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Reflect, reimagine and revive. Putting a timely focus on health workforce wellbeing

After more than two years of unprecedented challenges for the health system, the Giant Steps conference, hosted by Safer Care Victoria, will provide a welcome opportunity for all involved in healthcare to ‘reflect, reimagine and revive’.

This conference will be held on 26-27 May both in person and online (registrations are closed for in person attendance but still open for online attendees).

Investigative comedian Craig Reucassel, Victoria’s inaugural chief Aboriginal Health Advisor Nicole McCartney, and sustainable healthcare leaders Fiona Armstrong and Associate Professor Forbes McGain are among the presenters.

Jennifer Doggett, who is covering the event for the Croakey Conference News Service, previews the #GiantSteps22 discussions below.


Jennifer Doggett writes:

When the Victorian Government recently handed down the state budget, with a centrepiece $12 billion investment in health, including a Pandemic Repair Plan, the Premier and Health Minister both acknowledged the toll that COVID had taken upon healthcare workers, as well as patients.

The Plan includes a commitment to a global recruitment drive and hiring up to 7,000 healthcare workers, including 5,000 nurses, as well as investing $1.5 billion in efforts to increase surgical activity beyond pre-pandemic levels

“Our nurses, ambos, allied health professionals, doctors, and other healthcare workers have given so much to our state,” Health Minister Martin Foley said in an accompanying statement.

“They have been at the frontline of the coronavirus fight, and now we’re making sure they’re at the forefront of our Budget.”

The Victorian Healthcare Association (VHA) and the Victorian branch of the Australian Nursing and Midwifery Federation welcomed the workforce investment, but VHA cautioned that it would take time for these people to hit the ground and relieve pressure on health services.

Both VHA and community health organisation cohealth expressed disappointment in the lack of budget investment in community health services, and VHA stressed the urgent need for a national health workforce plan, warning “we have never experienced such an extreme shortage of qualified health workers in Australia”.

Focus on wellbeing

The need to focus on the wellbeing of the health workforce in all areas of the health system has prompted Safer Care Victoria to make this a major focus of this year’s Giant Steps conference. 

Robyn Hudson, Chief Operating Office and Executive Director Engagement, of Safer Care Victoria, says there is a clear link between health workforce wellbeing and quality of care.

“We know that when our health workforce is supported and engaged there are fewer errors. That’s why it’s so important that our workforce is in the best shape possible,” she said.

“Giant Steps is an inspiring and rejuvenating experience – giving health professionals and executives an opportunity to reflect on the past couple of years, share their ideas and experiences with others from different areas of the health system and to start thinking about the future.”

It’s not only clinicians and health service executives who can get something out of Giant Steps.

This event is unusual among health conferences in its broad appeal to a wide range of audiences, including consumers, policy makers and the general community.

One reason for this is its diverse and accessible program, which features speakers from both the health sector and non-health industries.

This year’s program includes health leaders from Australia and overseas, including Dr Kedar Mate, President and Chief Executive Officer of the Institute for Healthcare Improvement, which for 30 years has been using improvement science to advance and sustain better outcomes in health and health care across the world. He will speak on the need for courage and trust in improving health system to meet future challenges. (And follow him on Twitter at @KedarMate).

(Read Dr Kedar Mate’s Twitter thread here.)

Keynotes

The program also features keynotes from leaders working outside of the health system, including broadcaster and mental health advocate Jessica Rowe, Australian of the Year Dylan Alcott, the founder of Secondbite, Simone Carson and musician, broadcaster and  author, Clare Bowditch.

There’s a session involving speakers from a restaurant, primary school and one of Victoria’s leading galleries to discuss how these very different industries have responded to the challenges of COVID-19 and transformed the way they operate. Over lunch on Day 1 attendees can enjoy a talk on sustainability in healthcare from comedian and TV personality Craig Reucassel.

“We engage inspiring speakers who can broaden our horizons and give us a fresh perspective.  Health can be a bit of a bubble sometimes but we have a lot to learn from other industries, which have faced similar safety and quality challenges,” Hudson says.

In addition to the keynote addresses, Giant Steps will feature breakout sessions and poster presentations highlighting success stories from around Australia.

A number of these focus on integrated care, including examples from initiatives developed in rural and regional health services in conjunction with Primary Health Networks. Hudson describes integrated care as a logical area to focus on when seeking to improve quality and safety but also stresses that achieving gains in this area can be tough.

“When selecting presentations, we intentionally chose case studies with demonstrated quality and safety outcomes. These are programs and strategies that everyone can learn from,” she says.

Hightlights from breakout sessions

Mental health

  • How to co-design and evaluate a community of practice, presented by the developers of Australia’s first online Community of Practice for child mental health.
  • How to ensure quality and safety in digital mental health as the use of these services grows and how to overcome challenges in implementing accreditation and standards to ensure high-quality, safe care.
  • The success of TelePROMPT an innovative and award winning initiative, co-designed with consumers, clinicians and system partners, in connecting on-scene paramedics with mental health clinicians.
  • Peninsula Health’s experience in reducing restrictive interventions, including the framework that they utilise and outline some of their key processes.

Workforce wellbeing

  • Practical ways to support a depleted healthcare workforce, drawing on models of positive psychology and evidence-based interventions.
  • Sparking joy in Victorian healthcare workers – a panel conversation between experts and champions in the healthcare worker wellbeing field alongside teams participating in the wellbeing for healthcare workers initiative.

Indigenous health

  • Reframing Aboriginal health as the key to our future of health – a panel discussion led by Nicole McCartney, Victoria’s inaugural chief Aboriginal Health Advisor, with Michael Graham and Pat Turner AM.

Equity

  • How the Water Well Project is providing free, interactive and inclusive health education sessions to community groups from migrant, refugee and asylum seeker backgrounds, facilitated by volunteer healthcare professionals.
  • Early results from a co-designed child and family pilot hub in Wyndham Vale to support wellbeing among people facing hardship and challenges.
  • Championing positive change in support of transgender young people with physician Michelle Telfer and young trans person Elliott, who will share about his journey. Elliott’s parents, Uniting Church ministers, will join them later for a Q&A session.
  • How Auburn Hospital, part of the Western Sydney Local Health District, reduces risk and breaks the cycle of disadvantage by placing customers at the centre of healthcare delivery.

Climate

  • A discussion between Fiona Armstrong, Dr Forbes McGain and Craig Reucassel around climate change and its impact on the planet, the person, patients and PPE.

Rural and remote

  • How a GP workforce development team responded to the learning needs caused by an unprecedented global pandemic through rapid learning networks.
  • Using telehealth to improve rural medication safety, including presenting a model of care, medication safety improvements as well as barriers and enablers.
  • How a rural mental health inpatient unit went smokefree – an exploration of enablers, barriers, and available resources to help consumers quit smoking while an inpatient.

Health service performance

  • Strategies to facilitate major improvements in clinical governance, service delivery, community participation, employee engagement, data management and organisational performance, from community health organisation, DPV Health.
  • How implementing value-based, patient-centred healthcare improved outcomes, with a specific focus on patient-reported measures at Dental Health Services Victoria.
  • A workshop providing the essentials of collecting, visualising and learning from improvement data, including looking at data for research versus data for improvement.

There are also breakfast sessions on both days (free and open to all, including those not attending the rest of the conference) on a range of topics including: advance care planning, increasing access to services of disadvantaged groups, hospital without walls, reimagining the health workforce and shared decision making.

“Our experience shows that the key to improving quality and safety is strong working relationships between clinicians, consumers and health service managers. It’s this trifecta of leadership that can help address even the stickiest and most intractable problems,” Hudson explains.

“This is why Giant Steps has always focused on bringing these three key groups together and breaking down some of the barriers to improving quality and safety in the health system.

“What I hope people get from Giant Steps is the courage to implement change in their workplace to improve the safety of care.  It doesn’t need to be big or grand but taking one step towards improvement will make a big difference in the long run,” she says.

Timely discussions

The conference discussions will be timely, with media reports regularly documenting an ongoing crisis in hospital emergency departments (EDs), an exodus of stressed and burned out healthcare workers, and how Australia’s health system is struggling to meet demand for both routine and emergency care.

Recent media reports have highlighted the alarming situation in Victorian EDs as doctors speak out about how this deteriorating situation is impacting patients, and the importance of looking after existing staff.

This crisis, which has long term implications for health systems, education and training, is the result of multiple factors, including a steep rise in demand (The Age recently reported that the number of people whose emergency department stays were longer than a day more than doubled between first quarter of 2021 to the same period this year).

More than 3,000 people have died from COVID in Victoria since the pandemic and, as the VHA  noted in 2020, COVID arrived just as parts of the state were emerging from the worst bushfires in living memory.

However, the pandemic has also generated innovation and increased collaboration: for example, between health services, public and private, and into local communities through councils, community groups and businesses.

Croakey has also recently reported on the COVID Positive Pathway – a unique collaboration in Victoria aiming to provide holistic care for adults able to isolate at home, involving primary healthcare and hospitals.

Wider focus

These concerns are, of course, not unique to Australia and there are lessons we can learn from how other health systems are dealing (or not dealing) with these challenges.

Canadian emergency physician Dr Andrew Petrosoniak has tweeted about how the many ways in which COVID has impacted his work in Toronto.

“Every process that I encounter on a regular basis is harder to do now than pre-covid. By ALOT,” he tweeted.

Petrosoniak described how the pandemic has resulted in a staffing crisis as exhausted and burned out nurses, physicians and clinical support staff leave. This reduces the capacity of the health system, leading to long waiting lists and delays in treatment of up to 2.5 years.

When reduced capacity is combined with patients who are also tired, burned out, stressed and in pain Petrosoniak says he can understand why violence and verbal abuse of health care workers is increasing.

 

The need to support health workforce wellbeing is being recognised by organisations representing doctors and other health professionals.

For example, as part of its “wellness week”, the Australian College of Emergency Medicines (ACEM ) is highlighting the importance of “wellness” at work in medicine and healthcare.

ACEM President, Dr Clare Skinner, has highlighted the importance of the ACEM Quality Standards in driving system improvement to improve clinician wellness and patient safety.

A number of these standards address workforce wellbeing, including Standard 2.5 which states that EDs should have a healthy workplace plan which encourages the pursuit of health and wellbeing of all staff members.

In a recent Twitter thread, Dr Cheryl Martin, an emergency physician from Tasmania, has argued that wellbeing is core business for healthcare organisations.

She describes the “Quadruple Aim” of health care organisations, which includes clinician and healthcare staff wellbeing alongside optimising patient experience, improving population health and reducing costs.

“This means clinician and staff wellbeing needs to be a consideration across all healthcare organisational decisions. Having a dedicated committee/task force and leadership role such as a CWO (chief wellness officer) driving this has been shown to add value,” she tweeted.


From Twitter


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