Allied Health: Sustainable Integrated Health Care for all Australians Catherine Turnbull Chief Allied and Scientific Health Advisor SA Health Presentation to Indigenous Allied Health Australia Conference, Adelaide, 27 November 2013
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Overview > Leadership > Innovation > Quality evidence & decision support tools > Evaluation > Sustainability
Leadership Harvard Business Review Oct 2011 p79 MedSTAR Emergency Allied & Medical Scientific Retrieval Health
Leadership:Unity and Strategy > Australian Allied Health Forum DOHA Chief AH Officer & Advisor IAHA: Indigenous Allied Health Australia NAHAC: National Allied Health Advisors Committee SARRAH: Services for Australian Rural and Remote Allied Health AHPA: Allied Health Professions Australia > Defined AH > Key top priorities agreed & communicated
National AH Key Priorities 1. AH workforce development 2. AH workforce data 3. Health funding 4. E-health 5. Accreditation and registration 6. Assistant and support workforce 7. Inclusion of AH in Commonwealth KPAs
Innovation MedSTAR Emergency Allied & Medical Scientific Retrieval Health
Innovation: e-health records
Innovation: e-health AH data
Innovation: Client goals
Quality Evidence & Decision Support Tools for AH Grimmer, K et al 2013 (submitted for publication) MedSTAR Emergency Allied & Medical Scientific Retrieval Health
Quality and Evidence > Australian workforce (AIHW 2010) 57,000 medical practitioners 65,000 allied health (not Pharm or CAM) 202,000 nurse and midwives > Comparable to medical practitioners In numbers Not in published evidence No healthcare quality measures for AH Professor Karen Grimmer www.unisa.edu.au/cahe
Health workforce planning aims at the long term Mark Pearson OECD 13
The increase in HR supply is driven by increasing graduate numbers Number of medical graduates, selected countries, 1990 to 2011 Index (1990=100) 300 Australia Japan Canada United States Index (1990=100) 300 Denmark Netherlands Italy United Kingdom 250 250 200 200 150 150 100 100 50 50 Source: OECD Health Statistics 2013, http://dx.doi.org/10.1787/health-data-en 14
0.2 0.8 0.7 1.7 1.6 1.5 1.8 2.0 2.2 2.2 2.2 2.5 2.5 2.4 3.0 3.0 2.9 2.8 2.8 2.7 2.6 3.3 3.3 3.3 3.3 3.3 3.2 3.5 3.5 3.3 4.1 4.0 3.9 3.8 3.8 3.8 3.7 3.6 4.8 5.0 6.1 There are large variations in the number of doctor per (1 000 population) Per 1 000 population 7 6 5 4 3 2 1 0 15
Switzerland Denmark Belgium² Iceland¹ Norway Ireland¹ Netherlands¹ Germany Luxembourg United States¹ Sweden Finland Australia Japan New Zealand Canada OECD34 France¹ United Kingdom Slovenia Czech Republic Russian Fed. (2006) Austria³ Italy¹ Hungary Estonia Portugal¹ Slovak Republic¹ Spain Poland Israel Korea Chile² Greece¹ Mexico Turkey¹ China Brazil South Africa India Indonesia and nurses (per 1000 population) 20 16.6 15 10 12.9 12.2 11.8 11.111.1 11.3 11.4 10.010.010.1 10.3 9.3 8.6 8.7 8.8 8.3 7.8 8.0 8.0 15.415.4 14.8 5 6.1 6.2 6.2 6.3 5.9 5.2 5.5 4.7 4.8 4.2 3.3 2.7 1.5 1.7 1.7 0.9 1.0 1.1 0 16
Evaluation MedSTAR Emergency Allied & Medical Scientific Retrieval Health
Evaluation of performance Area for evaluation Set goals Performance indicators Information sources Report results Evaluate Lizarondo et al (2013) Clinical Service Performance Evaluation Project with ASHO www.health.sa.gov.au/alliedandscientifichealth
Sustainability MedSTAR Emergency Allied & Medical Scientific Retrieval Health
Sustainable change > Creating attraction rather than overcoming resistance Complex Adaptive Systems Social network theory Opinion leaders Attractors Leadership for spread VHA s 2000 Research Series Paul Plsek
Attractors > Identify change or improvement you want to spread > Identify group or individual resistor > What past changes have they naturally made? Characteristics of those changes? > What do they most like about their work? > What do they seem to dislike? > What do they really want deep down? > How can you make your change more naturally attractive to them?
Leadership for spread > Strategic aim setting > Spread thinking > Pacing > Coaching for sustainability > Engaging others > Barrier busting > Reflective thinking and learning > Building further organisational capacity for spread
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