How do you navigate a merger and at the same time improve patient access to health services? Jenaya Smith puts patient needs first, while balancing business, people and a vaccine roll-out.

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Jenaya Smith has been general manager at Health Central in Alexandra since 2019, when she guided three teams to become one, with the merger of three local practices.

Jenaya grew up in Balclutha, and it was the search for a change in lifestyle that brought her and her family to Central.

“My husband had been offered a job up this way, we’d holidayed here every Christmas and loved it.

“We decided we wanted to try something new.

“I was due to take a period of maternity leave, so we thought we’d come for a year and see what happens – and we haven’t looked back since.”

After managing the after-hours service at Dunstan, Jenaya eventually took on a practice manager role. When Cornerstone Health later merged with two other medical practices, she took on management of the larger entity.

“The biggest challenge initially was taking teams from three very distinct and separate businesses on a Friday, and on Monday, bringing the team together as one.

Jenaya said it was important to quickly find the best systems and processes, the best ways of working for everybody.

“It was just that whole transition from three to one, and it was literally overnight.

“Most businesses that undergo a restructure might close up for a period and get everything sorted before reopening.

“In health, you can’t do that.

“We still continued to deliver fast-paced services; at the same time we were trying to get systems running smoothly to ensure we were consistently delivering quality care.”

“It got easier as time went on, and now it’s like a well-oiled machine.”

It wasn’t just a merger, however, that Jenaya has successfully navigated with the team.

“At the same time as the merger, we were successful in our application to be a health-care home practice – the first one in Alexandra.

“And that’s been instrumental in getting where we are today, and moving forward.”

Jenaya explains health-care homes is a model of primary care centred around patient wellness.

“It’s about proactive care, keeping people well rather than only seeing them when they’re sick.”

The efficiencies gained, Jenaya said, were significant – and not only in terms of running a business. The result has been improved patient access to information and services, and a team approach that supports people to grow and develop in their professional practice.

“It’s flexible - it allows us to identify and address areas of priority or gaps in service provision for our community.

“In terms of providing the best service, the proactive approach we take can be anything from the way we lay out rooms so everybody always know where everything is, to scope of roles.

“It means frontline nurses can focus on patient contact, they don’t need to be ordering supplies or cleaning rooms – a healthcare assistant can take on that role.

“The registered nurses’ role is now all about the patient.

Jenaya says she began looking at roles with the whole team during the merger, and it has continued on from there. Everyone is involved, including the GPs, in deciding who should focus on specific areas, and how tasks could be completed efficiently.

“It’s a really effective way of running a practice.

“It means people can undertake training and work at the top of their scope, and that the right people are doing the right work. 

Megan Tierney is Jenaya’s Executive Assistant – helping Jenaya coordinate the COVID vaccination roll-out, alongside current and future projects.

“Initially we started coordinating the roll-out district-wide, until other practices were up and running.

“We travelled to Ranfurly, Roxburgh, Cromwell and locally, focusing on our aged care facilities, then moved on to vaccinate over 65’s with chronic conditions.

“And now it seems the COVID vaccinations are front of mind for everyone, but there’s so much more to what we do, and what we are working towards for the future.

Intrepid reporter Mary Hinsen receiving her COVID vaccine at Health Central.

“The recently announced healthcare reforms mean, I think, that primary care and rural areas are going to have a higher priority with a ‘healthcare closer to home’ concept.

“What that might look like, we’re not sure, but we have a vision of where we want to be and our current projects reflect that.

“Building on what we’re doing currently, outreach services, particularly around Māori health, and mobile clinics are areas we’re working on.

“We see them running here a bit like mini wellness checks, patient led – asking questions to find out what might be the patient’s priority.

Megan is a big part of implementing the new focus.

“Back in the day, people only came to the doctor when they were sick.

“Now, community wellness includes one of our GPs, Dr Chris Mulholland, talking with larger employers and community groups on topics that are of interest to them.

“It’s all about keeping people well while they’re still okay, before they need to go to hospital.”

Jenaya says having a lot more contact with well people is a positive move.

“There’s a lot more being asked of primary care going forward, in order to meet that need.

“We need to stay flexible and focused on priorities for our community.

“A big part of meeting the need is being proactive, working with well people, and not waiting until they are sick.” 

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