Leadership for the Sustainability of the Health System: Part 2 - Key ...

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governance was identified as being central to overcoming issues caused by vested interestgroups and bringing about the big structural changes needed in the health system—to thisend, it was suggested that Commonwealth and State Governments should considerintroducing an independent health commission that would loosely follow the model of theReserve Bank; the government would provide the health commission with some generalpriorities and guidance and leave the commission to do the restset up systematic processes to consult community members to determine their values andthe principles they would like health leaders to apply to resource allocation, and theplanning, delivery and targeting of health services; these processes could include:introducing citizens' juries—once the jury is informed, it makes great decisions onvalues and priorities, which strengthens the arm of politicians to take the right actionintroducing patient experience surveys that extend beyond quality- and safetyrelatedquestions (such as ‘were you happy with the quality of care provided?’) toquestions that seek to improve the user experience (such as ‘what do you thinkcould have been done better?’)creating patient and family advisory councils.An example provided by one participant of a successful user community engagement strategywas this:A group of 100 randomly selected members of a community werechosen to participate in a forum in [Western Australia]. The participantswere asked about their views and opinions on the potential closure ofa local hospital. The Local Government believed the community wouldbe fervently opposed to this closure. However, once they were madeaware of the parameters around how they could contribute to theprocess and the issue was clearly explained to them, theoverwhelming majority of the participants were in favour of the closureof the hospital in exchange for an improvement in services that theyvalued.HWA’s potential roleThis section outlines the potential roles respondents suggested that HWA could play in facilitatingthe development of health system leaders.Senior executive developmentSome thought that the return on investment in leadership development for HWA would be greatestat the most senior levels of the health workforce.Leadership for the Sustainability of the Health System: Part 2 – Key Informant Interview Report Page 23
In particular, cross-jurisdictional learning and development would be highly valuable, as a lot ofexecutives are highly mobile and there is a lot that can only be learned from interacting andworking with each other. This would also offer them a community of support and a source ofguidance—two things that interviewees believe are currently unavailable to senior leaders.A model similar to that used in the HEALS (Health Executive Action Learning Sets) program could beused, where participants first decide what they wish to learn from each other and then meet in adifferent jurisdiction every four to six months to visit facilities and institutions and learn firsthandabout the issues being faced in the jurisdiction and how they are being dealt with.HWA could also have a hand in exposing senior leaders to best practice internationally.Additionally, they could bring representatives from health educators, course accreditors andregulators together with senior leaders to discuss the development of future health system leadersand how their respective responsibilities contribute to the level and type of leadership that willsupport the future sustainability of health services and attract and retain the best workforce.Discussions should draw on information and views gleaned from the recent Workplace Innovationand Reform and Rural and Remote consultations.Finally, HWA could play a role in improving the political acumen of senior health leaders. Thevehicle recommended for this could be something similar to The Westminster Experience, whichwas explained in an earlier section of this report.National pool of evidenceIt was recommended that HWA build an evidence base on what works in leadership development,both internationally and in the jurisdictions, and then provide this information to healthorganisations so they can make more informed decisions on the leadership development of theirstaff. In this regard they would be playing more of a facilitative role rather than a directive one. Thecontents of the literature review 12 and environmental scan 13 completed for this project provide afoundation for this work.National evaluation frameworkInformation provided by Queensland, Western Australia, the Northern Territory and the AustralianCapital Territory indicates that the extent and nature of current evaluative effort consists of preandpost-tests of program participants, usually via 360-degree feedback, which do not cover theoutcomes for organisations and systems. In some jurisdictions, trends in ongoing culture and climatesurveys are attributed to the impact of leadership development. These short-term individual12Miller M, Elliott C & Siggins I (2012). Leadership for the Sustainability of the Health System: Literature Review. Reportprepared for Health Workforce Australia by Siggins Miller. www.hwa.gov.au13Miller M, Elliott C & Siggins I (2012). Leadership for the Sustainability of the Health System – An Environmental Scan. Reportprepared Health Workforce Australia by Siggins Miller. www.hwa.gov.auLeadership for the Sustainability of the Health System: Part 2 – Key Informant Interview Report Page 24
Page 3 and 4: ForewordI am pleased to present thi
Page 5 and 6: ContentsContents ..................
Page 7 and 8: Suggested improvements to leadershi
Page 9: developing a national leadership co
Page 12 and 13: quality and safety efforts to reduc
Page 14 and 15: Key informant interview reportMetho
Page 16 and 17: These findings have been synthesise
Page 18 and 19: Maximising productivity to meet inc
Page 20 and 21: Leadership exists at all levelsAchi
Page 22 and 23: Building ‘engaging’ leadershipT
Page 24 and 25: An additional solution offered is c
Page 26 and 27: These clinicians are selected based
Page 30 and 31: measures, and the more distal and c

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