On the 14th October we attended a learning session from South Central Foundation, Alaska on Nuka Health & Wellbeing. We attended in our capacity as an AQuA Lived Experience Affiliate. It was primarily a very powerful story of how the people of native Alaska transformed their healthcare – very uplifting. The South Central Foundation led the change and supported staff during the transformation to the Nuka system of care. It is a truly courageous programme of change against traditional systems of care to give customer-ownership to the population, changing the whole culture of healthcare.

Here are some facts about South Central Foundation:

· Incorporated in 1982

· Serves 65,000 customers

· Employees have gone up from 24 in 1987 to 2,000 in 2016

· Provides primary care services

· Has 80+ programmes and departments

· Covers 591,000 square miles

So how do you start such a courageous transformation?

Well . . .

· You ask your customers what are we doing wrong and what do we do right?

· You revisit everything . . . yes everything

· Your process and systems, your people, your culture, your buildings, your working environment, your services etc

· You start to co-design with your customers

They created a new vision with a mission to keep them focused at every point of the journey to achieve the transformation. Three main goals were created to challenge all their choices:

1. Shared responsibility

2. Commitment to quality

3. Family wellness

Operational principles based on relationships – it’s the strength and trust in relationships that provides the long term sustainable success.

Relationships between customer owner, family and provider

Emphasis on wellness of the whole person, family and community

Locations convenient for customer owners with minimal stops

Access optimised and waiting times reduced

Together with customers owners as an active partner

Intemtional whole system design to maximise co-ordination and minimise waste

Outcome and process measure continuously evaluated

Not complicated but simple and easy to use

Service financially sustainable and viable

Hub of the system is the family

Interests of customer owner drive system

Population based systems and services

Services and systems build on the strengths of Alaska native cultures

Evidence of success:

1. Top class in performance and satisfaction

2. Employee turnover decreased by 15%

3. Won national awards

4. 25% reduction in visits to both ER & Primary care

5. Government recognition

Everything changed, staff became motivated and happy, management were not frustrated, financial performance improved. Communication improved, work flow improved reducing clinical workload. Integrated teams were introduced helping continuity of care and reducing unnecessary visits. Working with your customers, taking time to really listen and take the appropriate action will drive the change you want to see and be proud of the service you give to everyone who needs care.

Work together in relationships to learn and grow

Encourage understanding

Listen with an open mind

Laugh and enjoy humour throughout the day

Notice the dignity and value of ourselves and others

Engage others with compassion

Share our stories and our hearts

Strive to honour and respect ourselves and others

Giving customer ownership and empowering your people to be accountable in a positive environment will deliver WELLNESS for everyone concerned.