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NEWSLETTER For innovators in healthcare & beyond February 2013

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Service Redesign for Women and Newborn Drug & Alcohol Service (WANDAS) Angela O’Connor, Renate McLaurin, Lynne Portwine

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Supporting Patients in Early Stroke Recovery Sarah Bates

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Introducing the Victorian Inter- Hospital Patient Transfer Project Alice Gleeson

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Creating Champions for Skin Integrity Dr. Kathleen Finlayson

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Expressions of Interest: Speaking Opportunity in England, United Kingdom POINT OF VIEW: Managing Change Dawn Skidmore

UPCOMING WORKSHOPS P.3

The Challenge of Long Term Alcohol Abuse in Older Adults

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ACT! Dementia: dealing with tricky situations

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Practical workshops on public speaking, leadership and change management

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Pathways to a Consumer Focused Organisation – Governance and Managerial Approaches

Service Redesign for Women and Newborn Drug & Alcohol Service (WANDAS) A Patient Centred Trauma Informed Model to reduce the wait time by 80%. 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 selfprotection, combined with the posttraumatic stress symptoms of hyper arousal or avoidance, make a (Continued p.2)


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survivor’s entrance into a situation such as a hospital

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

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

often diminished as stress levels increase. As a result AOD

WANDAS operates under the Governance of the Women

using women are at high risk for relapsing in the post

and Newborn Health Service (WNHS) at KEMH.

natal period. Evidence shows at four months after birth many will have relapsed back into pre pregnancy AOD use

The service has the philosophy of provision of service and

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

is one of harm reduction and minimisation. Harm

2012). In a review of studies looking at postpartum

reduction is the main feature of Australian public health

women with AOD problems, all studies showed AOD use

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

increased in the post natal period (Turnbull & Osborn,

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

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

harm reduction model of perinatal care aims to reduce

though

the health, social and economic harms of AOD use to

Management of Drug Use during Pregnancy, Birth and

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

the Early Development Years of the Newborn (NSW

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

Department of Health, 2006) recommend following the

2012).

women and their babies up for three months post natally.

WANDAS took part in a Lean Action Challenge as part of

The tools and methodology of lean enabled WANDAS to

an overall leadership programme with the aim of

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

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

Value Stream Map highlighted the deficits and helped

Action Challenge undertaken by our pod was to review

move the direction and focus of where the service

the whole service in order to incorporate a “Trauma

wanted to go.

the

National

Clinical

Guidelines

for

the

Informed” (Covington, 2008; Poole, 2007) model of care, which included the patient being central to the service.

Hospital wide discussions held between WANDAS and internal and external stakeholders resulted in the

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

following outcomes:

rate at ante natal booking visits which could be anything up to 100%. This impacted on staff waiting for patients

Reorganised space and rooms on clinic days to

with the flow on effect that on the subsequent Friday

encourage patient-centred multidisciplinary care and

clinics the team needed to accommodate the DNA from

thereby reducing DNA rates. Provide food on Friday

Wednesday. As a result the Friday clinics became

clinics and now are reviewing the need to have food

overcrowded.

and drink for the Wednesday follow up clinics. We have made savings from freeing up staff in the order

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

of $270,888.96 savings per annum. 

pregnant woman with body art of map of Australia

were asked to return to the waiting room to have lengthy

with the message that she was the centre of

waits to be seen by the other members of the allied

WANDAS universe. This was helped by the Queen

health team. This often resulted in the women leaving the

brand and song One Vision.

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

Pregnancy is often a prime motivator for a period of recovery and remission of AOD use (Sword, Niccols, &

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.

service including the outreach service for the provision of antenatal care to pregnant women in corrective services.

Branding of the service which included the image of a

Increased the appointment times and scheduling of appointment to remove batching.


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one

In conclusion WANDAS achieved the goal. WANDAS have

multidisciplinary form which will save three thousand

further developed the service where the woman is central

dollars per annum.

to her care and are building on improving the model

Redesigned

assessment

form

to

include

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

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)

bookings on Wednesday within the present FTE structure 

Authors:

Standard Operating Procedures (SOP) developed for the clinic which helps to empower the women as

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

they are central to their care. The SOP for outreach

Renate McLaurin RN BHSc, RM

to Bandyup Prison, and seven other SOP for the day

Lynne Portwine Bsc Social Work

to day running of the service.

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

course Outline 

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


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Supporting Patients in

Early Stroke Recovery 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

methodologies)

Improvement on

(CPI)

patient-oriented

principles goal

and

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

their recovery from stroke, they turned their focus to

actively involved in the planning and direction of their care.

observations of other patients on the unit to get this information. We know, however, that every stroke is

While goal setting practices are of huge benefit in stroke

different and affects people in different ways. This method

recovery and rehabilitation, we found that the more

is therefore not one that often sets patients up for informed

structured techniques and programs were more appropriate

engagement and participation in the planning of their care

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

and can sometimes lead to poor motivation and higher risk

is more medically stable and has been able to work through

of emotional distress and depression. For this reason, we

the typical crisis responses associated with such an event.

have developed a new version of the patient resource that

The rehabilitation setting also provides a longer length of

includes more information about the stroke care pathway

stay and more time for the patient to build rapport and

and addresses some “frequently asked questions” that

engage with the therapists to set goals and monitor their

patients and families will often have when first admitted to

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

hospital. The use of this personal resource will additionally

days.

support patients to focus on their individual situation and goals to hopefully decrease the chance of incorrect

We found that the most well-received concept developed

assumptions being made.

during our project was a patient logbook. The logbook was given to patients to compile information, record aspects of

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

their journey and to use as a motivational tool using

strong consumer involvement and feedback to achieve our

personalised photographs and letters/messages from family

goal of making this resource a useful and transferrable tool

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

that could be of use to patients across the stroke care

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

pathway and in various settings.

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

Sarah Bates Social Worker Comprehensive Stroke Unit Flinders Medical Centre


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I S TA & A g e d C a r e Tr a i n i n g

ACT! Dementia: dealing with tricky situations

A practical program for staff and families who care for people affected by dementia W ho should come? 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

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

W hat will you lear n?

openly discuss the situations which they have found challenging. It is a wonderful opportunity to seek advice and strategies in order to most

 

Helpful solutions for tricky everyday

effectively handle a wide variety of tricky

situations including showering and dressing

situations

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

For more information please visit:

www.changechampions.com.au

ISTA will train your staff face to Face


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Introducing the Victorian Inter - Hospital

P a t i e n t Tr a 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

The focus of the pilot project was to assess the

formed to progress the development of a generic IHPT form

effectiveness, usability and acceptability of the form and in

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

particular, to ascertain health service staff opinions of the form’s structure, format, content, terminology, data fields

Methods

and values. Additionally, the project aimed to identify the adequacy of instructions for use, areas for improving the

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

form, the usefulness of the form to transport operators and

using feedback from a VQC survey on current hospital

barriers and facilitators to the implementation of a generic

transfer practices and adaptation of a minimum clinical

form.

handover data set developed in Western Australia. Two surveys were developed to obtain information from The form was piloted in eight Victorian metropolitan,

staff at sending and receiving health services. Medical

regional and rural health service sites between August and

history audits were performed on all transfer forms to

November 2010 in 339 non- time critical patient transfers.

examine completeness of data fields, with a final project

Project officers were appointed in participating hospitals to

workshop convened to gather further information on the

implement the pilot project.

pilot project. (Continued next page)


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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

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 info@changechampions.com.au


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Upcoming

Workshops

REGISTER ONLINE: www.changechampions.com.au Handy Hints for the Novice Conference Presenter

19 February 2013: Sydney, NSW 05 March 2013: Melbourne, VIC 19 March 2013: Adelaide, SA

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.

14 May 2013: Brisbane, QLD 21 May 2013: Perth, WA 28 May 2013: Canberra, ACT

Moving Forward: Accepting and Embracing Resistance to Change

21 February 2013: Sydney, NSW 07 March 2013: Melbourne, VIC 21 March 2013: Adelaide, SA

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.

16 May 2013: Brisbane, QLD 23 May 2013: Perth, WA 30 May 2013: Canberra, ACT

The Better Boss Workshop

19 February 2013: Sydney, NSW 05 March 2013: Melbourne, VIC

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

19 March 2013: Adelaide, SA

workshop is ideal for enthusiastic emerging leaders, new managers and

14 May 2013: Brisbane, QLD

su-

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

21 May 2013: Perth, WA

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

28 May 2013: Canberra, ACT

Assessing Change Readiness

20 February 2013: Sydney, NSW

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.

06 March 2013: Melbourne, VIC 20 March 2013: Adelaide, SA 15 May 2013: Brisbane, QLD 22 May 2013: Perth, WA 29 May 2013: Canberra, ACT

Managing Forced or Unplanned Change

22 February 2013: Sydney, NSW

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

08 March 2013: Melbourne, VIC

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

22 March 2013: Adelaide, SA

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

17 May 2013: Brisbane, QLD

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

24 May 2013: Perth, WA

expected situation. (Not suitable for commercial entities)

31 May 2013: Canberra, ACT


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BRAND NEW Workshop!

Creating a Culture of

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

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:

www.changechampions.com.au

Suitable for Managers and Emerging Managers in All Facilities and Departments


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2013 IN-HOUSE MASTER CLASS Pathways to a Consumer Focused Organisation – Governance and Managerial Approaches With facilitators Stephanie Newell & Mitchell Messer

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

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 organisationwide quality improvement.

Audience Profile Board members, health services executives, clinicians, safety & quality co-ordinators/managers, risk managers, clinical governance managers and health consumers.

Visit www.changechampions.com.au To download official flyers and register online for seminars


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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

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

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

package has continued to be utilised by facility staff.

aged care. A recent project with seven Residential Aged Care Facilities (RACFs) and Queensland University of Technology’s

In discussions and evaluations of this project, it was identified

School of Nursing demonstrated lasting benefits for staff and

that dissemination of the CSI model and project resources on

residents in residential aged care. The Champions for Skin

a national scale would be of benefit and that updated

Integrity project focused on promoting healthy skin through

resources would enhance the products for dissemination. The

the application of best evidence to prevention, assessment

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

and management of wounds.

Nursing at Queensland University of Technology, are currently updating the resource package in preparation for an

The aim of the project was to implement the Champions for

extended roll-out of training workshops and resource kits for

Skin Integrity (CSI) model for practice to preserve skin

RACF staff around Australia in 2013 and 2014.

integrity and facilitate evidence based wound management. The CSI model utilises evidence based strategies to facilitate

This project was funded by the Australian Government

the transfer of evidence into daily practice and included

Department of Health and Ageing under the Encouraging Best

education, resources in easily utilised forms, audit and

Practice in Residential Aged Care (EBPRAC) Program.

feedback cycles, clinical decision making support systems, led by local Champions and management support. For further information contact: 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

Dr. Kathleen Finlayson School of Nursing Queensland University of Technology Email: k.finlayson@qut.edu.au 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 15th March 2013

NHS Innovations EXPO (London) 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 commissioned 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.


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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 expense 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 demonstrates 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: info@changechampions.com.au www.changechampions.com.au


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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-assistantscase-studies

Paediatric Fractures Guidelines– Online Resource The Victorian Paediatric Orthopaedic Network (VPON), in collaboration with The Royal Children’s Hospital and the Department of Health, has launched an on-line resource aimed at improving fracture care. The website includes guidelines for clinicians and carers on the identification 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-servicedevelopment-plan-2012-2017


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16

P

int of View

Managing Change

by Dawn Skidmore

Many organisations are feeling change weary right now. All

occurring that it negatively impacted on individuals and the

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

organisation. A common reason was that there was no one

budget can’t achieve full success unless people adopt the

taking a portfolio or organisational view of what was

changes into their daily working.

happening. Portfolio management enables executives, managers, program, project and change managers to see

Facing the challenging task of delivering reform while at the

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

same time protecting quality, effectively using resources

It also allows them to be managed to achieve integrated

and delivering increased productivity, Australian health

benefit realisation.

care organisations are going through much change. They need to manage and control the delivery of improvements

What many managers and change agents do when faced

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

with these challenges is turn to a number of existing

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

change or project solutions and develop a change process from those predetermined formulae. The human brain is

Looking around the globe, those organisations that are high

hardwired to prefer patterns and predictable behavior. 1

performing tend to have systematically and consistently

Unfortunately, what can happen is that the existing

applied approaches to the way they manage their projects

solutions are chosen without any assessment of the

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

appropriateness of that solution to the organisation's

used various methodologies and strongly believe that it is

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

crucial for an organisation to be able to assess its own

previous learning or past experiences – clearly they are

change and project capacity. This includes the following:

hugely valuable and important. However, the past should not be analysed with reference to the current context.

Understanding and measuring the organisation's capability and maturity

Long term, ensuring that projects and change are

Establishing where improvements are required

successfully delivered means that effective communication

Understanding how well change processes are

and change management need to be part of the

embedded into the organisation

organisation’s DNA.

Tracking achievements and

Being able to predict future performance.

Are you feeling change weary? Is your organisation managing its projects successfully? Why not see how

These are all important steps. Without such an approach,

Change Champions and Associates can help you?

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

Dawn Skidmore Principal Consultant Dawn.Skidmore.au@googlemail.com

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


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Confidential Coaching Service for Emerging Managers With Experienced Certified Executive Coach 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 info@changechampions.com.au for more info.

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 info@changechampions.com.au


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INTERNATIONAL 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


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INTERNATIONAL

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


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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 Australian 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 Psychology, 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 reduction 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 Pregnancy, Birth and the Early Development Years of the Newborn. North Sydney: Commonwealth of Australia 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 Journal 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 participants. 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=Z39.882004&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=2012-0101&rft.volume=1&rft.spage=CD004456&rft.externalDocID=22258956 U7 - Journal Article U8 - FETCHLOGICAL-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.


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Change Champions & Associates Newsletter FEB 2013  

Newsletter for Innovators in Healthcare and Beyond

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