NEWSLETTER For innovators in healthcare & beyond July 2013
ARTICLES AND NEWS
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RHD Australia: Eradicating the lucky country of a deadly, preventable heart disease. RHD Australia
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Driving improvement in antimicrobial use: Quality Use of Antimicrobials in Healthcare Program Evette Buono
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Is My Name Mushroom? The Case for Openness about the Fallout from Major Change Char Weeks
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A Shared Primary Health Care Record for Half a Million People : Learning from the Wellington Sub-region Jayden MacRae & Martin Hefford
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Kathryn McEwen: Upcoming Workshop on Resilience and recent book to be reviewed by a subscriber!
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NHS Workshops to visit Australia and New Zealand Information about most of our upcoming workshops and seminars are scattered throughout this newsletter. To download PDF flyers, to read facilitator bios and to register, visit: www.changechampions.com.au
RHD Australia: Eradicating the lucky country of a deadly, preventable heart disease.
It’s a disease of the disadvantaged, entirely preventable and highly treatable, yet Rheumatic Heart Disease (RHD) and Acute Rheumatic Fever (ARF) remains at remarkably high levels in Australia. Caused by the body’s reaction to a bacterium (streptococcus), and occurring mainly in children between 5 and 14 years old, ARF affects a number of different areas of the body, including the joints, brain, skin and heart. Symptoms can include fever, painful joints and uncontrollable jerky movements of the arms, leg and tongue.
If an episode of ARF is not correctly diagnosed and persists untreated, the patient can suffer significant heart valve damage as a consequence – and this is RHD. With disease rates within Australia’s remote Indigenous communities among the highest in the world, the question begs to be asked – just what is Australia doing to address this issue? One organisation looking to put RHD and ARF on the agenda of healthcare professionals and governments globally is RHDAustralia. (Continued p.2.)
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Launched in 2010, and funded by the Commonwealth, RHDAustralia was established under the Menzies School of Health Research, in partnership with James Cook University and Baker IDI.
This user-friendly self-paced education package is suited to those with little or no knowledge of ARF and RHD, and can also be used as a revision tool for those with existing prior knowledge.
RHDAustralia aims to reduce death and disability from ARF and RHD in Australian Aboriginal and Torres Strait Islander people, through the development of a number of initiatives.
RHDAustralia also works in partnership with other organisations, such as the World Heart Federation, to promote awareness about heart health. The 29th September marks World Heart Day.
The implementation of a central data collection and reporting system that operates in partnership with existing RHD programs, will allow RHD Australia to document cases of ARF and RHD across the country. This information will be fed to government and various jurisdictions enabling a greater understanding of areas requiring further attention, and resourcing.
This year’s theme will focus on a life-course approach to the prevention and control of cardiovascular disease (CVD) with a focus on women and children. For more information on RHDAustralia, to download the Guideline app, or to access the E-Learning Modules visit: www.rhdaustralia.org.au
RHDAustralia also provide a range of educational tools to healthcare professionals, accessible through their website. These facilitate a deeper understanding of how to better diagnose cases of ARF, and ultimately, treat the disease. Despite the unnecessary prevalence of RHD among Indigenous Australians, there is hope for those living with the disease. Patients with ARF or RHD can be treated successfully with monthly injections of penicillin, administered regularly for at least 10 years or until the patient is 21 years old. Last year, in partnership with the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand, RHDAustralia led a review of the national guidelines on RHD, to develop The Australian guideline for the prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (2nd edition). This document has been widely distributed across the country, and highlights evidence based best practice guidelines. There is also a free Guideline app available for IPad, IPhone and Android devices. Alongside disseminating information on RHD and ARF both within the healthcare sector and amongst the wider community, RHDAustralia provide accredited E-Learning modules on RHD and ARF for members of the health workforce.
(Pictured) Free Guideline app available for IPad, IPhone and Android devices)
3 WORKSHOP with Char Weeks
3 hour workshop
MANAGING UP Or…
How to help your boss add value to your work Ever bounced into your boss’ office to eagerly report on project progress, only to be met with a quizzical stare? Ever been stopped mid-sentence by a boss who has no idea what you are talking about? Ever been asked to cut to the chase when you thought you were actually giving a brief summary? Did their eyes glaze over half way through a perhaps long winded explanation? Feel a bit anxious when go into a meeting with your boss?
what is important to them as a leader and manager.
Here is a 3 hour workshop that will help
Understand the broader context in which your boss works and
Better understand how to tap into your boss’ skills and
you to make those meetings
expertise to enhance each others’ roles, to build trust, respect
with your boss a much more
and capability.
mutually rewarding
same page in update meetings and that you are more clear
experience
Register online!
Identify strategies to ensure that you and your boss are on the about what to do when you get back to your desk.
Build confidence in presenting information to your busy boss to elicit a considered, timely and appropriate response.
www.changechampions.com.au
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Driving improvement in antimicrobial use: Quality Use of Antimicrobials in Healthcare Program
The emergence and spread of antimicrobial resistance is an escalating threat to public health and is gaining international attention (1-3). Antimicrobial resistance compromises patient safety and public health, as antibiotics that were routinely used to treat common infections may no longer be effective (1,2). Antibiotics are one of the “miracles” of modern medicine, making interventions such as surgery, organ transplantation and cancer chemotherapy safer for patients (1). Improved use of antimicrobials is needed now so that their effectiveness is preserved for future patients (1,2,4). Optimising antimicrobial use is the key objective of antimicrobial stewardship programs, which aim to improve patient outcomes and reduce the adverse consequences of antimicrobial use, including the development of resistance (5,6).
Program aims and key messages The Quality Use of Antimicrobials in Healthcare (QUAH) Program at the Clinical Excellence Commission (CEC) facilitates and supports antimicrobial stewardship initiatives in NSW public health facilities, in line with the national recommendations of the Australian Commission on Safety and Quality in Health Care (5). In this context, ‘quality use’ of antimicrobials means:
antimicrobials are used only when needed the choice of antimicrobial is selected wisely antimicrobials are used safely and effectively (7)
Recommended strategies To improve quality use of antimicrobials in healthcare facilities, a range of strategies are recommended, including the use of guidelines, antimicrobial restriction and approval systems, and review of antimicrobial prescribing with feedback (5). The QUAH program encourages use of Therapeutic Guidelines: Antibiotic in NSW public health facilities, amended locally if needed according to trends in the kinds of organisms and antimicrobial susceptibilities commonly seen (5,8). The QUAH program also encourages the restriction of key broad-spectrum antimicrobial agents, limiting the use of these important antimicrobials to conditions where more narrow-spectrum agents cannot be used (5,8). Seeking approval to use a restricted agent encourages prescribers to think carefully about antimicrobial choice and provides an opportunity to receive helpful advice from expert clinicians in antimicrobial use (9). (Continued p.5.)
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Reviewing antimicrobial prescribing and providing feedback to prescribers from audits or interventions that occur at ward level are important elements to an antimicrobial stewardship program to drive change (5,10). The QUAH program will support these activities through promotion of audit tools, as well as use of simple interventions, such as prompting early conversion from intravenous to oral antimicrobial therapy where safe and appropriate. A tool kit is in development to assist NSW public health facilities with implementing their antimicrobial stewardship programs. Antimicrobial stewardship is one of many changes to practice driven by efforts to improve clinical quality and patient safety in healthcare. Clinician engagement and executive support is critical to success (5). The value of a core group of dedicated change champions to lead antimicrobial stewardship initiatives in their own workplaces cannot be overestimated.
For further information, please contact:
Evette Buono Project Officer, Antimicrobial Stewardship Clinical Excellence Commission Tel: (02) 9269 5581 hai@cec.health.nsw.gov.au http://www.cec.health.nsw.gov.au/programs/quah
References 1.
Gottlieb, T., & Nimmo, G. R. (2011). Antibiotic resistance is an emerging threat to public health: an urgent call to action at the Antimicrobial Resistance Summit. Medical Journal of Australia, 194 (6), 281-283. 2. World Health Organization. (2012). The evolving threat of antimicrobial resistance: options for action. Geneva: World Health Organization. 3. Davies, S.C. (2013). Annual Report of the Chief Medical Officer, Volume Two, 2011. Infections and the rise of antimicrobial resistance. London: Department of Health. 4. Ferguson, J. (2004). Antibiotic prescribing: how can emergence of antibiotic resistance be delayed? Australian Prescriber, 27 (2), 39-42. 5. Duguid, M., & Cruickshank, M. (2010). Antimicrobial stewardship in Australian Hospitals. Sydney: Australian Commission on Safety and Quality in Health Care. 6. MacDougall, C., & Polk, R. (2005). Antimicrobial stewardship programs in health care systems. Clinical Microbiology Reviews, 18 (4), 638-656. 7. NSW Therapeutic Advisory Group. (2007). Indicators for Quality Use of Medicines in Australian Hospitals. Retrieved from http://www.ciap.health.nsw.gov.au/nswtag/reviews/indicators.html (14 Jun 2013). 8. Antibiotic Expert Group. (2010). Principles of antimicrobial use. In: Therapeutic guidelines: antibiotic. Version 14 (pp.1-9). Melbourne: Therapeutic Guidelines Limited. 9. Bannan, A., Buono, E., McLaws, M.-L., & Gottlieb, T. (2009). A survey of medical staff attitudes to an antibiotic approval and stewardship programme. Internal Medicine Journal, 39 (10), 662–668. 10. Dellit, T. H., Owens, R. C., McGowan, J. E., Jr., Gerding, D. N., Weinstein, R. A., Burke, J. P., Huskins, W. C., Paterson, D. L., Fishman, N. O., Carpenter, C. F., Brennan, P. J., Billeter, M., & Hooton, T. M. (2007). Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical Infectious Diseases, 44 (2), 159–177.
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OPIN ION PIECE
By Char Weeks
Char is a Certified Executive Master Coach and Innovation Leader at Change Champions and Associates. She is holding several upcoming workshops across Australia in the fields of Change Management, Leadership, and Presentation skills.
Is My Name Mushroom? The Case for Openness about the Fallout from Major Change For over two decades now, legendary Prof John Kotter, has been preaching to us about the importance of designing organisational change programs that build engagement and commitment from the outset (1). Prof Kotter’s logic focuses on valuing people, their intelligence, motivation and insights and allowing them to contribute to optimise change efforts. It is simple:
One is a lonely number when it comes to pushing a clever idea forward.
Many brains make light shine more brightly than one.
A brightly shining light facilitates clarity…of shared vision.
When that bright light starts to fade, many invested brains can change the globe and its wattage or create a shift to clean energy or just open the blind and go solar. One person alone may create a shining light but when the globe blows, an organisation can find itself in a very dark place on a moonless night. With the exception of those who choose to live in clumps, beyond the need for warmth, most adult humans have very little in common with mushrooms. Sure, from time to time they both may prefer some protection from an ice blasting southerly. But generally, most adult humans are resilient enough to handle tough conditions. So why is it that many organisations choose to leave their most valuable asset, their people, in the dark when major change is looming? Moisture, warmth and dark conditions might be perfect for growing mushrooms but they are equally so for the proliferation of mould.
Why do some organisations adopt an information flows “on a needs to know only” basis for the “special” ones, leaving teams to speculate in tea rooms as to the whereabouts of managers missing in action? And why do others drip feed lean tit bits of change news that do little more than incubate scuttlebutt and fertilise fear? What organisations consistently miss is that organisational change and people transition go hand in hand. Without people, there is no organisation. How effectively you can create an ongoing dialogue with people about change that is respectful of their information needs and sensitivities is fundamental to change program success. Even when the news is bad, some organisations go the extra mile to help their people achieve a neat transition, even if it is to another organisation. There is a huge difference between communicating an urgency message to shift people out of their comfort zones to ready them for change and undermining team members’ stability with ill thought out pronouncements that impact adversely on their health and well being. Not to mention the impact on their productivity and job satisfaction. If you announce a change program that is short on detail, it is human nature for those affected to speculate and try to fill in the gaps. If you announce a change program that includes all of the gory details, you might reasonably expect that your people will respond perhaps as they would following a bereavement e.g. with feelings of shock, anger, denial etc. Fear of an unstable future may cause some people to jump ship even if their position remains unthreatened. (Continued p.7.)
7 Change is tough because it’s about people and trying to keep people on board while dealing with harsh organisational realities. Lose peoples respect by isolating yourself from your team, creating a blame game, trying to protect them from the inevitable or putting your need to be liked first. “Warmth” as in a kind word, a nod of understanding, a willingness to listen etc. rather than competence or strength is the new “conduit to influence” in organisations (2). Win your team’s respect by being as honest as possible and listening to their opinions regardless. Resist judging them or defending your own position or actions. From the outset, it is equally as important to give people regular opportunities to hear, consider and provide feedback about what is going on and why, as it is to reveal the right balance of information at the right time for the right reason. Sharing news about change requires a truthful and factual
WORKSHOP
balance of light and shade so concentrated to achieve a specific outcome. First, think through how your change communication might be interpreted and internalised. Walk in their shoes before you speak. References: 1. Kotter, J, BuypKotter International http:// www.kotterinternational.com/our-principles/buy-in 2. Amy J.C. Cuddy, Matthew Kohut, and John Neffinger, Connect, Then Lead, Harvard Business Review, July August 2013 http://hbr.org/2013/07/connect-then-lead/ ar/2 This article can be shared if the author and source are acknowledged. Suggested citation: Char Weeks, Innovation Leader, Change Champions & Associates Newsletter, July 2013.
Full day workshop with Char Weeks
Creating a Culture of NEXT WORKSHOP: 29th July 2013 in Melbourne, VIC
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 Visit our website: www.changechampions.com.au to download the full PDF flyer or to register online in your state. In-house opportunities at your organisation are also available upon request.
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A Shared Primary Health Care Record for Half a Million People : Learning from the Wellington Sub-region Overview The Shared Care Record project aims to share vital patient health information from general practice to other care settings such as emergency departments, after hours centres, hospital outpatient departments, community pharmacies, aged residential care facilities and paramedic services. Compass Health is leading the implementation of the project across three district health boards in the lower North Island that have a combined total patient population of approximately 500,000 patients. Currently there are two main concepts being adopted for electronic patient health records originating from primary care:
a record intended for the majority of the population that represents a read only overview of their vital information: “Shared Care Record” a record for those patients with significant and complex health needs, which involves a planned approach to care by a wider team of health professionals with write back access: “Shared Care Plan”.
This paper addresses only our “Shared Care Record” project.
Implementation We chose to begin in the Wairarapa initially as it is a small district having only seven general practices servicing the population of 40,000 people; all of the general practices used the same patient management system; and the DHB had an enthusiasm and willingness to undertake the work to modify their systems to attain the maximum integration of the information into the care pathway process. We used the Wairarapa as the pilot area, and to develop a framework that could be rolled-out to other areas as needed. The Wairarapa implementation took approximately 30 months from inception to making the SCR available. During this time, we undertook a comprehensive privacy impact assessment, negotiated a fitfor-purpose contract with the main software vendor, developed appropriate and robust provider participation agreements, designed communications material, designed processes, established a governance structure and recruited general practices into the project. At the same time, the hospital undertook the responsibility of beginning to work to provide a seamless and integrated experience of accessing this information for their clinicians – borrowing from work already underway in Auckland. Implementation in the MidCentral district occurred more quickly than Wairarapa, taking approximately 18 months. Implementation in Capital and Coast DHB has been more recent, but has followed a much accelerated implementation path – some 9 months.
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Figure 1 Information flows – from general practice to other health providers via the web
Privacy Considerations
The Opt out model
A SCR system that proposes to share information previously siloed in general practice inevitably has privacy aspects that need consideration. We tackled these issues by
The PIA informed the project’s decision to use an opt-out model for patients. All patients funded in a practice that was participating in the project have a record established by default unless they chose to opt to not have one (optout). A publicity campaign was run with an 0800 number to facilitate opt out. Over approximately 6 weeks, 19 patients chose to opt-out of the project in the Wairarapa. This represents a rate of 48 people in every 100,000, close to what has been observed internationally. In addition every patient can decide that the notes from a particular consultation not be shared.
Discussions with the privacy commissioner undertaking a privacy impact assessment release of two public drafts for comment and feedback independent governance group of 12 members representing consumers, primary and secondary clinicians, information professionals, privacy officers and Maori the contract with the software vendor provides the project with the ability to direct the vendor in what the data may only be used for, which is for “direct clinical care of patients”; which precludes use for statistical or reporting purposes. It also limits the vendor to being able to store the data or a copy of that data in New Zealand only, to ensure the simple and easy protection and interpretation of our privacy laws.
Barriers, Solutions and Lessons The success of the project relied on recruiting sufficient practices initially to make the project viable. Not all general practices wish to participate in this project. One of the largest barriers to gaining general practice participation is that of misunderstanding of the project. Initially we presented general practice with written information. We learned quickly that written information was often misinterpreted. (Continued p. 10.)
To avoid misunderstandings contributing to the nonparticipation decision we have learned that introducing the project face-to-face is key. This allows us to present the facts of the project, be able to answer questions, and correct incorrect assumptions before any decisions are made. This is an extraordinarily time-consuming exercise over a large number of practices; an investment ultimately worth making however. Overall, we found that the barriers come from individual clinicians and their attitudes to sharing health data; the technology was in many ways the simplest part of the project.
Medications Classifications Recalls Medical Warnings Lab Results Discharge Summary Consultation Notes Figure 2 overview of information shared
Figure 3 Shared care record screenshot
What’s Next ? The concept of ‘go-live’ in this project marks only the first phase of a larger and on-going mission. We are dedicated to working with those practices that are ready to begin providing patients access to their own health records.
Jayden MacRae Director of Research & Technology Innovation Compass Health jayden.macrae@compasshealth.org.nz
Although general practice has provided the first step in sharing their information more readily with the sector, it is important to acknowledge and continue the journey of sharing information from other parts of patient journeys back to primary care. We are also continuing to work with other care settings, such as community pharmacy to understand how the SCR can be deployed productively in those places.
Martin Hefford Chief Executive Officer Compass Health martin.hefford@compasshealth.org.nz
Rest Homes
Paramedics
Pharmacists
Hospital
A large number of misunderstandings could be resolved through face-to-face discussions with practices. Once a general practice has made a decision on its stance about the project, whether based on misunderstanding or not, it is significantly more difficult to recruit them into the project.
Emergency Dep
(Continued from p.9.)
After Hours GPs
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11 WORKSHOP with Char Weeks
The
BETTER BOSS Workshop 4 hour Introductory Workshop
Ever wondered how you rate as a boss? Who is a good boss? What qualities and skills do good bosses have? Why do team members see them as good bosses?
In this workshop we will draw on recognised best practice management and supervision, feedback from our own Good Boss surveys (accessible from our website) and the experiences of our international networks of change management consultants to:
Assist participants to improve their knowledge and confidence in managing and/ or supervising staff
How could you be a better boss?
Better understand: Too often very competent professionals are rewarded with promotion to the high diving board of management and/or supervision without adequate orientation, training and support. Often it’s assumed that because you have excelled at what you do, your transition to management and/or supervision will be effortless and seamless. And while the perks of promotion might seem enticing, the reality of a managerial role often turns out to be a touch more daunting than perhaps you had expected.
Their role in leadership, management,
responsibility and accountability Personal qualities, skills and behaviours
of good bosses Benefits the good boss brings to the
team and their organisation Respecting and valuing staff Motivating staff
Review and discuss case studies of common If you have been promoted into a managerial or supervisory role or have been suddenly thrust into the limelight because everyone else took one step back or your time has come ... this workshop could be for you.
dilemmas faced by bosses
Learn some tips and techniques for dealing with tricky managerial situations
For health professionals in acting positions or new managers Download the PDF Flyer at www.changechampions.com.au
WORKSHOP with Kathryn McEwen 12
SA: Thurs 24 Oct
VIC: Mon 11 Nov
QLD: Fri 22 Nov
Are you under constant pressure and fighting to stay on top of what you need to do? Are you leading a team fatigued by change with, more shifts on the horizon? Are you providing services where customer demand cannot be adequately met?
Working in health is challenging and often stressful. There are heavy workloads, insufficient resources to meet demands as well as high expectations from patients.
When you
combine these pressures with the complexity and risk of the
NSW: Fri 06 Dec
Attendance at the workshop allows participants to: Develop an understanding of
the characteristics of personal resilience in a work setting Gain Australian benchmarked
feedback on their personal resilience levels through
work, the inherent emotional labour and constant change,
completion of the Resilience at
resilience becomes a key requisite for working effectively.
Work (RAW) Scale
This workshop provides evidence-based strategies to build
Identify ideas and strategies
resilience at work that are derived from the literature as well
for building resilience that can
as from research by the consultant. The strategies have been
be incorporated into everyday
used successfully with leaders and teams across all
work routines and approaches
professions and organisational levels within the health industry.
Understand the leader actions
that support team resilience
Audience: This workshop is aimed at those in leadership positions, specifically senior management and executive teams. There is great value if teams undergo this workshop together so that team strategies, alongside individual ones, can be developed.
Implement strategies to boost
resilience within their work teams.
www.changechampions.com.au
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BOOK by Kathryn McEwen
WE ARE LOOKING FOR A BOOK REVIEWER! Author: Kathryn McEwen
Our resilience, or capacity to bounce back or even thrive in pressured times, is critical in work places today. With higher workloads, declining resources and frequent change, together with the hectic pace of personal lives, resilience is almost a key to survival. While strategies to build resilience have long been of interest in the areas of parenting, education and disaster recovery, less focus has been placed on how these ideas can be translated into resilient work places.
We have one copy of Kathryn McEwen’s new book:
Resilient people are more optimistic, adaptable
Building Resistance at Work
and independent. They are also better at solving
to give away!
problems and have sound levels of self control. Resilient teams have similar characteristics, and
If you have an interest in this topic, and would like to read this book and write a 300 word
find it easier to rebound from setbacks and adapt to change and pressure. All of these characteristics can be developed.
review for our next Newsletter (November 2013) please send a self- nomination to : info@changechampions.com.au
Based on sound psychological theory, Building Resilience at Work is a practical and easy-to-read book providing a proven path to self-help in developing personal resilience.
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WORKSHOPS TO VISIT AUSTRALIA & NZ!
Ambulatory Emergency Care: A solution to manage emergency demand, improve outcomes and reduce waits What is Ambulatory Emergency Care? Across the NHS in England emergency systems are under considerable pressure with Emergency Department (ED) attendances and the conversion rate to hospital admission both rising. Clinical teams across England have recognised that a new approach is needed and have successfully redesigned their systems to reduce demand by implementing Ambulatory Emergency Care (AEC). Using the AEC approach, appropriate patients are diagnosed and treated on the same day and sent home with on going clinical support and supervision as needed. This approach has improved both clinical outcomes and patient experience and reduced costs and pressures in the urgent care system.
How can the AEC Network help teams to adopt this approach? The national AEC network programme has supported over 48 sites to implement Ambulatory Emergency Care. Sites participating in the programme report managing significant numbers of emergency patients quickly, without the need for full admission, converting at least 20-30% of emergency admissions to same day care. Patients also report a much improved experience when treated on ambulatory pathways. The approach is based on the Directory of Ambulatory Emergency Care which outlines 49 emergency clinical scenarios suitable for ambulatory treatment.
CEO view – Pennine NHS Acute Trust, England Chief Executive, John Saxby is fully supportive of ambulatory emergency care. He comments “Ambulatory care in Pennine is an innovative service and a new approach to patient care, although at its heart it is a simple and well-tried concept. It means that, where possible, patients who were previously admitted to hospital are assessed, diagnosed, treated and discharged on the same day. The benefits for patients, their families and carers are enormous as, indeed, they are for hospital staff, the service and the wider health economy. I fully support the development and rapid roll out of ambulatory care at Pennine. Responding to the needs of our patients when designing and redesigning services has contributed to the success of ambulatory care.”
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Bringing NHS workshops to Australia & New Zealand with Change Champions & Associates The NHS AEC team in collaboration with Change Champions & Associates are planning to deliver a series of workshops across Australia and New Zealand to share the AEC approach. The workshops will create an interactive learning environment to share the success and challenges of the approach in the UK. The workshop will be led by an experienced Emergency Department Consultant and the Director of the NHS programme sharing the real experiences of delivering the change in some of the busiest NHS hospitals in England.
What are the potential topics for the workshops?
Sharing case studies and Stories from best practice sites The Principals of Converting to ‘Same Day’ Care Adopting and Adapting Day Surgery Principals for AEC Measurement and return on investment in ambulatory care Using data to inform AEC Plans and service design From conception to implementation Understanding and Doing Sustainability Experience Based Design – Improving Patient and Staff Experience Developing and designing pathways for ambulatory care Clinical leadership in ambulatory care Managing clinical risk Developing networks to drive the adoption and spread of good practice Using patient stories and experience to understand ambulatory care
EMAIL UPDATE LIST To receive latest updates about the upcoming NHS workshop please email info@changechampions.com.au with ‘NHS MAILING LIST’ in the subject header and your preferred email contact details.
For IN-HOUSE inquiries For serious enquiries about having the NHS workshop visit your organisation, please email info@changechampions.com.au with ‘NHS IN-HOUSE INQUIRY’ in the subject header. In the email, please include details about your organisation and the estimated number of participants.
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Current
Workshops
REGISTER ONLINE: www.changechampions.com.au 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.
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 supervisors with no formal management training and those who are just wondering 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.
Creating a Culture of Innovation This practical workshop draws upon the best international literature and focuses on how to create a culture of innovation in health and aged care. Suitable for managers and emerging managers in all facilities and departments.
Suitable for Managers and Emerging Managers in All Facilities and Departments.
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Current
Workshops
REGISTER ONLINE: www.changechampions.com.au
The Change Implementer’s Toolkit
NEW!
Is it your first time managing a project or program? Excited and enthusiastic about the opportunity to expand your horizons by working on a new initiative? Expert on the topic area? What about your expertise on how to manage change? Not too many ideas …. Great! You are the ideal participant in this full day workshop. This is a novices only workshop. If you dream at night about the work of the greats in change management i.e. Kotter, Bridges, Lewin, Senge, Moss-Kanter etc., you are too experienced to attend.
Lobbed On:
NEW!
When Change is Lobbed On You From a Great Height Don’t quite know what to do when you have been directed from far above to implement a change in your workplace or team? Feel like a junior tennis player facing Serena Williams or Roger Federer for the very first time? This is a great workshop for those wanting to develop their leadership skills so as to effectively implement change in their workplace. Suitable for middle level managers, team leaders and coordinators.
Managing Up
NEW!
Ever bounced into your boss' office to eagerly report on project progress to be met with a quizzical stare? Ever been stopped mid-sentence by a boss who has no idea what you are talking about? Ever been asked to cut to the chase when you thought you were actually giving a brief summary? Did their eyes glaze over half way through a perhaps long winded explanation? Feel a bit anxious when you are about to go into a meeting with your boss? Here is a 3hr workshop that will help you to make those meetings with your boss a much more mutually rewarding experience.
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IN-HOUSE MASTERCLASS
Pathways to a Consumer Focused Organisation – Governance and Managerial Approaches With facilitators Stephanie Newell & Mitchell Messer
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
2013
expanding mandatory requirements this Master Class is a strategic exploration and examination of the health consumer
in-houses available
participation trilogy: consumer engagement, consumer involvement and consumer partnerships for organisationwide quality improvement.
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
Visit
It is timely for health care organisations, from boards to
Audience Profile Board members, health services executives, clinicians, safety & quality co-ordinators/managers, risk managers, clinical governance managers and health consumers.
www.changechampions.com.au
To download official flyer & register your expression of interest
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MELBOURNE 2013 MASTERCLASS Building Self-Efficacy & Confidence in
Managing Behaviours of Concern in Older Adults A morning with Dr. Alice Rota-Bartelink 09.00-12.30 on 11th October 2013 The Business Centre, 365 Little Collins St Melbourne, VIC $150 per delegate* In this practical half day workshop participants will:
Discuss case studies of patients, clients and residents in their care who exhibit behaviours of concern
Explore the need for staff to identify and respond to negative emotions evoked by behaviours that challenge their own personal ideas, beliefs, or viewpoints
Analyse the underlying antecedents, background factors and causes of those behaviours
Understand and apply theory for the management of behaviours of concern
Develop effective behaviour management plans
* Registration fee becomes $200 for any payments made after the workshop date.
Download full PDF Register online today at www.changechampions.com.au
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Full day workshop
Culturally and Diversity Competent Workforce With Robyn Attoe and Daryl Oehm Background The Australian government has recently released the living longer, living better –Aged care Reform Package. Part of this package is 192 million dollars towards providing support for older people with diverse needs, including culturally and linguistically diverse backgrounds, and lesbian, gay, bisexual, transgender and intersex people (LGBTI) Aged services need to be sensitive and develop their services to encompass a person centred, inclusive service that embraces and supports diversity.
About the workshop This one-day workshop has been developed for all people working in the Aged Care Sector. Participants will gain skills and confidence in effectively engaging with individuals and communities from diverse backgrounds. They will also learn how to improve responsiveness to diversity within their organisations. Participants will:  Learn about the importance and relevance of diversity within the ageing population  Understand how you can contribute to responsive service delivery (at the individual,
organisational and systemic levels) and work collaboratively with diverse communities to foster access, participation and engagement
For more info and to download the full PDF flyer, please visit www.changechampions.com.au
DATES: SA: Mon 28 Oct WA: Mon 11 Nov QLD: Mon 25 Nov NSW: Mon 09 Dec
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“You would have to be half mad to dream me up.”
-Lewis Carroll, Alice in Wonderland
Delirium FULL WORKSHOP WITH ROBYN ATTOE “Delirium in older hospitalised people is often overlooked or misdiagnosed due to limited staff knowledge of delirium features or a perception that all cognitive impairment is due to dementia” (Australian Government Department
WHO SHOULD ATTEND? This workshop is ideal for any professional concerned with the care of our elderly. IN THIS WORKSHOP, YOU WILL:
of Health and Ageing). I. Learn about cause and types of delirium and Delirium is a serious medical problem which results in increased length of stay in hospital, premature institutionalization, morbidity and mortality in the elderly. Needless to say the cost to healthcare system is enormous!
delirium risks II. Understand the pathophysiology of delirium III. Understand non pharmacological approaches to managing delirium IV. Be introduced to the best practice guidelines for pharmacological management
This practical workshop by recognized dementia behavior expert, Robyn Attoe, is designed to assist anyone working with older people: to recognize the delirious patient early; improve their knowledge about delirium
management.
SA: Fri 25 Oct
WA: Fri 8 Nov
Visit
V. Share information about: Hospital environments – do they help or
hinder? What can be changed to assist in
management of delirium? An emerging problem, hyperactive delirium
in the younger person
QLD: Fri 22 Nov
NSW: Fri 6 Dec
www.changechampions.com.au
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The Service Providers Toolkit: Improving the Care of Older Homeless People
IN-HOUSE MASTER CLASS wi th A lice Rota -Bartelink Homeless and the Aged Content
Introducing Nigel: Case profile
Defining homelessness – primary, secondary and tertiary
IN-HOUSE WORKSHOP
Characteristics of an aged homeless population
Advocating for the older homeless person
Navigating complex service systems
as an in-house at your
Understanding life roles and the significance of
organisation. Download the
engaging in meaningful activities
PDF flyer from our website to
Facing the challenge of “behaviours of unmet need”
This workshop is available
read more info and to fill out the expressions of interest form.
The Service Providers Toolkit
www.changechampions.com.au
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The Challenge of Long Term Alcohol Abuse in Older Adults
IN-HOUSE MASTER CLASS wi th A lice Rota -Bartelink A master class on managing older clients living with Alcohol Related Brain Injury (ARBI)
Workshop Outline
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
Download the PDF flyer from our website www.changechampions.com.au and fill out the expressions of interest form
Master Class Aim To facilitate the transfer of skills and knowledge gained through evaluative research into the provision of appropriate support to clients living with alcohol related brain injury (ARBI) this presentation will provide education on the effects of long-term alcohol abuse on an older person and advice on strategies to assist service providers with managing behaviours of concern among older clients living with ARBI.
“This Master Class aims to improve the life quality of this often forgotten and neglected group of people by providing participants with an understanding of their unique set of care needs and imparting the skills required to enhance the delivery of effective care and support.” - Alice Rota-Bartelink
Make an inquiry for your facility!
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int of View
P
National Standards and Improving Performance by Dawn Skidmore In the last edition of this Newsletter I outlined The National Safety and Quality Health Service Standards (NSQHS Standards) and the Medicare Local Standards and suggested that they may be of relevance to readers. Whether you are a healthcare practitioner, support worker, manager or executive, these new standards may have implications for you and your organisation. Are you responsible for:
delivering or managing care?
supporting care?
Planning and commissioning services and care?
collating outcomes of improvement processes and evidence?
Do you work in a hospital, if so how are you preparing for accreditation? Do you know what is required of different sized hospitals?
If you work in day procedure service, do you know when the services need to be accredited to the new standards? Are you ready?
If you work in a Medicare Local, how are you progressing against the Medicare Local Accreditation Standards?
Do you work in private practice, if so do you know what is required for your practice?
Do you work in a dental practice, if so do you know what is required for your practice? If you provide contracted services to a Medicare Local or hoping to do so in the future, are you ready for accreditation?
If you provide community services do you know what is required for your services?
Do you provide mental health services, if so do you know what standards apply to you?
(Continued p.21.)
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The Deed for Funding for Medicare Locals requires that where Medicare Locals sub-contract services, those service providers must be accredited or registered for accreditation, where a relevant accreditation scheme exists. Where a contractor does not have an accreditation scheme available, the Medicare Local and the contractor must agree on, and include in the contract for services, appropriate levels of service. Some Medicare Locals might want Subcontractors to match the MLA Standards. Service improvement and accreditation can be demanding and while standards infer consistency, organisations and practices must be free to structure their operations to meet their objectives. If you need help - at any point in your improvement or accreditation journey - or just want to find out more, simply go to HDAA’s website: www.hdaau.com.au or email Dawn.Skidmore@HDAAU.com.au. For information on The Australian Commission on Safety and Quality in Health Care go to www.safetyandquality.gov.au.
Dawn Skidmore Principal Consultant
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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Australian RESOURCES
National Cancer Workforce Strategic Framework The National Cancer Workforce Strategic Framework provides advice to governments and service providers on the key issues for the cancer workforce and identifies innovation and reform that has the potential for national application. It focuses on enabling the cancer health workforce to provide appropriate, efficient and well-coordinated care for people affected by cancer and their families, from diagnosis, treatment and support to the management of follow-up care and survivorship. http://www.hwa.gov.au/sites/uploads/HWA-National-Cancer-WorkforceStrategy-Framework.pdf
Country Health South Australia Local Health Network (CHSA) BloodMove Project The Country Health South Australia Local Health Network (CHSA) BloodMove Projectis a collaborative program to facilitate best practice in blood management throughout regional South Australia. BloodMove oversees 60 regional hospitals that are supplied with blood and blood products by both regional and metropolitan transfusion services. BloodMove is supported by the Blood, Organ and Tissue Programs section of the SA Department for Health and Ageing and was implemented to minimise blood wastage through improvements to cold chain systems and inventory practices. http://www.blood.gov.au/bloodmove-project-case-study
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Australian RESOURCES SAN Pathology Case Study The Sydney Adventist Hospital Pathology Laboratory - San Pathology – was established in 1898 and provides pathology and blood banking services to the Sydney Adventist Hospital (SAN). The San Pathology has one of the lowest red blood cell discard rates in Australia with a discard rate of only 0.7% for the last two years. Director of Pathology Dr Bevan Hokin and Senior Scientist Sheldon Lamey lead the Blood Bank and Haematology Departments and provided insights into how they achieve this fantastic rate http://www.blood.gov.au/san-pathology-case-study
Managing Two Worlds Together: City Hospital Care for Country Aboriginal People The Managing Two Worlds Together project aims to add to existing knowledge of what works well and what needs improvement in the system of care for Aboriginal patients from rural and remote areas of South Australia (and parts of the Northern Territory). It explores their complex patient journeys and what happens when they come to Adelaide for hospital care Project reports, staff perspectives, experiences of patients and carers, and patient journey mapping tools are available here: http://www.flinders.edu.au/medicine/sites/health-care-management/ research/mtwt/
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Feel like you’ve bitten off more than you can chew?
CONFIDENTIAL COACHING SERVICE With experienced Certified Executive Coach Telephone coaching service available in or out of hours. (Hourly rates)
Get the support you need, when you need it. Suitable for emerging managers working in health, aged, primary and community care and especially those new to program, project and other funded initiative management and those who are:
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 your lack of skills will shortly be discovered)
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. Mebers 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
Face to face coaching also available by appointment.
Email: info@changechampions.com.au Receive support and advice in the areas of: Strategic planning, program implementation Relationship management, networking/collaboration building and management Working with a Board/Committee Managing up Working with staff Brain storming Management self development
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Conference aim: The aim of this conference is to build networks and share understanding of culturally respected ways of working with Aboriginal men, women, young people and families in a holistic approach that suits rural and remote communities with limited resources.
The conference will focus on the following issues:
Healing the scars of the past
Cultural approaches to healing and service deliveries
Men’s and Women’s business programs and groups
Family and Young person’s programs
How to empower Aboriginal workers to lead in our field
Keynote speakers include:
Mr Scott Wilson, Director of Aboriginal Drug and Alcohol Council (South Australia).
Mr Jack Bulman, CEO of Mibbinbah, Indigenous Men, Health and Indigenous Mens’ spaces.
Mr Jimmy Perry, GradDipIndigH (SubUse), Project Officer, Aboriginal Drug and Alcohol Council (SA) Makin Tracks Project
Prof. Yvonne Cadet-James, Chair of Indigenous Australian Studies, James Cook University
Mr Steve Ella, State Coordinator, NSW Aboriginal Drug and Alcohtol Traineeship Program, Central Coast Local Health District
Cost: $110 for one day (conference only) or $220 for two days including conference dinner (incl. GST) (other options available, please see registration form).
For further information: Please contact the Conference Organisers on healingthescars@lyndoncommunity.org.au Conference Organisers – Raechel Wallace, Precilla Boota and Joanne Norton-Baker (02 6492 0011) and Lara McLaughlin (02 6361 2300). Website: http://www.lyndoncommunity.org.au/healing-the-scarsaboriginal-rural-and-remote-drug-and-alcohol-conference/
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PO Box 302, Kew, Victoria 3101 AUSTRALIA E: info@changechampions.com.au W: www.changechampions.com.au
Change Champions & Associates invites you to contribute to this publication! Are you or your organisation working on a new project or initiative? We’d love to hear about it! Please send us a 1 page article highlighting the major aspects of the initiative you are part of. Email articles, suggestions and advertising enquiries to Diane Vatinel at: info@changechampions.com.au