vanguard health at capricorn coast: rural medicine australia 2016
TRANSCRIPT
WorkforcestabilityandservicequalityinruralhealthdeliveryMovingfromalocumtoapermanentmedicalworkforce
Dr Parbodh Gogna,MBChB MBAMRCGP FRACGP FACRRMMedicalSuperintendent,CapricornCoastHospitalandHealthServiceCentralQueenslandHospitalandHealthService
Mr Jason Currie,BSc LLB MIP GCPAProgramDirector- HealthServices,VanguardHealth
RuralMedicineAustralia201620October2016
Context– CapricornCoastHospitalandHealthService• Over13,000EDpresentationspa• 22inpatientbeds,running>90%occupancy• 35minutesbyroadtoRockhamptonHospital,1hourbyairtoBrisbane
RuralMedicineAustralia201620October2016
Context– theMedicalWorkforceProject
• Increasingworkloadsleadstoworkforceattrition• PermanentMedicalSuperintendentdepartedlate2013• Ongoingissuesattractingstaffandrelianceonfly-in,fly-outlocumworkforce• DeclineinGPandcommunityconfidenceinservice• VanguardHealthengagedearly2014toincreaseandstabilisetheworkforce
RuralMedicineAustralia201620October2016
Theapproach
• Systemredesignandenhancements• Workforceplanwith3centraltenetsdrovetheactivity• Attract• Develop• Retain
• GovernanceSystemdeployment• Communityengagementstrategy
RuralMedicineAustralia201620October2016
SystemRedesign
• Businessintelligenceatthecore-analysisofactivity,trendsandworkflows• Reshapeworkforcewithinconstraintsincludingplannedre-establishmentoftrainingpositions• Maximiserosterwithbalancebetweenworkforcepreferences(sociability)andmeetingcommunityrequirements
RuralMedicineAustralia201620October2016
WorkforceStrategy
• Attract theworkforce– cumulativeimpact/plannedreplacementswithstandardrecruitmentactivitiesandleverageprofessionalnetworks• Develop – attitudebeforeaptitude(withinreason),upskillandmentortheteam,enhanceskillsandbuildcapacity• Retain – targetedretentionpackages,flexibilityandresponsiveness,constantrefinementoftheservicetosupportstaffasmuchaspossible,maximisefinancialandnon-financiallevers
RuralMedicineAustralia201620October2016
GovernanceSystemDeployment
• Qualityandsafetyasthefoundationforenhancementsandimprovements• Targetrecruitmentactivitieswithafocusonclearperformanceexpectationsandroledescriptions• Establishframeworksforappropriatesupervision,professionaldevelopmentandactivelearning• Ongoingpeerreviewandasupportivelearningenvironment
RuralMedicineAustralia201620October2016
CommunityEngagementStrategy
• Dedicatedsignificantresourcestothisintheearlyphasestorebuildtrustandconfidence• Standardstakeholderengagementframeworkandassessment(usingainfluence/supportmatrix)• Engagementschedulecreated
• 1:1meetings• AdvisoryGroup• Phonecalls
Support / Interest
Influence / Power
HighLow
Low
High
ManageClosely
KeepSatisfied
KeepInformed
Monitor(minimumeffort)
RuralMedicineAustralia201620October2016
Outcomes
• A2:1potentialROIfortheHealthServicebasedonreleasedcapacity• ImprovementstoEDworkflowtosurpassnationaltargets• AbsorptionofgrowthinEDandreductionsintransferstosecondaryhospitalsite• Increaseinpositivecommunityfeedback 0
0.5
1
1.5
2
2.5
3
3.5
4
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
Jul-13
Aug-13
Sep-13
Oct-1
3 No
v-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-1
4 May-14
Jun-14
Jul-14
Aug-14
Sep-14
Oct-1
4 No
v-14
Dec-14
Jan-15
Feb-15
Mar-15
Apr-1
5 May-15
Jun-15
Jul-15
Aug-15
Sep-15
Oct-1
5 No
v-15
Dec-15
Jan-16
Feb-16
Mar-16
Apr-1
6 May-16
EmergencyCareWorkUnitsperday(blue- LHS)andEDISTransfersperday(orange- RHS)
RuralMedicineAustralia201620October2016
Thechallengeofnature
• TownshiptookdirectimpactofTCMarcia• Benefitoflocalworkforce• Maintainserviceandperformancedespitedisaster
RuralMedicineAustralia201620October2016
Lessons
• Dedicatedresourcesandfocus• Clearperformanceobligations(KPIsorcontractualterms)
• Timeandspacetofocus(notsomeonere-taskedfromelsewhere)
• Differentthinkingandfreshideas• Systemdesignisessentialtoofferthebestpossibleopportunityforsuccessfulrecruitmentandworkforceretention• Rebuildingaworkforceisalong-termpropositionthattakes2-3yearsoffocusedeffort
RuralMedicineAustralia201620October2016