Te Rautaki Manaaki Mana: Excellence in Emergency Care for Māori 2026-2029 (Te Rautaki Manaaki Mana) provides a framework and guidance on how the College and ED teams can continue to work together to achieve these goals.
ACEM President Dr Peter Allely described the strategy as both a “strategic direction and an obligation.”
"Te Rautaki Manaaki Mana is ACEM's enduring commitment to health equity and excellence in emergency care for Māori in Aotearoa New Zealand," Dr Allely said.
“It calls on us to work collaboratively across the specialty and wider ED team to deliver the highest standards of clinical practice by advancing cultural competence, cultural safety and hauora Māori, confronting inequity, and upholding Te Tiriti o Waitangi to support the mana of Māori patients, whānau and staff."
The strategy, in its third iteration since it was first launched in 2019 and developed by the Manaaki Mana Advisory Group, focuses on the goals and actions needed to address health inequities experienced by Māori which are driven by the ongoing impacts of colonisation and systemic racism within the health system.
Māori continue to experience poorer health outcomes and shorter life expectancy than non-Māori. They are also significantly more likely to die within 10 days of ED discharge than non-Māori, even after clinical factors are considered.
The refreshed strategy includes a stronger focus on implementing culturally safe care and introduces the PŌTAE (Partnership, Ōptions, Tino Rangatiratanga, Active protection, Equity) framework to embed Te Tiriti o Waitangi principles into everyday ED practice.
He Ara Tiatia ki te Taumata o Pae Ora is at the centre of the Te Rautaki Manaaki Mana, providing the step-by-step pathways to attain the priorities for each ED.
“We have made significant progress to date through leadership, advocacy, education and workforce development,” Dr Allely said. “I particularly want to acknowledge the Manaaki Mana Kaikōkiri network – our Māori health champions in EDs throughout the country who are integral to implementing the strategy and reporting on progress."
Dr Allely said that while there have been initiatives and improvements to enhance the experiences of Māori patients and whānau in EDs, "meaningful systemic change requires ongoing courage, action and accountability from clinicians, leaders and the wider ED team."
FACEM Dr Kim Yates, an emergency medicine specialist at North Shore and Waitakere EDs and co-chair of the Manaaki Mana Advisory Group, said that kaikōkiri are driving change by embedding the kaupapa of the strategy into everyday practice in EDs.
"Kaikōkiri are improving culturally safe care in our EDs for Māori patients, whānau and staff, and advocating for the data and measures that hold EDs to account,” Dr Yates said.
“Some kaikōkiri are recognised with paid roles, but for many the work is voluntary and happens on top of full clinician loads. If we want this work to endure, it needs recognised resource time.”
Dr Yates said that at the Kaikōkiri Hui held last month in Rotorua, the work and achievements of kaikōkiri were celebrated. “We also discussed the ongoing challenges they face to make progress in their hospitals so that we can collectively work on the best approaches to overcome these challenges.”
Ms Piki Te Aorangi Mathieson, Pou Matanga and Clinical Nurse Specialist at Taranaki Hospital ED and co-chair of the Manaaki Mana Advisory Group said culturally safe care is synonymous with clinically safe care and health equity.
"Achieving Pae Ora (healthy futures for Māori) means every Māori patient and whānau member who walks into an ED feels valued and receives care that upholds their mana. That takes genuine and sustained commitment from leaders and the entire ED team working together,” Ms Mathieson said.
As part of the refreshed strategy, ACEM will publish regular updates on meeting its goals, including growing the Māori ED workforce to reflect the communities it serves, supporting kaupapa Māori research and publishing an annual snapshot of Māori patient and whānau experience in EDs.
"The College acknowledges and celebrates all who have contributed to this kaupapa - the Manaaki Mana Advisory Group, our kaikōkiri, clinicians and all who continue to champion better outcomes,” Dr Allely said.
“Together we will continue to advocate for emergency care where excellence and equity are aligned and where the expectation is that everyone is treated with humanity and respect."