Redesign and innovation in hospitals: foundations to making it happen

This paper describes key features of hospital redesign processes in Australia by analysing Victorian, NSW and other models. It discusses frameworks and drivers of large scale change in health systems including challenges and barriers to success.  The use of systems thinking and institutional entrepreneurship to support achieving change is described.   Insights are provided to enable policy development that can support innovation and system redesign. What is the problem? Australia\u27s demand for healthcare services is escalating, driven by an ageing population with complex health care needs, rising rates of chronic illness, increasing health care costs and rapid information technology innovation. These pressures may not be adequately met within the health system\u27s current and future economic capacity. Therefore, healthcare services and systems must achieve wide-ranging reform and redesign if they are to meet these challenges. The key questions for those working as health services leaders are: how can we support the innovation and change required to address this reality? and what should national policy makers do to support this work? What does the evidence say? Considerable evidence describes overlapping aspects of successful redesign in hospitals. These include: leadership to achieve change; the use of data to monitor and evaluate change; coherent alignment to organisational strategic plans; the development of organisational culture that is ready for change; and ensuring integration of change into routine practice. Systems thinking and institutional entrepreneurship offer approaches to change and redesign that take into consideration networks and relationships of individuals, teams and clinical disciplines working within it, resources and current processes and the cultural context of the organisation. What does this mean for health service leaders? In order to fully meet the requirements for redesign and innovation, health service leaders will need to address a number of key areas. First and foremost, leaders need to develop their organisational strategic vision around the concept of redesign and innovation and build staff understanding of the importance of these concepts. Staff must be given the capacity and confidence to pursue meaningful change in their everyday operations. Leaders must recognise the benefits of data and analytics and support the development of systems to utilise these tools. Innovative practices from outside of the health sector should be studied and adapted, and partnerships with industry and academia must be pursued. What does this mean for policy makers? Policy makers need to commit to investment in the concept of redesign and innovation. They should consider funding models that reward health services for innovation. Policy makers must support health services to pursue and sustain meaningful change while recognising that transformation requires time, perseverance and willingness to learn from success and failure

Chronic illness care for Aboriginal and Torres Strait Islander people: final report

This project engage a range of stakeholders across different levels of the primary health care system, including service providers, management, policy-makers and researchers and capture their knowledge on the barriers and enablers to addressing the identified priority-evidence practice gaps and their suggestions on strategies for improvement. Overview The purpose of this project is to engage key stakeholders in the use of aggregate continuous quality improvement (CQI) data to identify and address system-wide evidence-practice gaps in Aboriginal and Torres Strait Islander chronic illness care. We aimed to engage a range of stakeholders across different levels of the primary health care (PHC) system, including service providers, management, policy-makers and researchers and capture their knowledge on the barriers and enablers to addressing the identified priority-evidence practice gaps and their suggestions on strategies for improvement. Our research has highlighted the wide variation in performance between different aspects of care and between health centres. While many aspects of care are being done well in many health centres, there are important gaps between evidence and practice in some aspects of PHC. System-wide gaps are likely to be due to deficiencies in the broader (PHC) system, indicating that system-level action is required to improve performance. Such system-level action should be developed with a deep understanding of the holistic nature of Aboriginal and Torres Strait islander wellbeing beyond just physical health (including healthy connections to culture, community and country), of the impact of Australian colonist history on Aboriginal and Torres Strait Islander people, and of how social systems – including the health system - should be shaped to meet the needs of Aboriginal and Torres Strait Islander people. This project aims to build on the collective strengths within PHC services in order to continue improving the quality of care for Aboriginal and Torres Strait Islander communities

Designing whole-systems commissioning: lessons from the English experience

The paucity of formal evidence, allied to the requirement for strategies that are sensitive to local history and context, means that a ‘blueprint’ for successful strategic commissioning is not currently available for adoption. We are therefore confined to proposing ‘design principles’ for those seeking to embark upon a transition towards a whole systems approach to strategic commissioning. People and relationships are of critical importance all the way through the chain from strategic commissioning to micro-commissioning. Most crucially, experience suggests that structural solutions alone cannot deliver effective relationships and will not be effective when relationships are neglected. The need to ensure staff, partner and political buy-in suggests that relationship management and consensus-building are an integral component of the leadership role in moving toward strategic commissioning. As with any major re-organisation, the move to strategic commissioning is essentially a change management initiative and therefore will stand or fall according to whether it adheres to good practice in the change management process. Central to this, and to achieving commissioning outcomes, is the requirement for meaningful service user and public engagement. Effective commissioning emphasizes individual capabilities as well as needs, and community assets as well as deficits and problems. Adoption of strategic commissioning approaches is still at the developmental and learning stage and arguably all structural arrangements should be regarded as transitional

Success for pacific learners : the impact of tertiary education strategies

This project examined the impact of the 3 successive tertiary education strategies (2002-2007; 2007-2012 and 2010-2015) on how tertiary education institutions have developed their support for Pacific learners. Findings show that the Pasifika objectives within each of the 3 strategies are considered to be an important signal to Tertiary Education Institutions (TEIs) that success for Pasifika learners is a significant and continuing government priority and that the strategies are seen as an important enabler of change. These objectives have raised the priority for action to support Pasifika learners, unlocked resources for Pasifika initiatives and promoted the inclusion of Pasifika priorities on the strategic agendas of TEIs. It was noted however, this influence is only one of a number of internal and external, and local and national influences on enhancing success for Pasifika learners

Planning for success : a framework for planning and quality

"This document is of interest to all colleges and training providers receiving LSC funding plus partners and stakeholders" -- front cover

Understanding EBLIP at an organizational level: an initial maturity model

Objective - Existing research around evidence based practice in the LIS (library and information science) professional context over the past two decades has captured the experience of individual practitioners, rather than the organization as a whole. Current models of evidence based library and information practice (EBLIP) relate to, and apply predominantly to, individuals or specific scenarios. Yet despite a growing demand from institutional and library leaders for evidence to demonstrate why investments in libraries should continue, little is known about how an organization can enhance its maturity in evidence based practice. This paper addresses this gap by seeking to understand what an evidence based university library looks like and answering the questions: how does a university library leader know the library’s service and practice is evidence based? How can a university library measure and progress its maturity in evidence based practice? Methods - Sixteen semi-structured interviews were conducted with library professionals employed at Australian and New Zealand university libraries. Transcripts were analyzed using thematic analysis techniques. The interviews, combined with a literature review and environmental scan of evidence based practices in university libraries, informed the development of a draft capability maturity model as a framework for developing evidence based practice in university libraries. Results - The model identifies and describes characteristics at five different levels of evidence based practice maturity from least mature (Ad hoc/Sporadic) to most mature (Transforming). Three dimensions of experience help to define the characteristics at each level of maturity and provide a framework to understand how a university library might develop its organizational capacity in evidence based library and information practice. Conclusion - Library leaders and practitioners will benefit from the model as they seek to identify and build upon their evidence based practice maturity, enabling more robust decision-making, a deeper understanding of their clients and demonstration of value and impact to their stakeholders