The Key Outcomes of a Regional/Rural Leadership Program Dr Nicole Byrne (Past Manager Organisational Capability – Area Leadership Senior Speech Pathologist, HNE Health) Linda Ritchard (Facilitator/Program Manager: Clinical Leadership Program) Health Workforce Innovation and Reform conference: 18 March 2010

Size of

Hunter New England Health Size of England (130,000 sq. kilometres) 14,500 Staff (10,500 fte) Population 852,655 (12.3% State’s population & 20% States Aboriginal population Major metropolitan, large regional, small rural centres and remote communities Hospital sizes vary from small multipurpose centres to a large tertiary referral hospital with NSW busiest trauma centre

HNE Health ‘Advancing Leadership’ Strategy

Different Leadership Programs HNE Health Syndicated Leadership Program Multidisciplinary Leaders at Tier 4 & 5 levels high potential employees for future Senior Leadership roles IRCST Leadership and Management Essentials Program Current managers or those interested in a mgt career CEC – Statewide Clinical Leadership Program Foundational leaders. experience in leading a team Commitment to improving patient safety CEC – Modular (Executive) Clinical Leadership Program Senior Executive Clinicians Director of Nursing or equivalent Must have an area wide role/responsibilities

Garling Recommendations Point 12, Point 23, Point 34 Point 36B “To design, institute, conduct and evaluate leadership training for clinicians to enable clinicians to become clinical leaders and also health system leaders Point 37a “That clinical education and training should be undertaken in a multidisciplinary environment which emphasises interdisciplinary team based patient centred care” Point 138 “Within 18 months, NSW health is to design and introduce a defined career path and structure for senior clinical leaders, and for senior clinician participation in senior administration and management roles.

Statewide Program Program is offered across NSW The 4th program has just commenced Funded by Clinical Excellence Commission and NSW Health 10 month experiential program Multidisciplinary Draws on contemporary leadership models of leadership and Practice Development

Statewide Clinical Leadership Program Seeks to enhance the capacity of clinicians to lead sustainable system improvement and patient safety initiatives To work more effectively with available clinical information and resources Develop a culture of patient-centred care within an environment that supports work based learning

Program Aims Build the capacity of the clinical team Advocate for patient safety and integrate system improvement into clinical care Develop insight into their own leadership style and its impact on others Ability to work effectively with a range of clinicians and managers Ability to use consensus development and vision to set, align and achieve goals, resolve conflict and balance demands within the larger environment Demonstrate a high level of technical mastery

Program covers: Face to face workshops 360 degree performance profile Development of personal development plan Monthly one on one coaching Action learning sets Undertake a Clinical Practice improvement Project Self directed learning modules and Portfolio activities

PARTICIPANTS BY DISCIPLINE Allied health breakdown

RURAL / REGIONAL BREAKDOWN

Outcomes Growth of Program Workforce Outcomes Personal Growth / Development 360 Profile Personal Development Plans and one on one coaching Action Learning Sets Clinical Practice Improvement Projects Feedback from Managers & Peers Qualitative Comments The bigger picture (Statewide Feedback)

Growth of Program 2007 – 44 applicants 2008 – 23 applicants 2009 – 15 applicants 2010 – 55 applicants

Workforce Outcomes Talent identification and expansion of “bench strength” is demonstrated by percentage of participants stepping up to higher grade duties during the programs:- 2007 program – 28% 2008 program – 78% 2009 program – 33%

Personal Growth / Development

360 Degree Profile Previous graph shows growth of one participant through 2 360 SHL results: Adapting & Responding to Change 75% pre / 100% post Delivering & results & meeting expectations 70% pre / 100% post Persuading & influencing 80% pre / 100% post Not all participants had this result, some actually reflected a reduction in their responses. When the results were discussed with these participants they reflected at the beginning of the program they were not aware of their limitations

Coaching & Action Learning Sets From the 360 degree profile, participants develop a personal development plan and commence one on one coaching monthly Constantly evaluated as one of the most valuable components of the program Action Learning Sets (ALS) take place monthly throughout the program in different geographic locals. The 2009 group have gained so much from the experience that they are continuing their ALS this year monthly. Participants find ALS a wonderful opportunity to identify strategies for work based issues & problems. Learn the art of using enabling questions and networking with managers from different work areas.

Clinical Practice Improvement Project All participants undertake a CPI project in their workplace. The project must aim at improving the quality and/or safety for the patients in their unit. Small sample of projects undertaking over the past 3 years: Decrease length of stay for delivery suite outpatient presentations *Winner of 2009 HNE Health Quality Award* Pathway for improved end of life care *2009 HNE health Quality Award finalist* Introduction of new abbreviated PTA testing for post traumatic brain injury. Reducing length of stay and improving quality of care for patients. Saving $30,000 in 6 months Introduction of an Alert for Children of Parents with Mental Health issues on Parent electronic file to flag a care plan in place for children

Participant Qualitative Reflections “I believe I have overall grown with confidence, I am happy to do a presentation to a group, previously I was not” “Developed personal goals able to be reflected in the work environment to improve/develop interaction with patients, staff and visitors” “After 25 years it refocused to me why I am employed in health” “Have more self awareness and try to improve in areas that I am lacking” “I am stronger and more confident” “Gain a great understanding of the concept of clinical leadership”

Comments from Managers about Participants “Appeared to gain more confidence in own strengths” “Has given the individual a better understanding of what it is to be a leader and they are actively involved in improvement programs” “Was good, now even better” Appears to have developed a great deal of respect from Team” “Already highly skilled clinician – this project added new dimensions to skills associated with data analysis and interpretation and working successfully with a diverse team”

Statewide Evaluation Jane Conway- April 2009 “There is evidence that participation in the Program energised, motivated and re-engaged some clinicians in their work and for some it assisted them to make decisions to alter their career paths within Health” Jane’s report also comments on: Increased interest in the patient/carer perspective Increased confidence in owns skills as a leaders Ability to review policy and suggest improvements Enhanced ability to respond to feedback and be accepting of own strength Increased ability to reflect on practice in a context that is multifaceted and multidimensional Enhanced motivation and enthusiasm for change (page 38, “Evaluation of the Clinical Excellence Commission Clinical Leadership Program” – Final Report)

15 applicants for the 2010 program reflected their main reason for applying for the program was the positive changes they had seen in previous participants of the program: “they had renewed enthusiasm and energy” “They had a new confidence!”

2009 Clinical Leadership Program in Action

2009 Graduation