2012 Skills Highway Award Entry

Counties Manukau District Health Board


The Counties Manukau District Health Board says staff numeracy and literacy training is leading to a more hygienic hospital and better communication with patients.CMDHB SH web

About half a million people in the South Auckland area rely on the Counties Manukau DHB (CMDHB) for healthcare services.  The population is characterised by great cultural and ethnic diversity.

Huge demand for services

Middlemore Hospital is the busiest in the country and employs nearly 6,500 people in roles ranging from medical specialists and nurses through to physiotherapists and cleaners, says Vicky Aperahama, Middlemore’s workplace trainer/assessor.

“Many of the non-clinical staff have English as a second language.  They have valuable roles within the CMDHB and play a pivotal role in ensuring quality patient care.  Literacy and numeracy support has increased through improved written and verbal communication,” says Vicky.

Rolling out training  

In 2008,  the hospital ended its cleaning contract with an external provider and employed the 276 cleaners and orderlies who had been doing the work. Management recognised the ‘new’ staff would benefit from literacy and numeracy (LLN) training.  

The Tertiary Education Commission helped fund the design and delivery of a reading, writing and communications programme called StepUP, whose pilot phrase in 2009 and 2010 involved 28 people – 20 cleaners and eight supervisors.

Since then, 150 employees have completed the programme and another 50 are currently enrolled; aged-care workers and translation services staff have also been included. “A major thrust of the programme,” says Vicky, “has been to reduce the alienation second-language learners often feel in a large and complex organisation by introducing them to the organisation’s values, vision, processes and procedures.”

Health and safety skills are embedded in the training. As an example, one group was asked to produce a poster on health and safety in the workplace by gathering information on computers, discussing the issues, and taking their own photos of people and materials.  “There is evidence to support a reduction in MRO (multi-resistant organisms) – directly attributable to improved hand hygiene and better cleaning processes.”


The outcome of the StepUP programme has been increased self-confidence, better teamwork and safer patient care.  A survey delivered the following results:

  • 100% of respondents reported better one-on-one conversations;
  • 71% asked more questions to better understand what they were told to do;
  • 71% were more willing to express their opinions  and more confident about doing so;
  • 100% had a better understanding of written workplace procedures;
  • 84% became more accurate at filling out forms.

Vicky says the StepUP venture has encouraged staff to keep pursuing education and go on to complete further qualifications.  “We will have more qualified staff who are open to change and better able to represent the communities which they work within.”    

Continuing education encouraged

The CMDHB has ensured that LLN is embedded by developing a formal plan and strategy in 2010, with partial funding from the Department of Labour.  Training companies Francis Group, and Sadler were contracted to gather information from staff, at all levels of the DHB, about needs and to develop the strategy.  Vicky says the biggest challenge was persuading people  they needed to learn, and  it was therefore necessary to have an organisational action plan.  It soon became apparent that everyone had something to contribute, and they quickly identified issues relating to numeracy and literacy in their daily work.   

This year, StepUP courses incorporate unit standards so staff can earn formal qualifications on the job.  A new learning space called Ko Awatea (dawn) has also been opened to create a comfortable place for learners.  Now managers, supervisors and team leaders throughout the non-clinical support teams are also being trained to better understand the DHB’s literacy and numeracy needs.

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