A program bringing together leaders to transform the healthcare system has just commenced, explain Craig Quarmby* and Greg Peterson*.
Many words have been written about the need to improve the performance of Tasmanian hospitals and related parts of the state’s health system. Some of the criticism is valid: waiting times in emergency can be too long, there are often delays in finding hospital beds for patients needing admission, and patients can face lengthy waits for some non-urgent surgery.
However, these comments can be distressing to those responsible for providing patient care. Our doctors and nurses, and all other hospital staff, feel they are doing a great job, and this view is echoed by patients – letters to the editor frequently say the staff were wonderful but the way the system is organised let them down.
Hospital managers are also proud of the care provided under their watch, and rightly so. The standard of clinical services delivered by the state’s four major hospitals is excellent.
Yet there are undeniable problems that cannot be ignored.
The demands on health care in the Australia of tomorrow represent an increasing challenge. There is no doubt things need to change if our hospitals are to continue providing quality care to an ageing, more medically complex, population in an era when costs are rising rapidly, and government health budgets - federal and state - are facing serious pressures.
These challenges have been flagged widely, not least by Health Minister Michael Ferguson who came to the portfolio determined to produce change and committed to a consultation process with the key players – including doctors, nurses, ambulance personnel, community care providers, patients and advocates.
The Minister has now presided over the release of ‘One Health System’, a blueprint for delivering quality focused change, and launched a unified Tasmanian Health Service aimed at improving the efficiency and quality of care provided by our hospitals and related services.
The Commonwealth, as the other key funder of healthcare in Tasmania, is closely involved in helping to foster improvements in the way services are delivered. A key initiative was investing in the formation of Health Services Innovation Tasmania (HSI Tas) within the Faculty of Health at the University of Tasmania.
HSI Tas is dedicated to implementing the process known as clinical redesign and upskilling the state’s health workers and students in its use. Simply put, this is a proven and sustainable way of doing things more efficiently while also delivering better outcomes for patients.
Across the state’s major public hospitals, redesign activities are now underway across emergency department presentation, the medical patient journey, surgery, outpatient specialist clinics and acute care for mental health.
As well as working closely with doctors, nurses, other health professionals and hospital managers over the past two years, HSI Tas approached the Commonwealth to fund a program that would bring together the most senior people from across the state’s healthcare system to collectively drive improvements within the system across both hospital and community care. Funding was granted, and endorsement and support was received by Minister Ferguson.
The idea of such a collaborative program was welcomed statewide by senior clinicians (medical, nursing and allied health) and the heads of key organisations across the healthcare system, including the Department of Health and Human Services, the new Tasmanian Health Service, Primary Health Tasmania (formerly Tasmania Medicare Local), Ambulance Tasmania and the University of Tasmania.
A limit of 40 participants was set, and this is split equally between senior clinicians and senior healthcare managers.
That such a leadership program proposal was received so enthusiastically highlights where Tasmania’s healthcare system is headed: our healthcare leaders are determined to deliver improved care. The program will delve into individual leadership styles and performance, seek probing feedback from those around the leaders, and question how effectively the most senior leaders work together to achieve better outcomes for patients.
Having already commenced statewide, the 14-month program continues with a two-day workshop next week, the first of several that will bring together in one place these senior leaders from across the state and from across the healthcare system. The program seeks to foster a fellowship of senior clinicians and managers that will role-model the high performance nature of teams required throughout the health system.
Importantly, such a collective leadership of the system does not depend on only these 40 senior individuals, but on every individual within the healthcare system. HSI Tas will continue to work with healthcare service providers and managers to deliver a suite of system-wide leadership programs for current and future leaders - programs to ensure that Tasmania both achieves and sustains an outstanding healthcare system.
Associate Professor Craig Quarmby, a Hobart surgeon, is co-director of Health Services Innovation Tasmania with Professor Greg Peterson from the University of Tasmania.