Management in Healthcare: The Frontline Management Initiative in Victoria Chris Selby Smith 1 & Ian Roos 2 1 CEET, Monash University 2 CPELL, University of Melbourne Funded by Australian Research Grants Scheme

The ARC Project Appropriateness of FMI to CS&H industry? How widely is FMI taken up in CS&H in Victoria? Which providers and users are involved? Can management training for frontline managers in CS&H industry can be improved?

Stages of Project Background to industry Other relevant research Interviews with FMI provider organisations Interviews with FMI user organisations Survey of individual participants

The CS&H Industry Large > 10% of GDP Significant private sector – approx 30% Contested area between governments –Commonwealth contributes just under 50% –State 25% –Local government and community inputs make up the rest Labour a critical input: 65 — 75% Workforce predominantly female, with many part-time Entry level qualifications vary: –School leavers – years 10, 11 & 12 –trade/TAFE qualifications –undergraduate and postgraduate degree Tradition of continuing education and training

Scope of Project  - Providing/Using FMI  - other than FMI frontline management training

Type of Health & Community Service

Reasons for FMI training Provider Organisations –extension of existing management education activities –FMI as part of change management User Organisations –internal change –environmental change

Participants Surveyed Gender:52% male, 48% female Age Range: –< 253% – % – % – % –55-648% –>65- Education: –6% no formal education beyond school (even spread years 10, 11 &12) –27% TAFE certificate –27% TAFE diploma (including hospital based nursing qualification) –25% Undergraduate degree –21% Postgraduate (mainly Grad Dip or PostGrad Dip – 2 Masters, 1PhD)

Who Does What and Why Level of Study (positive correlation between age and level of study [p = 0.01]) –6% certificate III –33% certificate IV –56% diploma (Level V) Experience: length of service with employer –> 5 years69% –1-5years31% –< 1 year0% Employment status: 90% full time, 62% on day shift (36% mixed shifts) Why participate in FMI program? –Self request20% –Management invited participation38% –Supervisor suggested they participate35% –Told to participate by management7%

Issues for User Organisations Unsatisfactory delivery Pedagogy and curriculum Assessment Participation and interaction Costs Contextualisation and transferability

Issues for Provider Organisations FMI participants from large enterprises Supplementation of FMI material Concern about assessment Changes they would like to see: –Increased industry contribution for an effective program –Explore ways to deliver to SME’s, particularly geographically dispersed –Greater interaction of participants within organisations and between organisations –Provision of further (relevant) teaching and learning materials

Issues for Participants FMI participants were generally supportive of their FMI programs, but substantial minorities had issues: Contextualisation Assessment Pedagogy and curriculum Usefulness of program Possible improvements to FMI program: –87% would have liked to have learnt more about different ways of managing –70% would have liked more interaction with people who manage in different ways –42% wanted more theoretical knowledge, 53% believed the amount of theoretical knowledge was about right.

Conclusion Effectiveness depends on the misfit or match between provider/user/participant Strengths Weaknesses Major issues of Funding, Costing and Charging (warrant further attention)

Sources of Misfit Learning Mode of Provider Unstructured Organic Informal Structured Mechanistic Formal Style of Organisation Learning Style of Individual

Other Issues Varied Approaches –brokerage role for Department? Safety Net –will auditing correct this? Is FMI front-line-management? –Has it become a middle management tool? Funding, Costing and Charging –Does the patient/client culture of the industry mitigate against management training?