THE HEALTH LEADER Vol. 3 No. 2 Summer 2016
2016 CONGRESS: An outstanding success Plus … Are Australian healthcare managers hardy? VALUE FOR MONEY IN HEALTHCARE: AT WHAT COST? Special interest: The dangers of aged care falls More people in health and community services choose HESTA for their super
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1781_HESTA_Generic_HealthLeader_210x276.indd 1 28/06/2016 1:12 PM FOREWORD
From the President
Welcome to this edition of The Health Leader.
The theme will be ‘The winds of change – adjust your sails’. Over a number of years and at many congresses, we have explored much about how to improve our healthcare delivery, our strengths and shortcomings, and where policy stops and management action starts. Now is the time to decide on the course of action to build resilience in our health system in the face of ongoing change, with a need for greater efficiencies, greater advancements in technology, and greater involvement by healthcare consumers in their treatment decisions.
So I look forward to seeing you at the 2017 congress in Sydney. It may sound like it is still a few months away but do seize the opportunity to secure early bird rates when they open. It’s also a good idea to ensure ACHSM has your latest contact details on file, so I encourage you to sign in at achsm.org.au and check that we have your most current details.
I would also like to invite our Associate Fellows to consider sitting the Fellowship examinations in 2017 in order to advance to Fellow of ACHSM. By the time you read this, applications are about to open and examinations will be held Mon 25 Sep in Sydney.
Fellowship is the highest level of membership within the College and provides the opportunity for you to demonstrate your ongoing commitment to excellence in health service management. Fellowship is recognised both nationally and internationally in the health t’s a great honour for me to write to you since being recently elected management arena. Ias the new President of the ACHSM. I’ve taken the reins from Adj A/ Prof John Rasa, who has overseen a very successful period for the THERE ARE THREE ESSENTIAL REQUIREMENTS TO BE MET: College, especially with the success of our annual congress, now held • Applicants must be Associate Fellows of the College, jointly with the Australian Council on Healthcare Standards (ACHS). The or eligible to be Associate Fellows. 2016 congress in Brisbane welcomed more than 530 delegates, an even • Candidates must score at least 20 points on the Membership bigger achievement than previous events in Melbourne and Adelaide. Our Application and Advancement Scoring Form. peak event featured new sessions with workshops and implementation • Payment of the Application Fee must be submitted intensives including well-known names in the healthcare and leadership with the application. spaces such as Georgie Harman, Dr John Heer, Prof Ian Kennedy, Catherine McGregor, Dr Norman Swan, Prof Peter Pronovost – to name a few. Fellows provide leadership across the spectrum of public, private and not-for-profit organisations, in the areas of acute, primary and What impressed me personally was the increasing awareness among long-term care, and health improvement. They are engaged in tertiary colleagues of the need to professionalise health service management. education and research, policy development and government service, The release of our new Master Health Management Competency professional services and project management. Being awarded Fellowship Framework in 2016 has started serious conversations among members means being recognised for your commitment to research, continuing and, more broadly, colleagues in the profession about how we develop, professional development and learning, and applying demonstrated measure and value the competencies in leading our healthcare system knowledge in health service management. at a more granular level. This is a conversation that I am also having at the level of the International Healthcare Federation (IHF) as Chair Lastly I hope you get involved in state and territory activities. This is of a special interest group aiming to further establish the health where great learning, mentoring and networking can take place. If you’re management professionalisation agenda. You can find out more about reading this and you are not a member, we encourage you to join! it on our website achsm.org.au in the Education section. I hope you enjoy this edition of The Health Leader. As always, please send your feedback and content suggestions to [email protected]. Our work for the 2017 congress, to be held at the Hilton Sydney from 27 to 29 September, has already begun. We’re excited to bring Dr Neale Fong FCHSM (Hon) Australasia’s peak health management event to the Emerald City and President look forward to delivering an even bigger offering this time. Australasian College of Health Service Management
Australasian College of Health Service Management 1 CONTENTS
THE HEALTH LEADER IS PUBLISHED BY: AUSTRALIAN CAPITAL TERRITORY BRANCH: Rebecca Byrnes Branch Support Offi cer E: [email protected] ON BEHALF OF: NEW SOUTH WALES BRANCH: Sharlene Chadwick 7 12 Executive Offi cer E: [email protected] The Australasian College of Health T: +61 2 8753 5120 Service Management (ACHSM) Yaping Liu ABN 41 008 390 734 | ISSN 2203-8760 Librarian Suite 3, Level 4, 230 Victoria Road, E: [email protected] Gladesville NSW 2111 T: +61 2 8753 5122 PO Box 671, Gladesville NSW 1675 T: +61 2 8753 5100 Danielle Morgan F: +61 2 9816 2255 Events Offi cer 16 20 E: [email protected] W: www.achsm.org.au T: +61 2 8753 5131 GENERAL ENQUIRIES: Accounts: +61 2 8753 5140 Kathy Maxwell Congress and Events: +61 2 8753 5130 NSW Administration Offi cer Membership: +61 2 8753 5115 E: [email protected] Features E: [email protected] T: +61 2 8753 5121 Managing Editor: Robin Dosoruth QUEENSLAND BRANCH: All editorial enquiries should be directed to ACHSM Joint program with ASHM to smash stigmas 12 Mike Knowles Editor: Trish Riley Executive Offi cer Advertising Sales: E: [email protected] Patient voice – hearing it, listening to it and using it 14 Crowther Blayne T: +61 7 3229 3170 Lyndon Smith: +61 7 5553 2800 IPSAM helps northern NSW LHD achieve Design and Layout: Debra O’Brien Andrew Crabb, Michelle Triana workforce improvements 16 Events Coordinator Administration: Robin Dosoruth E: [email protected] Printed by: Bluestar Web T: +61 7 3229 3171 Value for money in healthcare: at what cost? 18 © All material in this magazine is copyright and may not be reproduced, in part or in full, by any means, SOUTH AUSTRALIA BRANCH: without the written permission of the publisher. Accreditation ready, every day 20 Adrienne Copley Executive Offi cer THE ACHSM TEAM E: [email protected] NATIONAL OFFICE: Flying Doctor calls for targeted action T: +61 8 8379 3070 so accidents won’t happen 22 Catherine Chaffey Chief Executive Offi cer VICTORIA BRANCH: E: [email protected] Implications of the VAGO report Andrea Hutchinson on bullying and harassment 23 Richa Apte Executive Offi cer Membership Administration Offi cer E: [email protected] E: [email protected] T: +61 3 9654 4122 T: +61 2 8753 5125 Sherryl Hind Sylvia Chin Program Support Offi cer Accountants E: [email protected] Regulars E: [email protected] T: +61 3 9654 4111 T: +61 2 8753 5141 WESTERN AUSTRALIA BRANCH: NEWS Robin Dosoruth Sally Clark/Ashleigh Fong 2016 Congress: An outstanding success 3 Marketing & Communications Manager E: [email protected] Executive Offi cers ACHSM Defence Special Interest Group established 7 T: +61 2 8753 5151 E: [email protected] OPINION Rex Matthews NEW ZEALAND BRANCH (NZIHM): Finance & IT Manager Jayanthi Mohanakrishnan Are Australian healthcare managers hardy? 9 E: [email protected] President T: + 61 2 8753 5140 E: [email protected] INTERN PROFILES 24 Alison McCann T: +64 21 241 3196 Executive Assistant to CEO IN THE LOOP 28 E: [email protected] HONG KONG COLLEGE OF T: + 61 2 8753 5111 HEALTH SERVICE EXECUTIVES: ACHSM COUNCILS 45 Anders Yuen Melissa McLennan E: [email protected] Congress and Events Manager T: + 852 25898333 DIRECTORS 46 E: [email protected] T: +61 2 8753 5130 SPECIAL INTEREST Jack Muranty-Wilkins The dangers of aged care falls 50 Marketing and Communications Intern
Lea Sugay Admin Support Offi cer E: [email protected] T: +61 2 8753 5115 2 Australasian College of Health Service Management NEWS
2016 Congress An outstanding success The joint ACHSM/ACHS Asia-Pacific Congress held at the Sofitel Brisbane Central 26 – 28 Oct 2016 was a complete success, far outdoing initial estimates. With over 530 delegates in attendance, over 35 sessions, and with a line-up of 92 speakers, the conference outperformed previous events in Melbourne (2015) and Adelaide (2014).
Australasian College of Health Service Management 3 NEWS
ith a strong focus on providing information represented major value to delegates. Early in Wand inspiration for health managers and 2017, ACHSM will start publishing some of the leaders, the theme of ‘The health leadership presentations on its website. The interest from challenge: making things happen’ aimed to poster presenters was also notable and resulted deliver some practical, proactive pointers for in a large number of posters on display. those at the coalface in healthcare. Earlier in the week, the College welcomed 41 Action areas included ‘how to build a better new Fellows at the Fellowship conferment workforce’, ‘create stronger performances by ceremony, including those from New Zealand better utilising available data’ and ‘examining and Hong Kong. leadership qualities at an international level’, as well as a ‘review of the culture behind leadership’. Beyond the academic program, the social events were well attended. The congress Following a ‘Welcome to country’ by Danny dinner’s theme on Thursday 27 October was Doyle, the Hon Cameron Dick MP, Queensland ‘Halloween Howling.’ Delegates went all out Minister for Health and Ambulance Services, with their outfits and make-up, as you will see formally opened the congress, followed by from the remarkable photos. welcomes from outgoing ACHSM President John Rasa and ACHS President John Smith PSM. ACHSM and ACHS would like to salute the support of the organisations, from gold The plenary session hosted by leading ABC sponsors to lanyard sponsors to exhibitors, health commentator Dr Norman Swan asked without whose financial support this event the potent question ‘How can we make things would not have been possible: ADEC Preview, happen in health?’ This followed an audience- Australian Technology Network of Universities, participatory format that proved successful last Broadspectrum, Bureau of Health Information, year, with an ‘on-the-spot’ interactive survey Cabrini, Cognitive Institute, Deakin University, of the room utilising smartphones and tablets Francis Health, EY, HESTA, Holman Webb, to give insight into the country’s health leaders Intraspace, Johnson & Johnson, Lightfoot, and managers’ thoughts. Medirest, Medline, Murdoch University, Premis Solutions, Queensland Health, Roche, Schneider The list of commentators and thought leaders Electric, Spotless, University of New England, in healthcare and leadership who spoke at this University of Tasmania, and UTS. year’s congress played a big part in its success, as did our renewed partnership with the The 2017 Congress will be held at the Hilton Australian Council. Names like Martin Bowles, Sydney from 27 to 29 September. Keep an Sir Ian Kennedy, Prof Peter Pronovost, Anne eye out for announcements of when early Cross, Robert Cook, Catherine McGregor and so bird registrations will become available. Visit many more, ensured that the congress program achsm.org.au/congress to stay up to date. xyz
4 Australasian College of Health Service Management Australasian College of Health Service Management 5 NEWS
MORE INFORMATION: www.achsm.org.au/congress
6 Australasian College of Health Service Management NEWS
ACHSM Defence Special Interest Group established At its mid-year meeting, the ACHSM Board unanimously agreed to establish an Australian Defence Force (ADF) & New Zealand Defence Force (NZDF) Special Interest Group (SIG). Major David Bullock Royal Australian Army Medical Corps (RAAMC) proposed the establishment of the ACHSM Defence SIG.
s many of our members will be aware, our Acoalition partners have similar memberships with health management groups that promote professional discussion and membership.
Defence SIGs are most certainly not new with active branches or chapters established within similar institutions. Some coalition examples include the IHSM United Kingdom (Defence Branch) and the Defence ‘Starlight’ chapter of the Canadian College of Health Leaders (CCHL) and the American College of Health Executives.
Less the United States of America, these countries have similar health systems, similar defence structures and a strong commitment to providing high standard of care, health and clinical leadership and management. The United Kingdom and Canada have active Defence SIG within their respective colleges which recognise the nuances of Defence health management in support of what can only be described as ‘a healthy, yet high risk (by virtue of their employment), young cross section of society.’
At last count there are some 40+ ADF personnel who are fully paid members of ACHSM. This is inclusive of Permanent and Reserve personnel. All eligible personnel are very welcome to join the Group. • Provide opportunity for healthcare settings through professional interaction managers within the ADF to develop with the coalition/allied military SIGs. AIMS AND OBJECTIVES OF THE their skills and share best practice of the • Provide a platform for research paper AUSTRALIAN DEFENCE FORCE SIG unique military environment with other discussion, social media interaction and the The aim of implementing, developing and international college colleagues in the research, writing and presenting of military managing a Defence SIG to act as a voice for development of best practice. health management concepts. the continuous improvement and development • Provide opportunities to adapt and apply of health service management within Defence. knowledge and practices gained in their MEMBERSHIP The objectives that are required to achieve the peacetime roles to the unique circumstances The SIG will be inclusive of all serving aim include: found on military operations, and vice versa. personnel, active service, reserve service • Provide opportunity for healthcare This includes international engagement and and retired personnel from the ADF & NZDF. managers within the ADF to develop their discussion opportunities. Additionally, Defence civilians and Defence skills and share best practice of the unique • Provide the opportunity to interface, share contractors with a current contract are also military environment with each other and knowledge with, and develop international eligible to apply for membership, subject to across the four services. best practice within expeditionary healthcare ACHSM endorsement.
Australasian College of Health Service Management 7 NEWS
MAJOR David Bullock AVM Dr Tracy Smart CAPT Briony Morgan LTCOL Elisabeth Barnett
OPPORTUNITY The management of health services and capabilities within Defence brings a plethora of management challenges. A number of these challenges are unique to Defence. The many nuances that are neither better nor worse than more traditional health management roles and will be the subject of future articles.
MANAGEMENT Royal Australian Navy Rep: Commander Defence health management is multi-faceted, The Defence SIG will be managed in Robert Curtis (position will be made available multi-dimensional, supporting Defence accordance with the Constitution and ACHSM to a volunteer) and whole of Government efforts, within a Rules. A number of SIG committee positions Army Rep: MAJOR David Bullock (position will domestic, international expeditious and often have already been filled by volunteers. Several be made available to a volunteer) complex austere environment. positions remain vacant and we welcome Royal Australian Air Force Rep: Vacant volunteer nominations. The Defence SIG provides an exciting platform In accordance with the ACHSM Rules and for Defence Martime, Land and Air oriented Chair: MAJOR David Bullock* Constitution, committee positions are held for health managers to share information and Hon Chair: AVM Dr Tracy Smart three years. The positions of Chair, Vice Chair, intellectual concepts, to analyse, critically think Vice Chair: CMDR Robert Curtis Secretary and Registrar are re-elected by the and challenge the status quo. Additionally, Secretary: CAPT Briony Morgan committee annually. members will be able to seek out and embrace Registrar: LTCOL Toni Bushby innovation and best practice while adopting/ Assistant Registrar: LTCOL Rusell Linwood* *Denotes people who are also branch council members embracing the ‘Line of Sight’ vision of better CPD Manager: LTCOL Elisabeth Barnett* either elected or co-opted. Defence health. xyz
8 Australasian College of Health Service Management OPINION
Are Australian healthcare managers hardy? In 2010, I received permission to access the list of members of ACHSM to assist with my professional doctoral studies. Subsequently, ACHSM members were sent a link to an online survey of how hardy Australian healthcare managers are. This year, I am pleased to share my findings with the ACHSM membership.
Ann Hague
y professional doctoral studies involved Mexploring the personality construct of ‘hardiness’ and whether it is evident in the manager cohort across the Australian healthcare sector. Further to that, they also explored whether, once identified, hardiness could be predicted through the presence of either demographic or leadership factors. And finally, whether hardiness could be used as a means to help recruit for the difficult and challenging positions that senior roles in the Australian healthcare sector represent.
Investigating the association between hardiness and a number of demographic, individual and organisational constructs identified some consistencies that are supported by, and contribute to the field. In particular, this study found that managers in the Australian healthcare sector report hardy personalities, and that hardiness and contingent reward have a significant positive relationship.
The concept of hardiness, where individuals can be described as reacting positively to that over time, despite being exposed to the interrelated constructs provide the existential adversity, has its foundations in the work of same stressors, two different groups emerged. courage and motivation that allows the hardy the existential philosophers and psychologists One group had an increased occurrence of individual to turn negative stressful times Frankl (1960), Binswanger (1963) and medical and psychological problems, while into positive growth opportunities. Hardiness Heidegger (1986). These authors wrote about those in the other group showed little change is also known to be innate, meaning that this meaning in life, exploring how meaning was in their health or wellbeing, with a small character trait is evident early in life and can created and how individuals were able to live number becoming healthier and more robust. be developed further; however, if it is not life fully despite any challenges. They also evident early in life, it cannot be taught (Hague explored how one views the self, along with Employees in the second group were referred & Leggat, 2010). how one views the social and the physical to as being stress-hardy. The incidence of world outside of the self. those who showed little change or improved, There is much research that shows that and those who experienced health issues was hardiness is important as a means to reduce DEFINITIONS not related to whether they lost their job or or avoid the negative impact of stress (Kobasa, The term hardiness was first used by were reassigned. 1979a & b; Manganelli, 1998; Bartone, 1995; psychologist Dr Susan Kobasa who undertook Maddi et al., 2011). It is believed that the hardy a study of employees in the Bell Telephone Hardiness is described as comprising the three person views stressors as having meaning and Company in Illinois – an organisation that was interrelated constructs of personal control, as such hardy individuals appear involved and being reconfigured. The employees were either challenge, and commitment (Kobasa, 1979a & committed in their attitudes to life, work and to be redeployed within the company or lose b). Further to this, Maddi, Khoshaba, Harvey, play, and they generally have an optimistic their employment. Kobasa (1979a & b) found Fazel and Resurreccion (2011) add that these outlook (Kobasa, 1979a & b; Harrison, Loiselle,
Australasian College of Health Service Management 9 OPINION
Duquette & Semenic, 2002). In healthcare, and organisational leadership constructs may ensure these managers are supported to studies have shown that high levels of hardiness that have been linked with organisational continue to develop, rather than be overcome are related to lower levels of burnout (Topf, performance. The demographic characteristics by the pressures of the position. Measuring 1989; Boyle, Grap, Younger & Thornby, 1991). were age, gender, education level, occupation, hardiness will assist healthcare organisations organisational role, organisational type, in recruitment, staff development and staff Personalities that are known to be hardy organisational size and whether the support processes. Once hardiness is recognised tend to use measures that are support- organisation was located within Australia. in an individual, the investment in and seeking and problem-focused when managing development of the existing, and emerging stress, where those that are not hardy tend The leadership constructs were divided leaders can be specifically targeted. to avoid confronting or dealing with these into two groups. The first being individual issues (Williams, Wiebe & Smith, 1992). leadership related constructs which included Recognising contingent reward is linked to Thus hardiness is positively associated with empowerment, affective commitment, hardiness and offers an alternate or additional successful coping strategies. emotional wellbeing and organisational way of assessing candidates during recruitment citizenship. The second group was activities through the identification of how HARDINESS IN HEALTHCARE organisational leadership-related constructs an applicant operationalises contingent The demands of managing in healthcare are which included transformational leadership, reward behaviours. well known and well documented (Cosgrove, staff relationships, contingent reward, loyalty Fisher, Gabow, Gottlieb, Halvorson, James, and follower satisfaction. Each of these This may include pre-employment screening Kaplan, Perlin, Petzel, Steele & Toussaint, 2012; variables were chosen as a means to explore for hardiness, or the applicants approach to Harrison, et al., 2002; Rowling, 2011). It is linkages with or predictors of hardiness. contingent reward through interview questions suggested that hardiness is as important an that explore the three interrelated constructs attribute as any other for healthcare managers The results indicate that managers in the of hardiness; challenge, commitment and in meeting the challenges of this changing and Australian healthcare sector are hardy and control of the candidate, and using questions demanding environment. Given the evidence that this trait can be of assistance in activities that explore the experience and behaviours that hardiness assists with the management including recruitment, in setting policy of candidates, rather than merely their of stress in healthcare staff (Topf, 1989; Boyle, direction and in developing organisational clinical or managerial competence. Framing Grap, Younger & Hornby, 1991), it can be structures. Hardiness was also positively behavioural interview questions to explore expected that healthcare managers with high associated with contingent reward, namely the operationalisation of transactional and levels of hardiness would be best positioned those rewards that were of a psychological transformational contingent reward behaviours to cope with the complexities of the current rather than transactional nature. in candidates would support this approach. healthcare system. How organisations can tap into hardiness With regard to organisational structures, this As noted, this research was designed to identify This research suggests that healthcare research indicates that team based structures whether Australian healthcare managers are organisations should focus on identifying were a way of supporting both the hardy hardy, and if there is an association between hardiness among management staff. Matching employees, and those who do not have strong hardiness and demographic, individual hardy managers to challenging positions hardiness tendencies.
10 Australasian College of Health Service Management Organisational policies that include employee function of the SPSS program. One other Alternately, in the hardy manager, this is support though performance appraisal, limitation was the internal reliability of the represented as transactional contingent behavioural interviewing techniques for new hardiness measurement tool, the Personal reward leadership developing trust and employees and targeted mentoring support, Views Survey III-R. Two approaches were used transformational contingent reward and the development of existing and emerging to mitigate this issue, the first being to use leadership building on that trust. leaders, so where present, hardiness can the total score to determine the hardiness be developed and strengthened. Both the levels of the respondent group, the second organisational structures and policies can be was to remove those items with a low inter- supported through well-developed and targeted item correlation until the coefficient alpha training and support of all staff. In particular, score was above 0.7, and then proceed with Hardiness can be described as leaders in the organisation need to be able to the data analysis. individuals reacting positively understand and operationalise these policies, to adversity. Once hardiness so as to equip them with the requirements of In closing, it is apparent that managers their role. in the Australian healthcare sector are is recognised in an individual, generally hardy. It is the hardy personality the investment in and LIMITATIONS who features a consistent balance and There are conflicting views in the literature as stability across different situations, and development of the existing to whether demographic variables influence the who reflects a dispositional indicator and emerging leaders can be levels of reported hardiness. This research did that allows them to take advantage of specifically targeted. not find any positive link between hardiness, environmental opportunities and to learn and any of the demographic variables. from them. From this research we now also know that contingent reward behaviours Limitations of this research include the can have positive impacts on employees The hardy personality features a lower than hoped for response rate. This was when it is tempered by transformational consistent balance and stability across mitigated by the use of the bootstrapping leadership behaviours. different situations. xyz
REFERENCE: Bartone P, A short hardiness scale, presented at the 103rd Annual Convention of the American Heidegger M, Being and time, New York, HarperCollins, 1986 Psychological Society Annual Convention, New York, August 1995 11-15 Kobasa S, Personality and resistance to illness, American Journal of Community Psychology, Binswanger L, Being in the world: Selected papers of Ludwig Binswanger, New York, Basic 1979a 7 413-423 Books 1963 Kobasa S, Stressful life events, personality, and health: An inquiry into hardiness, Journal of Boyle A, Grap M, Younger J and Thornby D, Personality hardiness, ways of coping, social Personality and Social Psychology, 1979b 37 1-11 support and burnout in critical care nurses, Journal Advanced Nursing, 1991 16(7) 850-7 Maddi S, Khoshaba D, Harvey R, Fazel M and Resurreccion N, The personality construct of Cosgrove D, Fisher M, Gabow P, Gottlieb G, Halvorson G, James B, Kaplan G, Perlin J, hardiness, V: Relationships with the construction of existential meaning in life, Journal of Petzel R, Steele G, and Toussaint J, A CEO checklist for high-value health care discussion Humanistic Psychology, 2011 51(3) 369-388 paper. American Institute of Management, 2012, http://www.iom.edu/~/media/Files/ Manganelli P, Hardiness and Health, A Thesis submitted to the Department of Psychology, PerspectivesFiles/2012/DiscussionPapers/CEOHighValueChecklist.pdf, last accessed 3rd Saint Anselm College, Manchester NH 03102 1998 February 2015 Rowling E (Ed), The future of leadership and management in the NHS: No more heroes, Report Frankl V, The doctor and the soul, New York, Knopf, 1960 from The King’s Fund Commission on Leadership and Management in the NHS, The King’s Hague A and Leggat S, Enhancing hardiness among health-care workers: the perceptions of Fund, 2011 London senior managers, Health Services Management Research, 2010 23 54- 59 Topf M, Personality hardiness, occupational stress, and burnout in critical care nurses, Harrison M, Loiselle C, Duquette A and Semenic S. Hardiness, work support and psychological Research in Nursing and Health, 1989 12(3) 179-186 distress among nursing assistants and registered nurses in Quebec, Journal of Advanced Williams P, Wiebe D and Smith T, Coping processes as mediators of the relationship between Nursing, 2002 38(6) 584-591 hardiness and health, Journal of Behavioural Medicine, 1992 15 237-255
Australasian College of Health Service Management 11 FEATURE
Joint program with ASHM to smash stigmas
The Australian Government and all jurisdictions have adopted National Strategies1 to help combat HIV, Hepatitis B and Hepatitis C. Stigma and discrimination were identified as leading causes for missed diagnoses of HIV and viral hepatitis, and for the failure of people living with these conditions, to engage with the health system, and seeking timely care. ACHSM is partnering with ASHM on one of a number of projects running over the next two years to facilitate the implementation of the National Strategies.
Dr Neale Fong, ACHSM National, WA Country Health Service Chairman Levinia Crooks, CEO, ASHM, La Trobe University and UNSW
ccess to healthcare is mitigated by factors Aand barriers linked to a plethora of issues, some created by health services and others from stigmatising attitudes of staff within facilities. Others still come from health consumers themselves, with past experience influence from stories about discrimination in the health service. All these factors can reduce health outcomes, impede quality of life, and ultimately result in adding to the cost of providing healthcare, if health-seeking behaviour is delayed. HIV HEPATITIS C HIV stigma was fuelled from the first A similar chain of events occurred with An exciting new initiative funded by the identification the Acquired Immune Deficiency Hepatitis C, which is readily transmitted Commonwealth Department of Health Syndrome (AIDS)2, initially called Gay Related through contaminated injecting or surgical is seeking to introduce system changes, Immune Deficiency Syndrome (GRID)3. This set equipment and contaminated blood and blood particularly in relation to healthcare for the precondition for discrimination against a products. Recreational drug use, where injecting people living with Hepatitis B, Hepatitis subgroup that was already stigmatised: gay equipment is shared with a person living with C and HIV. The project is being run by the men. With approaches such as the Grim Reaper Hepatitis C is a common route of infection. Australasian Society for HIV, Viral Hepatitis Campaign, designed to shock the community, and Sexual Health Medicine (ASHM), and the fear permeated the health system, schools4 Hepatitis C can also be transmitted sexually, ACHSM is proud to be a partner. It will allow and other services, and we still experience the particularly where there is the potential for our Fellows, members and their organisations consequences of this in residual discriminatory blood-to-blood transmission, and through to benefit from the project’s outcomes while practices, and fear by people living with HIV other skin penetration procedures, such as giving the College direct input into how that disclosure will result in discrimination tattooing with contaminated equipment. the project is developed. Prof Neale Fong or exclusion. While periods of injection drug use may be is representing the ACHSM on the Project sporadic or short lived, chronic Hepatitis C Advisory Committee. It was easy to attribute HIV’s spread to a infection is life-long unless treated. The stigma subgroup rather than to a virus and specific associated with current or past drug use makes AN OVERVIEW OF HIV, HCV practices. Globally more women than men are it difficult for many people to come forward AND HBV IN HEALTH SETTINGS living with HIV5, and while infection patterns for testing. Once in the health system people Literature review and community differ around the globe, HIV is transmitted by who are viewed as ‘drug users’ can experience consultations have been conducted to help risk behaviours, not risk groups. suboptimal treatment, or be viewed as inform the project. These can all be found on untrustworthy, or even criminal. the website www.ashm.org.au/stopstigma. Attempts to protect people living with HIV While the project focuses on the health from discrimination have resulted in processes There is considerable evidence that people system, it is commonly recognised that stigma and systems in some jurisdictions which keep who inject drugs can comply with dosing in the community also impacts negatively on HIV off the health record, or which require data treatment schedules and this is evidenced people’s health- seeking behaviour. about HIV to be coded. through compliance with methadone and other
12 Australasian College of Health Service Management MORE INFORMATION: www.ashm.org.au/stopstigma
opiate substitution programs6, and a number such as liver transplant. Structural facilitators as NEXT STEPS of drug trials among people who are injection well as the removal of discriminatory practices We aim to develop a number of online learning drug users7. A strong public health argument and redressing concerns around disclosure modules for inclusion in the CPD programs and in favour of treating injection drug users is are required. Fellowship training programs, and other tools to reduce the amount of circulating HCV in and resources, to help health service managers the community8. WITH SO MANY PRIORITIES, identify areas of concern. WHY IS THIS IMPORTANT? HEPATITIS B As senior health officials we all manage The project is also working with the Royal Hepatitis B is endemic in a number of regions competing demands. Inviting more people into Australasian College of General Practitioners and communities worldwide9, including in the an often overcrowded health service can sound (RACGP) and Australian Primary Health Care Australian indigenous population, which can counterintuitive, but projects such as this Nurses Association (APNA) to develop training be identified back many thousands of years10, ultimately aim to reduce the burden: getting and resources. Importantly the ACSHM Board and in many Asian countries with significant people tested early allows timely treatment will look at providing opportunities for senior migration to Australia such as Viet Nam. initiation and averts new infections; task managers to discuss the issues raised in the Vaccination is the most effective way to reduce shifting, particularly to the community at earlier review, and to think critically about what steps chronic HBV, but that impact is not realised stages of disease progression can avert more should be taken. until subsequent generations. In Australia it is costly tertiary care as well as improve quality of estimated that 220,000 people have chronic life in people living with a chronic condition. In early 2017 the Australian Hospital and HBV and while it is increasing, only 50% of Healthcare Association (AHHA) will conduct a these have been diagnosed11. Many people who Systems-based approaches to prevention, simulation for the project, bringing together a have been diagnosed are not in care, and it is testing, diagnosis, monitoring and treatment range of health service partners, collaborators, thought that a number of competing factors are can reduce reliance on outmoded assumptions implementers and consumers to finalise a responsible for this. For example new migrants about infection demographics. We are all program of activity for the project through and refugees often have competing demands committed to delivering high-quality services, 2017-2018. on health, and are dealing with adjustment to and this can only be done if those services are a new country. It is thought that poor uptake delivered free from stigma and discrimination. Project resources and processes will be made of health services may be a result of previous The College has spent considerable time available by the ASHM and ACHSM website. negative experience in seeking health care, and/ addressing harassment and bullying in the We also hope to see presentations submitted or fear of disclosure. Progressive HBV disease workplace. Helping our Fellows, members and for the annual conference, in the SHAPE is largely asymptomatic, and significant liver their organisations to respond to stigma and program and through presentations at our damage including liver cancer can result, discrimination and to explore systemic barriers breakfast forums and webinars. xyz leading to death or highly costly procedures to service access is a logical next step.
REFERENCE: 1. Australian Government 2nd National Hepatitis B Strategy, 4th National Hepatitis C Strategy 7. Backmund M,Meyer K, Von Zielonka M, Eichenlaub D. Treatment of hepatitis C infection and 7th National HIV Strategy. http://www.health.gov.au/ internet/main/publishing.nsf/Content/ in injection drug users. Hepatology.2001 Jul; 34(1):188-93. http:// www.ncbi.nlm.nih.gov/ ohp-bbvs-1 pubmed/11431750 2. MMWR Epidemiologic Notes and Reports Pneumocystis Pneumonia --- Los Angeles June 5, 8. Grebely J and Dore GJ. Can hepatitis C virus infection be eradicated in people who inject 1981 / 30(21);1-3 http://www.cdc.gov/mmwr/preview/ mmwrhtml/june_5.htm drugs? Antiviral Research 2014; 104(1): 62-72 3. MMWR A Cluster of Kaposi’s Sarcoma and Pneumocystis carinii Pneumonia among 9. J.J. Ott, G.A. Stevens, J. Groeger & S.T. Wiersma (2012) Global epidemiology of hepatitis B Homosexual Male Residents of Los Angeles and Orange Counties, California June 18, 1982 / virus infection: New estimates of age-specific HBsAg seroprevalence and endemicity. http:// 31(23);305-7 http://www.cdc.gov/mmwr/preview/mmwrhtml/00001114.htm dx.doi.org/10.1016/j.vaccine.2011.12.116 4. Associated Press Eve Van Grafhorst http://www.apnewsarchive.com/1985/Three-Year-Old- 10. Sugauchi, F., Mizokami, M., Orito, E., Ohno, T., Kato, H., Suzuki, S., Kimura, Y., Ueda, R., AIDS-Girl-Banned-From-School-After-Biting-Friend/id-ff0d3f616d 98ca813e095071fd83b7f9 Butterworth, L. A. and Cooksley, W. G. E. (2001) A novel variant genotype C of hepatitis B virus 5. amfAR (2015) Statistics for Women with HIV http://www.amfar.org/about-hiv-and-aids/ identified in isolates from Australian Aborigines: complete genome sequence and phylogenetic facts-and-stats/statistics--women-and-hiv-aids/ relatedness. Journal of General Virology, 82 4: 883-892. 6. RP Mattick, C Breen, J Kimber (2009) Methadone maintenance therapy versus no opioid 11. McLachlan, J., & Cowie B. Hepatitis B Mapping Project: Estimates of chronic hepatitis B replacement therapy for opioid dependence - Cochrane database2009. http://onlinelibrary.wiley. diagnosis, monitoring and treatment by Medicare Local. ASHM http://www.ashm.org.au/ com/doi/10.1002/14651858.CD002209.pub2/pdf/ resources/Pages/1976963416.aspx
Australasian College of Health Service Management 13 FEATURE
Patient voice – hearing it, listening to it and using it
Patient Reported Measures (PRMs) support clinicians in identifying what is truly important to a patient, and focus on improving their health outcomes and experiences of care. They are key to helping our healthcare system make patient-centred care achievable.
Jessica Drysdale, NSW Management Intern Melissa Tinsley, Program Manager, Patient Reported Measures Program, ACI
n a world where the term ‘patient-centred Icare’ is dropped among health professionals every day, it is surprising to find how many different definitions this term holds amongst us – from clinicians to managers, executives and consumers. So what is patient-centred care and how do we achieve it? Currently working with the Agency for Clinical Innovation (ACI)’s, I come across this every day – and it’s something I am passionate about delivering to the continuum of healthcare within NSW Health.
The ACI works with clinicians, consumers and managers to design and promote better healthcare for NSW. The ACI’s Clinical Networks, Taskforces and Institutes provide a unique forum for people to collaborate to develop successful healthcare innovations, supporting the case for change using evidence, health economics and evaluation. Within the ACI, the PRM and Patient Experience and Consumer Engagement (PEACE) teams work to include patients as partners in their The NSW agency for clinical innovation (ACI) and its’ teams work with consumers to ensure patients’ voices are heard, to improve the delivery of healthcare. healthcare – ensuring that the patient voice is heard, and that understanding and listening to this voice becomes business as usual in the in July to facilitate a one day masterclass on Building on this theoretical base, the PRM organisation’s processes. transforming patient experience through co- team was established at the ACI as a key design – a way of bringing patients, families enabler of the NSW Health Integrated Care Whilst the concept is not new for NSW and staff together to improve health services. Strategy. The ACI PRM program aims to Health and the clinicians and managers The process and method of co-design is being improve health outcomes for patients and within the system, it is one that the ACI has recognised, both nationally and internationally, improve service delivery through the repeated developed into a formal program to support for the benefits it provides. Sustained quality and routine collection, measurement and use the continual improvement of healthcare improvement, strengthened partnerships and of direct timely feedback of PRMs. The ACI is delivery in NSW. The ACI program provides enhanced experience and satisfaction with currently continuing the co-design process opportunities to continually develop our healthcare are just a few of the many benefits with clinicians and consumers to test, refine understanding, knowledge and skills in this that have been achieved. The day was a great and implement the PRMs program across NSW. space through capability development and success, leaving attendees (who included staff educational workshops. of NSW Health services and organisations, PRMs have been collected across the world in consumers, carers and families) with some new a number of ways and across different settings CO-DESIGN ideas for capturing experiences and working in for many years. Whether these measures are workshop brought Dr Lynne Maher, Director partnership with consumers to improve health collected as part of routine care, research, of Innovation, Ko Awatea, Auckland to Sydney care in NSW. quality improvement, health assessments or
14 Australasian College of Health Service Management There are health systems globally which excel in collecting and using Patient Reported Measures and are used to inform clinical care, treatment and shared decision-making at both system and individual patient levels. other reasons, they all aim to do one thing: condition or presenting problem. In doing truly patient-centred care. It is the vision that capture the patient voice. Internationally, there so, these measures allow clinicians to better the collection and use of PRMs will become are health systems that excel in the collection identify and manage the concerns of the business as usual for clinicians and consumers and use of PRMs. These systems, such as patient they are treating, thereby assisting across NSW, enabling our system to deliver in Sweden and the Netherlands, utilise the with the shared decision making process. PRMs the right care, to the right patient, at the measures to inform clinical care, treatment and are as accessible by clinicians as pathology or right time. shared decision making at both a system level imaging results, making them easy to build in and also at an individual patient level. to clinical consultations. The Patient Reported Measures program is continually developing resources to support So what exactly are PRMs? These measures In Australia, PRMs have been collected the implementation and sustainability of this can be split into two distinct groups; Patient by clinicians and used for the purposes practice, these resources can be found at Reported Outcome Measures (PROMs) and outlined. We do however, know that the www.aci.health.nsw.gov.au/resources/prm xyz Patient Reported Experience Measures routine collection and use of PRMs is often (PREM). The former capture the patient’s not consistent for a variety of reasons, perspectives about how illness or care impacts namely limited knowledge around access on their health and well-being, whereas the to information and support in beginning latter capture a person’s perception of their the process, and other IT system and MORE INFORMATION ON PATIENT experience with health care or services. cultural barriers. REPORTED MEASURES: Please contact Mel Tinsley, PRMs add value for clinicians and patients in Not only do PRMs provide information for Program Manager, Patient Reported numerous ways. They can be used to identify local service improvement and encourage Measures, Agency for Clinical Innovation outcomes that are important and meaningful conversations between a patient and their E: [email protected] to patients, enabling clinicians to treat patients health care professional, but they provide P: (02) 9464 4649 holistically on top of their existing healthcare a way for our healthcare system to achieve
Australasian College of Health Service Management 15 FEATURE
IPSAM helps northern NSW LHD achieve workforce improvements
Rebecca Trude, Director IPSAM IPSAM Group were engaged to support the LHD to identify, agree and plan the implementation CUSTOMER PROFILE of, workforce improvement schemes to align Northern NSW Local Health District (NNSW clinical activity and workforce to ensure the LHD) has more than 5000 employees operating LHD continued to deliver quality clinical care to across seven Hospitals, four Multi-Purpose the community. Services (MPS) and multiple Allied Health/ Community Health Centres. The LHD is SOLUTIONS regionally located across a large geographic IPSAM delivered a short, focused, workforce area of 21,470 square kilometres in the far review that recommended practical north-east corner of New South Wales with improvement schemes that the LHD an ageing population. could implement across both Nursing and Medical workforces. The LHD has an annualised budget of $730 million of which $508 million (70%) are IPSAM worked in conjunction with the LHD to workforce costs. NNSW LHD delivers a provide an evidence- based workforce review combination of Acute, Allied, Community, and redesign that utilised the LHD clinical and Mental Health, and Aged Care Services to a workforce data to identify where improvements population of 300,000 residents, increasing could be made. The teams responsible for the seasonally by an additional 100,000 people. change implementation were engaged from day one in a collaborative process that involved Wayne Jones, Chief Executive NNSW LHD NNSW LHD is committed to improving stakeholders at all levels. the health and wellbeing of all people new solutions and services. The improvement in the district by providing high quality IPSAM were engaged because of their strategies were implemented by local teams, healthcare services. established reputation as healthcare workforce with the support of the Executive, to engender specialists who provide immediate value. The change and increase communication activities. CHALLENGES in-depth healthcare knowledge and experience The improvement schemes implemented As NNSW LHD continues to grow and the that IPSAM provided enabled the workforce were results-based and outcome-focused demand for services increases, the levels of review and redesign to be delivered in short, which enabled the LHD to realise tangible clinical activity have changed. focused three-month projects that enabled the results quickly. LHD to achieve real dollar savings across both To ensure quality clinical care is delivered, the workforces in short timeframes. The outcomes of the review and redesign LHD must continue to optimise the workforce provided NNSW LHD with the tools and to align the people rostered with the clinical The LHD sought a solution that could be easily resources to implement the change and continue activity. This is a complex task when factoring implemented without added investment in to review and monitor the progress year on year. in key components such as acuity, skill mix, awards and ever changing levels of patient activity throughout the day.
To ensure the LHD continues to deliver The work delivered by IPSAM has the highest levels of patient care in an environment of ongoing improved service provided the LHD with bottom line delivery, NNSW LHD engaged IPSAM to review and redesign targeted departments across savings to fund new models of care and Nursing and Medical workforces. improve the coverage of staff in clinical The challenge for IPSAM was to align clinical activity with workforce to increase throughput, areas. IPSAM provide the training and reduce waiting times, and secure accurate levels of Activity Based Funding (ABF) while tools to local stakeholders to sustain removing avoidable costs and improving patient care. This was no small challenge! the efficiency benefits.
16 Australasian College of Health Service Management RESULTS The LHD saw immediate in-year savings and is IPSAM provided NNSW LHD with outcome- continuing to realise improvements and savings IPSAM focused improvement schemes and practical through the targeted monitoring and continued IPSAM is a Sydney-based, specialist action plans that enabled the LHD to identify application of the recommended improvement workforce-optimisation consultancy. over $3.5 million of tangible savings over nine schemes for the service. IPSAM consultants are healthcare months. These savings will be reinvested into workforce specialists who deliver real new and broader models of care and ultimately The improvement schemes implemented have outcomes from evidence-based results. improve the level of clinical care provided. been maintained and continue to provide IPSAM has more than a decade’s the LHD with continuous improvements in experience in healthcare workforce By implementing the recommendations, delivering quality clinical care and better planning and optimisation and has the LHD made immediate improvements in operational outcomes. xyz a reputation for providing pragmatic aligning the workforce to clinical activity, advisory services. IPSAM offers both which resulted in improved quality care and strategy and delivery solutions including: increased effi ciencies. MORE INFORMATION OF HOW IPSAM • Workforce optimisation, review CAN HELP YOUR ORGANISATION and redesign ALIGN YOUR WORKFORCE AND The Nursing and Medical departments • Organisational development reviewed now provide better staffi ng coverage. CLINICAL ACTIVITY: • Customised reporting Throughput and waiting times have also been Please contact: Rebecca Trude, positively impacted. The LHD has identifi ed IPSAM, Suite 9, Raglan Square, • Project and programme management areas where levels of ABF can be increased Mosman NSW 2088 IPSAM is experienced in aligning through improved governance and compliance P: (02) 9969 0956 | M: 0420 312 120 workforces to clinical activity to ensure and is continuing to realign the activity and E: [email protected] optimum service delivery at all times. workforce costs.
Australasian College of Health Service Management 17 FEATURE
Value for money in healthcare: at what cost?
Determining which healthcare services continue to receive funding requires careful attention to value for money and adopting the right approach
Tony Roccisano, Contracts Professional
he Australian Federal Government’s Medicare TBenefits Schedule (MBS) review has drawn attention to value for money in healthcare and the problem of funding healthcare services that provide little value, or that might even be harmful. On the surface, it seems self-evident that such healthcare services should not be funded or commissioned, but this issue is not as simple as it might seem. This article will identify some of the different elements to this issue, by first briefly outlining aspects of the national context, and then highlighting some points that those commissioning healthcare services should take into account.
The MBS was created in 1984, at the same time that Medicare was introduced. As at 1 April 2015, there were 5,769 items on the MBS, most of which have been on the list for It is important that those commissioning healthcare services pay careful attention to achieving value for money, a considerable period of time1. Only a minority and to their methodology for doing so. of the items on the list have been subjected to the kind of evidence-based assessment to is a complicated issue for the MBS review, and they should prescribe a particular treatment or which new additions to the list are subjected2. for any commissioner of healthcare services. test, so a desire to err on the side of caution Therefore the MBS review is an important piece Some research published in the Medical Journal by prescribing more diagnostic tests would be of work, and the difficulty of the task should of Australia in 2012 concluded that it would understandable. It may be that the public needs not be underestimated. probably be quite rare to find healthcare to assume greater responsibility for this issue. services that are ineffective or unsafe across Further education of the public may allow The quantum of potentially wasted expenditure the entire population to which they are them to play a more active role in determining resulting from the MBS is not yet known. In applied5. Consequently, it suggested that which medical tests and procedures they September, public statements claiming that policies should be developed that allow for a undergo. In its August 2015 Health Policy 30 percent of Australia’s $155 billion annual more nuanced set of indications for coverage Report, the George Institute for Global Health health expenditure was spent on services, tests of particular healthcare services, in order to acknowledged that patients have a role to and procedures that provide negligible clinical minimise the use of those services outside play as ‘partners in care’, in the context of benefit, or at worst are unsafe and potentially of those indications6. When such policies are its recommendation for increasing public harmful, drew criticism from the Australian applied to fee-for- service healthcare funding awareness about the need to modify funding Medical Association3. Since then, it has been models, the report said it may require stricter approaches in order to improve Australia’s acknowledged that this figure was only a clinical item and patient descriptors and fee healthcare system8. very approximate estimate of what the actual refinements, whereas for program budget, number may be, and that it may take up to 18 bundled or capitated funding models, there THE ROLE OF HOSPITALS months before a more reliable estimate of the could be incentives created to encourage A report by the Grattan Institute in August amount of such wastage is known4. the use of services that offer the best 2015 considered the issue of Australian patient outcomes7. hospitals that provide unusually high levels WHICH METHODOLOGY? of do-not-do treatments9. Although it Determining a funding methodology for THE ROLE PATIENTS PLAY acknowledged that there can be legitimate healthcare services according to the efficacy Primary healthcare providers must sometimes reasons why this occurs, it nonetheless of those services based on reasonable evidence make difficult judgement calls as to whether recommended that the Australian Commission
18 Australasian College of Health Service Management Further education of the public may allow them to play a more active role in determining which medical tests and procedures they undergo.
considered incentives. That same Grattan measures, and the performance measures Determining a funding Institute report mentioned that funding should be constantly monitored cuts, which might be used as a ‘last straw’ and reviewed, methodology for healthcare services for any such hospitals that persisted in • performance measures should be assessed according to the efficacy of those carrying out unusually high levels of do- against the risks of likely negative services based on reasonable not-do treatments without an appropriate consequences of their use, and threshold evidence is a complicated issue for justification, should be applied with caution. measures, especially those with pass/fail This is because the use of simple formulas to outcomes, should be avoided wherever the MBS review. carry out funding cuts could lead to gaming, possible, and and because such funding cuts are likely to • data regarding performance management on Safety and Quality in Health Care publish alienate clinicians11. should be widely available and there a list of do-not-do treatments, and identify should be ongoing assessment of the those hospitals that carry out unusually high The risk of system gaming was one factor degree to which metrics are being gamed, numbers of such treatments10. It also suggested identified in an April 2015 report on the UK and performance measures should be that private health insurers should be allowed National Health Service by Dr Foster Ltd, applied fairly, so as to recognise legitimate to withhold funding from such hospitals. which considered the creation and use of mitigating factors such as resources performance metrics12. It made a number and factors outside the control of the THE UNSEEN IMPACT of recommendations13 regarding the use of relevant organisation. Given this broader context, it is important performance metrics that are worth noting that those commissioning healthcare services by those commissioning healthcare services The attention that value for money is currently pay careful attention to achieving value for in Australia, including that: receiving in the health sector in Australia money, and their methodology for doing so. • data quality should be accorded the has created fertile conditions for those For example, where this involves the use of same importance as achieving targets, commissioning healthcare services to explore financial incentives, clinicians will need to be to limit the negative consequences of new methods for incentivising the achievement properly consulted to obtain their input into performance management systems, of value for money. Yet any such methods the proposed incentives. This can help to avoid counterbalancing metrics should be require appropriate due diligence if they are to perverse consequences from inadequately monitored in addition to performance avoid the many pitfalls for the unwary. xyz
REFERENCE: 1 Medicare Benefits Schedule Review Taskforce Consultation Paper: Overview September 2015. 8 The George Institute for Global Health, ‘Investing in healthier lives: Pathways to healthcare 2 Medicare Benefits Schedule Review Taskforce Consultation Paper: Overview September 2015. financing reform in Australia’, August 2015, at page 11. 3 Page 44, Australian Financial Review, Tuesday 6th October 2015. 9 Grattan Institute, ‘Questionable Care: Avoiding ineffective treatment’ August 2015. 4 Page 44, Australian Financial Review, Tuesday 6th October 2015. 10 Grattan Institute, ‘Questionable Care: Avoiding ineffective treatment’ August 2015 at page 1. 5 MJA 197 (10) 19 November 2012 at page 559. 11 Grattan Institute, ‘Questionable Care: Avoiding ineffective treatment’ August 2015 at page 29. 6 MJA 197 (10) 19 November 2012 at page 560. 12 Dr Foster Ltd, ‘Uses and Abuses of Performance Data in Healthcare’, April 2015. 7 MJA 197 (10) 19 November 2012 at page 560. 13 Dr Foster Ltd, ‘Uses and Abuses of Performance Data in Healthcare’, April 2015.
Australasian College of Health Service Management 19 FEATURE
Accreditation ready, every day
How two Queensland health services are looking to change the face of accreditation in Australia
Sinead Taylor, Health Management Intern, Wide Bay Hospital and Health Service day-to-day operational responsibilities of all employees, rather than just at the time of assessment. The WBHHS Director of Clinical ccreditation is a long-standing process in Governance, Jeremy van den Akker, described Athe Australian health sector. Whether you the proposed process as ‘the only way have a clinical or administrative background, it forward to ensure standards are employed at is likely that you have had some involvement the bedside.’ in the accreditation process of your health organisation. It is the complex, cyclical process In partnership with Metro South Hospital that aims to safeguard the quality and safety and Health Service (MSHHS) in Brisbane, of patient care through monitoring the WBHHS approached the Australian Council performance of health organisations, against on Healthcare Standards (ACHS) to discuss a predetermined set of principles; which in the opportunity to trial a new accreditation Australia are the National Safety and Quality model. In the coming months, WBHHS and Health Service Standards. MSHHS hope to start a pilot run of this new model, in order to evaluate its effectiveness With its ominous reputation, accreditation and applicability for metro, regional and rural is the unrelenting black dog that creeps up health services. on health organisations every three to four years. Like a university student’s studies that The proposed model will be based on a four- culminate in one single, high-pressure exam, year accreditation cycle, and a ‘no notice’ whenever assessment looms, organisations approach to assessment. Surveys will occur at are sent into a frenzy trying to prepare huge Sinead Taylor is in her final year of her health a frequency unknown to the health services management internship with Wide Bay Hospital mounds of paperwork, and creating the veneer and Health Service. She has a keen interest in with Standard 1 (Governance for Safety and of perfection on one day. quality improvement, project management and Quality in Health Service Organisations) and health promotion. Standard 2 (Partnering with Consumers) Accreditation has become somewhat of an event management process in which auditors are presented with carefully manicured evidence folders, and are escorted down hallways lined with clinical staff who seem to have a penchant for washing their hands. Noun. 1. accreditation - the act of It is an event marked in every executive and manager’s calendar that must be carefully granting credit or recognition (especially planned and prepared for. But this begs the question: If you’re only ready on the days the auditors turn up, what does that mean for your with respect to educational institution patients on all of the other days? that maintains suitable standards); Wide Bay Hospital and Health Service’s motto for ‘Quality Care Everyday’ has given rise to this philosophy and the regional “a commission is responsible for the Queensland organisation aims to change the nature of accreditation in healthcare. The accreditation of medical schools” WBHHS Clinical Governance Support Unit has developed the notion of a rolling accreditation certification, enfranchisement - the act cycle with the goal being to achieve consistent readiness, and continual quality improvement. of certifying or bestowing a franchise on. The idea behind the strategy is to ensure that quality standards are embedded into the
20 Australasian College of Health Service Management WBHHS Chief Executive Adrian Pennington and Clinical Governance Executive Director Dr Pieter Pike assessed on each occasion due to their the wrong; rather it is an attempt to strip back on Safety and Quality in Health Care (ACSQHC) overarching functions. The remaining standards the façade of accreditation that has become is currently being sought. It is fair to say that will be evaluated on an alternating basis, but somewhat of a production. many will be watching with interest to see health organisations will not be aware of the what impact this ambitious new model will schedule of assessment. The organisations will Surveyors won’t be asked to wade through have on the Australian accreditation process, receive two working days’ notice prior to onsite piles of evidence folders, but instead invited and more importantly the quality and safety surveys occurring, which only allows for minor down onto the ward to witness the standard outcomes for patients. Watch this space! xyz logistical arrangements to be made. of patient care provided every day. It is an opportunity for health services to demonstrate Any High Risk/Not Met issues will follow the to the watchdogs, and the community alike, usual AC90 process, and could be identified in that ‘Quality Care Everyday’ isn’t just a any area regardless of standard the surveyors philosophy, it is a reality. MORE INFORMATION: are on site to assess. Please contact WBHHS Clinical Although the concept is yet to be finalised, Governance Support Unit: While it does sound scary, the idea of the new WBHHS and MSHHS have the support of ACHS, [email protected] model is not to try and catch health services in and approval from the Australian Commission
Australasian College of Health Service Management 21 FEATURE
Flying Doctor calls for targeted action so accidents WON’T happen
John Kirwan, Chief Executive Officer, Royal Flying Doctor Service Tasmania
o bride plans to spend her wedding night in Nhospital. But that is where Jo Rasche landed after her wedding ceremony, fearing she may never walk again.
On New Year’s Eve 2012, in a post-ceremony cool down on a 43°C day, new husband John Rasche was towing his new wife and a friend in a tube behind a boat on the River Murray at Waikerie in South Australia.
‘All I wanted to do was get married and not draw attention to myself,’ Jo said. But before the couple had even cut the cake, Mrs Rasche was flung from the tube while travelling at about 95km/h, and knocked unconscious.
She was rushed to the local hospital with serious neck injuries, before a flight to Adelaide with the Royal Flying Doctor Service (RFDS). Mrs Rasche’s ligaments were torn, dislodging spinal discs in her neck with seven minor discs bulging from the neck to the lower spine. A vertebra in her neck and the discs above and below the vertebra had to be removed. Luckily, Mrs Rasche managed to walk again.
‘The doctors said I was a miracle,’ Jo said. ‘When I came out of hospital we were joking that when we finally got married, John tried to kill me.’
Recent RFDS research has looked closely into accidents and injuries that occur in rural and remote Australia. The research paper entitled Responding to Injuries in Rural and Remote to accidents and injury, and that a very Australia, was prepared by the RFDS Research large percentage of the accidents could and Policy Unit, using data and evidence from be prevented. multiple sources and has been reviewed by academic experts, accident and injury experts, The RFDS is calling for governments to as well as RFDS staff. adopt a new accident and injury prevention strategy to save both lives and avoidable The research established that, across every hospital costs. Prevention saves lives, not measure, rates of injury and associated death to mention taxpayer dollars. Accidents such are higher in country Australia than in major as Jo Rasche’s don’t need to occur. Luckily MORE INFORMATION: cities. One in five aeromedical evacuations the she walked again – however, others are www.flyingdoctor.org.au RFDS undertakes every year are in response not so lucky. xyz
22 Australasian College of Health Service Management FEATURE
Implications of the VAGO report on bullying and harassment The recently promulgated VAGO report on bullying and harassment in the health sector highlights the endemic nature of the problem, and how management processes and structures have failed to deal with the issue. This issue has implications for emerging mangers that should also be part of the cultural revolution towards safe workplace environments.
research suggests that I fall into the category The health sector has rightfully so, always of groups most vulnerable to be subjected to prioritised the safety and wellbeing of service bullying and harassment. users, it is time employees were afforded similar protection through the creation of safe Other groups include junior staff, ethnic work environments. minorities, new starters and persons of certain sexual orientations (Priest, 2015). For a while now since reading the VAGO Being an intern can foster a certain degree report I have been in pursuit of a distinguished of resignation to the fate that you will not engineer to hammer my lower jaw back be running a department, but rather just into the closed position. I have found it running around after everyone else instead, incredulous how such disgraceful professional Mpilwenhle ‘MP’ Mthunzi, and therein lies the vulnerability to exposure turpitude, can fester so incessantly within Vic Management Intern to being bullied. The temptation not to the health sector. It makes a mockery of the “rock the boat” by reporting, or fear that much trumpeted pledge to ensure safety, doing so will jeopardise one’s career, can be and personal dignity across all working n 23 Mar 2016 the Victorian Auditor compelling. Through the elementary sense environments. I certainly hope that this report OGeneral’s Office (VAGO) tabled a report of self-preservation, this can lead to the will trigger a sense of rapprochement that will titled ‘Bullying and Harassment in the internalisation of the bullying experience, see the end to this insidious culture, and not Health Sector’. In short, the report portrayed prompting coping strategies in order to get just be yet another periodic bout of morality. a veritably grisly post-mortem of failure through the placement. It is my hope that I regarding the health sector’s poor response to never have to find myself in this position. effectively deal with bullying and harassment as a serious Occupational Health and Safety Secondly, being a future leader in the health issue. Poor leadership, and a lack of robust industry, I feel it is important that I be exposed processes to manage this insidious issue, were to processes and training on how to address Bullying and highlighted by the Auditor General as being this issue. If bullying and harassment is as particularly striking. big an issue as the VAGO report purports it to harassment is pervasive be within the health sector, then somewhere Bullying and harassment is pervasive for all along my internship I should have a section for all staff, particularly staff, particularly those subjected to such of my learning outcomes addressing the issue. those subjected to behaviour. It can be quite profound for victims This will invariably contribute a partial, albeit leading to physiological and psychological valuable piece of the management mosaic that such behaviour. distress. Given the current political appetite one hopes to achieve. for the topic, I thought to share my thoughts on the issue from the perspective of a Health For something as insidious as bullying and Management Intern. harassment; in order for change to occur, long accepted cultures of indifference and untoward As for all the bullies in work places in any The thrust of research literature to date behaviours, have to be confronted. Part of industry, take a long hard look in the mirror, regarding bullying vis-a-vis interns has been this process is arming the next generation of and know that as you put yourself to sleep on on Medical Interns, and not so much on leaders with appropriate work practice skills the pillow of your lost morals, you have truly Management Interns. Nonetheless, this body and knowledge on the issue. destroyed other people’s lives. xyz of available evidence does shed some light on the life of an intern in general. Being a Health REFERENCE: Management Intern, the VAGO report has a Priest, N. (2015) Promoting equality for ethnic minority NHS staff – what works? bilateral implication. The first is that being British Medical Journal 351: h3297 of a certain ethnic extraction, and an intern, Victorian Auditor-General’s Office (2016) Bullying and Harassment in the Health Sector. Victorian Government.
Australasian College of Health Service Management 23 INTERN PROFILE
Simon Hogan
Simon is a fi rst-year management intern in our Vic Health Management Internship Program (HMIP). He wrote this article for Monash Health iNews at the completion of his placement.
aving never previously worked in a and consulting fi rms. Following my time at Hhealth service, the past six months have Monash Health, I am sure I will have a very been a whirlwind of learnings – amplifi ed different experience at the East Grampians by the enormity of operation and service Health Service. that is Monash Health. My placement in the wonderful Innovation and Improvement team MONASH HEALTH has given me an insight into the complex My fi rst task at Monash Health was to workings of this mammoth health service, and organise a Change Day event, and to strengthened my desire to work in this space. collect hundreds of pledges from staff across Monash Health where they made a BACKGROUND commitment to improve patient experience. I was drafted to the Geelong Cats after Change Day also included an event featuring fi nishing school and spent the next six years four-time Premiership Coach David Parkin, in and out of the AFL side. Geelong was an and the launch of Monash Health’s Patient extraordinarily successful team during my Experience Strategy. time there, and I’m sure I will look back in years to come with genuine pride in playing It was a great experience in project alongside some of the game’s greats. management and communication, as well as a fantastic way to meet key people across the During this period I also studied organisation, and see the passion and skill undergraduate psychology and developed a that runs through Monash Health. Simon Hogan was based at Monash Health until July strong interest in mental health – planting this year. the seed for the next stage of my life. FOOTBALL AND HEALTH From what I’ve observed, the elements that THE NEXT STAGE I retired from professional football in 2012 led to success playing AFL at Geelong are I have learnt many new and interesting to fi nish off my studies, start a career in no different to the fundamentals of running things during my time at Monash Health health and, most importantly, to develop a a successful health service: individuals and I will leave the organisation with a great better work/life balance. For the next two understanding their role within the team and appreciation of health service management. I years, I worked at headspace, the National being guided by clear and genuine principles. will also keep a keen eye on Monash Health’s Youth Mental Health Foundation, in a At Geelong, there were a number of extremely continued development, and the efforts community engagement role that oversaw a talented players but, more importantly, to bring together talented individuals for number of national initiatives. everyone involved with the club knew their team success. role and adhered to it. The team approach was In 2015, I was hoping to broaden my view always more important than any individual. In Thank you to all who have assisted me along of health when I stumbled across a program a health service, the same philosophy applies. the way. Who knows where I will end up at the run by the Australasian College of Health end of the program – I may even see you again Service Management (ACHSM). In my short time at Monash Health in some capacity. I see the same opportunity. This is HEALTH MANAGEMENT an organisation, already achieving If you would like to keep in touch or fi nd out INTERNSHIP PROGRAM (HMIP) extraordinary things with the potential to more about the HMIP, please send me an email The HMIP involves four six-month rotations be an industry leader across many areas or add me on LinkedIn. xyz at various health-related organisations of healthcare. There are a great number of alongside the completion of a Masters of talented people throughout Monash Health, Health Administration. Most interns are ex- and bringing them together in a team clinicians with a wide range of experience approach will encourage success. Equally, the levels; my cohort of seven consists of supporting nature of the team approach will physiotherapists, osteopaths, nurses and an bring out the best in the individuals, just as it academic. Placements can range from metro did at Geelong. Individuals make up the team, and rural health services, through to the and the right team brings out the best in Department of Health and Human Services the individual.
24 Australasian College of Health Service Management INTERN PROFILE
Gideon Meyerowitz-Katz
NSW management intern
am a first-year NSW management intern I am currently working towards understanding I currently working in the Finance department of the financials of the hospital and the broader WSLHD in Blacktown. strategies that they are employing to manage funding and expenses. I am going to be placed I studied for my Bachelor of Science, majoring in the HR, and possibly population health in Psychology and the History and Philosophy departments, and am looking forward to of Science, and then finished a Master of Public obtaining a better understanding of the way Health, both at Sydney University. in which these important departments operate and interact. Prior to the program I had been working for private health companies in both admin and In the program I am looking to develop both sales roles. I am particularly interested in public my management skills and my understanding health, specifically vaccination policy and of the fundamental structures important to all electronic health interactions, as well as public managers, such as finance. I am also looking health implementation and how management forward to the large number of networking can affect policy. opportunities that are on offer, particularly the national congress and the mentoring program. I applied for the program for a number of reasons, first and foremost because of the I am excited to be attending the professional support and development opportunities that development events as I love grappling with it offers, particularly the career development concepts that I may not have come across at and networking support throughout the two work, and developing new ways of thinking years. I was also drawn by the placement about these issues. They will also offer me the organisations, and the breadth of experience opportunity to develop my understanding of that they each hold, and the mentoring the unique perspective of health management, opportunities on offer. It has been my long- outside of my previous experiences. xyz held ambition to work in health, and the HMIP offers unique opportunities to develop personally and professionally.
Gideon is one of the faces of our nationwide promotional campaign for the Health Management Internship Program (HMIP)
Australasian College of Health Service Management 25 Smart Flow™ Water Management Systems
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Providing facility designers and Each system is engineered to meet managers with a site wide performance the specific requirements of your solution capable of monitoring, facility, providing high performance controlling and measuring the whole management and compliance outcomes. ™ water delivery system. Smart Flow the benefits ...
Full BMS connection Technology link to Adaptable to fixtures & fittings Intelligent future needs & features
24/7 data capture Reduced fixture servicing Water costs Detailed Multilevel Reporting
Real time alerts Management Accurate water temperature monitoring Flow management reducing Legionella IMPROVING THE HEALTH, SAFETY AND growth risk* Adjustable Control over water PERFORMANCE OF THE BUILT ENVIRONMENT system parameters delivery system THROUGH THE INTELLIGENT MANAGEMENT * soon to be released OF THE WATER DELIVERY SYSTEM
As each facility and application has varying needs we welcome the opportunity to discuss your specific requirements. Please contact us to discuss yours ...
1300 369 273 (AUS) | [email protected] | www.enware.com.au IN THE LOOP
New South Wales
EVENTS Graduation – May There were seven trainees graduating from the Graduate Health Management Program (GHMP) at the end of 2015 with all graduates currently employed in the health sector. The graduation ceremony celebrating the 41st cohort was held on 19 May 2016, at the Kirribilli Club with over 50 people in attendance. Annette Solman, Chief Executive, HETI provided the opening address and Associate Professor Stephen Kent, Head of School from La Trobe University was also in Award recipient Briege Eva Award recipient Edmund Ng attendance for this occasion.
The Kevin Dodd oration was delivered by Carrie Marr, Chief Executive Clinical Excellence Commission. Carrie spoke to ‘What habits will define you as a leader?’ She focused on curiosity; just culture; co-creation; vision; systems thinking; reliability and authenticity, leaving the graduates to consider what behaviour they will choose to define their leadership practice. Carrie was inspiring, and the entire audience thoroughly enjoyed her speech.
Caleb Teh responded on behalf of the graduates and posed the question: ‘How will you – how will Award recipient Helen Emmerson we – continue to develop our skills and put them to use to better serve our communities?’ Budget Breakfast – July John Roach, Chief Financial Officer, NSW Recipients of the Awards presented for Health presented at a breakfast seminar which 2015 year: highlighted the 2015-16 NSW State budget • Helen Emmerson, A/Executive Director for health. He provided the opportunity for NSW Health Chief Financial Officer John Roach at the People and Culture, Western Sydney Local participants to gain an understanding of the July breakfast on the 2015-16 State budget for Health Health District – Placement Organisation of impacts at both a Federal and State level on the Year 2015 the public health care system. Elizabeth was also awarded an Honorary • Briege Eva, Sydney Children’s Hospital Fellowship and was presented with this award Network – Stan Williams Young Leaders’ Thank you to NAB Health for sponsoring at the event. Award 2015 – 1st Year Intern the event. • Edmund Ng, South Eastern Sydney Local We congratulate Elizabeth on this award Health District – Stan Williams Young NSW Health Minister’s Forum – August as recognition of her contributions and Leaders’ Award 2015 – 2nd Year Trainee ACHSM hosted a forum for NSW Health commitment to health over many years. Minister, the Hon Jillian Skinner to introduce Placement organisations were closely involved in the new Secretary of Health, Ms Elizabeth Koff, Thank you to HESTA Superfund for sponsorship the recruitment process and ongoing supervision to the wider Health personnel groups within the event. and development of management Interns. the NSW Public Health Sector and the broader NSW Health System. Emerging Health Leader Evening – August We would like to thank the placement Philanthropy in healthcare has never been organisations that participated in the Minister Skinner discussed how Elizabeth’s more important. With the pressure of increased 2015/16 Program. appointment will enable the further delivery of costs of healthcare on health service providers, the Government’s Health Plans and priorities. and expanding research areas, working with We would also like to acknowledge the Health In turn, Elizabeth spoke about how she hopes benefactors has become an integral part of Education and Training Institute (HETI) for their to build on systems and reforms to date, and healthcare research provision. ongoing support of the GHMP during 2015/16. lead the implementation of the next stage of the journey of NSW Health Service delivery, her St Vincent’s Health Network Sydney, is a leader Thank you to HESTA Superfund for sponsorship vision for the future and what she expects from in working with philanthropists to implement of the event. the leaders of the Health System. capital works and improved service provision.
28 Australasian College of Health Service Management Graduates of the NSW Health Management Internship Program (HMIP) with Branch Councillors and Executive Officer Sharlene Chadwick at the graduation in May
NSW Health Minister The Hon Jillian Skinner (above right) introduced the Secretary of NSW Health, and Honorary ACHSM Fellow, Elizabeth Koff (above left) at a breakfast in August
A/Prof Anthony Schembri, CEO St Vincent’s Meeting – August HEALTH MANAGEMENT INTERNSHIP Health Network Sydney chaired an interactive NSW Branch conducted its General Meeting PROGRAM (HMIP) Q&A panel with some of healthcare’s at the end of August and welcomed Dr Wayne Recruitment for the 2017 HMIP Program benefactors, debating philanthropy’s current Hsueh as the newly elected councillor. In is complete, with candidates having been and potential role in healthcare. Panel members addition, we also welcomed the HMIP Interns identified from across a wide range of included Charles Curran, former Chair of as councillors, Crystal Burgess and William health sectors. St Vincent’s; Nelune Rajapakse, co-founder Hackworth. We also thank and acknowledge the Nelune Foundation; Pater Wohl, Director of contributions of the retiring councillors – Lynette Thank you to those organisations who gave of SummitCare Australia; Jeremy Byrne, Executive Bruce, Matthew Noone and Nancy Piercy. their time during the recruitment process. xyz Director Coco Republic and Board member; Shanthini Naidoo, Chief Executive Officer, St President’s Awards were given to Mark Ashby Vincent’s Curran Foundation. of HESTA and Caleb Teh, Health Service Planner, Sydney Children’s Hospital Network and former Thank you to HESTA Superfund and St Vincent’s GHMP Trainee, for their contributions to the Hospital for sponsorship the event. branch and our membership.
Australasian College of Health Service Management 29 IN THE LOOP
Victoria
BREAKFAST FORUMS The Victorian Branch has held a number successful breakfast forums throughout the year, and following the well-patronised April and May events, the Branch secured a number of high-profile speakers that delivered a wide variety of engaging and informative presentations throughout the winter months.
The Victorian Branch was delighted to welcome Dr Grant Davies, Health Services Commissioner (Office of HSC) in June. Dr Davies talked about the role of the Health Service Commissioner, the recent changes at the OHSC, the types of issues that are dealt and not dealt with and provided a brief preview of the Health Complaints Act 2016. Dr Davies also went on to discuss the OHSC’s relationship with AHPRA and the Department of Health and Human Services. Dr Grant Davies, Michael Gorton AM, Health Services Commissioner Chair of the AHPRA Agency Management Committee The July Breakfast Forum was also well attended with another outstanding coming’ managers by creating opportunities HEALTH MANAGEMENT presentation, this time by Michael Gorton for them to network, obtain peer support, INTERNSHIP PROGRAM (HMIP) AM. Michael is the Chair of the AHPRA and grow professionally. The group, under The Health Management Internship Program Agency Management Committee. Michael’s the guidance of Fiona Sherwin (immediate (HMIP) began in 1990 and operates under the presentation discussed the role of AHPRA, past Chair of EHM Committee) and now auspices of the ACHSM. The program’s principal but more specifically the area of health Francisco Lopez (current Chair), continues aim is to develop future leaders for the health practitioner regulation in Victoria, and the to attract excellent speakers with a wide system, offering graduates the opportunity to recent reforms that have occurred over the variety of different events that are always develop their knowledge and understanding past few years. well attended. of the health sector and skills relevant to health management. In August, the Victorian Branch welcomed The EHM Committee also organised a Dr Sue Matthews who discussed the journey successful networking event at ‘Trunk’ of The Royal Women’s Hospital ‘From restaurant in Melbourne during June. HMIP Graduates typically Excellent to Exceptional’. Dr Matthews secure operational and support shared a number of interesting and In July, the EHM Committee ran an valuable insights into ‘The Women’s’ own interactive workshop facilitated by positions in hospitals, health transformation journey – learning’s that are ‘Global Ideas’, with keynote speaker Dr planning and corporate relevant to all areas of the health sector. Rob Grenfell, Public Health Physician and the Director of Health and Biosecurity at services roles, project, policy The Victorian State Branch would like to CSIRO. ACHSM and the EHM Committee and program administration thank NAB Health for the provision of the would like to thank Demos Krouskos, roles, or executive officer roles 2016 breakfast forum venue in ‘The Hall’ CEO of the North Richmond Community at NAB, as well as Workplace Legal, the Health for providing both the venue, and within the industry. Victorian Healthcare Association and HESTA supporting the EHM Committee in making for their ongoing sponsorship of our 2016 the workshop a success. Throughout the two years of the program, Breakfast Forum events. Management Interns are given the opportunity In August, the Committee ran one of its to be exposed to a variety of different workplace EMERGING HEALTH MANAGERS very popular ‘Wine and Cheese’ nights. and educational opportunities. (EHM) COMMITTEE Fiona Webster, General Manager, Health The Victorian EHM Committee oversees a Operations at Telstra Health was the guest Graduates typically secure operational and professional development program that speaker at that event. Fiona is well known support positions in hospitals, health planning is designed for emerging managers from in the Victorian health sector and presented and corporate services roles, project, policy all areas of the health sector. The aim of on ‘Digitising Health’, a topic that was of and program administration roles, or executive the group is to support new and ‘up and great interest to the group that attended. officer roles within the industry.
30 Australasian College of Health Service Management Dr Sue Matthews, Dr Rob Grenfell, Public Health Physician and Fiona Webster, Chief Executive, The Royal Women’s Hospital Director of health and Biosecurity at CSIRO General Manager Health Operations, Telstra Health
Advertising for the Victorian 2017 program was conducted during August, with a number of strong applications received, ensuring a high quality pool of talent to select.
The Victorian Branch is also looking to recruit Aboriginal Interns into the program for 2017. The Victorian Department of Health & Human Services (DHHS) is working with ACHSM to support Aboriginal people to participate in the HMIP, and encourages Aboriginal people to apply for the DHHS sponsored internship position.
The Victorian Branch would like to both thank and acknowledge the organisations that have supported the program this year by taking Management Interns into their workplaces, and those that will also do this again in 2017. This goes a long way to giving emerging health managers a strong start in the profession. xyz
Australasian College of Health Service Management 31 IN THE LOOP
Queensland
MARCH It was always going to be a tall order to follow Health Minister Cameron Dick with a 400+ attendance in February, but the very dynamic, high-energy speaker program continued in March with Telstra’s Tim Kelsey, who led the transformation of data and digital services in the NHS in England. Tim drew on international evidence to show how the modern information revolution is the precondition for sustainable, high quality and equitable healthcare. Tim identifi ed the key characteristics of high- performing health and care services as being data sharing, transparency and access to digital services that measurably improve clinical safety, effi ciency and integration. Patients and consumers must be empowered to take control of their health and care through easy access to personal data, online transactions and care planning services. Tim Kelsey Michelle Russell APRIL Our April presenter was Michelle Russell, JUNE attitudes of other team members. Signifi cant an Associate and former director of GE The much anticipated expose on the statistics were also presented by Dr O’Brien Healthcare who addressed ‘Engagement, Queensland Health budget was the focus of regarding the intention of some healthcare Leadership and Building a Culture of Director General for Health, Michael Walsh’s funders in the US to withhold a percentage Accountability’. Michelle asserted that the June breakfast presentation. The Queensland of payment to the clinicians for a period business case for leadership and engagement Health budget was increased by 4.3 per cent of time, depending on the ‘outcome’ of is compelling. The research shows that to $15.3 billion this coming year. Some of the the service provided! There are some organisations with engaged staff deliver major allocations were: controversial issues associated with this better patient experience, fewer errors, • the introduction of 68 ‘nurse navigators’ to proposal. We would like to thank Cognitive lower infection and mortality rates, stronger bridge the gap between hospitals and the Institute and Mark for their support of fi nancial management, higher staff morale primary health system; ACHSM Queensland. and motivation as well as less absenteeism • Fast-track 75 extra paramedics, and buy 170 and stress. High performing healthcare new and replacement ambulance vehicles; AUGUST organisations understand this and put culture • $35 million for Integrated Healthcare funds Urgent demand for healthcare comes from and leadership high on their transformation to improve care and effi ciency in hospitals; all parts of the world and many areas agendas. Thank you, GE Healthcare for making • $25 million for cutting-edge genomics are remote with diffi cult access, often in Michelle available. research by Queensland institutions; third world countries and with poor or • $6.6 million to refurbish and expand the no facilities. These are the circumstances MAY children’s ward at the Townsville Hospital; where Aspen Medical steps in, often at short Dr Steve Hambleton, former head of AMA was • $12 million for new community-managed notice. Our August presenter was Glenn our May presenter and in 2015 Steve led the mental health services to be built in Keys, Executive Director of Aspen Medical Federal Government’s Primary Health Care Mackay, Bundaberg and Gladstone; and and his presentation was entitled “Outcome Advisory Group that examined opportunities • $120m for ICT. based Healthcare – An Australian model for the reform of primary health care. One for delivering into an International Market”. of the most signifi cant recommendations to JULY Glenn provided some background, explaining come from that group was called the Health ‘Building a strong safety culture in Healthcare’ that Aspen Medical is an Australian owned Care Home. The aim is to provide a ‘home- was the title Dr Mark O’Brien of Cognitive and headquartered company that started base’ for people with complex and chronic Institute’s presentation at the July breakfast over a decade ago that provides complete disease, coordinating the comprehensive care forum. A feature of the Safety and Quality bespoke healthcare solutions, to support they need on an ongoing basis. Improved culture of all high-reliability organisations is healthcare demands in areas of high demand wellbeing for older Australians through a feeling of safety amongst team members to or remote locations. Aspen has grown to an targeted support, access to quality care and ‘speak up’ when they believe that immediate internationally operating company, across 12 related information services is now one of the harm is about to occur, or their culture of countries, 3 continents, with over 2,000 staff recommendations of the Federal Government. safety is threatened by the behaviour and providing a range of services to Governments
32 Australasian College of Health Service Management Steve Hambleton Michael Walsh Dr Mark O’Brien and resources sector companies. These services cover customers such has Defence, Indigenous, disaster response, public health and corporate health. Glenn’s presentation highlighted some key projects such as the Remote Area Health Corps (RAHC), Ebola response and Public surgery waiting lists.
SEPTEMBER At the September breakfast, Professor Nick Graves, Academic Director, AusHSI, presented a topic close to the hearts of all health managers with a title of ‘Improving the value for money of health services’. This presentation was challenging, and reinforced all the reasons why managers of health services should take up this challenge. Examples and case studies of failures and successes of implementation were used, as generated by the health Glenn Keys Prof Nick Graves services research group at the Australian Centre for Health Services Innovation (AusHSI). HMIP The support of the area supervisors has The Queensland HMIP has been running well been most valuable in assisting interns with WEBCASTS this year with eight, second-year interns their rotations within the systems, as well The Queensland Branch webcasts all the and seven first-year interns working hard in as by providing practical experiences in breakfast presentations, and these are the program. Without exception, excellent different departments. made available to everyone either live or at results have been achieved in the Masters personal convenience. The highest webcast of Health Administration undertaken online In recruiting for the 2017 intake, the take-up was for Steve Hambleton’s May from La Trobe University. Some PD days were Queensland Branch has been supported by presentation with just over 100 registrations. successfully carried out by videoconference at Queensland Health, which offered a number Total attendances at the eight breakfasts the request of the HHSs in north and central of funding scholarships, and by promoting the this year was approximately 1800 with 375 Queensland, as the distances for travel presents Health Management Internship Program to all webcast registrations. a real challenge. Hospital and Health Services in Queensland. xyz
Australasian College of Health Service Management 33 IN THE LOOP
South Australia
SA BRANCH COUNCIL HAPPENINGS The SA Branch Council continues its active planning of future professional development events for members and supporters, and some members are involved in the design of a revised membership eligibility process and changes to the constitution.
The annual meeting was held just before the annual dinner on Thu 28 Jul 2016 and we welcome Chris Barber as a new Branch Council member. Gary Day and Mark Diamond were re-elected to Council for a further term and our grateful thanks are extended to Kae Martin and Kerry Leaver who both retired following completion of their terms of office. Unfortunately, some long-term sponsors have not renewed their sponsorship and Council is actively seeking additional sponsors to ensure we can meet our budget projections. Professor Wilson Vickie Kaminski
The 2016 annual dinner and conference being clear that, for example, investing in PRIMARY CARE HEALTH REFORMS day were held on Thu 28 And Fri 29 Jul and driving down smoking rates and addressing Ms Deb Lee, Chief Executive Officer, Adelaide positive feedback was received about both issues of overweight and obesity can have Primary Health Network (APHN) spoke of events. We are very grateful to SA Health a major benefit on health expenditure in the APHN’s clear goal of “improving health who once again agreed to be our principal the future. outcomes for the people of metropolitan sponsor, to HardyGroup International for Adelaide, guided by both community and clinical sponsoring the dinner guest speaker and It is where some of the biggest gains can input”. She outlined the objectives set by the other organisations who sponsored attendee be made in improving the health of the Commonwealth that include a strong focus on tables and catering. community and avoiding unnecessary chronic disease and multiple co-morbidities, expenditure in hospitals. This is a longer- improving efficiency and effectiveness of Our long-term association with Flinders term strategy and governments need to be medical services for patients (particularly University Department of Health reminded continually and held to account. those at risk of poor health outcomes) and Care Management continues and our coordination of care to ensure patients receive congratulations are extended to Dr Elaine PROGRESS REPORT ON TRANSFORMING the right care in the right place at the right time. Pretorius on winning the ACHSM SA Health HEALTH IN SOUTH AUSTRALIA Management Prize that was presented to Ms Vickie Kaminski, Interim Chief Executive The APHN region spans north to south of her at the recent conference day. Transforming Health, SA Health, described Metropolitan Adelaide with a population of the ‘burning platform for change’ that was nearly 1.3 million people with diverse health HIGHLIGHTS FROM THE 2016 facing the SA Government. A whole-of- needs. A big challenge! BRANCH CONFERENCE system transformation was required that This year’s theme centred around readiness will see changes for metropolitan hospitals, MENTAL HEALTH REFORMS for the health reforms facing the various a better response to patient needs and Mr. David Butt, Chief Executive Officer, healthcare sectors and an excellent group enhanced models of care. National Mental Health Commission, outlined of keynote speakers discussed the impact the key principles underpinning the final report and the changes they are implementing. Vickie emphasised that managing of the mental health review recommendations Professor Brenda Wilson, Lieutenant expectations and public discourse is vital as provided to the Commonwealth Government Governor of South Australia and the people are passionate even about losing poor in Dec 2014. These include the engagement SA Branch Patron officially opened the quality health care and aged infrastructure. A of people with lived experience, their families 2016 conference. huge amount of time to be spent with people and other support people, holistic and inclusive dissatisfied with the plan and ‘clinician led’ person and family centred design principles. Prof Wilson questioned whether there was has to look and feel real. Everyone supports Plus stepped care matched to need with a cause of alarm for the massive increase change until it involves them and achieving focus on populations and a healthy start to life in expenditure in the health budget and sustainable benefits takes time. with more efficient and effective ‘upstream’ what the challenges were for health service services and supports for prevention, early managers today. She spoke of the evidence intervention and recovery.
34 Australasian College of Health Service Management Deb Lee David Butt Judy Gregurke
David outlined the spectrum of mental ill THE NEW ROYAL ADELAIDE HOSPITAL: health in Australia that has an economic HEALTHCARE REFORMS VIA FACILITIES impact of $40 billion each year. He explained DESIGN AND NEW TECH that the Commonwealth’s role is to provide Elke Kropf, Director Commissioning of the services that are nationally directed with the new RAH says it has been designed to manage services delivered regionally. increased activity, provide multiple green spaces to create a healing environment and be AGED CARE HEALTH REFORMS: environmentally sustainable. A MAJOR LOTTERY! Ms Judy Gregurke, National Manager Aged Elke provided an overview of the new ways of Care Reform, COTA Australia & Director, Aged working using various models of care and the Care Reform Secretariat, National Aged Care large number of automated systems that have Alliance, said aged care reforms were definitely been installed in the multi-billion dollar build. going to be a lottery for the ageing Australian A state-of-the-art wireless location service will population. Reforms commenced with the 2011 track equipment anywhere in the hospital via Productivity Commission Inquiry Caring for radio frequency identification devices. Bedside Older Australians Report in which older people computers will provide access to clinical and said they wanted transparency and fairness, non-clinical applications such as EPAS, online choice and control, a skilled and respectful meal selection and ordering, and patient workforce, respect for diversity, and control entertainment. Electronic health records will Elke Kropf over death. be immediately accessible at the point of care along with real-time clinical decision Why the lottery of aged care reforms? Currently support information. there are 113 places per 1,000 people over 70, so what happens to #114? The outcomes of the A new single statewide laboratory information full rollout of the National Disability Insurance system and new state of the art electronic Scheme (NDIS) for people over 65 acquiring a medical imaging technology will capture, disability remain unclear. Other questions such store and record medical images to support as where are the nurses to staff aged care, clinical care. Clinical digital integration what are the training standards for aged care will be available in all technical suites and staff and is there value in the current offerings resuscitation rooms that has a one-button of the user pays system in aged care need to recall of pre-set configurations and will display be answered. current clinical objectives, status and progress across the entire room. xyz
Australasian College of Health Service Management 35 IN THE LOOP
Western Australia
2016 WA STATE LEADERSHIP CONFERENCE This year, WA held its second annual State Leadership Conference, with enormous success. There were over 340 in attendance, from a myriad of sectors that came together to listen and learn from a fantastic array of prominent, and experienced leaders in health and other business areas.
The conference was formally opened by the newly appointed Minister for Health and Arts and Culture, Hon John Day MLA. Senior WA media commentators and journalists (Daniel Emerson, Geoff Parry and Jessica Strutt) then kicked off the day by giving an overview and debating the state of politics in health in WA, and nationally.
Keynote speakers included Shane Solomon (Managing Director of Telstra Health), Dr Craig Hassed (A/Prof Faculty of Health at Monash University) and General David Morrison (2016 Australian of the Year). Shane spoke about the lessons he had learnt from 30 years of being a health leader, and of the need for health systems to adopt new technology to help innovate and improve existing systems. Dr Hassed’s session was a standout, and relevant to all leaders across the board. WA Branch President, Dr Neale Fong presents a certificate General David Morrison (2016 Australian of the Year) He stressed the importance of concentrating to WA Health Director general, Dr David Russell-Weisz, was a keynote speaker at this year’s WA State and giving one’s full attention to one thing who was inaugurated as Patron of the Branch Leadership Conference at a time in order to be more efficient and present in the workplace, and at home. He chose to take a practical approach, having the audience close their eyes and relax for five minutes of silence, stating meditation is simple; it doesn’t have to be scary. General Morrison was very passionate about gender equality in the workplace, and this resonated well with all attendees.
Issues of PPPs, the new WA Health Service Boards, the importance of being a ‘healthy leader’, challenges for healthcare now, leadership in integration of services, and how to lead teams in large organisations, were all addressed and debated by stimulating panels of health, government and business professionals. Conference attendees were involved in all panel discussions through well-facilitated Q&As.
The 2016 conference received very positive feedback, and is going from strength to. It was a great way to finish WA’s financial year. Discussion panel at the State Leadership Conference
36 Australasian College of Health Service Management Members of the WA State Branch Council
The WA branch would like to thank major HEALTH BREAKFAST BRIEFINGS 2016 WA ANNUAL GENERAL MEETING sponsor Ramsay Health Care and all the Another signature event in WA is the Health The WA Branch held their AGM on Thursday conference sponsors: Hesta, Silver Chain, Breakfast Briefing where attendees get to 22 July at Hollywood Medical Centre Bethesda Health Care, Paxon Group, WA hear about the five key leadership issues and four Councillors were re-elected Department of Health, WA Country Health currently facing an organisation in the WA and unopposed. Congratulations to Learne Service and Murdoch University. The WA Australian health sector. Dr Lachlan Henderson, Durrington, Trenton Greive, Peter Mott and State Branch Council would also like to Executive Director St John of God Healthcare David Simmelmann. thank Dr Neale Fong, WA Branch President, Perth Northern Hospitals (including CEO SJOG for his enormous effort in putting the Subiaco Hospital) was our guest in April, and The successful completion by five WA conference together. spoke about the issues affecting SJOG. candidates for the Fellowship program in 2015 was acknowledged. The Director CUPPA WITH THE CHIEF SERIES HEALTH PUBLIC POLICY FORUM General of the WA Department of Health, The WA branch has continued its innovative A stimulating Public Policy Forum was Dr David Russell-Weisz, was inaugurated series of events called ‘Cuppa with the presented in May by Danny Sims, CEO of as Patron of the WA College and gave Chief’, which offers ACHSM members the Ramsay Health Care Australia. Ramsay Health an overview of 2015/16, as well as the opportunity to meet in small informal Care is Australia’s leading operator of private key priorities and goals for WA Health in groups with CEOs from different sectors hospitals with 63 hospitals, and six day- 2016/17 and beyond. In addition, the WA of the Health industry. These events have surgeries. Danny gave his perspective on the Annual Awards were presented to the continued to be popular with recent state of healthcare in Australia, the challenges following people: The President’s Award speakers Dr Robyn Lawrence, CE South the sector is facing, and how Ramsay Health – Elizabeth Rohwedder; Innovation and Metropolitan Health Service, Dr Frank Daly, Care is meeting the challenges. It was a great Excellence Award – WA Primary Health CE Child and Adolescent Health Service opportunity to hear of the personal leadership Alliance; and ACHSM WA Health Student and Perth Children’s Hospital, and Dr Tarun journey of one of the country’s most significant Management Prize – Jaspreet Pannu from Weeramanthri, Chief Public Health Officer. health leaders. Curtin University. xyz
Australasian College of Health Service Management 37 IN THE LOOP
Australian Capital Territory
PROFESSIONAL DEVELOPMENT ACTIVITIES This year we have had a wonderful array of contributors to our professional development activities.
February saw a visit to our breakfast forum by Dr Martin Liedvogel, the Chair of Capital Health Network. Martin spoke to us of the challenges faced by the new PHN upon its establishment in July 2015, preceded by the ACT Division of General Practice and ACT Medicare Local. He spoke to us about: • how CHN is meeting the objectives set for it by Government; • the differences between this organisation and its predecessor; • its key priority areas, and Top, left: Dr Kim Webber, Acting Chief Executive, • its commissioning program to meet the National Rural Health Alliance. Top right: Alison needs of its community. Verhoeven, Chief Executive, Australian Hospitals and Healthcare Association. Far left: Veronica Hancock, The presentation to our April breakfast forum Assistant Secretary, Mental and Social Health Branch, Dept of Veterans Affairs. Left: Dr Martin Liedvogel, was made by Ms Veronica Hancock, Assistant Chair of Capital Health Network Secretary of the Mental and Social Health Branch of Department of Veterans’ Affairs. Veronica described the incidence of mental illness amongst In July we were fortunate to welcome three main political parties, ahead of the ACT veterans, with over 45,000 veterans having an Alison Verhoeven, the Chief Executive of election held in October. The forum was an accepted mental health disorder, the largest the Australian Hospitals and Healthcare interesting affair, with a format that allowed cohort being that of Vietnam veterans – mostly Association, to speak at our breakfast the moderator to question the candidates with diagnoses of stress disorders of varying forum. Alison’s address focused on the about specific policies promoted by their severity. DVA has developed a range of tools Commonwealth health budget and reform parties, as well as audience participation. for its clients, ranging from mobile phone apps processes, what to expect from the re- elected aimed at modifying drinking habits, numerous Coalition Government on health, the impact publications, an eToolbox and a series of videos of Commonwealth processes on state and on its YouTube channel, accessed from the ‘at- territory health budgets and public hospital ease’ portal of DVA. Veronica portrayed to our funding, and how changes in the health sector members the comprehensive commitment that might affect public hospital demand. She DVA has made to its veterans suffering from provided specific insights about a number mental health disorders. of these topics, in particular public hospital funding after the current agreement expires in ACT’s breakfast forum in late May was 2020, the opportunities that present in respect attended by the Acting Chief Executive of the to the new initiatives surrounding health care National Rural Health Alliance, Dr Kim Webber. homes, and the challenges and disruption The presentation by Kim was an informative yet that could arise from the review of private challenging address, as she talked about the hospital funding. significant disadvantage faced by the people of rural Australia in accessing health needs. OTHER ACTIVITIES In particular Kim spoke about the significant Branch Council has planned a number of under-utilisation of health facilities and events to finalise the year, including the Annual Marina Buchanan-Grey services due to the shortages of clinical staff Members’ Dinner at which the outgoing Chief available in rural centres. She specifically spoke Medical Officer for the Australian Government FELLOWSHIP about workforce issues – the difficulties of Prof Chris Baggoley will speak, sharing some of Branch Council would like to congratulate attracting and retaining all categories of health his experiences and observations from his time Marina Buchanan-Gray upon her successful professionals to rural locations, strategies in Australia’s most senior medical role – we will exams and award of a Fellowship by the to overcome these difficulties, including have an update about this in the next edition. College at the Annual General Meeting. Marina the rotation of students, and some of the will not doubt be proud of her efforts in incentives available to try to attract suitable September saw the convening of a debate achieving this distinction and we wish her well staff to centres least able to sustain them. between the health representatives of the for the future! xyz
38 Australasian College of Health Service Management Tasmania
he annual Tasmanian Health Conference Dr Egger provided an extremely interesting and Twas held in Hobart on 30 July, with the practical perspective on the opportunities for ACHSM Tasmanian Branch again part of the Tasmania over the next decade. organising committee for the event. Around 100 people attended this year’s conference. Acknowledgment also goes out to ACHSM This included a number of ACHSM members members Phil Edmondson and Graeme Lynch who made the trip from across the state for their presentations at the conference. Well (a special mention to our ACHSM State done to both! President for driving the mini bus full of keen conference goers from Launceston!). In September the College was pleased to host an event in Hobart with Dr David Alcorn, Each year the Tasmanian Health Conference the Chief Executive Officer of the Tasmanian brings together a group of professional Health Service. This event provided attendees bodies to support and deliver a high quality an opportunity to hear about the priorities event in the state that also has a distinct for the state’s health service. The College was Tasmanian focus. This year’s theme was fortunate to be able to support one of the first “Communities of Health: It takes more than public engagements for Dr Alcorn since he took an apple a day”, which led a discussion on the CEO role in December 2015. A big thank around the State Government’s plans you to all those members and non- members for addressing chronic illness rates and for their interest in this event. improving the health of communities. Dr David Alcorn With another year quickly drawing to a The panel consisted of both local and close, the Tasmanian Branch has also started interstate speakers. This year’s keynote planning a member networking event to presentation was from Dr Garry Egger who is celebrate the year that was 2016. An exciting an advisor to the World Health Organisation line-up is currently being confirmed – please and expert in chronic disease prevention. keep watch for more details soon! xyz
Australasian College of Health Service Management 39 IN THE LOOP
New Zealand
MEMORANDUM OF UNDERSTANDING The Memorandum of Understanding between the New Zealand Institute of Health Management (NZIHM) and the Australasian College of Health Service Management (ACHSM) was signed on 26 October 2016 at the joint ACHSM/ACHS annual Congress in Brisbane.
NATIONAL EXECUTIVE The National Council was very pleased to have Jennifer Coles FCHSM and John McManus join the Executive Team.
2017 FELLOWSHIP COORDINATORS Jagpal Benipal and 2016 new Fellow Angela Francis have kindly accepted to be the Fellowship Coordinators for 2017.
2016 CONGRESS DINNER New Zealand delegates did not to unnoticed at the recent 2016 Congress in Brisbane. Angela Francis Marion Dixon The theme of the Congress Dinner on Thu 27 Oct was ‘Halloween Howling’, and Catherine Cooney won the best dressed award as well.
SUCCESSFUL NEW ZEALAND FELLOWS IN 2016 NZIHM counted two new Fellows after they successfully completed the program in 2016. Here is what they had to say about it.
Angela Francis: ‘The ACHSM Fellowship program provided a comprehensive learning environment that was professional, supportive and informative. The readings were interesting, the discussions within the study group enlightening and the formative feedback from our study The New Zealand Congress delegates present at the signing of the MOU group leader, Jagpal was most supportive. I would encourage health professionals who wish to gain broader perspectives on health systems, policy and funding to complete this course.
Marion Dixon: The ACHSM Fellowship process was thoroughly interesting and, dare I say it, enjoyable. The readings were enlightening and thought provoking and the teleconference discussions were interesting and collaborative. They were a great preparation for the examination and ably led by Jagpal. I thoroughly recommend the Fellowship path – if you want to challenge yourself and gain a broader perspective on health sector policy and current issues, consider undertaking this course.’
If you have any suggestions for future events and other activities, please let us know. Visit www.nzihm.org.nz. xyz NZ delegates at the 2016 Congress in Brisbane
40 Australasian College of Health Service Management Hong Kong
ith the primary objective of ‘link up Grade-A tertiary hospitals in Shanghai, China The HK College started the 2016-17 Wand equip health leaders for success’, and another one to Shenzhen-HKU Hospital Fellowship Program in Sep 2016, for which 16 the Hong Kong College of Health Service and the Shenzhen First People’s Hospital. The candidates have enrolled. An overwhelmingly Executives (HKCHSE) continues to provide visits were well supported by our members, successful Singapore Hospital Visit Tour was a series of activities ranging from seminars with participants in the range of 30-50 also held late Nov 2016 for a delegation of 24 and study tours to the Fellowship program, as per visit. College Members. well as academic activities to the members of the College. The Education and Examination Committee Looking ahead, the Hong Kong College of the College also organised a series of will continue to focus on expanding the The new College Council was elected study group meetings for the Fellowship membership base, building a more prominent with 16 new Fellows in Jul 2015. Over Examination candidates. For the year 2015- and professional identity, improving the the past year, the College has also invited 16, 18 candidates joined this program and Fellowship Training Program, and partnering a number of renowned speakers, and participated in various case studies and with professional bodies outside Hong Kong organised five seminars on different topics, journal presentations. Successful candidates on developing new healthcare leaders. xyz for members. These interactive seminars will be conferred as College Fellows in the provide an opportunity for the senior health Conferment Ceremony at the next AGM. executives/top civil servants to share their professional experience and knowledge with In Oct 2016, a Hong Kong delegation other members. attended the joint ACHSM/ACHS congress in Brisbane, Australia. The Hong Kong On 8 Apr 2016, the College hosted the sixth delegates enjoyed the opportunity to meet ‘Members’ Night’ that coincided with the with colleagues and ACHSM members 11th anniversary of the Hong Kong College. from Australia and beyond and listen to More than 100 members gathered in the thought-leaders in health leadership and Royal Plaza Hotel, Kowloon and a superb other sectors. All Hong Kong delegates spoke evening was had by all. highly of the Brisbane congress and treasured the opportunity to learn from overseas During the 2015-16 term, the Hong Kong experience on making things happen in College organised a study visit to three health management.
Australasian College of Health Service Management 41 ADVERTORIAL
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44 Australasian College of Health Service Management COUNCILS
ACHSM Councils
The list of Branch Councillors published hereunder was accurate as at the end of November 2016.
ACT SOUTH AUSTRALIA Chris Hanna FCHSM Lesley Dickens FCHSM President Stuart Schneider FCHSM President Elizabeth Rohwedder FCHSM Kieran Gleeson AFCHSM Treasurer Mark Diamond FCHSM Vice-President/ Frank Daly AFCHSM Jennie Gordon AFCHSM Professional Board Director Daniel Mahony AFCHSM Development Coordinator Linda South FCHSM Treasurer Caroline Yates AFCHSM Meg Milne AFCHSM Professional Branch Councillors Development Gary Day FCHSM NZIHM Coordinator Madhan Balasubramanian AFCHSM Jayanthi Mohanakrishnan FCHSM President Paul Dyer AFCHSM Communications, Chris Barber AFCHSM Catherine Cooney FCHSM Treasurer Member Relations Heather Baron AFCHSM Branch Councillors and Branch Roslyn Chataway AFCHSM Jagpal Benipal FCHSM Promotion Liana Niutta AFCHSM Jennifer Coles FCHSM Branch Councillors Amanda Shields AFCHSM Prof Jackie Cumming FCHSM Angela Magarry FCHSM (Board Director) Heidi Silverston AFCHSM Mala Grant AFCHSM Amanda Boers AFCHSM Wendy McEwan FCHSM Gaylene Coulton AFCHSM TASMANIA Karen Osborn FCHSM Kay Richards AFCHSM Amanda Quealy AFCHSM President John McManus MCHSM Julie Crowe AFCHSM Vice-President NEW SOUTH WALES John Kirwan AFCHSM Immediate Past HKCHSE Paul Preobrajensky FCHSM President President Dr LIU Shao Haei FCHSM President/ Terry Clout FCHSM Vice-President Julie Tate FCHSM Treasurer/Board Board Invitee Dr Christine Dennis AFCHSM Treasurer Director Ms CHIANG Sau Chu FCHSM Vice President Adj A/Prof Dominic Dawson FCHSM Immediate Past Jonathan Bugg AFCHSM Registrar Mr. Anders YUEN FCHSM Honorary Secretary President Branch Councillors Mr Leo LUI FCHSM FCHSM Honorary Treasurer Branch Councillors A/Prof Leonard Crocombe FCHSM Dr MA Hok Cheung FCHSM Immediate Past Dr Wayne Hsueh FCHSM Anne-Marie Stranger FCHSM President A/Prof Godfrey Isouard FCHSM Phil Edmondson AFCHSM Dr Fowie NG FCHSM Academic Convenor Mary Potter Forbes AFCHSM Lauren Parr AFCHSM Dr Steve CHAN FCHSM Publication Convenor Dr Anuj Saraogi AFCHSM Council Members Crystal Burgess VICTORIA Ms Pearl CHAN FCHSM Will Hackworth Wendy Davis FCHSM President Ms Liza CHEUNG FCHSM John Turner FCHSM Treasurer/Immediate Dr Flora KO FCHSM QUEENSLAND Past President Dr Gladys KWAN FCHSM Mark Avery FCHSM President Karen Minne FCHSM Registrar Mr Stephen LEUNG FCHSM Kate Copeland FCHSM Vice-President Branch Councillors Dr Arthur SHAM FCHSM Mick Davis FCHSM Treasurer Greg Allen FCHSM Ms Ivy TANG FCHSM Dominic Sandilands FCHSM Secretary Dr Mark Garwood FCHSM Dr Canissa YUEN Yin Fun FCHSM Duncan McConnell AFCHSM Assistant Gabrielle Honeywood FCHSM Secretary/ Adj A/Prof John Rasa FCHSM Membership Dr Margaret Way FCHSM Registrar Demos Krouskos AFCHSM Branch Councillors Major Wayne FCHSM WESTERN AUSTRALIA David Bullock Neale Fong FCHSM (Hon) President/ Dr Dennis Campbell FCHSM National President Dr Frances Cunningham FCHSM Peter Mott FCHSM Vice-President Prof Anneke Fitzgerald FCHSM David Simmelmann AFCHSM Treasurer Gwenda Freeman FCHSM Branch Councillors Richard Olley FCHSM Dianne Bianchini FCHSM Jeff Parker FCHSM Karen Bradley FCHSM Glynda Summers FCHSM Chair Learne Durrington FCHSM Graham Hyde FCHSM (Hon) Trenton Greive FCHSM
Australasian College of Health Service Management 45 DIRECTORS
Neale Fong Godfrey Isouard Graham Hyde Mark Avery Mark Diamond Angela Magarry Daniel Mahony
DR NEALE FONG President and Immediate Past President and sector in South Australia. He now provides FCHSM (HON) MBBS DIPCS MTS MBA FAICD retired from QBC in 2001. He was re-elected management consulting services to the health President to QBC in May 2013 and was elected President and community service industry and is sought Appointed to the Board in 2011 and elected again. Graham was appointed Executive after for his expertise in providing strategic President in 2016. Dr Fong has more than 25 Officer Gosford District Hospital (Woy Woy) and operational support to government, non- years’ experience in medical, health care and Medical/Rehabilitation Unit in 1974. In 1979 government and private sector organisations. aged care delivery and leadership roles. He he was appointed Chief Executive Officer Mark first joined the College in 1997, is is currently Chairman of Bethesda Hospital Brunswick Byron Area Health Service. In currently the Vice President SA Branch (since and Professor of Healthcare Leadership at 1991 he was appointed as District Manager 2010) and was appointed to the former Junior Curtin University. He was Director General of Bayside Health Service District, one of the Vice President position of the Board in 2012. of the WA Department of Health and Chief Districts in the former Brisbane South. Graham Executive Officer of St John of God Health retired from public health services in 2001 MS ANGELA MAGARRY Care Subiaco. He currently consults through and established a Consultancy business in FCHSM BHA MPS Australis Health Advisory to a number of key specialising in Quality Management Systems, Branch Councillor Director health clients in Australia. He holds Bachelor Health Service Management, Strategic Angela Magarry is an experienced healthcare Degrees in Medicine and Surgery, a Masters Planning, Organisation Development and CEO who has extensive experience in both in Theological Studies and a Masters in Financial Accounting services. government and non-government sectors Business Administration. mainly in strategic policy and government MARK AVERY relations roles, nationally and internationally. ASSOCIATE PROFESSOR GODFREY ISOUARD FCHSM BHA MBUS(RES) FAIM FAICD She is currently CEO of the Committee of FCHSM BSC MHA PHD AFAIM Branch Councillor Director Presidents of Medical Colleges. In 2011 Angela Vice President Appointed to the Board in 2016. Mark Avery received an Australia Award for excellence in Appointed to the Board in 2009. Godfrey is an academic and the Program Director for higher education reform. Angela holds a BHA, Isouard is Associate Professor of health Health Services Management at the Griffith MPS and is a Fellow of ACHSM. Angela is on Management at the University of New England. University. His research and consultancy the ACT Branch. He has a medical science and public health interest areas include leadership and background, and before moving to academia management in health services; patient safety MR DANIEL MAHONY held senior clinical and health service executive and quality care; community information B. PHYSIO G.DIPHSM AFCHSM APAM MAICD positions. He is currently chair of the National in health services. Mark has over 30 years’ Additional Director ACHSM Education Committee, Foundation experience in senior leadership, management Daniel is currently Chairman of Future Health Member of the Editorial Advisory Board for the and corporate roles in both the public and Leaders, ACHSM WA Branch Councillor Asia Pacific Journal of Health Management, private health care sectors in Australia and and Chair of the Australian Physiotherapy and Past President of ACHSM NSW Branch the United Kingdom. His career and experience Association (APA) National Rural Group. Daniel and the Society for Health Administration has been at senior executive, chief executive, has a passion for rural and remote health Programs in Education. His research interests consultant, board director levels in hospitals, and is a past Board Member of Services for focus on leadership, evaluation and review community health and regulation. Mark has Australian Rural and Remote Allied Health of organisational performance, the health been a member of the College for some 40 (SARRAH). As a Senior Physiotherapist in rural management workforce, and quality and years and in that time has been member of Western Australia, Daniel aims to promote and safety improvement. three State and Territory Branches. support the next generation of health leaders and managers into the future. GRAHAM HYDE MARK DIAMOND FCHSM (HON) FIPA FAIM FRSH FCHSM BA (BCAE - LATROBE UNIVERSITY) MS JAYANTHI MOHANAKRISHNAN AFAAQHC PHF MASQ BSW (UNIVERSITY OF MELBOURNE) FCHSM Treasurer Branch Councillor Director President NZIHM Graham is currently Queensland Branch Appointed to the Board in 2009. Mark has Jayanthi has a wealth of private and public President. He joined ACHSM in 1974 and more than 25 years’ management experience healthcare experience gained during 25 years has represented the NSW Branch College on in the health and community services industry in a number of senior management roles in the NSW Health Department Fire Advisory in three Australian states. He has worked in India and New Zealand. Jayanthi’s expertise Committee the Education and Seminar both metropolitan and rural environments lies in having a vision and getting everybody Committee. He was elected to Queensland and has been involved in the implementation on board, set clear expectations and work Branch Council in 1991. He served as Registrar, of significant reforms in the mental health efficiently towards a common goal. Jayanthi
46 Australasian College of Health Service Management Jayanthi Mohanakrishnan John Rasa Tim Smyth Julie Tate John Turner Liu Shao Haei has built a reputation as someone with MS JULIE TATE Invitee high integrity, strong professionalism, and FCHSM FIR MBUS GRADDIPHSM GRADDIPED DR LIU SHAO HAEI passion, that is committed to high quality DIPDIAGRAD MAICD PRESIDENT - HONG KONG COLLEGE OF outcomes in all her endeavours. Her strong Branch Councillor Director HEALTH SERVICE EXECUTIVES technical abilities, focus and drive play Appointed to the Board in 2015. Julie He was the Medical Superintendent of an important role in supporting the DHB. has recently commenced in the position Tuen Mun Hospital from 1990-1992 and Jayanthi is on a number of Regional and of Operations Manager Medical Imaging commissioned the regional hospital. In 1993- National Committee’s as the Health Board Services for the Tasmanian Health Service 1995, he was the Hospitals Chief Executive representative on health service design. Southern Region following five years with the of Ruttonjee Hospital to implement new Department of Health and Human Services management initiatives. During the SARS ADJUNCT ASSOCIATE PROFESSOR Tasmania as Manager Clinical Support and epidemic, he was a member of the Head Office JOHN RASA Cancer Services Development. Julie has outbreak team and was involved in infection FCHSM BA MHP FAIM MAICD FAHRI extensive health management experience control, data administration and dissemination Additional Director gained during 27 years in a number of senior of information. In 2008, he coordinated Appointed to the Board in 2009. John is management roles in Victoria and Tasmania. the Hospital Authority rescue operations to Chief Executive Officer of Networking Some of her special interests include process Sichuan Earthquake and the leader of the Health Victoria (NHV) and was involved in redesign, workforce planning and community Initial Assessment Team. Dr Liu is also the the development of Medicare Locals and participation in health. Julie has been a in-charge and Advisor of the Corporate Clinical subsequently the PHNs in Victoria. John is member of the College since 1995 and has Psychology Service in Hospital Authority still Executive Director of the Australian served on Stage Branch Council in both Head Office. He is now the Chief Manager Centre for Leadership Development Victoria and Tasmania. She has previous of Infection, Emergency and Contingency and continues to be involved in health Board experience as a Board Director for the Department. His portfolio includes coordination management leadership programs. John Cooperative Research Centre for Biomedical of various specialist services such as Accident has been National President of ACHSM for Imaging Development and she is a current & Emergency Service, Intensive Care Service, the past four years and is also the Chair of Board Director for MS Tasmania. Trauma Centres, Isolation Facilities, Major the Victorian Chronic Disease Prevention Incident Control Centre, Toxicology and Critical Alliance. He has served as President of the MR JOHN TURNER Incident Psychology Service. xyz Victorian Branch of the College and as FCHSM JP GRAD DIP H SC (ADMIN) Chief Examiner for the College’s Fellowship CERT BUS program. John is also currently on the Board Branch Councillor Director of the Latrobe Regional Hospital. John retired in January after 19 years as Chief Executive of Bentleigh Bayside Community DR TIM SMYTH Health which is based in metropolitan MB BS LLB MBA Melbourne’s southern suburbs for the past Additional Director seventeen years. The service provides a wide Tim joined the Board in August 2014 as a range of services across two municipalities. Board appointed independent director. He He has worked in healthcare administration in is well known in the health sector having both South Australia and Victoria for fifty years had a range of senior executive roles in city and rural hospitals, community health across hospitals, health services and the services and specialist medical institutions. NSW Ministry of Health. Tim is a Special His involvement in community health dates Counsel in corporate and commercial law back to 1974 when the Federal Government with Holman Webb lawyers, Chair of the commenced funding community health. Western NSW Primary Health Network and a A member of the College since 1969 and management consultant. Immediate Past President of the Victorian State Branch, John has also been convenor of the Community Health CEO Special Interest Group for eleven years and a member of the Education & Seminar Committee. John was awarded Life Membership of the College in 2015.
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The dangers of aged care falls
There is substantial evidence and research that demonstrates falls and falls-related fractures are significant among older people living in residential aged care. Falls can be prevented. However, up to 50 per cent of older people living in residential aged care services fall every year, with 40 per cent experiencing recurrent falls. Approximately 20–32 per cent of older people who fall will experience a fall-related fracture. Adverse clinical events that can occur as a result of falls include: death, fracture, decreased independence, increased functional decline as well as anxiety and fear of falling.
50 Australasian College of Health Service Management Key facts must be assessed to determine what assistance the person may need People aged 80 years or more are at the highest risk of falls and to get around. fractures. This age group represents the highest proportion of residents in aged care. There are a variety of reasons why the elderly might experience a fall, including weakness and gait problems associated with old age, in some Aged care residents are up to five times more likely to fall than those cases due to negligence. Examples include falls caused by: who live in the community. The proportion of residents with a diagnosis • Wet floors; Poor lighting; Clutter of dementia who fall has been reported as even higher. Dementia, • Medications, especially psychoactive stroke, diabetes and Parkinson’s disease are common conditions (antipsychotic medication, drugs) associated with high risk of falls. Nearly 85 per cent of fall-related • Difficulty in moving patients, or assisting them to the restroom, deaths occur in people who are aged 70 years and over. The hip is the due to understaffing most common site of fall-related fracture. • Failure to have sufficient staff to answer call buttons • Failure to have call buttons that are in proper working condition Fall related injuries - a major health threat • Failure to properly train staff in lifting and handling techniques Fall-related injuries are a major health threat for nursing home • Failure of the staff to adequately supervise residents residents. When older people fall, they can experience decreased • Poor foot care physical functioning, a reduction in the quality of life, decreased • Restraints confidence, and an increased fear of falling, which can lead to • Weakness and gait problems associated with malnutrition further functional decline, depression, social isolation, and feelings of and/or dehydration helplessness. When a resident enters a nursing home, a plan of care • Lack of necessary bedrails and improper bed height must be developed. Within this plan of care, the resident’s risk of falling • Improperly maintained or fitted wheelchairs
Australasian College of Health Service Management 51 Falling, prevention and tips more chronic illnesses. Arthritis, for instance, is one of the major "The amount of human suffering associated with falling accidents factors in falling. Pain associated with joints can cause falling. Fatigue, is staggering," says Dr. Thurman Lockhart, an assistant professor of osteoporosis, dementia, and all sorts of things that more commonly industrial systems engineering at Virginia Polytech Institute and State strike the elderly, can lead to falls. University. "And by 2020, medical costs from hip fractures alone— resulting from falling accidents—are expected to cost the American At what age does falling become a real risk? healthcare system between 20 and 50 billion dollars." Well, it's different for everybody. But after about fifty-five, our muscle mass begins to decrease and all of the factors associated with In a study sponsored by the Centers for Disease Control and the National musculoskeletal degradation begin to develop. Including bone loss. Also Institutes of Health, Dr. Lockhart has researched the mechanics of falling around age fifty-five, there is a drastic decrease in strength of the lower in order to develop intervention strategies. Below, he talks about the extremities. And this reduction in strength affects our gait style, or the mechanics of falling, and offers some practical prevention advice. way we walk. This change is one of the factors associated with how we recover from slip-and-fall accidents. Why do people fall more as they age? There are intrinsic changes associated with the ageing process. The But it all depends upon a person's lifestyle. We have tested some eighty- changes that increase the risk of falling are a degrading musculoskeletal five year old individuals who are very, very healthy and active. Their system, sensory function, and gait changes associated with ageing. strength is maintained, and they didn't slip and fall in our tests. So age in years is not as important as actual physiological age. How do changes in sensory function affect balance? The maintenance of balance is organised, or controlled by three senses: Are the rates of falls different among women and men? sight, inner-ear function, and sense of touch, or tactile sensation. We Elderly men fall more often than elderly women, but elderly women are maintain balance with these senses. more at risk of hip fractures. We know that bones are affected by falling. Hip fractures are associated closely with the osteoporosis, or a fragility So these three factors contribute to falling as we age? of bones and their liability to fracture. And osteoporosis is much more Yes. For example, you can divide slip-and-fall accidents into three common in women than men. But the risk of hip fracture is also related different stages: Initiation, or the beginning of a slip, detection, or when to muscle mass. You have very thin muscle lining around your hips, and we realise we're slipping, and recovery. So imagine when you are slipping as it gets thinner, it becomes very bony. When you hit that area, the and falling. There is the initiation process, where you slip a little bit, fracture rate increases as well. and in order to make a recovery, you have to detect that you're falling, which is assessed by your vision, inner-ear, and sense of touch. After Any advice to prevent falls? that detection period, you have to make some recovery. So the initiation, One important piece of advice is: stay healthy. Walk around and detection and recovery phases are all altered for the older individuals, keep the lower parts of your body strong. An active lifestyle is very because we have a gait change and the sensory change, as well as important. And be aware of your surroundings. That's tougher for older musculoskeletal degradation. individuals, because their senses and awareness of their surroundings is not as keen as younger individuals. But it's also very important that Are there other reasons why the elderly are at risk? people not be overly afraid of falling. Fear should not prevent you from There are actually many factors that contribute to slip-and-fall going outside and exercising and doing your activities. Just take some accidents in the elderly. Medication side-effects can cause balance considerations of your surroundings and eliminate all of the hazards problems or dizziness, which can lead to falling. Elderly people have associated with fall accidents. xyz
Tips from Dr. Lockhart for preventing falls around the house:
GENERAL AREAS: • Install slip-resistant tile/matt; • Position top of the railing at elbow height • Minimise changes in walking surfaces, and • Increase door width to 30 inches for of the homeowner; use slip-resistant coverings such as rough homeowners with wheelchairs or walkers; • Use handrails that allow the homeowner tile and carpet with short, dense pile; • Clean up grease, water and other encircle their thumb and fingers around it; • Use lighter-coloured floor surfaces to liquids immediately; • Use a different color contrast to mark the create colour contrasts between walls • Don't wax floors; first and last step; and floors; • Avoid climbing and reaching to high • Limit stair rise to seven inches; • Increase lighting and reduce the contrasts cabinets or shelves and use a sturdy step • Make tread at least 11 inches deep; in lighted areas; stool with handrails if necessary; • Use incline risers with 15-degree angles; • Install wall-mounted light fixtures, • Always keep a night-light on in • Remove carpets 3/8 inch or thicker and accessible while standing on the floor; your bathroom; underpads on treads; • Install more outlets to minimise the use of • Use bathroom rugs with nonskid backing; • Make sure stair height and tread widths extension cords; and • Add bright decals or red tape to provide are adequate, and each step is identical • Relocate switches so that the contrast between the white tub, white in size; homeowner doesn't have to walk through toilet and white walls; and • Install light switches at the top and darkened areas. • Be sure shower stalls have code standard bottom of stairs; and shatterproof glass. • Be sure carpeting is tightly woven and KITCHEN AND BATHROOM: installed so it doesn't move or slide. • Securely install two grab-bars positioned STAIRWAYS: for support when entering and exiting in • Install handrails on both sides of the stairs Reproduced with permission from Dr. T.E Lockhart, tub/shower and near toilet at height and and extend them one foot beyond the last Virginia Polytech Institute and State University and angle best suited for homeowner's needs; step at both top and bottom; AgedCareCrisis.com
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Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. *According to Australian Bureau of Statistics (ABS) Retirement and Retirement Intentions, Australia, July 2012 to June 2013, women in Australia retire with 47% less in their super than men. abs.gov.au/ausstats/[email protected]/mf/6238.0
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