title: Innovations in service delivery to improve Maori health outcomes: a mobile disease state management nursing service.
abstract: An innovative nursing service to Maori communities was initiated in 2000, based on continuing disparities between health status of Maori and non-Maori peoples in New Zealand and a recognition that much Maori morbidity and early mortality is accounted for by three disease states, diabetes, heart disease and airways disease. The paper describes the project based on Kaupapa Maori heath providers employing registered nurses who completed an advanced post-graduate diploma programme specialising in disease state management. The first nurses to be employed as Maori mobile DSM nurses who lacked models and mentors needed to develop their professional practice and document outcomes for clients. Using case notes and drawing from community health theory, the paper describes the scope and strategy of practice in client's home settings that these nurses developed. Although it is too early to demonstrate statistically that the initiative is improving health outcomes for Maori, anecdotally the service is succeeding where mainstream services have had limited effect.
authors.affiliation: Moni Nursing Services Limited, 4 Windsor Street, Opotiki janetmoni@hotmail.com
authors.forename: Janet
authors.initials: J
authors.lastname: Maloney-Moni
authors.forename: Nicola
authors.initials: N
authors.lastname: North
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D019468:Disease Management; D006801:Humans; D009520:New Zealand; D009729:Nursing; D009936:Organizational Innovation; D016896:Treatment Outcome