change champions & associates newsletter feb 2013

NEWSLETTER

For innovators in

healthcare & beyond

F e b r u a r y 2 0 1 3

The service redesign was done by the

Women and Newborn Drug and

Alcohol Service (WANDAS) at King

Edward Memorial Hospital. KEMH is

the only tertiary referral centre for

women of Western Australia and has

on average 6,500 births per year.

KEMH provides specialist care to

women with a range of pregnancy

complications through dedicated

specialist antenatal clinics.

WANDAS is one specialist clinic,

providing care for women with current

complex alcohol and other drug (AOD)

use in pregnancy, birth and early

parenting. It is the only team in

Western Australia providing this

service, having expert staff who

operate within a multidisciplinary

team model of care across medical,

social work, psychiatry and allied

health disciplines (Bell, Geraghty,

McLaurin, & Bayes, 2010). WANDAS

also delivers an Outreach service to

pregnant incarcerated women.

WANDAS has been operating for over

twenty years.

WANDAS women belong to some of

the most disadvantaged and

traumatised women in society (Blyth,

2006), often having complex medical

and social problems (McCallin &

Bamford, 2007; Schafer, 2011). Many

identify substance use as a way to

cope with abuse and trauma

(Covington, 2008; Poole, 2007).

Strategies survivors develop for self-

protection, combined with the

posttraumatic stress symptoms of

hyper arousal or avoidance, make a

(Continued p.2)

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P . 6

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P . 1 2

P . 1 6

Service Redesign for Women and Newborn Drug & Alcohol Service (WANDAS) Angela O’Connor, Renate McLaurin, Lynne Portwine Supporting Patients in Early Stroke Recovery Sarah Bates

Introducing the Victorian Inter- Hospital Patient Transfer Project Alice Gleeson Creating Champions for Skin Integrity Dr. Kathleen Finlayson Expressions of Interest: Speaking Opportunity in England, United Kingdom POINT OF VIEW: Managing Change

Dawn Skidmore

UPCOMING WORKSHOPS

The Challenge of Long Term Alcohol Abuse in Older Adults ACT! Dementia: dealing with tricky situations Practical workshops on public speaking, leadership and change management Pathways to a Consumer Focused Organisation – Governance and Managerial Approaches

P . 3

P . 5

P . 8

Service Redesign for Women and Newborn

Drug & Alcohol Service (WANDAS)

A Patient Centred

Trauma Informed Model to reduce the wait time by 80%.

P . 1 0

2

survivor’s entrance into a situation such as a hospital

difficult (Elliott, Bjelajac, Fallot, Markoff, & Reed, 2005).

WANDAS operates under the Governance of the Women

and Newborn Health Service (WNHS) at KEMH.

The service has the philosophy of provision of service and

is one of harm reduction and minimisation. Harm

reduction is the main feature of Australian public health

and AOD policies (Lightfoot et al., 2009; Wright,

Schuetter, Fombonne, Stephenson, & Haning, 2012). A

harm reduction model of perinatal care aims to reduce

the health, social and economic harms of AOD use to

individuals, communities and societies (Lightfoot, et al.,

2009; Rhodes, Bernays, & Houmoller, 2010; Wright, et al.,

2012).

WANDAS took part in a Lean Action Challenge as part of

an overall leadership programme with the aim of

improving the service for the women. The aim of the Lean

Action Challenge undertaken by our pod was to review

the whole service in order to incorporate a “Trauma

Informed” (Covington, 2008; Poole, 2007) model of care,

which included the patient being central to the service.

The main areas of concern for the team was the high DNA

rate at ante natal booking visits which could be anything

up to 100%. This impacted on staff waiting for patients

with the flow on effect that on the subsequent Friday

clinics the team needed to accommodate the DNA from

Wednesday. As a result the Friday clinics became

overcrowded.

Historically in the ante natal clinics the medical staff were

prioritised the room space. This resulted in patients who

were seen by the medical staff relatively quickly and then

were asked to return to the waiting room to have lengthy

waits to be seen by the other members of the allied

health team. This often resulted in the women leaving the

clinic before they were assessed by their care team. The

allied health clinicians identified that they were not

supported to effectively provide quality care.

There were no standard operating procedures for the

service including the outreach service for the provision of

antenatal care to pregnant women in corrective services.

Pregnancy is often a prime motivator for a period of

recovery and remission of AOD use (Sword, Niccols, &

Fan, 2004). The motivation after the birth of the baby is

often diminished as stress levels increase. As a result AOD

using women are at high risk for relapsing in the post

natal period. Evidence shows at four months after birth

many will have relapsed back into pre pregnancy AOD use

(Dowdell, Fenwick, Bartu, & Sharp, 2009; Wright, et al.,

2012). In a review of studies looking at postpartum

women with AOD problems, all studies showed AOD use

increased in the post natal period (Turnbull & Osborn,

2012). WANDAS had no post natal follow up clinic even

though the National Clinical Guidelines for the

Management of Drug Use during Pregnancy, Birth and

the Early Development Years of the Newborn (NSW

Department of Health, 2006) recommend following the

women and their babies up for three months post natally.

The tools and methodology of lean enabled WANDAS to

review the service; data was collected over 100 days. A

Value Stream Map highlighted the deficits and helped

move the direction and focus of where the service

wanted to go.

Hospital wide discussions held between WANDAS and

internal and external stakeholders resulted in the

following outcomes:

Reorganised space and rooms on clinic days to

encourage patient-centred multidisciplinary care and

thereby reducing DNA rates. Provide food on Friday

clinics and now are reviewing the need to have food

and drink for the Wednesday follow up clinics. We

have made savings from freeing up staff in the order

of $270,888.96 savings per annum.

Branding of the service which included the image of a

pregnant woman with body art of map of Australia

with the message that she was the centre of

WANDAS universe. This was helped by the Queen

brand and song One Vision.

DNA rates to 90% attendance: text messages at 48

hrs and 24 hrs prior to clinics.

Negotiated extra time to be in clinic on a Friday

increasing Tact time to 87 minutes.

Increased the appointment times and scheduling of

appointment to remove batching.

3

course Outline

MASTER CLASS with Alice Rota Bartelink

The Challenge of Long Term Alcohol Abuse in Older Adults

Managing Older Clients living with

Alcohol Related Brain Injury

Book an in-house

In house opportunities available for facilities in Australia & New Zealand

To read Alice Rota-Bartelink’s bio, or for more details about the

master class, visit www.changechampions.com.au

Introduction Alcohol & Alcoholism Symptoms Alcohol and the Ageing Body Comorbidity Alcohol and the Brain The Role of a Neuropsychologist Treatment Managing Challenging Behaviour Aggressive Behaviour Self Care Practices - Staff Case Profile Conclusion

Redesigned assessment form to include one

multidisciplinary form which will save three thousand

dollars per annum.

Redesigned the patient information brochure which

streamlines the information provided to the women.

Patient centred room allocation freeing up space on

Friday, no ownership of rooms.

Postnatal follow up clinic as a result of reorganising

bookings on Wednesday within the present FTE

structure

Standard Operating Procedures (SOP) developed for

the clinic which helps to empower the women as

they are central to their care. The SOP for outreach

to Bandyup Prison, and seven other SOP for the day

to day running of the service.

In conclusion WANDAS achieved the goal. WANDAS have

further developed the service where the woman is central

to her care and are building on improving the model

especially on the trauma informed aspect. To date the

women have provided positive feedback. WANDAS have

run the post natal clinic for four months now and have

85% attendance rate which is a major success.

(Full reference list on page 20)

Authors:

Angela O’Connor RN, RM, BSC Bus,Post Grad Social Science and Masters Degree

Renate McLaurin RN BHSc, RM

Lynne Portwine Bsc Social Work

http://www.changechampions.com.au/seminar/master-class--the-challenge-of-longer-term-alcohol-abuse-in-older-adults_242

http://www.changechampions.com.au

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Supporting Patients in

E a r l y S t r o ke R e c o v e r y

The National Stroke Foundation Clinical Guidelines for

Stroke Management (2010) state that “Stroke patients and

their families/carers should be given the opportunity to

participate in the process of setting goals”. The challenge of

addressing this recommendation in the acute hospital

setting prompted our 6 month project (guided by the

Clinical Practice Improvement (CPI) principles and

methodologies) on patient-oriented goal setting.

Throughout this project, which was completed in December

2011, we were able to make positive changes to initial

assessment proforma’s, case conference discussions and

documentation templates to ensure that goal setting

discussions were taking place and patients were more

actively involved in the planning and direction of their care.

While goal setting practices are of huge benefit in stroke

recovery and rehabilitation, we found that the more

structured techniques and programs were more appropriate

for use in sub-acute rehabilitation settings, once the patient

is more medically stable and has been able to work through

the typical crisis responses associated with such an event.

The rehabilitation setting also provides a longer length of

stay and more time for the patient to build rapport and

engage with the therapists to set goals and monitor their

progress, given that our current average length of stay is 6-7

days.

We found that the most well-received concept developed

during our project was a patient logbook. The logbook was

given to patients to compile information, record aspects of

their journey and to use as a motivational tool using

personalised photographs and letters/messages from family

to assist them in their early recovery. The books were also

used to keep a record of progress made in therapy and to

use as a communication diary for patients and their

families/carers.

Patients have often reported to me that when they were

lacking information and were uncertain of what to expect in

their recovery from stroke, they turned their focus to

observations of other patients on the unit to get this

information. We know, however, that every stroke is

different and affects people in different ways. This method

is therefore not one that often sets patients up for informed

engagement and participation in the planning of their care

and can sometimes lead to poor motivation and higher risk

of emotional distress and depression. For this reason, we

have developed a new version of the patient resource that

includes more information about the stroke care pathway

and addresses some “frequently asked questions” that

patients and families will often have when first admitted to

hospital. The use of this personal resource will additionally

support patients to focus on their individual situation and

goals to hopefully decrease the chance of incorrect

assumptions being made.

This new resource will be trialled on the unit in 2013 with

strong consumer involvement and feedback to achieve our

goal of making this resource a useful and transferrable tool

that could be of use to patients across the stroke care

pathway and in various settings.

Sarah Bates Social Worker Comprehensive Stroke Unit Flinders Medical Centre

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A practical program for staff and families who care for people affected

by dementia

ACT !

Dementia: dealing with

tricky situations

Ideal for a variety of people including family

members, clinical staff and managers working in

aged residential, primary and community care,

mental health, emergency departments and after

hours medical facilities

W ho should come?

I S TA & A g e d C a re Tra i n i n g

W hat wi l l you lear n?

Helpful solutions for tricky everyday

situations including showering and dressing

How to safely respond to unexpected or

unpredictable behaviour

Improved communication with people

affected by dementia/delirium

How to reduce harm to yourself and your

team members

De-escalation and breakaway techniques

In-House Opportunity

at your workplace!

Often carers feel ill-equipped to support people

with dementia in a way which both protects

themselves and the relationship.

This is a practical workshop where carers can

openly discuss the situations which they have

found challenging. It is a wonderful opportunity to

seek advice and strategies in order to most

effectively handle a wide variety of tricky

situations

ISTA will train your staff face to Face

www.changechampions.com.au

For more information please visit:

6

Introducing the Victorian Inter - Hospital

Pa t i e n t Tra n s f e r P r o j e c t

Introduction

Inter-hospital patient transfer (IHPT) is a frequent and

important part of the Victorian health care system and falls

into two broad groups – time-critical emergency transfers

and non-time critical patient transfers. Patients are

transferred between hospitals and other facilities for

numerous reasons, most frequently to access specialised

inpatient care not available at one hospital (up transfer), to

return to a hospital previously transferred from (down

transfer), to receive emergency care, or to co-ordinate

resources across health services.

A number of IHPT issues have been identified including poor

documentation, and challenges in referral, communication

and transport processes. Poor documentation results in

incomplete and delayed communication, which has been

associated with loss of continuity of care, duplication of

services, increased costs, adverse advents and mortality.

The former Victorian Quality Council (VQC) conducted a

range of workshops and surveys that repeatedly identified

clinical handover and documentation relating to non-time

critical IHPT as an area requiring improvement and

standardisation. The VQC Patient Transfer Group (PTG) was

formed to progress the development of a generic IHPT form

(the form) for use in non-time critical IHPT.

Methods

A generic form was developed by members of the VQC–PTG

using feedback from a VQC survey on current hospital

transfer practices and adaptation of a minimum clinical

handover data set developed in Western Australia.

The form was piloted in eight Victorian metropolitan,

regional and rural health service sites between August and

November 2010 in 339 non- time critical patient transfers.

Project officers were appointed in participating hospitals to

implement the pilot project.

The focus of the pilot project was to assess the

effectiveness, usability and acceptability of the form and in

particular, to ascertain health service staff opinions of the

form’s structure, format, content, terminology, data fields

and values. Additionally, the project aimed to identify the

adequacy of instructions for use, areas for improving the

form, the usefulness of the form to transport operators and

barriers and facilitators to the implementation of a generic

form.

Two surveys were developed to obtain information from

staff at sending and receiving health services. Medical

history audits were performed on all transfer forms to

examine completeness of data fields, with a final project

workshop convened to gather further information on the

pilot project.

(Continued next page)

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Healthcare Emerging Managers Network

– now on Linked In

This brand new group provides support to emerging

managers (e.g. clinical, program/project managers)

working in health and aged care in Australia and

New Zealand. Members will be willing to share

their experiences, ideas for dealing with challenges

and information/resources. So if you are out on a

limb and all at sea…

join up at www.linkedin.com or email us to join you

up at [email protected]

Findings

The pilot project identified that:

the concept of a generic form was supported by health service staff

areas for improvement on the form required modification prior to ongoing use

staff from receiving hospitals expressed greater satisfaction with the form than staff from

sending hospitals

the form was of use to transport operators

barriers and facilitators to the implementation of a generic form.

Subsequent Actions

The VQC–PTG modified the original form based on the feedback provided in the pilot

project, and feedback provided in a subsequent workshop with the pilot sites.

Subsequently, the form was endorsed by the VQC and the Secretary for Health for

implementation in all public health services from January 2012.

All form users were invited to provide further feedback on the form between 1 and 31 May

2012 and the form was modified further in June 2012 and December 2012 once it was in

use for a period and following a coroner’s recommendation to enhance patient transfer

communication.

Alice Gleeson Senior Project Officer Commission for Hospital Improvement, VIC Further information can be accessed at: http://www.health.vic.gov.au/qualitycouncil/activities/patient_transfer.htm

http://www.linkedin.com

mailto:[email protected]

http://www.health.vic.gov.au/qualitycouncil/activities/patient_transfer.htm

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Upcoming Workshops

Handy Hints for the Novice Conference Presenter

If you are doing great work but never or hardly ever present to a live

audience because the thought of it turns your knees to jelly.... then here is a

workshop for you. Delegates from outside health also welcomed.

19 February 2013: Sydney, NSW

05 March 2013: Melbourne, VIC

19 March 2013: Adelaide, SA

14 May 2013: Brisbane, QLD

21 May 2013: Perth, WA

28 May 2013: Canberra, ACT

Moving Forward: Accepting and Embracing Resistance to Change

This one day workshop is a fantastic opportunity for new leaders and project

managers from any industry or public sector who are keen to develop their

skills in change management.







The Better Boss Workshop

Ever wondered how you rate as a boss? How you could be a better boss? This

workshop is ideal for enthusiastic emerging leaders, new managers and su-

pervisors with no formal management training and those who are just won-

dering if they are really are being the best boss they can be.







Assessing Change Readiness

Overflowing with enthusiasm to implement an exciting new program that

promises to bring much needed change for the better? This workshop offers a

step by step introduction by systematically assessing change readiness across

a range of levels to optimise the potential for success.







Managing Forced or Unplanned Change

Take this opportunity to learn how to transition from a change recipient to a

change champion. This is a great new workshop for managers who are work-

ing in small organisations, in the not for profit sector or on funded programs-

and want to learn change management strategies in the face of a crisis or un-

expected situation. (Not suitable for commercial entities)







REGISTER ONLINE: www.changechampions.com.au

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BRAND NEW Workshop!

Creating a Culture of

2013 DATES

18 FEB 2013 - Crows Nest, NSW 04 MAR 2013 - Melbourne, VIC 18 MAR 2013 - Adelaide, SA 13 MAY 2013 - Brisbane, QLD 20 MAY 2013 - Perth, WA 27 MAY 2013 - Canberra, ACT

In-house opportunities at your organisation are also available

upon request

For more information visit:


This practical workshop draws upon the best international literature and focuses on how to create a culture of innovation in health and aged care.

Delegates will learn a step by step approach to

creating a culture of innovation in their organisation:

Define what constitutes “innovation” as a

pre-requisite for culture change

Understand the DNA of innovators and

how they inspire others

Consider case studies of innovation in

organisations

Look at strategies and tools for fostering

innovation in your organisation

Develop a road map for fostering

innovation in your organisation after the

workshop

Suitable for Managers and Emerging Managers in All Facilities and Departments

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Pathways to a Consumer Focused

Organisation – Governance and

Managerial Approaches

It is timely for health care organisations, from boards to

front-line staff, to gain a clear understanding of consumer

participation and consumer experience principles.

Set within the context of the current health reforms and

expanding mandatory requirements this Master Class is a

strategic exploration and examination of the health consumer

participation trilogy: consumer engagement, consumer

involvement and consumer partnerships for organisation-

wide quality improvement.

2013 in-houses available

For more details please visit our website and

download & fill out an expressions of interest

form. We’ll then get back in touch with the relevant information

Audience Profile

Board members, health services executives, clinicians, safety

& quality co-ordinators/managers, risk managers, clinical

governance managers and health consumers.

With facilitators

Stephanie Newell

& Mitchell Messer

Visit www.changechampions.com.au

To download official flyers and register online for seminars

2013 IN-HOUSE MASTER CLASS

11

Creating Champions for Skin Integrity:

Facilitating the uptake of evidence based wound management in residential aged care

Prof. Helen Edwards, Prof. Anne Chang, Dr. Kathleen Finlayson, Michelle Gibb, Christina Parker

School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology

Wounds such as skin tears, pressure ulcers and chronic leg

ulcers increase in incidence with age and are a serious issue in

aged care. A recent project with seven Residential Aged Care

Facilities (RACFs) and Queensland University of Technology’s

School of Nursing demonstrated lasting benefits for staff and

residents in residential aged care. The Champions for Skin

Integrity project focused on promoting healthy skin through

the application of best evidence to prevention, assessment

and management of wounds.

The aim of the project was to implement the Champions for

Skin Integrity (CSI) model for practice to preserve skin

integrity and facilitate evidence based wound management.

The CSI model utilises evidence based strategies to facilitate

the transfer of evidence into daily practice and included

education, resources in easily utilised forms, audit and

feedback cycles, clinical decision making support systems, led

by local Champions and management support.

Following a six month implementation phase, evaluation of

outcomes from the project found a decrease in the

prevalence and severity of wounds, along with increased

implementation of evidence based practices for prevention

and management of wounds. In the longer term, the resource

package has continued to be utilised by facility staff.

In discussions and evaluations of this project, it was identified

that dissemination of the CSI model and project resources on

a national scale would be of benefit and that updated

resources would enhance the products for dissemination. The

project team, led by Prof. Helen Edwards from the School of

Nursing at Queensland University of Technology, are

currently updating the resource package in preparation for an

extended roll-out of training workshops and resource kits for

RACF staff around Australia in 2013 and 2014.

This project was funded by the Australian Government

Department of Health and Ageing under the Encouraging Best

Practice in Residential Aged Care (EBPRAC) Program.

For further information contact:

Dr. Kathleen Finlayson School of Nursing Queensland University of Technology Email: [email protected] Ph: 07 3138 6105

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Expression of Interest

Speaking Opportunity in England, United Kingdom

13-15th March 2013

Change Champions & Associates is again assisting the NHS in its selection of ONE only keynote speaker

from Australia to present an international perspective at several events that showcase achievements to

date for the new vision in nursing care.

Expressions of interest are now invited from suitably qualified nursing professionals who are willing and

able to travel to England, UK and be available to present between 13-15 March 2013.

Candidates will be expected to arrive in the UK by the 11th March 2013 and travel across England.

The successful candidate will deliver keynote presentations at:

13th/14th March 2013 NHS Innovations EXPO (London)

15th March 2013 International Conference, “Recruiting for the values of the NHS” (Manchester) –

particularly focusing on how you assess values and behaviours in new recruits to

Healthcare Professions in your organization.

Background Compassion in Practice is the new three year vision and strategy for nursing, midwifery and care staff drawn up Jane Cummings, the Chief Nursing Officer for England (CNO) at the NHS Commissioning Board, and Viv Bennett, Director of Nursing at the Department of Health. It was launched at the CNO annual conference in Manchester on December 4th 2012 following an eight week consultation with over 9,000 nurses, midwives, care staff and patients. For further information about new vision for nurses, please visit, http://www.commissioningboard.nhs.uk/nursingvision/ This is an exciting opportunity for the successful candidate who will:

Have an opportunity to meet key players in UK Nursing

Represent Australia as key note speaker as the NHS launches the findings of recently commis-sioned reviews, including at a prestigious international conference.

Recruiting for the values of the NHS

The International Conference, “Recruiting for the values of the NHS” is a. showcase event to be held on Friday 15th March 2013. Jane Cummings, Chief Nursing Officer, will set the NHS Commissioning Board Authorities’ vision. Perspectives of screening recruitment from Australia and Texas, United States of America will be showcased together with Health Education England’s commitment to delivering the constitution through higher education contracts. The Texan speakers have 20 years experience using the Hartman Values tool for selection http://www.hartmaninstitute.org/HartmanValueProfile.aspx During this one day conference, delegates will have an opportunity to look at case studies in workshops which will demonstrate some of the UK tools and techniques.

13

Requirement

The successful applicant:

MUST have demonstrated expertise in screening out either student applicants or other healthcare

staff using objective behaviour and values tests

MUST be willing to prepare and deliver the presentations as outlined above and being willing to

engage in discussion panels if requested.

Will be an articulate and engaging speaker

Will be an experienced traveller or unflappable novice traveller, who is willing to go with the flow

and remain calm in the event of any uncertainty about arrangements.

Have a valid passport and be able to obtain a visa to enter the United Kingdom if required.

Package

The successful applicant will be offered:

Costs covered for EITHER one return business class flight OR two economy class flights so that they

can travel with their partner to UK and any internal travel (Any stop overs at the candidates ex-

pense and the offer is not negotiable.)

Accommodation while in UK between 11-16 March 2013

Living allowance for 5 days in UK

Registration fee for Recruiting for the values of the NHS Conference.

Register Your Interest by COB 8th February 2013:

Prepare an abstract for your presentations that is no more than 400 words in length and demon-

strates your expertise as it relates to the Requirement as outlined above.

Include a 100 biography together with your contact details.

Provide the names of contactable referees that can verify your bonafides and comment on your

capacity as an engaging, knowledgeable speaker

Confirm that you are available to travel on the set dates and have a valid passport.

Late applications will not be considered.

Please check your expression of interest carefully as incomplete applications will not be considered.

Selection

Submissions will be reviewed by a panel and the successful applicant contacted as soon as possible after the

review process is complete.

For further information:

Phone: 0467 635150 Email: [email protected]


14

RESOURCES From Australia & New Zealand

Mental Health Liaison - eSimulation Resource

Mental Health Liaison is an interactive, multimedia eSimulation resource, aimed at developing

the skills of generalist nurses in caring for patients who exhibit psychological, emotional and

behavioural difficulties in general hospitals.

http://inkysmudge.com.au/eSimulation/

Supervision and delegation for allied health assistants case studies

The following case studies describe how eight different health and community services from

across Victoria identified a service need and expanded their allied health services through the

utilisation of AHAs.

http://docs.health.vic.gov.au/docs/doc/Supervision-and-delegation-for-allied-health-assistants-

case-studies

Paediatric Fractures Guidelines– Online Resource The Victorian Paediatric Orthopaedic Network (VPON), in collaboration with The Royal Chil-dren’s Hospital and the Department of Health, has launched an on-line resource aimed at im-proving fracture care. The website includes guidelines for clinicians and carers on the identifica-tion and management of the most common upper and lower limb paediatric fractures. http://ww2.rch.org.au/clinicalguide/fractures/

Rising to the Challenge: The Mental Health and Addiction Service Development Plan 2012–2017 Rising to the Challenge: The Mental Health and Addiction Service Development Plan 2012–2017 (the Plan) provides a strong vision to guide the mental health and addiction sector, as well as clear direction to planners, funders and providers of mental health and addiction services on Government priority areas for service development over the next five years. http://www.health.govt.nz/publication/rising-challenge-mental-health-and-addiction-service-

development-plan-2012-2017

16

P int of View

Managing Change by Dawn Skidmore

1

Many organisations are feeling change weary right now. All

too often we forget that a project delivered on time and in

budget can’t achieve full success unless people adopt the

changes into their daily working.

Facing the challenging task of delivering reform while at the

same time protecting quality, effectively using resources

and delivering increased productivity, Australian health

care organisations are going through much change. They

need to manage and control the delivery of improvements

across a number of levels including unit (or project),

directorate (or program) and organisational (or portfolio).

Looking around the globe, those organisations that are high

performing tend to have systematically and consistently

applied approaches to the way they manage their projects

and any change. I have worked in the UK and Australia and

used various methodologies and strongly believe that it is

crucial for an organisation to be able to assess its own

change and project capacity. This includes the following:

Understanding and measuring the organisation's

capability and maturity

Establishing where improvements are required

Understanding how well change processes are

embedded into the organisation

Tracking achievements and

Being able to predict future performance.

These are all important steps. Without such an approach,

organisations run the risk of delivering poorly managed

change. I have worked with organisations in which there

were so many projects underway and the change was not

well managed. In some there was so much change

occurring that it negatively impacted on individuals and the

organisation. A common reason was that there was no one

taking a portfolio or organisational view of what was

happening. Portfolio management enables executives,

managers, program, project and change managers to see

the extent of the changes occurring, often for the first time.

It also allows them to be managed to achieve integrated

benefit realisation.

What many managers and change agents do when faced

with these challenges is turn to a number of existing

change or project solutions and develop a change process

from those predetermined formulae. The human brain is

hardwired to prefer patterns and predictable behavior.

Unfortunately, what can happen is that the existing

solutions are chosen without any assessment of the

appropriateness of that solution to the organisation's

change or project context. This is not to deny the value of

previous learning or past experiences – clearly they are

hugely valuable and important. However, the past should

not be analysed with reference to the current context.

Long term, ensuring that projects and change are

successfully delivered means that effective communication

and change management need to be part of the

organisation’s DNA.

Are you feeling change weary? Is your organisation

managing its projects successfully? Why not see how

Change Champions and Associates can help you?

Dawn Skidmore Principal Consultant [email protected]

Brown P 2011 Neuroscience New Science for New Leadership, Developing Leaders Executive Education in Practice 1.

17

Submit your

Tricks of the Trade

It is often the surprising discoveries and personal experiences that make all the difference in change management, reform, redesign programs, etc. We invite you to submit a short article for our newsletter, sharing the personal experiences and unpredicted lessons that could never be found in a book.

All submissions should be emailed to [email protected]

Hourly Rates

Improve your confidence Get the support you need when you need it Suitable for new managers working in health and aged care, especially those working on projects. Ideal for project and acting managers:

working in isolated regions or just working in isolation those with little previous experience sufferers of imposter syndrome (i.e. feeling way out of your

depth or certain that you lack of skills will shortly be discovered) Telephone coaching service available in or out of hours. Face to face coaching also available by appointment. Ph: 02-9692 0533 or email [email protected] for more info.

Confidential Coaching Service for Emerging Managers With Experienced Certified Executive Coach

mailto:[email protected]

18

I N T E R N A T I O N A L

Public Health Agency of Canada

Canadian Best Practices Portal

This enhanced Portal provides you with resources and solutions to plan

programs for promoting health and preventing diseases in your community.

The site consolidates multiple sources of trusted and credible information in

one place, making it a one-stop shop for busy health professionals and

decision-makers.

http://cbpp-pcpe.phac-aspc.gc.ca/

Tapping Front-Line Knowledge: Identifying Problems as

They Occur Helps Enhance Patient Safety

This article describes a methodology, developed and tested by IHI and

Cedars-Sinai Medical Center, that helps front-line staff to "see" patient

safety problems in their systems and enables them to solve the problems

and share that learning with others. The methodology is constructed around

an informal unit visit and designed to be a “conversation” about safety

issues, versus an inspection or evaluation, with specific staff duties and

desired outcomes also articulated.

http://www.ihi.org/knowledge/Pages/Publications/

TappingFrontlineKnowledge.aspx

Guiding Transformation: How Medical Practices Can

Become Patient-Centered Medical Homes

This report outlines and describes the changes that most medical practices

would need to make to become patient-centered medical homes. The broad

"change concepts," as the report terms them, include: engaged leadership; a

quality improvement strategy; empanelment or linking patients with specific

providers to ensure the continuity of the patient–provider relationship;

continuous and team-based healing relationships, including cross-training

staff to allow team members to play various roles; organized, evidence-based

care, including the use of decision support systems; patient-centered

interactions to increase patients' involvement in their own care; enhanced

access to ensure patients have access to care and their clinical information

after office hours; and care coordination to reduce duplication of services

and increased anxiety and financial costs for patients and their families.

http://www.commonwealthfund.org/Publications/Fund -

Reports/2012/Feb/Guiding -Transformation.aspx

19

I N T E R N A T I O N A L

2nd World Congress of Clinical Safety

12 - 13 September 2013, Heidelberg, Germany

(Main theme) Risk in Clinical Care (Abstract submission) 1st Feb. 2013 - 31st May, 2013 (Conference registration) from 2013 Spring This academic congress is organized by IARMM and aims to improve and promote the science and technology of better safety in both risk and crisis management in health care. The congress covers a wide range of topics such as patient safety, medication safety, medical device safety, infectious disease outbreak, and the other related subjects. German scientific culture of risk has the longest history of over hundred years in the world and has absolutely active movements in risk science and technology which generated the important key concepts, such as philosophy of risk, risk communication, risk management, etc. We are sure that the Congress will assist the world wide exchange of knowledge and skill in this specialist area with excellent German risk scientists. Let's all join together at our Heidelberg Congress to meet and share information with your colleagues.

Abstract submission manner

http://www.iarmm.org/2WCCS/Abstract_Submissions.pdf Key topics:

'Philosophy and strategy of managing risk and error'

'Clinical communication for risk and safety'

'International perspectives for clinical safety'

'Safety culture in healthcare and group medicine'

'IT and medical informatics in clinical safety'

'Education and training for clinical safety'

'Patient's or career's role in clinical safety"

'Simulation and human factor for clinical safety'

'Survey and report of clinical errors'

'Risk and safety in medical device'

'Surgical safety, preoperative risk management and Checklist'

'Medication safety'

'Drug safety'

'Emergency healthcare system'

http://www.iarmm.org/2WCCS/poster_2WCCS.pdf

http://www.iarmm.org/2WCCS/Abstract_Submissions.pdf

http://www.iarmm.org/2WCCS/poster_2WCCS.pdf

20

REFERENCES (pp. 1-3.)

Service Redesign for Women and Newborn Drug & Alcohol Service (WANDAS)

Bell, L., Geraghty, S., McLaurin, R., & Bayes, S. (2010). Pregnancy care for drug and alcohol misusing Western Aus-

tralian childbearing women: The ‘WANDAS’ Women And Newborn Drug and Alcohol Service. . Australian

Midwifery News(September Issue).

Blyth, A. (2006). Team building: a daily task.(speech and language therapist team building tips for child care).

Paediatric Nursing, 18(7), 44(41).

Covington, S. S. (2008). Women and addiction: a trauma-informed approach.(Report). Journal of Psychoactive

Drugs, 40(S5), 377(379).

Dowdell, J. A., Fenwick, J., Bartu, A., & Sharp, J. (2009). Midwives' descriptions of the postnatal experiences of

women who use illicit substances: A descriptive study. Midwifery, 25(3), 295-306. doi: 10.1016/

j.midw.2007.03.008

Elliott, D. E., Bjelajac, P., Fallot, R. D., Markoff, L. S., & Reed, B. G. (2005). Trauma-informed or trauma-denied:

Principles and implementation of trauma-informed services for women. Journal of Community Psycholo-

gy, 33(4), 461-477. doi: 10.1002/jcop.20063

Lightfoot, B., Panessa, C., Hayden, S., Thumath, M., Goldstone, I., & Pauly, B. (2009). Gaining insite: harm reduc-

tion in nursing practice. The Canadian nurse, 105(4), 16.

McCallin, A., & Bamford, A. (2007). Interdisciplinary teamwork: is the influence of emotional intelligence fully

appreciated? Journal of Nursing Management, 15(4), 386-391. doi: 10.1111/j.1365-2834.2007.00711.x

NSW Department of Health. (2006). National Clinical Guidelines for the Management of Drug Use during Preg-

nancy, Birth and the Early Development Years of the Newborn. North Sydney: Commonwealth of Aus-

tralia Retrieved from http://www.health.nsw.gov.au/pubs/2006/pdf/ncg_druguse.pdf.

Poole, N. (2007). Gender does matter; coalescing on women and substance use.(focus). CrossCurrents - The Jour-

nal of Addiction and Mental Health, 10(3), 8(1).

Rhodes, T., Bernays, S., & Houmoller, K. (2010). Parents who use drugs: Accounting for damage and its limitation.

Social Science & Medicine, 71(8), 1489-1497. doi: 10.1016/j.socscimed.2010.07.028

Schafer, G. (2011). Family functioning in families with alcohol and other drug addiction. [Report]. Social Policy

Journal of New Zealand(37), 135+.

Sword, W., Niccols, A., & Fan, A. (2004). "New Choices" for women with addictions: perceptions of program par-

ticipants. BMC public health, 4(1), 10.

Turnbull, C., & Osborn, D. A. (2012). Home visits during pregnancy and after birth for women with an alcohol or

drug problem. Cochrane database of systematic reviews (Online) U6 - ctx_ver=Z39.88-

2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/

summon.serialssolutions.com&rft_val_fmt=info:ofi/

fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Home+visits+during+pregnancy+and+after+birth+for+w

omen+with+an+alcohol+or+drug+problem&rft.jtitle=Cochrane+database+of+systematic+reviews+%

28Online%29&rft.au=Turnbull%2C+Catherine&rft.au=Osborn%2C+David+A&rft.date=2012-01-

01&rft.volume=1&rft.spage=CD004456&rft.externalDocID=22258956 U7 - Journal Article U8 - FETCH-

LOGICAL-p598-295652c052736fc725596d9beeca003d1ed0936454f10f1068afc23e73c0b3361, 1(Journal

Article), CD004456.

Wright, T., Schuetter, R., Fombonne, E., Stephenson, J., & Haning, W. (2012). Implementation and evaluation of a

harm-reduction model for clinical care of substance using pregnant women. Harm Reduction Journal, 9

(1), 5.

http://www.health.nsw.gov.au/pubs/2006/pdf/ncg_druguse.pdf

21

P: + 61 2 9692 0533

E: [email protected]

W: www.changechampions.com.au

change champions & associates newsletter feb 2013

Documents

wandas women

service redesign

outreach service

traumatised women

newborn health service

women of western australia

pregnant incarcerated

managerial approaches