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
