Welcome to

EDWWIN*

The NZ Emergency Department Workplace Wellbeing Improvement Network

  • A network of frontline health care workers (HCWs) and consumers who aim to build and share knowledge and skills for the application 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 make 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 can be challenging. Scientific methods, such as QI, are sometimes required.

    Evidence suggests that in the area of improvement in NZ EDs, there is likely room for improvement. 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 would be on step 2.

  • 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.

    Monthly hui will be online.

  • 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. Lead for other workgroups:

    9. Research Lead: Dr Alina Pavlova

    10. ACEM Wellbeing liaison: Dr Suzi Hamilton

    11. CENNZ liaison:

    12. Registrar/Fellow lead:

    13. QI lead: Dr Tim Ritchie

    14. ACEM QI Liaison: Dr Mark Hussey

    15. ASMS liaison: Dr Eugene Fayerberg

    16. NZNO liaison:

    17. Clinical Director Lead: Fiona Bowles??

    18. Whakawhanaungatanga lead: Dr Jo Cole

    19. Assessment lead: Jo Cole?

    20. Te Whatu Ora | HNZ Lead:

    21. Care-Bundles Lead: Cecilia Rademeyer

    22. Rural lead:

    23. Regional lead:

    24. Big Smoke lead:

    25. Acute Flow lead:

    26. Surf lead: Tim Ritchie

    27. Finances: Alieke Dierckx?

    28. ACEM Education liaison:

    29. Web Lead: Mike Nicholls

    30. 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:

    • IGLOO refers to the level at which the project is aimed.

    • Details of each project will be added

  • Organization-Wide Approaches to Foster Effective Unit-Level Efforts to Improve Clinician Well-Being. T. D. Shanafelt, D. Larson, B. Bohman, R. Roberts, M. Trockel, E. Weinlander, et al. Mayo Clinic Proceedings 2023 Vol. 98 http://dx.doi.org/10.1016/j.mayocp.2022.10.031

    “How QI is organised institutionally also demands attention. It is often conducted as a highly local, almost artisan activity, with each organisation painstakingly working out its own solution for each problem.

    Much improvement work is conducted by professionals in training, often in the form of small, time limited projects conducted for accreditation. But working in this isolated way means a lack of critical mass to support the right kinds of expertise, …. Having hundreds of organisations all trying to do their own thing also means much waste, and the absence of harmonisation across basic processes introduces inefficiencies and risks.

    A better approach to the interorganisational nature of health service provision requires solving the “problem of many hands.” We

    need ways to agree which kinds of sectorwide challenges need standardisation and interoperability; which solutions can be left to local customisation at implementation; and which should be developed entirely locally. Better development of solutions and interventions is likely to require more use of prototyping, modelling and simulation, and testing in different scenarios and under different conditions, ideally through coordinated, large scale efforts that incorporate high quality evaluation.”

    from: How to improve healthcare improvement—an essay by Mary Dixon-Woods. M. Dixon-Woods. BMJ : British Medical Journal (Online) 2019 Vol. 367 DOI: http://dx.doi.org/10.1136/bmj.l5514

  • Want to get the time you spend involved with EDWWIN to contribute to your ACEM education continuing professional development time? We aim to make this happen.

    What about nurses and others? We will aim to ensure time spent involved with EDWWIN will count towards annual educational requirements for nurses and others.

  • How can we make this work financially sustainable?

    Many of us (e.g. FACEMs) have paid non-clinical time which we can use for EDWWIN work. Others do not.

    It seems inequitable to expect some groups to work without compensation on this work, while others are compensated.

    It may be possible to ensure those without others sources of income can be compensated for their valuable time and expertise.

    We will endeavour to make this possible in a financially responsible and neutral way.

  • “I love it. Can definitely see huge benefit it this space. Most importantly community. Can't wait to see what evolves.” Dr Cecilia Rademeyer

    "Feels like workplace wellbeing has turned a corner and is no longer just a fluffy "nice to have" on the side, now a core issue of business as usual. Very keen to continue the conversations." Suzi Hamilton, ChCh.

    “No one is as strong as all of us” Boney, Chch.

  • There seem to be four of these in NZ.

    Here’s a link to the NZ HQSC page: https://www.hqsc.govt.nz/our-work/leadership-and-capability/improvement-networks/#Quality

  • ACEM NZ hui March 2025.

    Link here.

    Slides here

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

  • 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

    • 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 session: life or like drawing

    • Crazy sock day every Friday

    • Dog walking groups

    • Dressing how to mix and match

    • Dressing to your body shape

    • Dressing to your colours

    • Throwback aerobics class on the lawn – 10 min

    • Pilates class

    • HIIT classes

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

    • 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

Please contact Mike mnicholls@adhb.govt.nz

*Site, and entire concept, under construction!