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Change Champions & Associates Newsletter - FEBRUARY 2015
NEWSLETTER
C o n t e n t s
For innovators in
healthcare & beyond
F E B R UA RY 2 0 1 5
P. 1 ‘The Pitch’ innovation challenge Barbye Castillo Sydney Local Health District
P. 7 Engaging consumers to develop a cancer survivorship and wellness model of care in the ACT David Larkin PhD Canberra Region Cancer Centre Canberra Hospital & Health Service
P. 8 Being clear about death and dying
Steve Offner UNSW Media
P. 10 The Smile Mum Project, Wagga Wagga
Jennifer Lang Murrumbidgee Local Health District
P. 12 Squashed in the Middle by You Char Weeks Change Champions & Associates
P. 16 Keeping older Australians on their feet Dr Anna Barker, Dr Darshini Ayton, Ms Sheral Rifat & Ms Margaret Brand Monash University
P. 17 Setting out on Firmer Foundations Melissa Walshe & Jackie Jenkins Good Shepherd
P. 18 One Disease Duneeshya Gunasekara 1disease
P. 19 Benefits of training and staff development for recreation staff in aged care Lauretta Kaldor Diversional Therapist, Workplace Trainer
P. 20 C.R.A.T.- A constipation risk assessment tool Kimberley Zanik Broome Hospital, WACHS Kimberley
P. 24 WORKSHOPS & IN-HOUSES P. 38 RESOURCES
(Continued p. 3.)
Sydney Local Health District embraces, encourages and supports a culture of
innovation through its innovation challenge - The Pitch.
The Pitch is a new initiative through which staff are able to pitch their innovative idea
to a panel of experienced judges, giving them permission to change our system. The
Pitch aims to invigorate a culture of innovation across the District and is open to all
staff. It provides a sense of empowerment to all levels of the organisation by
showcasing that the District is interested and excited by all ideas that aim to improve
the system and patient experiences – no matter how big or small.
‘THE PITCH’ innovation challenge
Sydney Local Health District encouraging & supporting innovation
2 Change Champions & Associates Newsletter - FEBRUARY 2015
25-27 February 2015 Melbourne City Conference Centre
333 Swanston St Melbourne (Opposite the State Library), VIC, AUSTRALIA
Delivering integrated, consumer directed care where, when and how it’s needed.
Respecting Our Loved Older One’s Wishes
www.changechampions.com.au
DOWNLOAD THE PDF PROGRAM ONLINE! http://tinyurl.com/programrespecting
REGISTER TODAY!
www.changechampions.com.au
3 Change Champions & Associates Newsletter - FEBRUARY 2015
Prof Chris Brook
Chief Advisor, Innovation, Safety and Quality; and Health and Medical Commander Department of Health Victoria
Dr Régis Blais
Pan Canadian Home Safety Study, University of Montreal, Canada (confirmed)
Carol Foster Locality Manager, Adults North, Nottingham Citycare Partnership, UK (confirmed)
Prof Peter Gonski
SouthCare, South East Sydney LHD, NSW (confirmed)
Carolyn Gullery General Manager, Planning, Funding & Decision Support
Canterbury & West Coast District Health Boards, NZ (confirmed)
Tracy Haddock PEPS Manager, Bedfordshire Partnership For Excellence in Palliative Support (PEPS)
Co-ordination Centre and Local Implementation Manager, Vitrucare End of Life Pilot St Johns Hospice, UK (confirmed)
Prof Joseph E Ibrahim
CRE-Patient Safety, Department of Epidemiology & Preventive Medicine & Prevention Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, VIC
Department of Epidemiology & Preventive Medicine, The Alfred Centre, VIC Department of Forensic Medicine, Victorian Institute of Forensic Medicine (confirmed)
Caroline Mulcahy
CEO, Carers Victoria (confirmed)
Rod Quantock Comedian, Dinner Speaker (confirmed)
Dr John Rasa
CEO, Networking Health Victoria, President Australian College of Health Service Management (confirmed)
Dr David Skyes General Manager, Learning and Development, Alzheimer's Australia Vic (confirmed)
Respecting Our Loved Older One’s Wishes
25-27 February 2015
DOWNLOAD THE FULL PDF PROGRAM: Visit: http://tinyurl.com/programrespecting
Invited Keynote Speakers
4 Change Champions & Associates Newsletter - FEBRUARY 2015
Workshops with Char Weeks
[p. 27] Manage Your Energy Not Your Time
[p. 28] Moving Forward: Accepting and Embracing Resistance to Change
[p. 29] The New Leaders Toolkit
[p. 30] Managing Up (How to help your boss add value to your work)
Workshops with David Schwarz
[p. 31] Board Appointments Master Class
Workshops with Robyn Attoe
[p. 32] Delirium and the Older Person
[p. 33] Managing Behavioural and Psychological Symptoms of Dementia
Workshops with Alice Rota- Bartelink
[p. 34] The ABC of BOC– Working with Older Adults with Complex Care Needs
[p. 35] The Challenge of Long Term Alcohol Abuse in Older Adults
[p. 36] The Service Providers Toolkit: Improving the Care of Older Homeless People
Workshops with Julie Faoro
[p. 37] The Long Stay Patient
In-house workshops
www.changechampions.com.au
Upcoming seminars 25 FEBRUARY 2015 (1/2 day workshop in Melbourne, VIC)
Care Homes Programme [p. 24]
with Pam O’Nions
26-27 FEBRUARY 2015 (2 day seminar in Melbourne, VIC)
Respecting Our Loved Older One’s Wishes [p. 2]
Delivering integrated, consumer directed care where, when and how it’s needed
APRIL– MAY 2015 (travelling one-day workshop, to WA, QLD, NSW, VIC)
Working effectively with clients experiencing family estrangement [p. 26]
with Kylie Agllias
Online courses
Sustain Success On Line Resilience Course [p. 25]
with Kathryn McEwen & Char Weeks
5 Change Champions & Associates Newsletter - FEBRUARY 2015
The District will invest $240,000 annually ($50,000 per
quarter) on staff’s innovative ideas, highlighting its
commitment to its core values – Collaboration, Openness,
Respect and Empowerment (CORE). The Pitch removes the
red tape and introduces a transparent process accessible to
all staff. A one page online application form allows staff to
provide a brief description of their innovation; what the
desired outcomes are; whose involvement will be required;
the timeframe and budget for the solution; and the
sponsorship acquired for the project. The Pitch process,
screening and scoring tools (which are used by both the
District’s Innovation Group and The Pitch panel) are also
accessible to staff via the District’s Innovation web page
providing staff with all the essentials for their pitch.
Twenty-one applications were received in the August 2014
intake, making the selection process difficult and
competitive. The Kerry Packer Auditorium at Royal Prince
Alfred Hospital opened its doors to the inaugural The Pitch
event on Friday, 22nd August 2014. Over 120 staff joined
the six pitchers who would stake their claim for a chance to
win the initial $50,000 to fund their innovative idea.
With excitement in the air, each presenter creatively
introduced their idea to the esteemed panel who were then
we able to ask questions at the end of each presentation.
Staff were invited to a cocktail-style experience while The
Pitch panel members deliberated on the winning Pitch.
As difficult as it was for the panel, the winning pitch would
be announced on the night. Two ideas were able to share in
the winnings:
(‘THE PITCH’ innovation challenge, continued from page 1)
Pitch: Back to basics in Balmain’s front yard Brief Description: This innovation explores the establishment of a restorative and therapeutic garden for Balmain Hospital
inpatients which will simulate normal every day activities and assist patients with a smooth transition to the community.
Awarded: $33,000
Pitch: No time to pitch the tent – Catching up with best practice Brief Description: This innovation confronts issues with dysphagia (an impairment to swallow function) and its contribution to
the development of aspiration pneumonia. It addresses such challenges by promoting objective assessments using key
equipment which will improve the patient experience and reduce cost.
Awarded: $16,683
(Continued next page)
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6 Change Champions & Associates Newsletter - FEBRUARY 2015
The second The Pitch session was held at Concord Medical
Education Centre at Concord Repatriation General Hospital
on Friday 21st November 2014. Staff from across the District
supported its six key pitchers who presented their
innovative ideas to the esteemed panel. With much
excitement and some extra funds in the air, the panel
announced the winning pitches for the night:
(‘THE PITCH’ innovation challenge, continued from page 5)
Contents Articles Workshops In Houses Resources
Pitch: 'DEPROX' Strikes Back-The way forward in environmental decontamination Brief Description: This innovation introduces the Deprox System (Hygiene Solutions) which is an automated vapouring system
that disinfects and systematically eradicates microorganisms.
Awarded: $50, 000
Pitch: Fire Service – Training Centre Brief Description: This innovation explores the completion of structured training for clinical staff in regards to evacuation skills
via a simulation fire training centre.
Awarded: $40,000
Sydney Local Health District is looking forward to continuing its culture of innovation by supporting quarterly Pitches throughout
2015/16.
For more information regarding The Pitch visit the Sydney Local Health District Innovation website at www.slhd.nsw.gov.au/
innovation or contact Sydney Local Health District Performance and Clinical Redesign Program Manager, Barbye Castillo via email
7 Change Champions & Associates Newsletter - FEBRUARY 2015
Although survival rates for many cancers have improved
significantly, more people are living with the consequences of
a cancer diagnosis and its associated treatment. The ACT has
the best cancer survival rates in Australia (AIHW, 2012).
Survivorship is a new area of the cancer care pathway. Cancer
survivorship can refer to a number of different timeframes in
the cancer patient trajectory. In the past, the term ‘cancer
survivor’ was used to describe someone cured of their cancer.
This usually meant someone who was free of disease for 5-10
years after treatment. Nowadays , however, survivorship
means different things to different people. There are a number
of emotional, physical, practical and social challenges that
cancer survivors may face during or after finishing cancer
treatment, including late effects of cancer treatment and the
fear of cancer returning . The main elements of effective
survivorship care include care after treatment, cancer
surveillance, prevention of cancer recurrence, the
management of late effects and overall wellbeing.
The Canberra Region Cancer Centre (CRCC), commenced
operation in 2014, integrating most Canberra Hospital and
Health Services Cancer Services into one location. It is now the
primary adult tertiary referral hub for cancer diagnosis and
treatment in the ACT and South East New South Wales region,
servicing a population in excess of 500,000 people. A
significant part of the vision to provide this population with
integrated and contextually appropriate cancer care involves
implementing a Cancer Survivorship Model of Care for within
the region. This project aimed to engage and consult with local
consumers and service providers to help inform priorities in
establishing a model of care.
The researchers devised survey tools based on current issues
in cancer survivorship research. These tools have been widely
distributed in both paper and electronic format to consumers
(people who have had a diagnosis of cancer and their carers)
and clinicians involved in the treatment and follow up of this
patient group. Selection criteria were identified to reflect the
unique population groups serviced by the CRCC. The survey
was designed to determine how the local consumers and
service providers define survivorship; to enquire about the
physical emotional and practical support needs of cancer
consumers; and to examine coordination of resources and
support from a clinician perspective.
108 patients, 31 carers and 72 clinicians have completed the
survey. Results overwhelmingly demonstrate that respondents
understand survivorship to be living with cancer, beyond
diagnosis and treatment. Consumers and carers indicated they
would like ongoing psychosocial support during and following
treatment. They also desired better communication and
collaboration with their GP and other health professionals and
felt this could be achieved with the use of a summary
treatment plan. This plan, outlining treatment details,
recommendations and other planned health interventions,
could be available from diagnosis, and updated during and
after treatment. Clinicians indicated they would like a greater
understanding of resources and support available to patients.
In light of the results from the surveys, the Model of Care will
place emphasis on survivorship as living well with cancer,
beyond diagnosis and treatment. Work is now underway to
examine this in detail and determine how this will frame
patient care and support. Development of a Model of Care
that enhances the wellbeing approaches important in
survivorship provided to patients and carers has commenced.
For more info please contact [email protected]
Engaging consumers to develop a cancer survivorship and wellness
model of care in the ACT David Larkin PhD
Clinical Cancer Research Nurse Canberra Region Cancer Centre
Division of Cancer, Ambulatory and Community Health Support Canberra Hospital & Health Service
Contents Articles Workshops In Houses Resources
8 Change Champions & Associates Newsletter - FEBRUARY 2015
Being clear about death and dying
This article first appeared on the UNSW Newsroom on 22 January 2015 at http://newsroom.unsw.edu.au/news/health/being-clear-about-death-and-dying
Published with permission.
UNSW researchers have developed an assessment tool
that helps doctors and caregivers more accurately identify
elderly patients whose death is imminent and unavoidable
at the time of hospital admission. The CriSTAL (Criteria for
Screening and Triaging to Appropriate aLternative care)
tool identifies patients who are likely to die within a three-
month period.
Elderly people with chronic, age-related illness commonly
endure repeated admissions to hospital in the last months
of life and may be subject to distressing, expensive and
futile medical procedures. The new tool provides more
certainty in prognosis and enables an end-of-life care plan
to be developed that best meets patients’ needs.
A paper describing the assessment procedure is published
today in the BMJ Supportive & Palliative Care.
“Most terminally ill people want to die at home, but in fact
three quarters end up dying in acute hospitals, often after
intrusive, expensive and ultimately pointless medical
procedures,” says Dr Magnolia Cardona-Morrell, who led
the research at UNSW Medicine’s Simpson Centre for
Health Services Research, alongside UNSW professor of
intensive care Ken Hillman*.
“Current acute hospital systems often fail to
recognise or cater to the needs of people for whom
death is imminent and unavoidable. They are geared
for aggressive treatment and emergency resuscita-
tion, not peaceful, harm-free transitions,”
Dr Cardona-Morrell says.
“Elderly people who are dying need to be protected from
heroic but intrusive live-saving hospital interventions that
often only prolong suffering rather than enhance quality of
remaining life.”
CriSTAL consists of a 29-item screening list that can be
completed by a nurse or a doctor before hospital admis-
sion and takes account of factors such as vital signs,
cognitive impairment, recent hospitalisations, measures of
frailty and the presence of active disease such as cancer or
chronic kidney or liver disease.
The process is informed by an extensive review of the
strengths and weaknesses of medical literature that
attempts to “diagnose dying” or devise an end-of-life
assessment tool for clinical use. Most of the existing tools
rely on clinical judgment or subjective assessments and
value judgments. Others are unacceptably inaccurate.
(Continued next page)
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9 Change Champions & Associates Newsletter - FEBRUARY 2015
The authors say developing a more objective and accurate
way of identifying patients near the end of life is crucial to
prevent inappropriate hospital admission and unnecessary
treatments.
“It can be difficult to reach a decision that balances the
rights of patients to die with dignity and the expectations
of families about satisfactory end-of-life care, while
considering the limitations of health resources,” they write.
“Delaying unavoidable death through aggressive and
expensive interventions may not influence patient
outcome; may compromise the bereavement process for
families; and cause frustration for health professionals.”
Dr Cardona-Morrell says the research is not about
dictating the withdrawal of treatment, but about
minimising uncertainty and establishing objective
criteria for imminent death.
“It’s about coming to terms with the fact that death from
old age and multiple chronic conditions is part of a natural
process and that medicine cannot work miracles. And it’s
about ensuring that people at the end of their lives have
the best possible care and support, in line with their
wishes,” she says.
Professor Hillman emphasises that “the management of
elderly frail patients at the end of life in acute hospitals is
one of the greatest challenges facing health care. Most
patients and their carers do not wish to be admitted to a
hospital at the end of their life and this is a major
contributor to the unsustainable costs of health care.”
CrisTAL will be trialled in selected hospital emergency
departments in Sydney this year. It will include
communication training for medical staff, so they can ably
and comfortably discuss with dying patients and their
carers the limitations of medical treatment and the most
appropriate place and process of dying.
The paper, “Development of a tool for defining and
identifying the dying patient in hospital: Criteria for
Screening and Triaging to Appropriate aLternative care
(CriSTAL)” is an Open Access publication.
The research was funded by a grant from the National
Health and Medical Research Council of Australia.
*Professor Hillman is a well-known advocate for reform in
end of life care and has written books and articles on the
subject.
Media contact: Steve Offner, UNSW Media, 02 9385 1583
or 0424 580 208 [email protected]
(Being clear about death and dying, continued from page 8)
Join us in September 2015 in Sydney NSW for the 2nd Productive Series conference. Those who came to Melbourne last year left excited, inspired and full of good ideas to take back to their health service. 2015 promises to be even better with overseas keynote speakers and presentations from teams around Australia and New Zealand that are improving services for patients using the Productive programs. Mark September 2015 in your diary and join us in Sydney, NSW. Register your interest now [email protected]
2015 Productive Series
Conference DATE CLAIMER
Contents Articles Workshops In Houses Resources
10 Change Champions & Associates Newsletter - FEBRUARY 2015
The Smile Mum Project, Wagga Wagga
Good oral health enables an individual to eat, speak and socialise without active disease,
discomfort or embarrassment.
While oral diseases are common, they are largely preventable through water fluoridation and
individual practices, such as brushing twice a day with fluoride toothpaste and regular
preventive dental care.
However, poor oral health during pregnancy can impact on the health outcomes of
mother and baby, increasing the chances of infants developing early dental caries
(tooth decay) and associated with adverse pregnancy outcomes, such as preterm and
low birth-weight babies.
Dental caries is one of the most common diseases in childhood. A particularly damaging form,
early childhood caries, can begin at a very young age when developing primary (baby) teeth are
especially vulnerable. Severe dental decay undermines the quality of life of young children
through pain and problems with sleeping, eating and behaviour. There is evidence suggesting
good oral health in infancy and early childhood contributes to better general health in
adulthood.
Murrumbidgee Local Health District (MLHD) Wagga Wagga Oral Health Service established a
partnership with MLHD Midwifery and Clinical Redesign and Charles Sturt University Oral
Health Clinic to form the Smile Mum Project Team.
The Agency for Clinical Innovation Methodology for Change resources guided the development
of a priority program for eligible pregnant women to receive subsidised dental care.
Jennifer Lang
Oral Health Promotions Officer
Murrumbidgee Local Health District
(Continued next page)
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11 Change Champions & Associates Newsletter - FEBRUARY 2015
Oral health staff, midwives and pregnant women were
involved in the consultation, diagnosing the problem and
developing solutions to create an innovative model of care.
The Smile Mum Project eligibility criteria is limited to
participants under 25 years of age and holders of
Commonwealth Government concession cards.
The Smile Mum Project enabled oral health information and
a direct referral process to be provided to local midwives.
Prioritised pregnant women received subsidised dental care
and preventive advice at Charles Sturt University Oral Health
Clinic and Wagga Wagga Base Hospital Dental Clinic.
Over a six month period:
86 referrals were received.
37 women completed a full course of dental care
20 women in the process of treatment.
Feedback from patients and clinicians indicated that the
Smile Mum Project is improving maternal oral health,
reducing the risk of infants developing early dental decay
and positively influencing the oral health behaviours and
attitudes of the women and their children.
The Smile Mum Wagga Wagga program has provided a
patient centred clinical pathway Model of Care to improve
oral health outcomes of rural disadvantaged and low socio-
economic patients.
Project supported by Centre for Oral Health Strategy NSW
For further information please email:
Smile Mum Project team members (Back L-R):
Anna Bromham, CSU Bachelor of Oral Health student,
Jennifer Lang, MLHD Oral Health Promotion Officer,
Shirley O’Brien, and MLHD Adolescent Pregnancy Support
Midwife. Seated: Smile Mum participant Samantha
Buckley.
Missing from the photo are team members:
Joanne McLennan, MLHD Oral Health Services Team
Leader and Senior Dental Therapist, Leanne Beasley,
Project Coordinator from MLHD Oral Health Services,
Bronwyn Paton from MLHD Clinical Redesign.
(The Smile Mum Project, Wagga Wagga, continued from page 10)
Contents Articles Workshops In Houses Resources
12 Change Champions & Associates Newsletter - FEBRUARY 2015
Squashed in the Middle by You
Putting the Juice into Middle Management
Orange in the Middle Picture yourself as a pulp perfect navel orange, lazing in the
afternoon warmth of an early Sunraysia spring. It’s a good
life. Every orange in every tree in your orchard is on
message to ripen as evenly as you can. There’s no pressure
except for the odd nudge here and there from a branch
hopping wagtail. Each developing orange is equally nurtured
with a careful balance of water. Each is protected from
birds, bats, fruit flies and two legged poaching varmints by a
vigilant avuncular orchardist. Each receives a word of
encouragement, an approving nod or a proud smile from
their avuncular orchardist. All you have to do is deliver the
juice. It can’t get much easier than that.
In the bigger picture of oranges and juice, unnatural
predators, those fiercely competitive supermarket giants
despatch B Triples that rumble like earth tremor aftershocks
toward your orchard. Your tree branches vibrate through
the trunk and into the tree’s roots. Suddenly, your stem
loses the better half of its hold on its twig. You are left
swinging in mid air, not sure what is going on.
You are not quite ready to drop your vitamin filled goodness
and the thought of being plucked out of the cosy protection
of your tree fills you with trepidation. The big B Triple driver
from the city pulls out his clip board and pen and financially
and emotionally squeezes the orchardist for more and more
oranges for less and less return. Panicked about the future
sustainability of their livelihood, the orchardist tractors
through their inherited rows of citrus trees, churns the
ground willy nilly with growth enhancers so as to keep up
with big city demand. Careless backpackers snatch half
ripened fruit for the cash on offer.
Perfect as you, you become one of the first to be backpacker
plucked from the tree. You find yourself slam dunked into
the murky depths of a canvas bag with other oranges of
similar calibre and a swage of leafy debris. Confusion reigns.
Then, you are all tossed into the wash, conveyed through
grading, boxing and finally labelled, “Premium Juicer”.
When all the cartons are packed and stacked, you are
trucked off to some mystery city supermarket conglomerate.
It’s not exactly the ideal career progression; to be
crushed between the citrus producer and the KPI
driven supermarket executive. There you are
powerless, in the dark, not sure what you can and
can’t do and with others determining your fate.
But that is what happens to many middle managers, even to
those with tertiary qualifications in management.
Premium Oranges Can Survive With Their Juice Intact Every day middle managers seesaw between the demands of
those above and those arising in their teams. It takes balance
and emotional intelligence to manage competing pressures
while continually making adjustments to maintain stability,
productivity, positivity and your own sanity. You are working
in a landscape that, by necessity or design, is constantly
changing, perhaps only subtly.
Some adapt more easily than others. That’s life. Some
emerging middle managers will feel squashed in between the
top and bottom plates of a manual vice juice extractor.
Without resilience and support, pulp, juice, pith and skin could
be squashed out and sprayed everywhere but in the catch cup.
Char Weeks Innovation Leader
Change Champions & Associates
(Continued next page)
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13 Change Champions & Associates Newsletter - FEBRUARY 2015
There is a plethora of leadership and management develop-
ment courses on offer, delivered by all manner of institutions.
There appears little evidence between having an EMBA and
being a great manager as there is the converse i.e. having no
qualifications while becoming a brilliant manager. What
appears to be widely agreed is that organisations commit to
provide development opportunities, some lavish, for
executives. They willingly invest as necessary in training for
the front line. But, very little attention is dedicated to
delivering training that addresses the expressed immediate
needs of those in the middle. Most of what they need to
learn is not in the book. Their questions often start with,
“What do I do if...”. And the answer isn’t always on the
Internet. In fact, sometimes it lies within and just needs a
little help to surface. Many middle managers learn from their
own manager. And while some of those managers provide
wonderful guidance, there are others who deserve a
magnifying mirror to facilitate a little self reflection.
No wonder some middle managers burn out and
retreat to the comfort zone of the front line.
Could middle management be the litmus test for career
progression and the acid test of resilience? There are fewer
executives on the rungs above you and competition for
promotion is often fierce. Those ambitious few who cope
best and show greatest ability are those who are most likely
to be promoted or poached. That is not to detract from the
courage and tenacity of the career middle manager.
Putting the Juice into Middle Management Let’s now look at some practical strategies for surviving
middle management.
1. PUT YOUR OWN WELLBEING FIRST
This is not about becoming self obsessed about your ability/
inability or letting your ego run riot about your promotion
from the open plan work benches to a cupboard office. Just
like anything you take on for the first time, tandem para-
chuting, driving lessons, getting married, it is reasonable to
feel a little anxious. If you feel that you might become a
runaway bride/groom, choose to not take the middle
management role until you feel ready.
“Choice” is an important word.
We all always have choices.
Many new middle managers commence their role by coming
in early, staying back late and, can you believe, showing up
for work on weekends to make up for what they may
perceive as conscious incompetence. Mathematically, it
doesn’t work to accept a promotion with a salary boost and
then volunteer your time in the same organisation. If you are
one of those people, check your salary now by dividing the
hours you usually work in an average week and see how it
looks. Some of you may discover that, in real terms, you are
actually earning less now than before you were promoted.
Staying back may make you look dedicated but it also makes
you highly visible. Everyone who comes into work after you
and leaves before you sees that you are still there. That
makes other people feel guilty and creates a source of wash
basin gossip. Worse, it sets an unhealthy precedent for all of
your direct reports. And it’s VERY unhealthy, not just for you,
but for the organisation as a whole.
Some of you will say that working extra time is expected from
managers. Your manager does it and they expect the same
from you. Check your contract. If it’s written into your
contract that you are required to donate additional
hours...well, whoopsy. Perhaps it would have been better if
you had checked the fine print first. But, all of that following
the old culture is phooey if you want happy staff, happy
organisation and a successful organisation. You are not your
job. You have a life and if you don’t have a life, create one.
Set your working hours. Leave a little flexibility for anything
that is genuinely urgent. And spend the rest of your time on
healthy body, healthy mind activities.
(Continued next page)
(Squashed in the Middle by You, continued from page 12)
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14 Change Champions & Associates Newsletter - FEBRUARY 2015
2. GET CLEAR ABOUT WHAT IS EXPECTED FROM YOU AND WHAT YOU EXPECT FROM OTHERS
Middle management is about matching demands and
expectations from above and with your team. Your job exists
to help your organisation, via your senior managers, to
translate strategy into action. As a middle manager, you are
the bridge between the big picture and the detail. You are
the conveyor of information to and from senior managers
and to and from your team.
It makes sense then to have some idea about what your
actually boss does, to whom they report, their KPI’s and
challenges, and broadly, how they like to work. More
importantly, try to get a handle on their communication style
and preferences. This will help you to see where and how
you fit with their role and to understand their priorities and
pressure points.
By the way, whether you approve or otherwise of your boss’s
communication style, people will always do what people do.
Try not to be judgemental. No one is perfect, not even you.
One good choice is to learn to anticipate your boss’s
behaviour and adapt your own behaviour to become
appropriately accommodating. That will help to free you to
be able to propel yourself forward and may be even share
with your boss some of your skills, knowledge, emotional
intelligence etc. that you have and they haven’t that inspired
them to hire you in the first place.
Once you have clarified priorities and deliverables
with your boss, take the time to learn about the
people in your team. Who are they? What makes
them tick at work? How do they things are going or
could be improved? What are their future career
plans? Discuss your own role, communication style
etc as you did with you own boss. Let your team
know who you are and what makes you tick. What
leadership/management style do they consider
motivating? Who do they admire as a leader and
manager and why?
It is amazing how many people still think that the best way to
motivate their people is to cut them down, in the belief that
it will inspire them to do better. They are the managers
whose communication commences with what you did wrong,
with or without mention of what you did right. Or the first
answer is always, “No” or if you are lucky, it’s “No, but...”
And they wonder why you are shocked when you hear via
someone else that they have a high opinion of your work.
Please.
A better way to motivate your people is to see the good in
them and treat them with respect and courtesy. Saying
please, thank you, well done and treating them with respect
also helps. Sharing information always helps to dispel
concerns. You are aiming to create a continuous improve-
ment team where individuals respond to constructive
feedback and feel confident about their ability. As a team,
your internal mission is to “do it better”.
3. KEEP MOULD AT BAY When things aren’t working
quite the way you had hoped,
open up a calm, constructive
conversation early. Avoid the
blame game. Sentences that
commence with “You did...”,
“You said...” or “You told
me...” demonstrate a culture
of blame and abdication from responsibility. Going off your
rocker in anger erodes trust and confidence among your team
members and gives them a license to talk about your bad
behaviour. Blaming and shaming serve only to build anger,
resentment and apathy in your team; none of which are
conducive to a high achieving, collaborative workplace. It’s
inexcusable to imitate anyone else’s blame game behaviour
toward your own team. If it happens to you and you are brave,
it might worth nudging your boss in the direction of your
priority to find ways to solve the problem, rather than bear the
brunt of what went wrong. They may glare at you or come back
with an unwelcome retort. But some people just have to have
the last word. So let them.
Taking a proactive approach to dealing with issues with your
boss or your team helps to keep you on the front foot. The
stability and predictability in your own behaviour helps to build
everyone’s confidence and resilience.
Waiting for mould to bloom before drawing attention to it is
tantamount to letting management happen to you. In the
absence of information and/or direction, people find ways to
speculate. Before you know it, a tiny solvable problem
transforms into an emotive bonfire. You have a choice to be
brave and close down the wash basin clap trap that sometimes
has only the flimsiest relationship with the truth.
(Continued next page)
(Squashed in the Middle by You, continued from page 13)
Contents Articles Workshops In Houses Resources
15 Change Champions & Associates Newsletter - FEBRUARY 2015
When management happens to you, the juicer is extracting
from you from top and bottom simultaneously. Your
personal resilience may become compromised. That is
concerning when it flows onto your team and then you take it
home to your family. Take a look at this video by Kathryn
McEwen if you are thinking about your resilience https://
www.youtube.com/watch?v=Rg_x1dy9KCU
4. WHAT IF YOU THINK THE TOP ORANGE IS A
HALF MANDARIN?
There are some middle
managers who feel
frustrated when they
believe that their boss
is inept, less intelligent
or just sitting it out for
a retirement in a job
they believe they
should have. As frustrated as you may feel, you have a choice
to act professionally by keeping your toxic lips sealed. If you
spray cynical comments about your boss over your team like
pesticide, you are setting a new low in behaviour precedents.
You can choose to help your boss to learn just in a similar way
that they have a responsibility to help you to learn. And you
can decide to demonstrate more broadly that you are ready
to step up to the next level by supporting your boss so that
you ALL look good.
5. YOU NEED YOUR JUICE TO MANAGE UNPOPULAR
CHANGES FROM THE TOP
All too often middle managers are directed from way above
to deliver to their teams messages for unpopular change. For
even the most experienced middle manager, this can be
confronting, especially when they don’t agree with or
understand the changes or what is actually changing remains
a mystery.
Remember, that it’s the role of the top echelon to envision
and strategise. Sometimes, in the very early stages, the
executive has little idea how vision and strategy will translate
into implementation, action and outcomes. Often times,
team members, perhaps, mistakenly interpret that manage-
ment keeps them in the dark. “They don’t tell us anything”, is
a frequent catch cry. Sometimes, executive can’t tell you
because they neither know yet nor have assessed organisa-
tional readiness. It’s that simple.
If you are a middle manager who has been asked to
share information about change, here are a few tips
that might help you through:
ask your boss to help you to craft some key messages
about what it is, how it will benefit the organisation and
the team and what is the likely impact on the team.
be clear that you and your team are keen to be involved in
the consultation process. After all, no one knows more
about what you and your team do than you and your team.
be open about not having all of the answers but be willing
to commit to keep the communication lines open
share what you know when you know you can share
information
if there is no update, that in itself is information for sharing
with your team. This will help to dispel any “They know
but they are just not telling us” twitter
avoid saying or even giving an air of knowing what is going
on but not being in a position to reveal. You can lose trust
by creating a power differential in your team if you have
the temerity to make statements like, “I know but I can’t
say right now.” Remember, no one likes surprise parties.
keep in mind that a good change strategy has flexibility and
the change may need to change to make it more workable.
So its best not to present information from above as set in
stone until it’s actually set in stone. Otherwise, you will
hear and perhaps say, “It keeps changing and we don’t
know what is going on.” Of course, it keeps changing. It’s
on the top echelon’s head to get it right and they will do
whatever it takes to get it right.
invite questions and discussion among the team members
while discouraging cynicism and speculation, especially
your own.
make yourself available for your team member’s personal
concerns about the change, especially if it impacts their job
or their personal circumstances.
Remember, that you may be delivering the message that
change is coming, but you are not an orange parked on head of
William Tell’s son.
Finally, be confident, believe in yourself and remember your
career comprises many journeys each with a beginning and an
end. Middle management offers its own series of journeys. It’s
not a destination. Enjoy those journeys.
(Squashed in the Middle by You, continued from page 14)
This article can be republished if author and source are clearly acknowledged.
Contents Articles Workshops In Houses Resources
16 Change Champions & Associates Newsletter - FEBRUARY 2015
Falls are one of the leading causes for presentation to hospital
Emergency Departments (ED). More than 83,000 Australians
aged 65 and over were hospitalised following a fall in 2010.
More than 50 per cent of these fallers experience a second fall
within the next six months. However, less than 30 per cent of
fallers discharged from the ED access the services
recommended by hospital staff.
Recent studies suggest that older Australians are
reluctant to participate in fall prevention activities.
Almost 3 in 4 fallers are unwilling to attend exercise
classes, more than half are hesitant to discontinue using
psychotropic medications and more than a third are
reluctant to have a home safety assessment.
Research suggests that the lack of participation in proven fall
prevention activities are due to the stigma associated with
programs targeted toward ‘older adults,’ an individual’s under-
estimation of the risk of falling and the perception that a
program is not personally relevant.
The RESPOND project
Researchers from Monash University, and health partners
across Victoria, NSW and Western Australia, are leading a
multi-centre randomised controlled trial to test an innovative
post ED discharge program designed to reduce secondary falls
in older people—The RESPOND project. This program aims to
address the lack of perceived personal relevance by adopting a
patient-centred approach that encourages older adults to get
involved in the decision making process.
The RESPOND program connects patients with evidence based
falls-prevention strategies and improves their knowledge and
ability to navigate the complex healthcare system. The
intervention provides ongoing coaching and telephone
support to assist individuals to participate in self-selected falls
prevention activities; assistance in the identification of barriers
and facilitators to achieving goals; and positive reinforcement
when patient selected goals are achieved and sustained.
Further information on the RESPOND project can be found
here.
The Falls and Bone Health team host educational seminars
annually.
To ensure you remain up to date on the latest research
findings, join our mailing list by emailing your interest to
The RESPOND project
Respond to the first fall to prevent the second
Dr Anna Barker, Dr Darshini Ayton,
Ms Sheral Rifat & Ms Margaret Brand
Department of Epidemiology and Preventive Medicine
School of Public Health and Preventive Medicine
Monash University
Keeping older Australians on their feet
Contents Articles Workshops In Houses Resources
17 Change Champions & Associates Newsletter - FEBRUARY 2015
“Why doesn’t she just leave?” It is a comment most of us have heard in relation to
women living with family violence. The reasons why
women stay in violent relationships are many and
varied, but an innovative pilot program from community
services organisation Good Shepherd Australia New
Zealand aims to address one of the known factors
trapping women in abusive relationships: lack of
financial independence.
As part of the organisation’s aim to create an emotionally,
economically and physically safe world for women, the
Firmer Foundations program supports women to gain
confidence, skills and knowledge to build a secure financial
future. Research has shown that women who are financially
independent are less vulnerable to financial stress and have
greater resources to leave situations of family violence. This
includes women having access to their own money, having
equal decision making power about family finances and the
ability for them to earn a reasonable income.
Many people think of family violence as physical, verbal or
emotional abuse. Economic abuse is also another, less
understood form of family violence that can have
devastating consequences for those affected. Economic
abuse can happen to anyone regardless of their socio-
economic or ethnic background. Signs that financial abuse
may be occurring include women having no bank account of
their own, being unable to provide for their needs or those
of the children and debts incurred in her name without her
approval or knowledge.
Economic abuse is a crime in most parts of Australia.
Withholding money, controlling spending and making all the
financial decisions are some of the ways financial abuse is
carried out. The Firmer Foundations program helps to
empower women in these areas, providing them with the
awareness and skills needed to minimise their risk.
Women in Australia earn 17.6 per cent less
than men and taking time out of the paid
workforce to care for family further reduces
their access to financial security. Traditional
ideas about men as breadwinners, and of
financial matters being a male domain, also
contribute to a lack of money management
skills and confidence for many women.
One in three women experiences family
violence during their life, and it is the
leading contributor to death, disability and
illness in Victorian women aged 15 to 44
years (Vic Health 2004).
Mitigating this pervasive problem through building women’s
financial confidence is vital. Good Shepherd Australia New
Zealand aims to disrupt the intergenerational cycle of
disadvantage with a focus on women and girls. The Firmer
Foundations program offers women information and resources
about money management, either individually or in group
sessions. It is an opportunity for women to talk about money,
learn from each other and be assisted with employment,
education or training options.
Firmer Foundations is for any woman living in the
Mornington Peninsula Shire or Greater Western Melbourne
areas. They can be working, unemployed, single, partnered,
separated, with or without children or other care
responsibilities and may be on any type or level of income or
no income.
For more information phone 03 5971 9444 or email
[email protected] or 03 8312
8800 or email [email protected].
Setting out on Firmer Foundations Empowering women experiencing economic abuse
Melissa Walshe Senior Practitioner Firmer Foundations
Good Shepherd
Jackie Jenkins Financial Capability Worker Firmer Foundations
Good Shepherd
Contents Articles Workshops In Houses Resources
18 Change Champions & Associates Newsletter - FEBRUARY 2015
For a nation which calls itself the “Lucky Country”, it’s a little
secret that life is far from lucky for our Indigenous Australians,
who can expect to live 10-20 years less than other Australians.
One contributor to this life expectancy gap can be attributed
to a small microscopic bug known as scabies.
Scabies is a highly contagious skin disease. According to The
World Health Organization, as many as 130 million people are
affected by scabies at any one time with the majority these
people living in developing countries where overcrowding and
poverty coexist. Shockingly, in the Northern Territory (NT) of
Australia, one of the richest countries in the world, 7 in 10
Indigenous kids are affected by scabies at least once before
they can celebrate their first birthday, and 1 in 3 kids under
the age of 5 are affected by scabies at any one time. These
children can require sedatives to help them sleep at night and
painful antibiotic injections for infections from scabies sores.
The severe form of scabies, known as crusted scabies (CS)
causes significant skin disfigurement and these individuals
often suffer in silence and shame, receiving little ongoing care
and become the ‘super spreaders’ of scabies in the
community. Furthermore, historically crusted scabies patients
had a 50% mortality rate over 5 years.
One Disease is a non-profit organization that believes no
Australian should die of a preventable disease and is aiming to
help close the Indigenous health gap disadvantage. Our
mission is to eliminate disease from remote Indigenous
communities with the first on our hit list being scabies. We
work in partnership with Indigenous communities in the NT to
(i) identify crusted scabies patients and ensure they receive
the appropriate treatment in a culturally respectful manner
and (ii) assist local clinics with conducting skin screenings to
diagnose and treat simple scabies.
We believe the disease can only be eliminated when
people are empowered to take care of their health. For
this reason, we employ and up-skill local Indigenous
workforce to conduct community education at schools,
mothers groups and via door to door visits to problem
households.
One Disease’s nurses conduct education sessions at local
clinics and have written clinical guidelines for diagnosis &
treatment of scabies and crusted scabies. Furthermore, One
Disease is the only organization in the world that is designing
a clinical registry of CS patients to ensure contact tracing
could be done to effectively identify and treat everyone
affected by this disease.
Since the organization’s inception in 2011, One Disease have
been invited to work in 28 communities across the NT. We
have identified 65 individuals with crusted scabies who are on
personalized care plans and in one community have seen a
76% reduction in the number of days a CS patient spends in
hospital and a 100% reduction in patients reporting skin
condition impacting their ability to work. In 2013, One Disease
was able to register the medication, ivermectin, with the
Australian Therapeutic Goods Administration for the use of
scabies and findings on CS and the need to identify and treat
these super spreaders was recognized and published in the
peer reviewed and highly respected Medical Journal of
Australia (MJA).
To find our more about what it’s like to live with crusted
scabies, you can watch the story of one of our patients,
Stephen Maymuru- http://1disease.org/healthy-skin/stories-
from-our-communities/stevens-story/
To find out more about our One Disease,
please visit www.1disease.org
One Disease
Duneeshya Gunasekara Communications Coordinator
www.1disease.org
Contents Articles Workshops In Houses Resources
19 Change Champions & Associates Newsletter - FEBRUARY 2015
Benefits of training and staff development for recreation staff in aged care
Lauretta Kaldor Diversional Therapist, workplace trainer &
supplier of resources for leisure staff aged care [email protected]
www.laurettakaldor.com.au
One of the most important marketing tools aged care facilities
use today focuses on recreation opportunities within the
facility. Future customers (or their families) are more than
likely to be critical if recreation as advertised is not up to their
expectations. This puts an added pressure on the facility to
provide an excellent leisure program.
However the level of educational background of people
employed as leisure staff in aged care, varies greatly in all
states. It is really important that leisure staff be upskilled to
do a job that is really essential in aged care homes. By
participating in practical workshops leisure, staff really
appreciates seeing the value of a good leisure program.
As the impact of person-centred care and consumer directed
care changes from the medical model, all staff will be involved
in the leisure and lifestyle of each client at a facility. No longer
will it be OK for leisure staff to just be expected to mind the
clients while task orientated care staff and nurses get on with
their routines. Leisure staff must evolve into facilitators to
help all care staff find ways to engage residents in activities
(can be individual or group) as part of a team. As a majority of
residents in aged care homes are living with dementia, leisure
staff needs to know what activities will engage their residents
regardless of their cognitive issues and work with care staff to
produce excellent resident lifestyle outcomes.
Therefore leisure staff needs the practical skills and education
and come up with ideas that will enhance their clients’
lifestyle and help to foster well-being (as opposed to ill-
being).
They need to know how to help care staff (e.g. when residents
show distressed reactions) as part of a team to improve
overall well-being of such residents.
Topics for staff development that may be useful are:
How to use the life story of each resident to plan what
activities will engage that resident
How we might involve the residents in planning social
programs and outings to suit their needs and preferences?
What creative activities can be adapted so that people who
have challenges to leisure can enjoy creating art, craft or
writing?
How can families assist to provide individual activities that
will make their visits valuable?
How to use current technology e.g. Laptop, iPad etc. to
connect people, provide sensory enhancement and joy to
people whose ability to engage in leisure is challenged.
Practical ways to use reminiscing as an enjoyable activity
with older people.
In- house workplace leisure training or staff development for
all staff (or just leisure staff) might be one way of upskilling all
to improve their understanding of what leisure is all about.
For more information, please contact Lauretta at: [email protected]
Contents Articles Workshops In Houses Resources
20 Change Champions & Associates Newsletter - FEBRUARY 2015
AIM: To reduce the risk of developing constipation
while in the acute care setting through utilisation of a
constipation risk assessment tool.
A constipation risk assessment tool has been designed and
trialled in Broome Regional Hospital as a result of research,
evidence based practise and observation that constipation in
the acute care hospital setting is poorly managed by health
professionals. There is a distinct knowledge deficit into the
risk factors of constipation development and best treatment
modalities. An ingrained culture exists that bowel
management is a nursing duty despite the need for medical
collaboration regarding pharmacological intervention and
physiological considerations. The disconnect and under
recognition of constipation and management strategies is
linked to a shift in nursing culture away from basic care
towards policy and procedure. By having a standardised
assessment tool available with clear guidelines for the
healthcare team, consistent evidence based care can be
delivered.
The burden of hospital induced constipation on
individuals includes discomfort, pain, headache,
confusion, electrolyte imbalance, embarrassment,
investigations, and potentially severe medical
complications. The direct and indirect costs of
constipation on the healthcare system can be
widespread including increased staffing, drug therapy,
imaging, and intervention. Untreated constipation in
the acute care setting can culminate in increased
length of hospital stay, cost of care and places extra
burden on an already pressured healthcare system.
The Constipation Risk Assessment Tool is an integrated tool
used collaboratively by doctors and nurses to assess an
individual’s risk of developing constipation while in the acute
care setting. The Tool identifies risk factors for an individual
developing constipation while hospitalised and places
pharmacological interventions pre-emptively in place. By
reducing the incidence of constipation there are significant
cost savings for the healthcare facility as well as reducing
length of stays, and improving quality and health outcomes
for patients.
The Constipation Risk Assessment Tool was initially
introduced into Broome Regional Hospital as a trial
document for a period of three months from June-August
2013. During this time the tool was utilised by nursing and
medical staff for all admissions onto the medical- surgical,
maternity and mental health units. The roll out of the tool
was coupled with formal education sessions, informal
feedback sessions, a self directed learning package and
regular written updates. Much of the education and
reinforcement came via face to face interaction with the
author.
After the trial, feedback was gained on the tool and minor
alterations made to make the tool more user friendly. A pre
and post implementation audit was conducted. As an
outcome of the significant improvement in results the tool is
now a standard admission document on the medical -surgical
ward at Broome Regional Hospital.
Prior to the introduction of the Tool only 8 percent of
patients had bowel activity documented and 58 percent of
patients had no documentation for the entire admission. Post
implementation showed a significant improvement with 76
percent of patients having bowel activity documented on the
Constipation Risk Assessment Bowel Chart. The risk
assessment component showed a completion rate of 64
percent total and 26 percent partial completion.
The roll out of the tool has been a challenge like most change
and quality improvement initiatives. Time and resource
constraints by the author have further slowed the roll out
process with implementation in the maternity and mental
health units at a standstill. However the positive results from
the initial audit cannot be ignored. The change noticed on the
ward environment with regards to bowel documentation,
aperient prescriptions and nurse initiation has been
refreshing. Seeing nurses empowered to take charge of
bowel care confidently is evidence enough to continue to fuel
the change and quality improvement process. My journey
with the Constipation Risk Assessment Tool has been long
but enjoyable and my passion towards improving patient
outcomes through bowel care continues to drive my vision
for change in practise.
A COPY OF THE TOOL IS INCLUDED ON THE NEXT 2 PAGES
A constipation risk assessment tool
Kimberley Zanik Clinical Nurse, Medical Surgical Unit Broome Hospital, WACHS Kimberley
Contents Articles Workshops In Houses Resources
21 Change Champions & Associates Newsletter - FEBRUARY 2015
______________ Hospital / Health Service
Kimberley Region
Constipation Risk Assessment Tool
Ward: _______________________________
Doctor: ______________________________
Surname UMRN / MRN
Given Name DOB Gender
Address Post Code
Telephone
Document Developer: Kimberley Zanik, CN General Ward, Broome Hospital VERSION DATED 31 OCTOBER 2013 (WACHS Manager, Health Record Forms)
MR
K 1
55
C
ON
ST
IPA
TIO
N R
ISK
AS
SE
SS
ME
NT
TO
OL
Mobility 1
Independent 0 Less activity than normal for patient 1 Uses frames, sticks or standby assistance 2 Restricted to bed / chair 3
SUBTOTAL
Diet 2
No change in regular diet and fluid intake 0 Reduced nutritional intake 1 Reduced fluid intake 2 Needs assistance to eat and drink 3
SUBTOTAL
Prior to Diagnosis
Consider the environment and cultural consideration of the patient.
Can they get to the toilet? Is it private?
Do they have adequate time to evacuate their bowels?
Are they likely to inform you of problems with their bowels or constipation?
Do they understand what you are asking?
Encourage fluid intake, mobility, fibre and correct position for bowel evacuation.
Illness 3
Orthopaedic 2 Haemorrhoids, anal fissures and rectoceles, perianal abscess 2 Gynaecological conditions, surgery and pregnancy 2 Neuromuscular and neurological
3 Consider spinal chord injury, motor neuron, multiple sclerosis, chord compression, parkinson’s and stroke
Diabetes 2 Abdominal conditions and surgery
2 Cholecystectomy, appendectomy
Psychiatric illness, learning disability or dementia 2 Post operative 2 Chronic constipation 3 Cancer 3 Peritoneal dialysis, haemodialysis / electrolyte imbalance 3
SUBTOTAL
Patient 4
Symptoms Yes No
Patient believes they are currently constipated 3 0 Patient has a history of constipation 2 0 Patient usually uses laxatives 3 0
SUBTOTAL
Medications 5
Opioids 4 Antidepressants 2 NSAIDS 2 Antipsychotics 2 Antiemetic 2 Antiparkinsons 2 Calcium channel blockers 2 Antispasmodic 2 Iron supplements 2 Polypharmacy 2 Anticonvulsants 2
SUBTOTAL
Results TOTAL SCORE
Low Risk <8
PRN BD two tablets of Coloxyl and Senna
(Coloxyl only if pregnant)
PRN Movicol one sachet BD
Moderate 8 - 14
Coloxyl and Senna two tablets BD regular and Movicol one sachet BD regular
High >14
Coloxyl and Senna two tablets BD regular and Movicol two sachets BD regular
Consider STAT doses of other aperients eg microlax enema
*Consider rectal preparations such as suppositories and enemas only if faeces is evident in the rectum through examination or as requested by the Medical Officer
Question Yes No
Will patient need a bedpan or bedside commode? 3 0
Patient last used bowels (date prior to submission)
Patient usually uses bowels (times day/ week)
Stool is usually a (rate 1-7) on Bristol stool scale
Bristol Stool Scale provided overleaf
Assessment Completed By (Please Print Name & Designation)
Date:
22 Change Champions & Associates Newsletter - FEBRUARY 2015
______________ Hospital / Health Service
Kimberley Region
Constipation
Risk Assessment Tool
Ward: _______________________________
Doctor: ______________________________
Surname UMRN / MRN
Given Name DOB Gender
Address Post Code
Telephone
Date Time Bowels
Opened Bristol Scale
Amount (S)mall, (M)edium,
(L)arge
Was Laxative
used In last
24 hours?
Comments
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
Yes No 1 2 3 4 5 6 7 S M L Yes No
For more information about the Constipation Risk Assessment Tool, Please contact Kimberley Zanik at [email protected]
23 Change Champions & Associates Newsletter - FEBRUARY 2015
After a five-year hiatus in publication Professor Joseph E Ibrahim and Dr Nicola
Cunningham are delighted to announce the return of the Communiqué, an electronic,
quarterly educational newsletter, that uses a narrative case-study approach to report
lessons learned from deaths in acute health care settings investigated by the Coroners’
Court.
Our return to production is made possible through Victorian Managed Insurance
Authority and Monash University who are supporting the return of the Communiqué as
an educational resource for medical practitioners and health professionals with a focus
on patient safety in acute health care settings.
The first issue of the Clinical Communiqué examines the National Standards while
pulling together three clinical cases from our past issues. We do this to introduce
ourselves to the newcomers; hail our return to past subscribers; and trial our new
layout and presentation – in modern IT parlance, perform ‘an alpha test of product’.
The first issue is now available and we present cases about: Medication and Safety -
“Knowing what the right hand is doing”); Clinical Handover - “Hard to swallow”; and
Recognising and Responding to Clinical Deterioration in Acute Health Care “Measuring
pain and sedation”.
Subscription is free register at: http://www.vifmcommuniques.org/subscribe/
The Communiqué is returning!
The newsletter written by clinicians for clinicians about lessons learned from deaths investigated
by the Coroners’ Court.
Contents Articles Workshops In Houses Resources
24 Change Champions & Associates Newsletter - FEBRUARY 2015
1/2 DAY WORKSHOP WITH PAM O’NIONS
25 February 2015, Melbourne VIC
Background
There is a growing appetite for
improvement across the aged care sector
coupled with increased demand from
residents, relatives, commissioners and
regulators. This makes it essential to share
best practice and support improvement
initiatives… and to do so now.
The Care Homes Programme is designed to
help care homes strengthen
communications with the wider health and
care community and improve resident,
relative and staff experience. It is divided
into two parts: Wellbeing and Connect.
Care Homes Wellbeing focuses on
improving resident, relative and staff
experience by creating better
communication channels within care
homes.
Care Homes Connect focuses on
strengthening external relationships by
creating more effective communications
between care homes and the wider health
and care community
Facilitator name:
Pam O’Nions RN BSc MNsg GDipED DipBus
Doctoral Candidate
Senior Consultant, Qualitas Consortium
Objectives:
The focus of this interactive workshop will be
to introduce you to the Care Homes
Programme to find ways that help the aged
care facilities to better engage with staff,
residents & relatives and enhance
communications between the different
groups.
Learning Outcomes:
At the completion of the workshop the learner
will have been introduced to the Care Homes
Programme structure and tools to:
empower staff to make the improvements
that residents and relatives want
improve safety through better
communication
improve efficiency to release more time
caring for residents
improve relationships between aged care,
local community and the wider health and
social care system
Change Champions & Associates presents:
To register your interest email: [email protected]
Download the PDF flyer online. Visit www.changechampions.com.au
Contents Articles Workshops In Houses Resources
25 Change Champions & Associates Newsletter - FEBRUARY 2015
If you are under the pump and not sure that you are
managing as well as you could, this online program, Sustain
Success, will help you to build your resilience at work and
beyond.
Best of all its easy! There is no need to ask your manager
for permission for time off to attend a course. No need to
feel embarrassed about your capacity to cope. No need to
consider withdrawing or watering down decision making
because you feel that your ability and your confidence are
living on different planets.
Developed by revered, organisational psychologist, Kathryn
McEwen, here's an opportunity to reflect on the way work
pressure impacts on the way you function at work and
beyond. You can complete the program, in your own time
and at your own pace.
Better, you will be supported by a Resilience at Work
accredited coach. This is not a one size fits all program. One
75 minute individualised coaching session is included in the
program but for an additional fee you may book additional
sessions.
Coaching sessions are held face to face in Victoria and by
telephone or skype elsewhere.
Sustain Success provides:
An assessment of your current personal resilience levels
An evidence-based model to use to develop resilience
in the workplace
Specific strategies to maintain personal strengths and
address gaps in relation to resilience
Individualised practical coaching to:
Support focused reflection and action
Develop practical strategies for dealing with
challenges in the work place and beyond
Insight into personal work resilience levels
Understanding of the components proven to build
resilience at work
A customised and coach-supported plan to build or
maintain resilience in your current job
Increased capacity to work in a sustainable way, both
physically and psychologically
6 Activities each including Activity Sheets and videos
Completion of the Resilience at Work (RAW) Scale
RAW score results sent to your RAW accredited coach
75 minute strictly confidential coaching session to
develop strategies going forward
Each participant will receive a certificate of attendance
upon completion
Contents Articles Workshops In Houses Resources
26 Change Champions & Associates Newsletter - FEBRUARY 2015
Working effectively
with people experiencing
family es trangement
Full Day Workshop with Kylie Agl l ias
24 April 2015– Perth, WA
27 April 2015– Brisbane QLD
29 April 2015– Sydney, NSW
01 May 2015– Melbourne, VIC
or as an in-house at your organisation
A practical approach for health & welfare professionals
Make an inquiry for your facility! www.changechampions.com.au
Contents Articles Workshops In Houses Resources
27 Change Champions & Associates Newsletter - FEBRUARY 2015
Change Champions & Associates presents a brand new workshop
Manage Your Energy
Rather Than Your Time
3 Hour Workshop with Char Weeks
If you are over trying to manage your time so that you can do
everything on your wish list on time all the time, this workshop might
be for you.
Join Char Weeks for this practical and inspiring workshop which
could change the way you do everything.
Book this in-house workshop today!
Email [email protected] for more details
Make an inquiry for your facility! www.changechampions.com.au
Contents Articles Workshops In Houses Resources
28 Change Champions & Associates Newsletter - FEBRUARY 2015
Moving Forward
Accepting and Embracing Resistance to Change
This master class will enable you to:
EXPLORE reasons for and sources of resistance to
change both more broadly and in the context of your
role as a change agent, leader, implementer or
recipient
LEARN strategies for anticipating, addressing and
managing resistance to change and any unintended
consequences
DISCUSS ways to build dynamic coalitions for
sustainable change
MANAGE the messages, manage people and
networks, develop competencies, find comfort zones
DELGATES ARE TO BRING:
1. Organisational chart with names of position
holders de-identified
2. Project proposal or implementation strategy or a
change resistance issue (real or hypothetical)
Who is this workshop for?
New leaders and project managers
from any industry or public sector who
are keen to develop their skills in
Change Management
BOOK THIS IN-HOUSE WORKSHOP
email [email protected]
for expressions of interest
Make an inquiry for your facility! www.changechampions.com.au
Contents Articles Workshops In Houses Resources
29 Change Champions & Associates Newsletter - FEBRUARY 2015
The New Leaders Toolkit
A Practical Workshop on the Stuff That’s Not in the Book
Full day workshop with Char Weeks
This full day workshop is suitable for emerging, acting, tired, frustrated or
continuously improving managers of just about any project, program,
facility, department, group or organisation. It’s about building your
confidence and sharing tips for dealing with some of those tricky
challenges that come with the territory.
For in-house expressions of interest Email: [email protected]
www.changechampions.com.au
Contents Articles Workshops In Houses Resources
30 Change Champions & Associates Newsletter - FEBRUARY 2015
MANAGING UP (How to help your boss add value to your work)
Understand the broader context in which your boss works and
what is important to them as a leader and manager.
Better understand how to tap into your boss’ skills and
expertise to enhance each others’ roles, to build trust, respect
and capability.
Identify strategies to ensure that you and your boss are on the
same page in update meetings and that you are more clear
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
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 going into a meeting with your boss?
Here is a 3 hour
workshop that will help
you to make those meetings
with your boss a much more
mutually rewarding
experience
Email your expression of interest to: [email protected]
IN HOUSE WORKSHOPS
www.changechampions.com.au www.changechampions.com.au
Contents Articles Workshops In Houses Resources
31 Change Champions & Associates Newsletter - FEBRUARY 2015
Board Appointments
Master Class
For in house bookings email:
All you need to know to get
the board position you want.
More and more professionals are looking to share their expertise,
and add to their own credibility, as Non Executive Directors (NEDs)
on Boards and other Committees of Management. But, landing that
first Board position is not so easy, especially when you are pitting
your skills and experience with others who are equally talented and
passionate about the same cause, company or industry
NEDs often describe finding their first directorship as an arduous
and time consuming process. More experienced NEDs suggest find-
ing subsequent board roles can be equally difficult. Not starting your
board vacancy search early enough, relying on existing or stale net-
works and not fully understanding the complexities of how board ap-
pointments are made can cripple your chances of being appointed to
a Board. Addressing these issues is why our Board Appointment
Seminars are so popular.
Each half day seminar, led by David Schwarz (an experienced non-
executive director, international head-hunter, board recruiter and the
MD of Board Direction), is designed to practically demystify the
board appointment process. It will also provide you the skills and
assistance you require to get ‘board ready’ and onto the board you
want.
www.changechampions.com.au
With
David
Schwarz
Contents Articles Workshops In Houses Resources
32 Change Champions & Associates Newsletter - FEBRUARY 2015
“You would have to be half mad to dream me up.” -Lewis Carroll, Alice in Wonderland
Full day 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 of Health and Ageing).
Delirium is a serious medical problem which results in increased length of stay in hospital,
premature institutionalisation, morbidity and mortality in the elderly. Needless to say the cost to
the healthcare system is enormous!
This practical workshop by recognised dementia behaviour expert, Robyn Attoe, is designed to
assist anyone working with older people:
to recognise the delirious patient early
improve knowledge about delirium management
Delirium And the older person
For in-house bookings, email
www.changechampions.com.au www.changechampions.com.au
Contents Articles Workshops In Houses Resources
33 Change Champions & Associates Newsletter - FEBRUARY 2015
Up to 90 % of people who have
dementia will experience behavioural
and or psychological symptoms during
the course of their illness .
FOR IN HOUSE BOOKINGS,
PLEASE EMAIL
for expressions of interest
Managing Behavioural
& Psychological
Symptoms of
Dementia
One day workshop with Robyn Attoe
OUTLINE
1. Discuss the different types of dementia, the changes to the brain and the behaviours
staff may see in each type of dementia
2. How to communicate effectively with the person with dementia (PWD)
3. How the environment impacts on behaviour and how staff can modify the environment
to reduce BPSD
4. Discuss and define Psychological Symptoms of dementia and how to manage them
5. How staff can assist in the transition from home to hospital or residential care by
identifying the needs of the PWD and then providing a detailed strengths based care
plan for the PWD
6. Discussion of case studies and more …
Make an inquiry for your facility! www.changechampions.com.au
Contents Articles Workshops In Houses Resources
34 Change Champions & Associates Newsletter - FEBRUARY 2015
The ABC of BOC Working with Older Adults with Complex Health
Care Needs Who Display Behaviours of Concern
Need some practical tools to help you unravel
and prioritise those complexities to deliver the
best outcomes for your clients?
Join recognised expert, Dr Alice Rota Bartelink,
in this full-day practical case-study workshop.
Workshop Content
This practical case study day offers a vibrant, supportive, but strictly confidential forum for
professionals who are:
Uncertain about where to start unraveling complexities in caring for older adults who
display behaviours of concern
Keen to understand the implications of behaviours of concern e.g. the impact and
flow-on effect on staff, patients, clients, residents etc.
Interested in discovering tools and techniques to be able to more effectively identify
and prioritise the management of behaviours of concern displayed by clients
Recognise the need to be able to measure the success of behaviour interventions
and management plans
www.changechampions.com.au
FOR IN HOUSE BOOKINGS,PLEASE EMAIL
for expressions of interest
Contents Articles Workshops In Houses Resources
35 Change Champions & Associates Newsletter - FEBRUARY 2015
A practical in-house master class with Alice
Rota-Bartelink on managing older clients living
with Alcohol Related Brain Injury (ARBI)
The Challenge
of Long Term Alcohol
Abuse in Older Adults
Make an inquiry for your facility!
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.
Master Class Aim
“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
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
www.changechampions.com.au
Contents Articles Workshops In Houses Resources
36 Change Champions & Associates Newsletter - FEBRUARY 2015
The Service Providers Toolkit:
Improving the Care of Older
Homeless People
In-house master class with Alice Rota-Bartelink
Introducing Nigel: Case profile
Defining homelessness
– primary, secondary and tertiary
Characteristics of an aged homeless population
Advocating for the older homeless person
Navigating complex service systems
Understanding life roles and the significance of
engaging in meaningful activities
Facing the challenge of “behaviours of unmet need”
The Service Providers Toolkit
Homeless and the Aged
IN-HOUSE
WORKSHOP
This workshop is available as an
in-house at your organisation.
Download the PDF flyer from
our website to read more info
and to fill out the expressions
of interest form.
www.changechampions.com.au www.changechampions.com.au
Contents Articles Workshops In Houses Resources
37 Change Champions & Associates Newsletter - FEBRUARY 2015
Learning Objectives
To identify patients that may benefit from
the application of the long stay model
prior to consuming excessive bed days
To learn how to engage all stakeholders
in the implementation of the long stay
program
To develop knowledge and skill in the
application of the tools and methodolo-
gy related to the long stay program
model
She is a 74 year old widow who was living
independently at home prior to presenting at
your hospital ED in an altered conscious state.
On assessment and investigation, layers of
medical issues appear and need unravelling.
Moving on, our Joan is still in hospital after 154
days. She's frustrated and bored. There is no
agreed discharge plan and Joan just wants to
go home. Your team are reluctant to discharge
Joan because they are yet to be convinced
that all her layers of issues have been resolved.
These sorts of long stays are preventable. And this
workshop with serve as a valuable investment
for your hospital in preventing these long stays.
Is this your patient?
Could you do with some help to free up her bed?
Ideal audience:
ANUM's, discharge planner, case manager, care
co-ordinators, performance analysts and anyone
else who genuinely cares about Joan and her
need to live out her days independently and in
her own home.
IN HOUSE WORKSHOP ONLY! Please email [email protected]
for expressions of interest
The Long Stay Patient A workshop with Julie Faoro
Many of you will have met Joan.
Contents Articles Workshops In Houses Resources
38 Change Champions & Associates Newsletter - FEBRUARY 2015
Limitation of care orders: Making an informed choice Dementia Training Study Centres Professor Joseph E Ibrahim MBBS, Grad Cert HE, PhD, FRACP, FAFPHM This education resource was developed by Professor Ibrahim to raise awareness of the important issues around limitation of care orders and cardiopulmonary resuscitation in persons with dementia, a sensitive and often contentious matter. People with dementia deserve the same opportunities as everyone else to be involved in making decisions about their treatment and lives and care should be exercised by others when presuming a certain quality of life for the person living with dementia. PDF available upon request, email [email protected]
VIDEO: Driving with Dementia Professor Joseph E Ibrahim MBBS, Grad Cert HE, PhD, FRACP, FAFPHM This animated video addresses the myriad of complex issues involved in assessing whether a person with dementia is fit to drive. We hope that it will engage the audience and generate discussion amongst the general public and health professionals to help us all be better informed. https://www.youtube.com/watch?v=4F9z8mPhcTw&feature=youtu.be
VIDEO: To Resuscitate or Not? Professor Joseph E Ibrahim MBBS, Grad Cert HE, PhD, FRACP, FAFPHM Prof Joe wants your help. He's sitting having a tea when the ward bell sounds - a patient has collapsed in the hallway... his patient! Prof rushes to the scene to find that the person who has collapsed is Mr Rupert Jones, a man with dementia. The ICU doctor wants to know how bad his dementia is and whether or not they should stand down the code blue. Should they resuscitate Mr Jones? https://www.youtube.com/watch?v=4ps03E-NCaI
Anaesthesia Perioperative Care Clinician Storybook ACI- NSW Agency for Clinical Innovation The Anaesthesia Perioperative Care Network (APCN) interviewed people to find out about their experiences with surgery and general anaesthesia. The APCN is sharing these experiences with you in order to foster better conversations between patients, carers and clinicians. The ability to communicate effectively is a core skill for understanding and engaging with patients, for negotiating appropriate treatment, for ensuring health care practices are safe, and to encourage patients to be actively involved in their care and recovery. This storybook uses storyboards to share some of the key issues confronting people who undergo general anaesthesia and offers questions to enable health care providers to reflect on their current attitudes and practices. Ideally, it will encourage more person centred approaches to health care delivery. http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0008/247049/Anaesthesia-Perioperative-Care-Clinician-Storybook.pdf
Victorian Chemotherapy Service Redesign Project (VCSRP) Peter MacCallum Cancer Centre Key Messages and Executive Summary http://www.nemics.org.au/icms_docs/187330_VCSRP_Key_Messages_and_Executive_Summary_11th_April_2014.pdf
Australian & NZ RESOURCES
Contents Articles Workshops In Houses Resources
39 Change Champions & Associates Newsletter - FEBRUARY 2015
The Right to Refuse: Examining Forced Marriage in Australia A joint project of Good Shepherd Youth & Family Service, Domestic Violence Victoria and Good Shepherd Australia New Zealand McGuire, Magdalena, Social Policy Researcher Good Shepherd Youth & Family Service This project drew on The Right to Refuse forum (a cross-sectoral forum on forced marriage which was held by the research partners) and the literature to devise some key findings about forced marriage. http://www.goodshepvic.org.au/Assets/Files/Right_to_Refuse_final_report.pdf
Acute Coronary Syndromes Clinical Care Standard Australian Commission for Safety and Quality in Healthcare This resource provides guidance to clinicians and health service managers on delivering appropriate acute coronary syndromes care. http://www.safetyandquality.gov.au/our-work/clinical-care-standards/acute-coronary-syndromes-clinical-care-standard/
Preventing Falls for Older Farmers Australian Centre for Agricultural Health and Safety This guide has been developed with the help of farmers aged over 55 years to help you identify your own risk of falling and to take steps to prevent falling on the farm. Risks can include individual risks as well as risks in the farm workplace. Individual risks are specific to you and may be increased by health problems, your medications, and poor balance, limited flexibility and reduced muscle strength. Risks in the farm workplace will vary according to the type of farm and type of work being undertaken. Section 1 provides a falls risk checklist to help you identify your individual risk for falls, as well as a test of balance and strength to assess your falls risk. Section 2 helps you plan a way to prevent falling on the farm including practical exercises you can do to build strength and balance, simple things you can do on the farm to reduce the risk of falls and also provides a personal action plan to help you reduce your risk of falls. Section 3 adds ideas to the “Great Idea Bank” of older farmers for making farm work easier and safer. http://www.aghealth.org.au/tinymce_fm/uploaded/falls_resource.pdf
Smartphone Speeds Up Ed to Ward Bed Transition Nursing Review NZ, December 2014 Vol 14 (6) Whangarei nurse PETER WOODS outlines how using a smartphone cut out the 'middleman' and got ED patients more quickly allocated a ward bed. http://www.nursingreview.co.nz/issue/december-2014-vol-14-6/smartphone-speeds-up-ed-to-ward-bed-transition/#.VMr5q2iUdlr
Antimicrobial Stewardship Clinical Care Standard Australian Commission for Safety and Quality in Healthcare The Commission, in collaboration with consumers, clinicians, researchers and health organisations, has developed the Antimicrobial Stewardship Clinical Care Standard and resources to guide and support its implementation. This resource provides guidance to clinicians and health service managers on delivering appropriate care when prescribing antibiotics http://www.safetyandquality.gov.au/our-work/clinical-care-standards/antimicrobial-stewardship-clinical-care-standard/
Contents Articles Workshops In Houses Resources
Australian & NZ RESOURCES
40 Change Champions & Associates Newsletter - FEBRUARY 2015
International RESOURCES
System leadership- Lessons and learning from AQuA's Integrated Care Discovery Communities The Kings Fund, UK This paper seeks to identify the skills, knowledge and behaviours required of new system leaders and to learn from systems attempting to combine strong organisational leadership with collaborative system-level leadership approaches. The paper draws on three years' development work with leaders in health care systems in north-west England, undertaken by the Advancing Quality Alliance (AQuA) and The King's Fund which has adopted a 'discovery' approach to developing integrated care and the leadership capabilities supporting it. http://www.kingsfund.org.uk/publications/system-leadership
Making our health and care systems fit for an ageing population The Kings Fund, UK Within each component of care, the report sets out the goal the system should aim for, presents key evidence about works, gives examples of local innovations, and some pointers to major reviews and relevant guidance. It argues that if the health and care systems can get services right for our older population – those with the highest complexity, activity, spend, variability, and use of multiple services – they should be easier to get it right for other service users. The twin challenges of demography and funding demand no less. http://www.kingsfund.org.uk/publications/making-our-health-and-care-systems-fit-ageing-population
Japan’s Fureai Kippu Time-Banking in Elderly Care: Origins, Development, Challenges And Impact International Journal of Community Currency Research Mayumi Hayashi, King’s College London Japan’s Fureai Kippu (‘Ticket for a Caring Relationship’) refers to mutual support networks of members of all ages, targeted at providing care for older people through exchanges of time credits, sometimes supplemented by cash payments (‘time-banking’). This has attracted increasing attention as a potential contribution to the ‘Big Society’ with an ageing population. However, despite its pioneering role and scale, relatively little is known about the details and outcomes of Fureai Kippu, and meanwhile simplistic and optimistic generalisations predominate. This article, using historical analysis and empirical evidence, seeks to address these gaps by examining the origins of Fureai Kippu, its early expansion, post-2000 slowdown and responses. It considers the practical contributions and varied beneLits potentially offered by the system, along with its operational difLiculties. The conclusion is that Fureai Kippu is so complex that not only is evaluation difLicult but also no universal panacea can be expected from it. https://ijccr.files.wordpress.com/2012/08/ijccr-2012-hayashi.pdf
Preparing Tomorrow’s Leaders Today: Investing in Capacity Building for Nursing Health Services Research NHSRU (Nursing Health Services Research Unit), Canada This report provides an evaluation of the Undergraduate Student Research Internship Program (USRIP) and demonstrates how the program achieves its intended outcomes and how government investment contributes to health research capacity. Document analysis was used, which included financial records, publications and a review of annual reports dating back to the inception of the Nursing Health Services Research Unit. In addition, the McMaster University Research Internship Program Survey was sent to former student research interns. Quantitative and qualitative analysis of survey responses was conducted. Information obtained from all sources was plotted on a logic framework (Cooke, 2005; Cooke & Sarre, 2009). http://nhsru.com/publications/preparing-tomorrows-leaders-today-investing-in-capacity-building-for-nursing-health-services-research/
Contents Articles Workshops In Houses Resources
41 Change Champions & Associates Newsletter - FEBRUARY 2015
Corner Kylie Agllias Kylie Agllias (Ph.D.) is a social work academic with a practice background in family counselling, domes-
tic violence, homeless youth and women in corrections. Kylie's world renown research in family es-
trangement commenced in 2007 and is ongoing with different populations. She continues to publish
widely on this topic, with publications including an entry in the Encyclopedia of Social Work and highly
ranked journals including Qualitative Health Research and Affilia. She provides evidence based es-
trangement workshops and master classes to health and welfare professionals and interest groups.Char
Weeks is in internationally certified Executive Master Coach, a graduate of the Australian Institute of
Company Directors. She has formal qualifications in change management from the Australian School of
Business (formerly the Australian Graduate School of Management) and has studied business manage-
ment at the Australian Institute of Management.
Kylie blogs about Family Conflict on the Psychology Today website. To read her articles, simply visit:
http://www.psychologytoday.com/blog/family-conflict
Char Weeks
Char Weeks is an internationally certified Executive Master Coach, a graduate of the Australian Institute
of Company Directors. She has formal qualifications in change management from the Australian School
of Business (formerly the Australian Graduate School of Management) and has studied business man-
agement at the Australian Institute of Management.
Char has a passion for change management and health care service reform and is a strong advocate for
older people’s health and well being. She is the full time carer for her 86 year old mother, Alison.
Writing provides a luxurious vacation from the more mundane aspects of daily life for Char. In 2010,
she published her first book, Handy Hints for the Novice Conference Presenter" which sold in 9 coun-
tries.
Char blogs about a variety of topics including aged care, mental health and change management at:
http://charweeks.hubpages.com/
Contents Articles Workshops In Houses Resources
42 Change Champions & Associates Newsletter - FEBRUARY 2015
We offer a comprehensive, practical
service that aims to put you back in the
driving seat at work.
These are just some of the skills and services on offer:
Improve your effectiveness at work, build a
sustainable, positive team culture that drives
innovation and productivity
Identify and build on your strengths as a leader
Learn practical skills to develop your emotional
intelligence at work
Build your confidence in a new role inc:
choosing your leadership style to achieve the
results you need from your team
how to deal with imposter syndrome
how to make the most of being “the new kid on
the block” in a well established culture
how to deal with situations where you got the
job that someone else in your organisation
missed out on
Learn how to manage your energy rather than your
time
Learn how to support your manager to bring out the
best in both of you
Build your resilience at work with RAW scale
assessment
Learn practical change management skills
(including how to assess readiness, develop a
change strategy and deal with resistance)
Receive confidential advice about complex
change management issues
Access the support you need to help you and your
team survive turbulent times
Develop your presentation skills or simply rehearse
that all important presentation and receive
constructive feedback.
NB: Some services are suitable for tertiary students.
Feel like you’ve
bitten off more than
you can chew?
STRICTLY CONFIDENTIA L
Coaching for Emerging
Leaders, Program and
Project Managers
With Char Weeks
Executive Master Coach
GAICD, GCCM, BMC, CHE, BA
Accredited in Resilience at Work Scale
First consultation minimum 90 mins
Bookings available at our Kew Junction
(take the 48 or 109 tram) or our Little
Collins Street Office
Appointments available between
10.00-14.00 weekdays and Saturdays
Book your appointment
Phone 0467 635 150, or email
43 Change Champions & Associates Newsletter - FEBRUARY 2015
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
PO Box 302
Kew, Victoria 3101
AUSTRALIA
W: www.changechampions.com.au
44 Change Champions & Associates Newsletter - FEBRUARY 2015
25-27 February 2015 Melbourne City Conference Centre
333 Swanston St Melbourne (Opposite the State Library), VIC, AUSTRALIA
Delivering integrated, consumer directed care where, when and how it’s needed.
Respecting Our Loved Older One’s Wishes
Don’t forget to download a copy of the program!
http://tinyurl.com/programrespecting
REGISTER TODAY!
www.changechampions.com.au