Working Together: Strategy for Inclusive Clinician ... · 4 Workin Tog Strategy lusiv linici gagement 201618 Progress Report 2016-17 Foreword MNHHS Clinical Engagement Strategy Report

Working Together

STRATEGY FOR INCLUSIVE CLINICIAN ENGAGEMENT 2016–18

PROGRESS REPORT 2016 – 2017

Published by the State of Queensland (Metro North Hospital and Health Service), August 2017

This document is licensed under a Creative Commons Attribution 3.0 Australia licence. To view a copy of this licence, visit creativecommons.org/licenses/by/3.0/au

© State of Queensland (Metro North Hospital and Health Service) 2016

You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Metro North Hospital and Health Service).

For more information contact:

Email: [email protected] Phone: 07 3647 9673 Visit us at: Level 14, Block 7 Royal Brisbane and Women’s Hospital ButterfieldStreet,HerstonQld

An electronic version of this document is available at www.health.qld.gov.au/metronorth

Disclaimer:

The content presented in this publication is distributed by the Queensland Government as an information source only. The State of Queensland makes no statements, representations or warranties about the accuracy, completeness or reliability of any information contained in this publication. The State of Queensland disclaims all responsibility and all liability (including without limitation for liability in negligence) for all expenses, losses, damages and costs you might incur as a result of the information being inaccurate or incomplete in any way, and for any reason reliance was placed on such information.

Linkshttp://qheps.health.qld.gov.au/metronorth/clinical/streams/home.htmhttp://qheps.health.qld.gov.au/metronorth/clinical/cosi/default.htmhttp://qheps.health.qld.gov.au/metronorth/council/home.htm

3Working Together Strategy for Inclusive Clinician Engagement 2016-18 Progress Report 2016-17

Foreword ......................................................................................................................................................................................................................................................4

Introduction ............................................................................................................................................................................................................................................5

Clinical Councils ...............................................................................................................................................................................................................................5

Clinical Streams ................................................................................................................................................................................................................................6

Clinical Operations Strategy Implementation Unit (COSI) ....................................................................................................6

Structure of the Report ...........................................................................................................................................................................................................6

Section 1: Showcasing Clinician and Staff Engagement .........................................................................................................7

Let’s Talk with the Chief Executive ............................................................................................................................................................7

Together Against Occupational Violence ..........................................................................................................................................8

Caring Together ....................................................................................................................................................................................................................9

Innovation Alliances .................................................................................................................................................................................................. 10

FARM Collaborative: Facilitating Admission Rapidly to Medicine ............................................................... 11

Metro North Research Strategy .................................................................................................................................................................12

Health Service Planning .......................................................................................................................................................................................12

The SEED and LINK Innovation Funding Programs ..........................................................................................................13

‘Learning from Harm’ Safety and Quality Alliance Forum ......................................................................................13

Annual Healthy Aging Expo and the Reconciliation Cup .........................................................................................14

Allied Health Workforce Survey .................................................................................................................................................................15

Consultation Hub - Metro North Bariatric Care Survey ............................................................................................. 16

Section 2: Building on what has been achieved ............................................................................................................................. 17

Focus areas for 2017/18 ...................................................................................................................................................................................... 17

Conclusion ............................................................................................................................................................................................................................................ 17

Contents

4 Working Together Strategy for Inclusive Clinician Engagement 2016-18 Progress Report 2016-17

Foreword

4 MNHHS Clinical Engagement Strategy Report 2016-17

We are pleased to publish this report on the Working Together Strategy for Inclusive Clinician Engagement 2016-2017.

Across Metro North there are more and more opportunities for clinicians and staff to get involved and have input into how we can achieve the best outcomes and experience for consumers and support our staff. We would like to acknowledge the clinicians and staff who, on top of their usual work, take time to assist us in planning, developing and improving our hospital and health service.

Clinician engagement is not an additional task but rather our way of working. Consequently it is not possible to represent all the instances of clinician engagement that occur across our health service in one report. This report therefore showcases a sample of activities and initiatives, in areas such as, health service delivery, safety and quality, research, capital development and technology innovation, where clinicians and staff are engaged and their voice is valued.

The activities highlighted in this report show how we are all working together, building a culture of engagement across our organisation that will underpin safe, quality, patient centred care and establish Metro North as a great place to work.

Metro North is a large diverse organisation and as such clinician and staff engagement and on-going communication is challenging. However, the activities highlighted in this report show how we are overcoming this challenge and working together; to build a culture of engagement across our organisation that will underpin safe, quality, patient centred care and establish Metro North as a great place to work.

David Rosengren Acting Executive Director, Operations Metro North Hospital and Health Service


Introduction

Clinical Councils

There is quality evidence that shows where clinicians engage with the organisation there are improved outcomes and a better healthcare experience for consumers. It is also well established that highly engaged staff have higher morale and motivation and less absenteeism, stress and burn-out.

Section 40 of the Hospital and Health Boards Act 2011 requires Metro North Hospital and Health Service to publish a clinician engagement strategy every three years. Metro North’s second strategy, Working Together: Strategy for Inclusive Clinician Engagement 2016-2018 was published in March 2017.

TheWorkingTogetherstrategyhasfivekeyobjectivesto achieve meaningful and sustained clinician engagement.Thestrategyobjectivesfocusonthefollowing areas:

1. Proactively involving clinicians to identify and progress strategic and clinical issues across Metro North.

2. Connecting clinicians across Directorates and professional streams and with management, the Board and executive leaders.

3. Building leadership to deal with complex issues.

4. Communication that is timely and two-way.

5. Strengthening relationships with external partners to facilitate a whole of community approach to healthcare.

Effective clinician engagement is seen in the everyday working relationships between clinicians, management and executive. Working relationships where clinicians feel they are listened to, well-informed, empowered to improve practice as well as having a range of opportunities for speaking up and on-going involvement .

The strategy was developed when Metro North was in a transition period from instability to new leadership. As a result, the strategy focusses on strengthening the working relationships between all front-line clinical and non-clinical staff, management and executives. It also emphasises the structures, processes and tools needed to enable working together. While the legislative requirement of the Hospital and Health Boards Act 2011 requires a clinician engagement strategy, many areas of this report have a broader focus than clinicians. Engagement strategies are rarely confinedtosingleprofessionalgroupsbutareinclusiveof staff working in many different areas of our Hospital and Health Service. As a result, several activities described in this report refer to clinicians and staff.

The Clinical Councils, Clinical Streams and the Clinical Operations Strategy Implementation Unit (COSI) are important enablers of clinician engagement and contributesignificantlytobuildingastrongcultureofengagement in Metro North.

Currently there are six Clinical Councils:

Metro North Hospital and Health Service;

Royal Brisbane and Women’s Hospital;

The Prince Charles Hospital;

Redcliffe Hospital;

Caboolture Hospital;

Metro North Oral Health Services.

Clinical Councils are a vital mechanism for clinicians to have input into the direction of Metro North. Broadly, they provide leadership, direction and advice on issues relating to the planning, management, delivery and evaluation of Metro North Hospital and Health services.

The Clinical Councils have a multi-disciplinary membership with clinician members being appointed through expressions of interest. In addition to the clinician members, the Clinical Council membership includes representation from the Metro North executive leadership team.

The Metro North Clinical Council is an overarching group which brings together the Chairs of all 6 Clinical Councils

with the Metro North Board, Metro North Executive and professional leads. The Councils continue to be an active clinical body providing a valuable clinician perspective on strategic and operational issues which can impact on the delivery of patient-centred care, clinical outcomes and the health and wellbeing of staff.

In 2016 Working Together Against Occupational Violence was a priority for the Metro North Clinical Council and was the focus for the Council’s inaugural Forum on Tuesday 3 May 2017. The Forum brought together over 180 staff from across Metro North to explore practical ideas to address violence against healthcare workers. The Forum was an opportunity for staff to put forward suggestions on what could be done to prevent occupational violence and how to protect and support their colleagues. Building on the success of the Together Against Occupational Violence Forum, the Clinical Councils will host a follow-up Forum in 2018. The 2018 Forum will consider strategies for promoting and supporting the health and well-being of staff including protective factors for work-related stress and burn-out.


Clinical Operations Strategy Implementation Unit (COSI)

Clinical Streams

Structure of the Report

The focus of COSI is to support innovation and promote and enable integrated care. COSI is an important enabler of clinician and staff engagement. COSI encourages and supports an active community of clinicians and partners that create and follow through on opportunities for service integration and innovation. Working with the clinical streams, COSI provides many different opportunities for clinicians and partners to be involved in service improvement and development. Listening to the concerns of clinicians and our partners they target the issues that matter to health care professionals and consumers and carers.

Using clinically meaningful data and analytics issues are unpacked, measures of improvement developed and change monitored. By bringing together our health care workers and partners together around ‘real’ issues, working relationships that can deliver patient centred care are built. COSI continues to support an engaged community of health professionals that drive service innovation and integration – changes that will ultimately lead to better outcomes for consumers and experiences for consumers and staff.

Metro North Hospital and Health Service has seven Clinical Streams in the areas of Cancer Care, Critical Care, Heart and Lung, Medicine, Research, Surgery and Women’s and Children. The Clinical Streams work in close partnership with hospital networks to betterintegrateandconnectcareforthebenefitofpatients. They provide a mechanism for a whole of HHS approach to clinical service development and delivery based on the principle that irrespective of location, patients will be assured of equity of access to services, equity of clinical outcomes and a positive clinical experience.

By bringing together clinicians from across Metro North the Clinical Streams facilitate a patient centric and whole of health service perspective that crosses traditional hospital and service boundaries.

Thefirstsectionofthisreporthighlightssomeexamples of engagement activities that are having a positive impact on the level of engagement by clinicians and staff in our organisation. The activities that have been included in this report are not representative of all the clinician engagement work that is being undertaken rather, they showcase a

range of on-going, innovative and evidence based approaches to clinician and staff engagement being implemented across Metro North. The second section of this report describes the focus for clinician engagement in 2017 and going forward.

Their collaborative approach encourages clinicians from different specialties to work together towards integration and coordination of care across our Health Service and be actively involved in the governance of clinical services across Metro North. It also facilitates a whole of health service approach to education, training, research and service redesign and improvement. The positive impact of the clinical streams engagement with diverse clinician groups and external partners is evident by the success of initiatives such as the FARM Collaborative described on page 11 of this report.


Let’s Talk with the Chief ExecutiveMetro North Engagement Team

Let’s Talk gives all Metro North staff the opportunity to have an informal conversation with the Chief Executive. Let’s Talk was implemented in response to feedback that staff value opportunities to have an informal conversation with executive leaders about their ideas and concerns. The approach provides a ‘safe space’ for staff to talk to the Chief Executive and importantly, enable feedback to be given in real time.

Staff feedback on their experience of Let’s Talk with the Chief Executive:

Section 1: Showcasing Clinician and Staff Engagement

Let’s Talk gave over 200 front-line staff the opportunity to talk informally with the Chief Executive about issues that were important to them.(Strategy objectives 1 and 2)

Caboolture Hospital staff with Chief Executive Ken Whelan


Together Against Occupational ViolenceMetro North Clinical Council, MNHHS Occupational Violence Implementation Committee, Metro North Engagement Team

Working Together Against Occupational Violence was a Metro North Clinical Council priority for 2016. Front-line staff across Metro North took part in Let’s Talk Occupational Violence sessions and the inaugural Metro North Clinical Council Front-line Forum. In these forums staff shared their concerns about the increasing violence against health workers and talked about what could be done to protect and support each other from occupational violence. Together, these activities made up an extensive staff consultation on how to address occupational violence in Metro North.

The concerns and ideas that were raised repeatedly by staff during the consultation were presented to the Chief Executive as priority strategies and short term actions. The strategies fell into two broad types of issues - systems issues and cultural issues. Systems issues included: leadership by government for policy and legislation that safeguards staff; safety, security and reporting systems; designing environments for safety; and training and upskilling staff. The cultural issues included acknowledging that zero tolerance isn’t always appropriate; leading attitudinal change; working together; looking after each other; and customer service.

Many of the practical suggestions on how violence against health workers could be addressed have been actioned through the establishment of six implementation working parties by the Chief Executive.

Highlights from 2017

Implementation of the Broset Violence Checklist that helps staff identify early signs of aggression, and know how and when to seek help.

Post-incident line manager’s workshops to examine how we can best support our staff that have been exposed to occupational violence.

Each group has representation from each facility and service line within Metro North and each of the six groups are working to address the issues of: clinical practice; data; information technology and reporting; work environment; policy; partnerships; and education and training. Some practical changes that clinicians will have seen in their workplaces include: security guards in every emergency department; signage reinforcing that violence against health workers is unacceptable; body worn cameras on security staff; additional CCTV and personal protective equipment for all security staff; and increased inter-agency relations with QAS and QPS.

Metro North continues to lead the way in preventing and protecting staff against occupational violence with the appointment of our Chief Executive as Chair of the Queensland Health Occupational Violence Implementation Committee. In this role the Chief Executive continues to be a voice for clinicians and staff at the whole of government level.

Enabling clinicians and staff to lead change and ‘closing the loop’ by putting their ideas into practice.

More than 380 front-line staff gave up their time to contribute to a Metro North action plan against occupational violence


‘Our commitment to Caring Together underpins how we engage the community, consumers and our staff’. (Strategy objectives 1,2,3,4 and 5)

Caring TogetherCaboolture and Kilcoy Hospitals, and Woodford Corrections Health Service

Through Caring Together we aim to improve the health of our community. Trust, caring and kindness, open two-way communication and our commitment to continuous improvement underpin how we work with patients and staff.

Fit Fab Cab – Improves staff health, builds teamwork and pride, values staff.

AhealthandfitnessgroupprogramforCabooltureHospital staff was created to support the health and wellbeing of staff and strengthen morale. By working togethertoachievesharedhealthandfitnessgoalsin a fun environment staff build relationships with colleagues working in different teams; relationships that make patient and family centred care possible.

Morethan200staffmembersparticipatedinthefirstFit Fab Cab program with over 90 staff completing the program. The total weight lost across all participants was 115 kilograms.

CRASH - Communication, Respect, Accountability, Safe Healthcare

In 2015/2016 more than 1100 staff participated in training to build awareness and provide practical communication skills that support patient and staff safety.

CARING in action!

Afterfeedbackfromstaffonthebenefitsofthistrainingand the importance of it being sustained, the CRASH program was developed.

CRASH is a highly interactive four-hour learning experience that allows individuals and groups to explore the impact of communication and personal skills on patient care and workplace interactions. CRASH is mandatory for all new staff, and will run once a month for individuals or teams to attend. CRASH promotes safe and respectful behaviour that underpins a strong culture of engagement across all staff.

Project DOVE: Decreasing Occupational Violence in the Emergency Department

Occupational violence is an everyday concern for staff at Caboolture Emergency Department. 80% of EmergencyDepartmentstaffthatcompletedaProjectDOVE survey reported experiencing verbal abuse or harassment in the last six months. Almost one-third had been physically assaulted and more than 50% of Emergency Department nursing staff reported that they “never” or “only sometimes” feel safe at work. Talking and listening to staff led to two important changes that will help to keep staff in the Caboolture Hospital Emergency Department safe:

• A CC-TV Security Screen behind the Triage Desk

• On-site, seven-day cover Emergency Department SecurityOfficer

Caboolture Hospital security staff in the Emergency Department


Alliances

What are they all about?

• InfluentialstaffworkingtogethertosolvebigperformancechallengesforMetroNorthHHS(Medical,Nursing,AlliedHealth,Professional,Administrationetc.)

• Alliancesprovidespace,opportunityandmethodologyoutsideorganisationalborders,toraiseperformancechallengesandimplementimprovements.

• Alliancesacknowledgethatstaffarekeytodrivingperformanceimprovement.

Principles

• Interdisciplinaryandcollaborative

• Peersupport

• Continuouslearning

• Systemsapproach

• Informedproblemsolving.

What happens at Alliances?

• Membersarechallengedto:

– shareperformanceinformation/data– rethinkassumptions– presentevidence– giveanopinion– makechoicesanddecisionsinconsiderationofsystemicfactors

– setandownperformancemetrics.

• Groupsareprofessionallyfacilitatedwithaprotocolunderpinnedbysocial,economic,systemsandpsychologicaltheoriesandresearch.

• Membersdefineandvalidatetheproblems,theorisecausesandchoosesolutionsandperformancemetrics.

• AllianceGroupsmeetover4-5timesinstructuredgroupsessions.

Outcomes

• Deepercollaboration.

• Stafflednovelsolutions.

• Fasttrackingofhighimpactsolutions.

• Improvedcooperationandnetworking.

• Sponsorshipandchampioningofperformanceimprovementinitiatives.

• Metricscloselyconnectedtoperformanceissuesarebroughttolight,sharedandmonitored.

• Allsolutionsandoutcomesfindanimplementationpathway.

The Challenges Ahead

• TheAlliancesneedtointegrateoutcomeswiththeexistingorganisationalclinical,operationalandadministrativegovernancesystems.AllsolutionsneedtofindapathwayamongMNHHSstrategies,planning,projectsandchangeinitiatives.

• TheAlliancesareaninvestmentofstaff’stime.Theyneedtodemonstrateefficacyandaddedvaluebeyondexistingclinicalandadministrativecontexts.

• Alliancesshouldcaptureandmeasurethegreatestpotentialbenefitsoftheprocess,suchas:

– attitude/culturechange– cooperation– sharedperformancemetrics– dataopenness.

Innovation

Who participates?

• Clinical,operationalandadministrativestaffincludingsomeofthemostseniordoctors,nursesandothercliniciansfromacrosstheorganisationvolunteertheirtime.

• Allvoicesmatterandareequalinthispeersupportiveenvironment.

Innovation AlliancesOrganisational Development Strategy and Implementation

The Innovation Alliances is a facilitated, evidence informed, and action focussed methodology for engaging multi-disciplinary staff to resolve long-standing and complex issues that are detrimental to patient care. In 2016, around 100 clinical and administrative leaders partnered with Brisbane North PHN, consumers and the aged care sector to addressthechallengesofpatientaccessandflowacrossthepatientjourney.TheAllianceframeworkhasbeenfurtherimplemented in 2017 as the methodology for the Better Connecting Cancer Care Services in Metro North initiative.

Innovation Alliances have led to novel solutions that improve patient care• Inter-hospital transfer protocols

reduced the transfer time for patients back to their home hospital or community

• Bedside QCCAT hearings reduced average hospital wait time for a guardianship hearing from 66 days to 20 days.

(Strategy objectives 1,2,3,4 and 5)

Access and flow performance dashboard• An innovation generated by the Alliances that putscriticalpatientflowinformationinthehands of clinicians, managers and executives.

• Provides a centrepiece for clinician and leaderengagementaroundkeypatientflowperformance data.

• Promotes an inter-disciplinary approach to performance improvement

Allia

nces

Wha

t are

they

all

abou

t?

•Influentialstaffworkingtogethertosolvebigperformancechallenges

forMetroNorthHHS(Medical,Nursing,AlliedHealth,Professional,

Administrationetc.)

•Alliancesprovidespace,opportunityandmethodologyoutside

organisationalborders,toraiseperformancechallengesand

implementimprovements.

•Alliancesacknowledgethatstaffarekeytodrivingperformance

improvement.

Prin

cipl

es

•Interdisciplinaryandcollaborative

•Peersupport

•Continuouslearning

•Systemsapproach

•Informedproblemsolving.

Wha

t hap

pens

at A

llian

ces?

•Membersarechallengedto:

–shareperformanceinformation/data

–rethinkassumptions

–presentevidence

–giveanopinion

–makechoicesanddecisionsin

considerationofsystemicfactors

–setandownperformancemetrics.

•Groupsareprofessionallyfacilitatedwitha

protocolunderpinnedbysocial,economic,

systemsandpsychologicaltheories

andresearch.

•Membersdefineandvalidatetheproblems,

theorisecausesandchoosesolutionsand

performancemetrics.

•AllianceGroupsmeetover4-5timesin

structuredgroupsessions.

Out

com

es

•Deepercollaboration.

•Stafflednovelsolutions.

•Fasttrackingofhighimpactsolutions.

•Improvedcooperation

andnetworking.

•Sponsorshipandchampioningof

performanceimprovementinitiatives.

•Metricscloselyconnectedto

performanceissuesarebroughtto

light,sharedandmonitored.

•Allsolutionsandoutcomesfindan

implementationpathway.

The

Chal

leng

es A

head

•TheAlliancesneedtointegrateoutcomes

withtheexistingorganisationalclinical,

operationalandadministrativegovernance

systems.Allsolutionsneedtofindapathway

amongMNHHSstrategies,planning,projects

andchangeinitiatives.

•TheAlliancesareaninvestmentofstaff’s

time.Theyneedtodemonstrateefficacyand

addedvaluebeyondexistingclinicaland

administrativecontexts.

•Alliancesshouldcaptureandmeasurethe

greatestpotentialbenefitsoftheprocess,

suchas:

–attitude/culturechange

–cooperation

–sharedperformancemetrics

–dataopenness.

Innovation

Who

par

tici

pate

s?

•Clinical,operationalandadministrativestaff

includingsomeofthemostseniordoctors,

nursesandothercliniciansfromacrossthe

organisationvolunteertheirtime.

•Allvoicesmatterandareequalinthispeer

supportiveenvironment.


Yellow Envelope Innovation Alliances tap into the experience and expertise of clinicians not only to come up with new ideas but also to revisit strategies that have proven to be effective in the past - the re-launch of the Yellow Envelope in Metro North is an example.

The Yellow Envelope is a clinical handover tool designed for use within the North Brisbane and Moreton Bay catchment to support the transfer of aged care residents to and from hospital. Residential aged care facilities use the yellow envelop to send clinical information to the healthcare team who will be looking after the older person. It is also a way hospitals can provide timely discharge information back to the residential aged care team - the yellow envelope travels with the patient.

How does the FARM Collaborative sustain clinician engagement?

• Acknowledge early that work would be slow.

• Recognise the ‘busyness of clinical life’ and that education and research interests compete for non-clinical time.

• Make the best use of the secretariat and program support and expertise provided by the Clinical Streams.

• Agree up-front that FARM is time-limited – ‘untilthejobisdone’.

• Value clinician time:– Meet on an as needs basis when

decisions have to be made.– Do not be afraid to cancel meetings – Teleconference where possible.

FARM Collaborative: Facilitating Admission Rapidly to MedicineCritical Care Stream, Medicine Stream and COSI supported by the Innovation Alliances

FARM is a collaborative: the Medicine and Critical CareStreamsjoiningforcestoworkonsolutionsthatwill prepare patients for transfer from the Emergency Department to a medical ward. FARM seeks to improve the clarity of referral, assessment and transfer processes for patients and clinicians. Problem solving withclinicianshastodateidentifiedthreeactivitiesthat would enable these outcomes to be achieved.

1. Comparing and contrasting the Acute Assessment Units across Metro North. The models of care, staffingandhoursofoperationdifferfromsitetosite; some work well, some are constrained by exit block. Understanding these better can help identify ‘what works’ across units.

2. Development of a data dashboard that shows the timestamps between decision to admit in the emergency department to arrival into the ward bed. By making this visible, improvements may be made in performance and patient care.

3. Development of clinical handover and interim orders to standardise the nursing and medical handovers between emergency departments and the wards. This will support all units to know what is expected of them and also ensure the right information is available to bedside clinicians to keep patients safe.

Metro North HHS, Brisbane North PHN and Queensland Ambulance Service staff with the refreshed Yellow Envelope at Redcliffe Hospital

“Joint working between with the Critical Care and Medicine Stream has led to cross specialty teamwork at each hospital as well as demonstrating the value of a Metro North approach to problem solving our day to day clinical challenges.”


Health Service PlanningMetro North Health Service Strategy and Planning

Health service planning is the process of aligning health services with the growing and changing needs of the community whilst making the most effective use of current and future resources. During 2016/17 several hundred clinicians and staff from across Metro North have actively participated in and informed the development of population, facility and clinical health services plans.

Facility Plans• The Prince Charles Hospital Clinical Services Plan

• Caboolture Hospital Health Services Plan

• Redcliffe Hospital Health Services Plan

Population Plans• Children’s Health Services Plan

• Older People Health Services Plan

Clinical Services Plan• Rehabilitation Clinical Services Plan

• Cancer Care Clinical Services Plan

• Palliative Care Clinical Services Plan

• Statewide Genetic Health Queensland Services Plan

Active clinician engagement has resulted in service plans that include:

• proactive actions that improve health care immediately;

• innovative actions that challenge traditional thinking;

• commitment and ownership to deliver service change through implementation of the plans; and

• patient centred service redesign.

Metro North Research StrategyMetro North Office of Research

Metro North is a diverse Health Service, with varying degrees of research investment, infrastructure and services; as a result there is also varying research capacity and cultures. The Metro North Research Strategy is therefore an important enabler for a cohesive approach to research across the Health Service. Capturing Metro

North’s diversity in a meaningful and visionary research strategy that took into account different clinical and researcherviewpointswasasignificantchallenge.

Using a ‘ground-up’ evidence based and inclusive approach, which responded to the increasing risk of ‘survey fatigue’ amongst clinicians and researchers, a series of considered conversations with a representative group of Metro North staff were undertaken.

Giving people in research a voice, acknowledging their valuable insights, contribution and experience.

(Strategy objectives 1, 2, 4 and 5)

Using a ‘snowball’ approach to conversation invitations, taking recommendations and suggestions from attendees as to further contacts, the consultation group expanded until the total number of conversationswasinexcessofonehundredandfifty.Tapping into clinical and research networks the Metro North Research team were able to address issues as they arose, work collaboratively to understand the problem at hand and to build positive relationships. In seeking the considered input of the people involved in research, as to current issues, potential solutions and research strengths, a Research Framework and Strategy with an evidence based grounding was achieved.

“Together we deliver exceptional health outcomes through globally recognised discovery and translation”

Clinician Engagement in Health Service Planning

• Values the clinician viewpoint

• Brings together diverse perspectives often considered in isolation

• Brings together data, evidence, clinician and consumer experience

• Provides the opportunity to reality test whether alternate healthcare delivery concepts and models are a ‘goodfit’forMetroNorth

(Strategy objectives 1, 2, 3, 4 and 5)


The SEED and LINK Innovation Funding ProgramsClinical Operations Strategy Implementation Unit

In 2016 the SEED (Support, Explore, Excel and Deliver) and LINK (Leading Innovation through Networking and Knowledge Sharing) programs supported clinician led projectstriallinginnovativewaystoreduceunnecessaryhospital admission or re-admissions, improve discharge and admission practices and deliver quality patient-centred care. By supporting clinician and staff – led initiatives SEED and LINK seek to build a culture of innovation, excellence and partnership from the ground-up.

SEEDisnowinitsfifthyear.InrecognitionoftheimpactSEEDhasmadetosupportinginnovationandstaff-ledimprovements, funding was recently increased to $1.1million. In 2016, 51 submissions were received, 21 were selectedtodevelopprojectplansand12projectsfunded.

TheLINKprogramfundsprojectstostrengthenpartnershipsforthedeliveryofintegratedconsumerfocussedhealthcare.In2016theLINKprogrambudgetof$1millionwasusedtofundeightnewpartnershipprojectswhichconnect our clinicians with our community partners. 36 LINK innovative partnership proposals were submitted for LINK funding in 2016. Eighteen LINK submissions were selected to pitch their innovative ideas to multidisciplinary panelsand8projectswerechosenforfunding.

The SEED and LINK programs support staff engagement at two levels. Firstly clinicians and staff with great ideas and a passion for improvement are funded to take their ideas from concept to practice; and secondly the highly interactive application process connects clinicians and community partners from diverse areas with Metro North executive and management, building relationships that lay the foundations for working together in the future.

Clinician-led innovation connects clinicians and staff, Metro North executive leaders and community partners to improve health care

(Strategy objectives 1, 2, 4 and 5)

Tapping into the ideas, passion and expertise of clinicians, staff, consumers and partnersidentifiedfront-linecommunicationand patient safety culture through leader rounding as priorities for change.

(Strategy objectives 1,2,3,4 and 5)

“WithouttheLINKfundingourprojectwhichsupportsourhighlyvulnerableandcomplexpatients would never have gained traction.”

Learning from HarmSafety and Quality Alliance Clinical Governance, Safety, Quality and Risk

In September 2016 Metro North hosted the Inaugural Safety and Quality Alliance Forum, ‘Learning from Harm’. The Forum was an opportunity for staff and clinicians to build their understanding and experience how clinical incidents, patient feedback and activity datacanbeusedtoriskprofilepatients.TheForumengaged over 100 people from Metro North including Board members, Executive, front line staff, safety and qualitymanagers,consumerliaisonofficers,patientsafetyofficers,communitypartnersandconsumers.

‘Innovation and co-design’ featured heavily on the day to initiate and connect thinking around ‘where to from here?’. Namely, the redesign of systems to reduce preventable harm. The Forum also drew on the consumer experience to demonstrate to participants the importance of ‘compassion and connection’ and the vital role it plays in patient safety. The Forum was an important mechanism to involve clinicians, staff, consumers and partners in shaping the Metro North Safety and Quality Agenda for 2017 and into the future.

STEP 1: IDEA

STEP 2: PROJECT BRIEF

STEP 3: PITCH PANEL

STEP 4: RESOURCES

STEP 5: PARTNERSHIP


Annual Healthy Aging Expo and the Reconciliation Cup Community, Indigenous and Sub-Acute Services (CISS)

The inaugural Healthy Ageing Expo 2016, hosted at Brighton Health Campus, brought together over 400 staff, consumers, community partners and Metro North Board members to celebrate Seniors Week. The Expo included a stakeholder forum where, using a World Café approach, attendees from diverse organisations explored the challenges of community health care - sharing concerns, ideas and opportunities for improvement. Moreton Bay provided the back drop for 36 stall holders to display information on their services and share their work with each other while the Community Transition Care staff and the Heart Foundation Walking Team provided heart health information and blood pressure checks.

Celebrating shared values, recognising diversity and promoting inclusivity; engagement that builds trust and lays the foundations for partnerships that can deliver consumer-centred healthcare.(Strategy objectives 1, 2, 4 and 5)

Newpartnershipswereformedleadingtojointinitiatives such as, Meals on Wheels promoting the mobile library services to people at home.

2016 also saw the inaugural CISS Reconciliation Cup and barbecue, a touch football game involving staff from a range of services. The CISS Reconciliation Cupwastheopportunityforstafftoreflectontheimportance of our Indigenous staff and recognise the past, present and future challenges and opportunities for indigenous people.

General Practice Liaison Officer ProgramTheGeneralPracticeLiaisonOfficer(GPLO)ProgramisapartnershipbetweenMetroNorthandBrisbaneNorthPrimary Health Network. The focus of this program is to improve patient care across the different health sectors and lay the foundation for the development of connected health care for our patients.

TheMetroNorthGPLOsarequalifiedGeneralPractitionerswithmoststillpracticinginMetroNorth.Theyworkwiththe clinical streams and our clinicians to identify where primary care can support Metro North in areas such as improving referral processes, developing shared care models, visiting GP practices and providing education and training. The GPLOs are important advocates for patients, primary care and Metro North clinicians.

(Strategy objectives 2, 4 and 5)

Members of the Aboriginal and Torres Strait Islander Health Unit with Local Elder Uncle Alex Davidson, and at the expo.


Allied Health Workforce Survey Metro North Allied Health Workforce Unit

The Allied Health Survey is conducted every two years to capture the opinions of more than 2500 allied health staff working across Metro North.

The survey examines a broad range of topics covering: working in MNHHS, clinical rotations, career advancement, learning and development, professional supervision and support, student supervision, operational management, communication, research, innovation, workplace health and safety, fatigue in the workplace and improvements.

While the survey is a useful engagement tool providing staff the opportunity to comment on issues relating to the organisation and functioning of allied health in Metro North, it also provides insight into how engaged allied health staff are with their work.

When administered regularly, surveys such as this are an important tool for us to monitor some of the key factorswhichinfluenceclinicianandstaffengagementand can ultimately impact on the safety and quality of patient care and the health and wellbeing of our staff.

2016 Allied Health Workforce Survey

18% increase in respondents

89% of staff respondants were clear about their work related responsibilities and expectations

81% of staff respondants reported they weresatisfiedwiththeirjob

66% of staff respondants reported that workandworkexperienceisfulfillingtheir expectations.

77% of staff felt respected for their skills and experience.

85% of respondants felt supported by their colleagues.(Strategy objectives 1 and 4)

Hackathon People’s Choice Winners

Clinical Wound Photography Application 2016 Hackathon People’s Choice winnner

Goal: Enables clinicians to easily and securely share and obtain photographs and feedback from other clinicians on a patient’s wound/s.

Benefits: Supports timely information sharing and multi-disciplinary care

Right Gear 2017 Hackathon People’s Choice winnner

Goal: Enables the right equipment to be in the right place at the right time with the patients in the operating theatre.

Benefits: Reduces the number of cancelled surgeries that are caused by not having the correct equipment available

Metro North Information Technology (MNIT) Hackathon Metro North Information Technology

The MNIT Hackathon is a design sprint event where computer programmers and others involved in software development, including graphic designers, interfacedesignersandprojectmanagersworkwithclinicians on software solutions.

The inaugural MNIT Hackathon involving more than 70 participants was hosted in 2016. The Hackathon is an opportunity for clinicians and staff to drive technology innovation and work hands on with our IT staff to develop solutions that can make the day-to-day deliveryofhealthcareeasierandmoreefficient.

To date, the MNIT Hackathons have focussed on challenges such as ‘Making Technology Work Better for Us’ and ‘Supporting the Frail and Elderly’.

Interactive forums where clinicians and technology experts work together to transform technology ideas into prototypes in one day.(Strategy objectives 1 and 2)


Consultation HubMetro North Engagement Team and Metro North Strategy and Planning Unit

Consultation hub was introduced by the Metro North Engagement Team in 2015 to support staff to design and implement high quality staff and consumer surveys. Consultation Hub is a cloud- based system allowing the design andcompletionofsurveystohappenanytimeanywhere.AkeybenefitofConsultationHubisthatitallowsstafftosee whether prior surveys have been undertaken in their area of interest, reducing the likelihood of duplication and the risk of ‘survey fatigue’.

To date 159 Metro North staff have experienced using Consultation Hub to consult with clinicians and staff in areas such as health service planning, models of care and safety and quality.

Consultation Hub‘Intuitive to use and easy to navigate’(Strategy objective 1)

How does your service classify/define bariatric patients? Specialist outpatient services:

10 Questions

Only 10 Respondants

7 Recommendations

46%

0%

50%

38%

19%

0%

27%0%

BMI

Waist circumfrence (cm) Neck circumfrence (cm)

Not answered

Width exceeds 90cm

Other

Weight (kg)

Height (cm)

Size (size exceeds SWL of hospital equipment, restricts mobility)

Metro North Bariatric Care Survey in Consultation HubConsulting which clinicians and staff to understand the logistical and clinical challenges to providing bariatric services across Metro North Hospital and Health Service:


Section 2: Building on what has been achieved

The examples of clinician engagement showcased in this report demonstrate that much has been achieved across Metro North since the ‘Working Together’ strategy was published. The engagement activities included in this report have been embedded in our organisation and there is a commitment to sustain them into the future. Together, theseapproachescontributesignificantlytobuildingacultureofengagementthatenablessafe,qualitypatientcentred health care and supports clinician and staff health and wellbeing.

We recommend that ‘Working Together’ remains the focus of the clinician engagement strategy in 2017/18. It is hoped that by showcasing these innovative approaches to clinician engagement that others across Metro North will be inspired to provide opportunities for more clinicians and staff to be involved in shaping the future direction of our Hospital and Health Service.

Focus areas for 2017/18In 2017/18 the clinician engagement agenda will be shaped by the passion and commitment of the Metro North Clinical Council to establish Metro North as a great place to work. The focus for the Metro North Clinical Council and clinician engagement team going forward will be to work with the Directorate Clinical Councils, the Board and Metro North Leadership Team to achieve the following.

• Establish a program that builds and sustains a culture of safety and respect across Metro North.

• Increase our understanding of the factors that support work related health and wellbeing amongst clinicians and staff in Metro North, in particular identifying those factors which are protective against occupational stress and burn-out and how to monitor staff health and wellbeing over time .

The Clinical Councils are an important enabler of clinician engagement across the organisation. Given their important role, it is recommended that a broad evaluation of the support systems required by the Clinical Councils to function effectively and the extent to which these supports are in place is undertaken.

TheWorkingTogetherstrategyalsoidentifiestheneedtomeasuretheimpactofthestrategyonstaffengagement.Taking into account there is potentially a risk of ‘survey fatigue’ amongst staff this will be achieved in the short term by monitoring trends in engagement reported through the Working for Queensland Survey conducted annually. These measures will be built upon through the work of the Metro North Clinical Council addressing staff health and well-being and the protective factors for occupational stress and burn-out which promote staff engagement .

Conclusion

ThisreportdemonstratesthattherehasbeenasignificantcommitmenttoclinicalengagementbyourDirectorates,Clinical Councils, Clinical Streams and COSI since the ‘Working Together’ strategy was developed. These activities have been far reaching in that together they have connected with clinicians and staff at all levels of the organisation and across many disciplines as well as involving our health care delivery partners. Over the next 12 months we will continue to strengthen this emerging culture of engagement by working together to build a culture of safety and respect and establish Metro North as a ‘great place to work’.


Documents

Working Together: Strategy for Inclusive Clinician ... · 4 Workin Tog Strategy lusiv linici gagement 201618 Progress Report 2016-17 Foreword MNHHS Clinical Engagement Strategy Report