EDWWIN*

A network of frontline health care workers (HCWs) and consumers 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 will be multidisciplinary, composed of representatives 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. But reducing these frustrations, HCW wellbeing may indirectly be improved, alongside other areas of care quality.

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.

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 will be 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 will have a soft launch at 09:30 on Thursday May 22nd 2025. We will have an official launch later in 2025.

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. EDWWIN is a direct consequence of this long path, which we hope to continue.

The team:**

1. Lead: Mike Nicholls

2. Deputy Lead: Suzi Hamilton

3. Consumer lead: Melanie Welsh

4. Māori Lead:

5. Nurse Lead: Lauree Southerden?

6. Medical Lead: Dr Caitlin Solomon

7. Clerical lead:

8. Ops Manager lead:

9. Lead for other workgroups:

10. Research Lead: Dr Alina Pavlova

11. ACEM Wellbeing liaison: Dr Suzi Hamilton

12. CENNZ liaison:

13. Registrar/Fellow lead:

14. QI lead: Dr Tim Ritchie

15. ACEM QI Liaison: Dr Mark Hussey

16. ASMS liaison: Dr Eugene Fayerberg

17. NZNO liaison:

18. Clinical Director Lead: Fiona Bowles?

19. Whakawhanaungatanga lead: Dr Jo Cole

20. Assessment lead: Jo Cole?

21. Te Whatu Ora | HNZ Lead:

22. Care-Bundles Lead: Cecilia Rademeyer

23. Rural lead:

24. Regional lead:

25. Big Smoke lead:

26. Acute Flow lead:

27. Surf lead: Tim Ritchie

28. Finances: Alieke Dierckx?

29. ACEM Education liaison:

30. Web Lead: Mike Nicholls

31. Web Support: Polly Grainger

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

Please get in touch if you have any suggestions, questions and/or want to be involved.

**Almost no one has been consulted about this list! Mike has essentially made it up.

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.

ACEM NZ hui March 2025.

Link here. and

Slides here

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

ACEM ASM in Gold Coast 23-27 Nov 2025. A data workshop for QI.

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.