outside the Organisation). Barriers and enablers at each level will affect workplace wellbeing.

EDWWIN aims to use the collective skills, knowledge, and passion of NZ ED HCWs and consumers to improve the care provided in NZ EDs, and improve the wellbeing of those HCWs.

This is a work in progress. If this were a 10 rung ladder, as of 1 March 2025 we were on step 2. As of 30 May 2025, we are on the 4th rung.

How will we know EDWWIN is effective? Not sure… Developmental Evaluation is a method by which we may assess effectiveness of this Innovation Platform.

Here is a 5-year vision and 12 month plan for EDWWIN.Please feel free to download, think about it, feedback with suggestions for improvement.

This will be a continuous process, that will have asynchronous and synchronous efforts.

Monthly 1 hour hui on line will be the synchronous component.

These are 09:30-10:30 on the 4th Thursday of each month (not December and January). There are no perfect times to meet. Based on our collective experience, this is considered the least imperfect time.

EDWWIN had a soft launch at 09:30 on Thursday May 22nd 2025.

We had our “official launch” at The Free House, Whakatū Nelson 25 March 2026, at the ACEM NZ conference in Nelson. Here’s a brief video. Longer video coming soon.

Everyone with an interest in this area are welcome to join EDWWIN. It is vital that as many stakeholders are represented in EDWWIN. For example, of all workgroups, nurses have the highest rate of burnout in NZ EDs. Therefore, strong nursing representation is required. Similarly, we know that in the COVID pandemic, the importance of our cleaning staff was highlighted. We need representatives from this group, and from all groups.

See the team, below.

The bulk of the work will be done by HCWs throughout NZ EDs. Colleagues throughout NZ healthcare, and overseas, are also welcome to join.

We consider that there are 35 EDs in NZ.

Monthly hui will be online.

EDWWIN is just being born, and has been gestating for many years.

From a 2018 survey of burnout in a single NZED and a 2020 nationwide survey, we understood that burnout among ED staff was not just an individual phenomenon. It is widespread and important, for individuals, and (presumably) patients and the health system. But what to do?

Our research over the past 2 years in 9 NZEDs was an attempt to intervene to make a positive difference. Has it worked? Not sure… we are still analysing lots of data. One thing that has come from this is EDWWIN.

Monthly research meetings have demonstrated the potential strength we have as a diverse collective of enthusiasts with lived experience and expertise.

Following discussions with various folk (Suzi Hamilton, Tim Ritchie, Caitlin Solomon, and others) EDWWIN is a direct consequence of this long path, which we hope to continue.

EDWWIN was officially launched on 25 March 2026. Here is the very moment it was launched.

And a seven minute introduction to EDWWIN at the official launch.

The team:

1. Lead: Mike Nicholls

2. Deputy Lead: Suzi Hamilton

3. Consumer Advocate:

4. Māori Lead:

5. Nurse Lead: Lauree Southerden, and Rochelle Harper

6. Nurse Practitioner Lead: Janene Waye

7. Clinical Nurse Specialist Lead:

8. Medical Lead:

9. Clerical lead:

10. Ops Manager lead:

11. Lead for other workgroups:

12. Research Lead: Dr Alina Pavlova/Dr Laura Joyce

13. ACEM Wellbeing liaison: Dr Suzi Hamilton

14. CENNZ liaison: Jo Aston

15. Registrar/Fellow lead:

16. QI lead: Dr Tim Ritchie

17. ACEM QI Liaison: Dr Mark Hussey

18. ASMS liaison:

19. NZNO liaison:

20. Clinical Director Lead: Fiona Bowles?

21. Whanaungatanga lead: Dr Jo Cole

22. Assessment lead: Jo Cole?

23. Te Whatu Ora | HNZ Lead: Jo Cole is liaison

24. Ministry of Health lead: Amanda Rosenberg

25. Care-Bundles Lead: Cecilia Rademeyer

26. Academic Lead: Prof Maree Roche

27. Clinical Governance Lead: Jerome Ng

28. Rural lead:

29. Regional lead:

30. Big Smoke lead:

31. International Lead: Ellen Burkett

32. Acute Flow lead:

33. Surf lead: Tim Ritchie

34. Finances:

35. ACEM Education liaison:

36. Web Lead: Mike Nicholls

37. Web Support: Polly Grainger

38. Artificial Intelligence Lead:

39. Sustainability Lead: Tom Jerram

40. GP Lead:

All positions are held for 2 years, renewable once. Similar to ACEM framework

Other interested parties***:

• Amar Shah (ELFT, NHS, IHI)

• Tait Shanafelt

• Fiona Herco (IHI)

• Mark Linz

***Being on this list does NOT imply endorsement of the views, actions, etc of EDWWIN!

Please get in touch if you

• have any suggestions,

• questions and/or

• want to be involved.

Here are some examples from our Leading Innovative Change initiative.

Here are some others (we will load reports for these as they are available):

• Bedside Handovers (O)

• Labs and Rads: Improving sign off of results (O)

• Communicating in the ED: Email improvements (O)

• Triage 2: Improving efficiency of placement of patients on arrival (O)

• IV cannulation use in ED (O)

Please note:

• IGLO(O)* refers to the level at which the project is aimed: Individual, Group, Leader, and Organisation (plus Outside of the organisation)

• Details of each project will be added

* Nielsen, K. (2017). The IGLO framework: Understanding and leveraging resources at multiple levels in organizations. Journal of Organizational Effectiveness: People and Performance, 4(3), 190-203.

We are considering two main categories for research.

1. Assessing the effectiveness of EDWWIN. We consider that developmental evaluation may be a useful approach

2. Other areas of research.

   • There are numerous potential research questions that could be explored. The advantage of EDWWIN is that there are potentially multiple projects and sites of research throughout Aotearoa.

Laura Joyce and colleagues at Christchurch have produced a fantastic report of some fantastic work. Can this be a standard to aspire to?

Laura says “I think the most important thing with this initiative is that we have managed to sustain the change - habits always slip, particularly with new staff starting all the time.”

Check it out.

ACEM ASM in Gold Coast 23-27 Nov 2025.

Poster 1: Wellbeing Intervention

Poster 2: QI and wellbeing in NZEDs

Poster 3: Coffee in ED

ANZOPOB 20th, 21st Nov 2025 Auckland

Slides

ACEM NZ hui March 2025.

Link here. and

Slides here

NIVA courses are held in Nordic countries. Here’s one in Iceland.

ACEM NZ Nelson 25-27 March 2026

From ACEM (and CENNZ?)

8-14 June 2025

Invite everyone to participate: RN, RMO, SMO, HA, Admin, Orthopaedics, Paediatrics, Radiology, Security, Orderly, Allied Health

Here are some suggestions:

• Barista in the ED

• Coffee vouchers

• “Resus Trolley” – treats on a trolley supplied each shift

• Hangi!

• Sausage sizzle, especially with produce and goods from staff, e.g. chili sauce, walnuts

• Sunday PM soup or other hot food

• Matariki shared breakfast

• International food lunch

• 101 Knitting classes

• Sewing Bee – patchwork

• 3 Good Things (3GT) booklet to note 3GT that happened for the day / shift

• 3-5 min mindfulness at end of selected handover dates

• Art sessions, internal and Sip’n’Paint (or ‘Sip’n’Slop’)!

• Crazy sock day every Friday

• Walking groups - Taupo lakeside, Christchurch Hagley Park, dog-walking in the hills

• Step challenges

• Planking challenge

• Golf putting coaching discount (gifted)

• 10-min throwback aerobics class

• Dressing how to mix and match

• Dressing to your body shape

• Dressing to your colours

• Spa days (gifted)

• Pilates class

• HIIT classes

• Kudos promotion – nominate a colleague for behaviours above and beyond – gifts from the kitty money

• ED journal Life in the bike lane article

• Photo competition: CIA (Colleagues in Action) – sporting or fun activity

• Pink shirt Friday: staff wear a pink accessory or shirt (professional attire)

• Random acts of kindness

• Recycled boutique shopping

• Sheep raffle (for drought affected areas)

• Sign language week

• Tree of appreciation “Good vibes tree” poster – add a post-it-note of one good thing about working in ED and / or share something about what wellbeing is in your culture (nationality / profession or any other culture)

• Wellbeing bingo

• What’s going on bingo

Do you have ideas to share?

More details and ideas to follow

Here are the minutes.

Here are the slides from Hawke’s Bay

Please feedback!

Thank you.

Attached, the minutes.

And SLIDES from consumer advisor, Melanie W.

Here are the minutes

Tim Ritchie explains how he became an ED quality guru in under 2 decades

Here are the minutes

Here are Suzi’s slides

And the article Suzi referred to

Minutes

14 minute recording and slides

Slides

Some Minutes

Some slides. Amelia Abbott is doing her PhD… assessing the effect of workplace wellbeing on organisational performance. Thank you for presenting Amelia! GReat work!

max of 3 per ED, IMO. Maybe...

• GROSS -  something to de-implement

Implement or improve something, either new, or something that requires a re-do

Improve psychological safety

Opportunities for improvement training, coaching, and support

'Launch' March 2026 in Nelson at ACEM NZ conference (March 25-27).

How can we choose what to take on?

There are various ways of deciding. e.g. the PICK matrix.

There are other tools as well, e.g. from the Clinical Improvement Network at Te Toka Tumai Auckland City Hospital. (MN will share a link).

We need to carefully choose

• what is important,

• for whom, and

• what may be doable, and

• what may have a reasonable impact.

• what may be aligned with other goals, priorities and stakeholders

Do we really care about evaluation and reporting?

Pros:

enables efficient communication.

enables us and other to learn from what has been done before

enables us to build credibility

making informed choices about discarding things that have not worked

Cons:

more work, at least in the short term

How should we evaluate and report our efforts and improvement?

Many ways… The The Standards for Quality Improvement Reporting Excellence (SQuIRE) are the ‘Gold Standards’. Here is a link to their site. EDWWIN will establish a template for evaluation and reporting based upon SQUIRE 2.0 and other source.

When should we begin the evaluation and report take place? AT THE START OF ANY PROJECT! So much easier and robust to work prospectively, rather than retrospectively.

CONGRATULATIONS!

See this, from ACEM:

ACEM congratulates Dr Caitlin Solomon for being awarded the 2025 ACEM Wellbeing Award in the Individual category. This annual award celebrates the initiative(s) of an individual member, group of members or an emergency department that have resulted in the enhancement of wellbeing for their emergency department colleagues.

Caitlin was nominated by her colleagues at Hawke’s Bay Regional Hospital Emergency Department as an exceptional colleague whose tireless commitment to staff wellbeing has improved the general level of positivity around the ED, and has enabled people to feel heard, and appreciated. Her efforts have strengthened morale across the department and reinforced a strong sense of community and belonging.

Most notably, Caitlin delivered an ACEM Wellness Week featuring an extensive and inclusive program of activities. Thoughtfully designed to engage all staff, including night teams, these activities supported physical, mental, and social wellbeing and brought the department together in meaningful ways. In addition, Caitlin led a Wellbeing Quality Improvement project that enabled real-time staff feedback, ensuring every voice was acknowledged and responded to. She also introduced the local Ka Pai First initiative, recognising good work within the department and enabling colleagues to give positive “shout outs” to one another. Caitlin’s inspiring dedication has measurably improved the wellbeing of the entire department.

Here are the minutes:

1 minute summary:

1. EDWWIN will continue in 2026

2. Goal of EDWWIN: to make it easier for us to implement stuff that is aimed at improving quality of care, including staff wellbeing, in our complex environment

3. Official launch of EDWWIN is March 25th or 26th at Nelson ACEM NZ conference. Details TBC

Here are the slides for the Respect at Work program.

Here is an example of a rigorous QI project.

A video of the official launch moment!!

And a seven minute video at the official launch.

TBC

Slides for CENNZ 19 March 2026