Shaping the future of palliative care leadership: taking the reins

Deborah LawProgram Manager Workforce Innovation and Reform

Health Workforce Australia

Palliative Care Victoria

Melbourne 23 – 24 August 2012

Today’s presentation

1. About Health Workforce Australia

2. Health Workforce 2025

3. Workforce innovation and reform

4. Caring for older people program

About Health Workforce Australia

Building a sustainable health workforce that meets the healthcare needs of all Australians

This workforce should have the capacity to meet the growing demands on Australia’s healthcare system, arising from:

• an ageing population• growth in chronic disease• increased community expectation

A Commonwealth Government statutory authority

HWA: Our four key programs

We are working in four key areas:

• Information, analysis and planning

• Workforce innovation and reform

• Clinical training reform

• International health professionals

Health Workforce 2025

Health Workforce 2025 Doctors, Nurses and Midwives

Volumes 1 and 2

FINDINGS:What did we learn?

NURSES Short term: supply of nurses is stable Long term: significant shortfall (109,490 by 2025)

due to:

• ageing workforce

• poor retention rates

• population health trends Some areas of nursing are especially at risk in terms

of supply: mental health and aged care

WORKFORCE INNOVATION AND REFORM:A national approach to reform Large-scale workforce reform is necessary to meet

Australia’s future health needs

Business-as-usual is not going to cut it Delivering a national program of health workforce

innovation and reform by leading and adding value to current reforms and innovations being undertaken in the health and education sectors

The work program is guided by the National Health Workforce Innovation and Reform Strategic Framework for Action 2011-2015

WORKFORCE INNOVATION AND REFORM:National frameworkThe framework provides action in five inter-dependent domains for health workforce reform

Domain Health workforce reform

1 Health workforce reform for more effective, efficient and accessible service delivery

2 Health workforce capacity and skills development

3 Leadership for the sustainability of the health system

4 Health workforce planning

5 Health workforce policy, funding and regulation

WORKFORCE INNOVATION AND REFORM:Caring for Older people (CfOP) program Aimed at enhancing the capacity and capability of the

health workforce to improve older peoples’ health service experiences and outcomes

Designed to test a number of hypotheses whilst using the best available evidence regarding transformational change

19 projects were implemented to trial strategies and explore various scopes of practice in an effort to work towards the optimal use of current workforce skills and adaptability

CARING FOR OLDER PEOPLE PROGRAM:Using the evidence Demonstrated shifts in how and where we are using

Australia’s health workforce

Collaborated on and established relationships with a broad range of stakeholders including jurisdictions, aged care peak organisations, education and VET sectors and private providers

In 2012 we have funded grants for 26 projects across various sectors, settings and geographies to:

• implement evidence of workforce re-design• assess productivity impacts on a larger scale • determine support required for national adoption

CARING FOR OLDER PEOPLE PROGRAM:Evidence of what works Building on the outcomes of CfOP projects, jurisdictional

initiatives and international best practice Service and workforce reform are interdependent Developing leadership capacity at all organisational levels

to support and lead health workforce innovation and reform Single role workforce change versus large scale change Improving silos of action across boundaries through

collaboration Working back from client needs with a competency based

approach Importance of wellness and early intervention Measuring success and time

WORKFORCE INNOVATION AND REFORM:Fit for purpose workforceService and skills pyramid

Adapted from National Priority Health Action Council 2006 National Chronic Disease Strategy Australian Government Department of Health and Ageing, Canberra pp 4 accessed 4 February 2012 <http://www.health.gov.au/ internet/main/publishing.nsf/content/7E7E9140A3D3A3BCCA257140007AB32B/$File/stratal3.pdf

WORKFORCE INNOVATION AND REFORM:

The five pillars of workforce change Competency based role re-design

More efficient utilisation of skills for assistants ,

generalist and clinical roles

Partnering across the continuum of care

Building leadership for change

System enablers

WORKFORCE INNOVATION AND REFORM:Investing in change Fit for purpose workforce

Leadership in different forms across all levels

Culture and change management

Ambitious reform and resilience for emergence

Toolkits

Communities of practice

Managing partnerships and sponsors to achieve mutual

outcomes

Stimulating, incubating and accelerating

WORKFORCE INNOVATION AND REFORM: Next practice innovation model

© The Innovation Unit (2007)

WORKFORCE INNOVATION AND REFORM:How do we sustain change? The right leadership can turn around deeply rooted

institutional and professional cultures, organisational

structures and social dynamics that can act as barriers

to adopting workforce innovation

Health care delivery and professional/clinical

leadership needs to be supported by the system

Local and systems level enablers are vital

Integration and care coordination are required to

sustain change

Development of an enrolled nurse role into the role of team leader, with distance supervision via telehealth to address workforce shortages in residential aged care

Introduction of an extended palliative care carer specialist role, mentored by a clinical nurse consultant in residential aged care

Re-design of an assistant in nursing role in a resident focussed model of care assigned to residents rather than assigned tasks

Incorporation of more clinical service provision and care coordination and less administration and management into a registered nurse role

CARING FOR OLDER PEOPLE PROGRAM:Evidence of what works continued

Summary

HWA has compiled evidence about what workforce changes

should be delivered and how

“Whole of workforce approach” – strong leadership capacity

will be required across all levels of the system to guide the

workforce changes to support national reforms

Development of leadership competencies in the health

workforce is necessary and a national approach will

improve consistency and reduce the duplication of effort

The CfOP report is available on the HWA website

For more information

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