The vision of this strategy is that emergency departments will provide excellent, culturally safe care to Māori, in an environment where Māori patients, whānau and staff feel valued, and where leaders actively seek to eliminate inequities.
HUTIA TE RITO O TE HARAKEKE,
KEI WHEA TE KŌMAKO E KŌ, KĪ MAI KĪ AHAU
HE AHA TE MEA NUI O TE AO, MĀKU E KĪ ATU
HE TĀNGATA, HE TĀNGATA, HE TĀNGATA
If the heart of harakeke was removed, where will the bellbird sing?
If I was asked, what was the most important thing in the world;
I would reply, It is people, it is people, it is people
In 2020, The Manaaki Mana rōpū were focused on preparing two documents, which are now ready for wider membership consultation.
Please read, reflect and feedback on our two draft documents that outline the way ACEM, its members and emergency departments can achieve Pae Ora - equity and excellence in emergency care for Māori and uphold te Tiriti o Waitangi (Treaty of Waitangi). These documents have been prepared by the Manaaki Mana rōpū (implementation group) as detailed stepwise guides to help us all grow our skills in four key domains:
- Equity of emergency care outcomes
- Culturally safe care
- Anti-racist policies
- Practices and upholders of te Tiriti.
ACEM will be undertaking a formal consultation process before these documents are endorsed by the ACEM board and we welcome any feedback.
He Ara Tiatia ki te Taumata o Pae Ora
Te Tiriti o Waitangi and the health and disability system
You can provide feedback on these documents here.
Te Rautaki Manaaki Mana: Excellence in Emergency Care for Māori (May 2019 - April 2022)
The Manaaki Mana Strategy was launched at the ACEM Winter Symposium in Rotorua on 1 May 2019. We are pleased to share the strategy with you:
ACEM is honoured to have been gifted the name Manaaki Mana for this strategy by Dame R. Naida Glavish, Ngāti Whātua me ngā Ngāti Hine. We thank Dame Naida for this generous gift.
Download Te Rautaki Manaaki Mana (PDF)
Last updated: 18 November 2020
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Pae Ora: healthy futures for whānau

Goal
|
Actions
|
Priority
|
Responsibility
|
Status
|
1. ACEM’s vision for Manaaki Mana is clearly communicated to key stakeholders
|
1.1 Develop a set of ACEM Standards on Pae Ora for emergency departments in Aotearoa New Zealand. The standards will describe:
- What excellence in care looks like.
- How to measure equitable care.
|
Medium term
|
Policy and Strategic Partnerships
|
In Progress
|
2. Develop partnerships to progress shared Manaaki Mana goals
|
2.1 Contribute to Te Ohu Rata o Aotearoa New Zealand/Te ORA (Māori Medical Practitioners’ Association) medical colleges advisory group
|
Ongoing
|
MM Rōpu
Policy and Strategic Partnerships
|
Ongoing
|
2.2 Develop an engagement strategy to develop partnerships with key stakeholders
|
Short term
|
MM Rōpu
|
Ongoing
|
3. ACEM will advocate for embedding Manaaki Mana in EDs
|
3.1 Work with our stakeholders to influence Government policy and health reform
|
Medium term
|
MM Rōpu
Policy and Strategic Partnerships
|
Ongoing
|
3.2 Offer media training to Māori Fellows and trainees to be our public advocates
|
Short term
|
Marketing and Communications
|
In Progress
|
3.3 Communicate opportunities to Māori Fellows and trainees to present at relevant conferences
|
Ongoing
|
Policy and Strategic Partnerships
|
Ongoing
|
3.4 Scope holding a bi-annual hui with our partners and stakeholders to progress our vision for Pae Ora
|
Long term
|
MM Rōpu
|
Not started
Delayed by COVID-19
|
4. Governance entities at ACEM represent our commitment to Manaaki Mana
|
4.1 Explore updating the ACEM Constitution to reflect a commitment to the principles of Te Tiriti o Waitangi and the United Nations Declaration on the Rights of Indigenous Peoples
|
Short term
|
MM Rōpu
Office of the CEO
|
Complete
|
4.2 Explore establishing a Te Reo Māori name for ACEM
|
Short term
|
MM Rōpu
Office of the CEO
|
On Hold
|
4.3 Consider the appointment of a strategic Te Ao Māori adviser to the ACEM Board, Council of Education and Council for Advocacy, Practice and Partnerships
|
Short term
|
Policy and Strategic Partnerships
|
Complete
|
4.4 Review the Terms of Reference for the ACEM Aotearoa New Zealand Faculty to ensure Māori representation
|
Short term
|
New Zealand Office
|
Complete
|
5. ED staff understand Te Tiriti responsibilities and Manaaki Mana context
|
5.1 Develop a statement on giving effect to Te Tiriti o Waitangi in an emergency medicine context
|
Medium term
|
MM Rōpu
|
Not started
|
5.2 Advocate to District Health Board executives and Directors of Emergency Medicine the value of regular Te Tiriti o Waitangi training for all ED staff
|
Long term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
6. ACEM’s senior office bearers understand the socio-political context within which the College operates in Aotearoa New Zealand
|
6.1 Provide Te Tiriti o Waitangi and tikanga training for ACEM’s Board, Council of Education, Council of Advocacy, Practice and Partnerships, and the ACEM Executive Leadership Team
|
Medium term
Ongoing
|
Office of the CEO
|
On Hold
due to COVID-19
|
7. Ensure appropriate oversight and implementation of the Manaaki Mana Strategy
|
7.1 Establish a Manaaki Mana Implementation Steering Group (Rōpu) to oversee the implementation of the Manaaki Mana Strategy
|
Short term
|
Policy and Strategic Partnerships
|
Complete
|
7.2 Employ a project lead at the Aotearoa New Zealand office to support the implementation of the Manaaki Mana Strategy
|
Short term
|
Policy and Strategic Partnerships
|
Complete
|
8. Engage ACEM staff and members in understanding the significance of tikanga
|
8.1 Develop an acknowledgement/mihi to open all College meetings that recognises tangata whenua and a commitment to Te Tiriti o Waitangi
|
Short term
|
Policy and Strategic Partnerships
|
Complete
|
8.2 Ensure ACEM email signatures and ACEM website recognise tangata whenua and a commitment to Te Tiriti o Waitangi
|
Short term
|
Corporate Services
|
Complete
|
8.3 Ensure that a pōwhiri is conducted at appropriate College hui (e.g. Aotearoa New Zealand-based Annual Scientific Meetings, Winter Symposia and the annual Aotearoa New Zealand Faculty Conference)
|
Ongoing
|
Policy and Strategic Partnerships
|
Ongoing
|
9. Establish mechanisms to evaluate Pae Ora achievements
|
9.1 Support the delivery of a research project that creates a set of measures to provide an annual snapshot of Māori health outcomes in the ED
|
Long term
|
Policy and Strategic Partnerships
|
Not started
|
10. Advocate for research in emergency departments that is relevant, safe and responsive to Māori
|
10.1 Advocate for Emergency Department research and audits in Aotearoa New Zealand to include analysis of Māori health outcomes. Where inequities are uncovered, advocate for action plans to address inequities
|
Long term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
10.2 Advocate for researchers to utilise Kaupapa Māori values, and to liaise with local Māori Health research services
|
Long term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
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Mauri Ora: healthy individuals

Goal
|
Actions
|
Priority
|
Responsibility
|
Status
|
11. Weave aroha and manaakitanga practices into patient care
|
11.1 Run an ongoing advocacy campaign with supporting guidelines to encourage the everyday use of Te Reo in EDs:
- Encourage all Fellows and trainees working in Aotearoa New Zealand to practice pronunciation and use Te Reo with patients.
- Focus campaign on DEMs[1] and DEMTs[2] to promote the use of Te Reo and to support regular Te Reo study for ACEM trainees and Fellows.
|
Short term
|
MM Rōpu
Policy and Strategic Partnerships
Marketing and Comms
|
In progress
|
11.2 Run an ongoing advocacy campaign with supporting guidelines to encourage best practice patient tikanga in the ED.
|
Medium term
|
MM Rōpu
Policy and Strategic Partnerships
Marketing and Comms
|
In progress
|
11.3 Encourage DEMs and DEMTs to provide information to ED staff about Te Ao Māori views on health, healing and rongoā (traditional Māori healing practices)
|
Long term
|
MM Rōpu
Policy and Strategic Partnerships
Marketing and Comms
|
Not started
|
12. Create a kete of resources for all emergency medicine trainees and Fellows to support culturally safe care in EDs
|
12.1 Encourage EDs to review their practice based on the Ministry of Health’s Literacy Framework, and advocate to EDs the benefits of workforce development in good health literacy practice
|
Long term
|
MM Rōpu
Policy and Strategic Partnerships
Marketing and Comms
|
Not started
|
12.2 Produce an e-learning resource for trainees, Specialist International Medical Graduates and Fellows:
- A culturally safe visit to the ED from the perspective of a Māori patient and their whānau. The resource will incorporate Māori history and Te Tiriti, understanding the impacts of colonisation and racism, understanding health inequities/equity vs equality, bias mitigation and self-reflection, asking patients if they identify as Māori and their iwi affiliations, and using Te Reo with patients and staff.
|
Medium term
|
MM Rōpu
Policy and Strategic Partnerships
Education and Training
|
In progress
|
13. Ensure all trainees and Fellows working in Aotearoa New Zealand are provided with regular Te Reo and tikanga training
|
13.1 Review ACEM’s Accreditation Standards for Training Sites to include provision of adequate time and resourcing for trainees and Fellows to attend Te Reo Māori and tikanga training
|
Long term
|
Education and Training
|
Not started
|
13.2 Include a component on teaching Māori Health and Cultural Safety in ACEM DEMT Workshops
|
Medium term
|
Indigenous Health Committee
Education and Training
|
In progress
|
13.3 Continue to advocate to DEMTS for teaching sessions and events to be held around Waitangi Day, Te Wiki o Te Reo Māori and Matariki
|
Ongoing
|
Education and Training
|
Ongoing
|
13.4 Partner with key stakeholders to ensure there are no barriers for trainees who wish to undertake ACEM’s Special Skills Placement in Aboriginal, Torres Strait Islander and Māori Health
|
Ongoing
Long term
|
Education and Training
|
Pending
|
13.4 Support the implementation of mandatory cultural competence and cultural safety activities in the ACEM CPD programme
|
Ongoing
|
Indigenous Health Committee
|
Ongoing
|
13.5 Work with the organising committees of the Annual Scientific Meetings, Winter Symposia and Faculty Conferences to ensure that Māori Health and Cultural Safety content is prominent in programmes
|
Ongoing
|
MM Rōpu
Policy and Strategic Partnerships
|
Ongoing
|
14. Ensure ACEM’s training programme has robust mechanisms in place to assess the cultural competence of trainees
|
14.1 Work with the Leaders in Indigenous Medical Education (LIME) Network to hold a workshop on embedding assessment in Māori health and cultural competency into the medical colleges’ training programmes
|
Medium term
|
MM Rōpu
RAP Steering Group
Indigenous Health Committee
|
In progress
|
[1] Directors of Emergency Medicine
[2] Directors of Emergency Medicine Training
-
Whānau Ora: healthy families

Goal
|
Actions
|
Priority
|
Responsibility
|
Status
|
15. Weave aroha and manaakitanga practices into Emergency Care
|
15.1 Encourage DEMs to establish a relationship with the DHB General Manager Māori Health and Māori Health Units to utilise their cultural expertise to support whānau and staff in the ED
|
Medium term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
16. Grow the Māori emergency medicine workforce to represent the communities they serve
|
16.1 Work with the ACEM Selection Subcommittee to consider including knowledge of Mātauranga Māori as a selection criteria for entry into FACEM Training in Aotearoa New Zealand
|
Medium term
|
MM Rōpu
|
In progress
|
16.2 Establish targets for recruiting and retaining Māori doctors into the ACEM Training Programme
|
Short term
|
MM Rōpu
Education and Training
|
Not started
|
16.3 Host ACEM Foundation funded national hui or regional dinners to recruit house officers into emergency medicine
|
Short term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
16.4 Establish a relationship with Te Oranga Māori Medical Students’ Association to explore how ACEM can promote emergency medicine as a specialty to its membership
|
Short term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
16.5 Host ACEM Foundation funded dinners or events at the Auckland and Otago University medical school orientations for new students
|
Short term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
16.6 Explore linking with Te Ohu Rata o Aotearoa New Zealand (Te ORA) (Māori Medical Practitioners’ Association) outreach work with high schools to engage with students to consider medicine/emergency medicine as a career
|
Short term
|
MM Rōpu
Policy and Strategic Partnerships
|
Not started
|
16.7 Explore how ACEM can use its website and social media to engage with students and doctors to promote emergency medicine as a career choice
|
Medium term
|
|
Pending
|
16.8 Continue to sponsor the annual Te Ohu Rata o Aotearoa New Zealand/Te ORA (Māori Medical Practitioners’ Association) Hui-ā-Tau and the biannual Pacific Region Indigenous Doctors Congress (PRIDoC)
|
Ongoing
|
Policy and Strategic Partnerships
|
Ongoing
|
16.9 Consider sponsorship of other conferences and grant opportunities that would increase the exposure of medical students and doctors to emergency medicine
|
Ongoing
|
Policy and Strategic Partnerships
|
Ongoing
|
17. Support and retain the Māori emergency medicine workforce
|
17.1 Collaborate with ACEM Māori trainees and Fellows to establish a support network
|
Ongoing
|
Policy and Strategic Partnerships
|
Ongoing
|
17.2 Based on feedback from trainees and Fellows, establish a mentoring model for Māori trainees and Fellows within ACEM’s overarching mentoring programme
|
Long term
|
Education and Training
|
In progress
|
17.3 Ensure Māori trainees have opportunities to attend relevant hui and conferences (e.g. Te ORA Hui-ā-Tau, PRIDoC, ACEM Annual Scientific Meeting and Winter Symposium), and are aware of grant, award and scholarship opportunities
|
Ongoing
|
Policy and Strategic Partnerships
Marketing and Comms
|
Ongoing
|
17.4 Consult with our current Māori trainees to understand how ACEM can best support them on their journey through the FACEM Training Programme, and implement their recommendations where practicable
|
Medium term
|
Education and Training
|
In progress
|
17.5 Ensure ACEM staff in the Melbourne and Aotearoa New Zealand offices receive regular training in Te Reo Māori, Tikanga and Te Tiriti o Waitangi
|
Ongoing
|
People and Wellbeing
|
Ongoing
|
17.6 Scope a Māori Leadership Pathway in Emergency Care for trainees and FACEMs in ACEM and more generally in medical education and advocacy
|
Long term
|
Education and Training
|
Not started
|
-
Wai Ora: healthy environments

Goal
|
Actions
|
Priority
|
Responsibility
|
Status
|
18. Emergency departments provide a welcoming physical environment that supports Pae Ora for patients, whānau and staff
|
18.1 Create a set of Tikanga Māori practical guidelines to assist EDs to make the ED a welcoming environment
|
Medium term
|
Policy and Strategic Partnerships
|
Not started
|
18.2 Run an advocacy campaign to support the Tikanga Māori guidelines outlined in 18.1
|
Medium term
|
Policy and Strategic Partnerships
Marketing and Comms
|
Not started
|
18.3 Continue to promote the Al Spilman Award for Culturally Safe EDs to encourage and support EDs on their cultural safety journey
|
Ongoing
|
Policy and Strategic Partnerships
Marketing and Comms
|
Ongoing
|
18.4 Produce and promote a video series showcasing recipients of the ACEM Al Spilman Award for Culturally Safe EDs
|
Ongoing
|
Marketing and Comms
|
Ongoing
|
18.5 Continue to run an annual campaign celebrating Te Wiki o Te Reo Māori/Māori Language Week, encouraging and supporting the use of Te Reo Māori in the ED
|
Ongoing
|
Policy and Strategic Partnerships
Marketing and Comms
|
Ongoing
|
We look forward to keeping you updated on our progress to implement the strategy.
Ehara taku toa i te toa takitahi
Engari he toa takitini.
Success is not the work of one,
It is the work of many.
Manaaki Mana: the journey
Three years ago, a hui was convened in Auckland with a large group of stakeholders from Aotearoa to discuss ways in which ACEM can work in partnership to achieve equity for Māori in Aotearoa New Zealand emergency departments.
The hui led to the establishment of a steering group to oversee the development of a strategy for ACEM.
A consultation was held with our stakeholders in March, seeking feedback on the strategy. Aku mihi nui kia koe (many thanks) to everyone who took the time to provide comment.
Equity for Māori Hui
A very successful hui (meeting) was held on 8 March 2018 in Auckland at Te Manukanuka o Hoturoa Marae. A broad range of stakeholders working in emergency departments, health research and other Colleges met to discuss ways in which ACEM can work in partnership to achieve equity for Māori in emergency departments.
A joint project between the Indigenous Health Committee and the Aotearoa New Zealand Faculty, the hui involved a formal pōwhiri, a range of speakers and robust and spirited workshop sessions.
The insights and input collated from the hui have informed the development of the College’s long term strategy. The ACEM Board has committed to the formation of a Steering Group to oversee this work.
Hui Speaker Presentations
-
David Tipene-Leach

-
Rhys Griffith-Jones

-
Elana Curtis

-
Tengaruru Wi-Neera

-
Marama Tauranga

-
Riki Nia Nia

ACEM acknowledges Māori as tangata whenua and Treaty of Waitangi partners in Aotearoa New Zealand.