Vanguard Health at Capricorn Coast: Rural Medicine Australia 2016

WorkforcestabilityandservicequalityinruralhealthdeliveryMovingfromalocumtoapermanentmedicalworkforce

Dr Parbodh Gogna,MBChB MBAMRCGP FRACGP FACRRMMedicalSuperintendent,CapricornCoastHospitalandHealthServiceCentralQueenslandHospitalandHealthService

Mr Jason Currie,BSc LLB MIP GCPAProgramDirector- HealthServices,VanguardHealth

RuralMedicineAustralia201620October2016

Context– CapricornCoastHospitalandHealthService• Over13,000EDpresentationspa• 22inpatientbeds,running>90%occupancy• 35minutesbyroadtoRockhamptonHospital,1hourbyairtoBrisbane

RuralMedicineAustralia201620October2016

Context– theMedicalWorkforceProject

• Increasingworkloadsleadstoworkforceattrition• PermanentMedicalSuperintendentdepartedlate2013• Ongoingissuesattractingstaffandrelianceonfly-in,fly-outlocumworkforce• DeclineinGPandcommunityconfidenceinservice• VanguardHealthengagedearly2014toincreaseandstabilisetheworkforce

RuralMedicineAustralia201620October2016

Theapproach

• Systemredesignandenhancements• Workforceplanwith3centraltenetsdrovetheactivity• Attract• Develop• Retain

• GovernanceSystemdeployment• Communityengagementstrategy

RuralMedicineAustralia201620October2016

SystemRedesign

• Businessintelligenceatthecore-analysisofactivity,trendsandworkflows• Reshapeworkforcewithinconstraintsincludingplannedre-establishmentoftrainingpositions• Maximiserosterwithbalancebetweenworkforcepreferences(sociability)andmeetingcommunityrequirements

RuralMedicineAustralia201620October2016

WorkforceStrategy

• Attract theworkforce– cumulativeimpact/plannedreplacementswithstandardrecruitmentactivitiesandleverageprofessionalnetworks• Develop – attitudebeforeaptitude(withinreason),upskillandmentortheteam,enhanceskillsandbuildcapacity• Retain – targetedretentionpackages,flexibilityandresponsiveness,constantrefinementoftheservicetosupportstaffasmuchaspossible,maximisefinancialandnon-financiallevers

RuralMedicineAustralia201620October2016

GovernanceSystemDeployment

• Qualityandsafetyasthefoundationforenhancementsandimprovements• Targetrecruitmentactivitieswithafocusonclearperformanceexpectationsandroledescriptions• Establishframeworksforappropriatesupervision,professionaldevelopmentandactivelearning• Ongoingpeerreviewandasupportivelearningenvironment

RuralMedicineAustralia201620October2016

CommunityEngagementStrategy

• Dedicatedsignificantresourcestothisintheearlyphasestorebuildtrustandconfidence• Standardstakeholderengagementframeworkandassessment(usingainfluence/supportmatrix)• Engagementschedulecreated

• 1:1meetings• AdvisoryGroup• Phonecalls

Support / Interest

Influence / Power

HighLow

Low

High

ManageClosely

KeepSatisfied

KeepInformed

Monitor(minimumeffort)

RuralMedicineAustralia201620October2016

Outcomes

• A2:1potentialROIfortheHealthServicebasedonreleasedcapacity• ImprovementstoEDworkflowtosurpassnationaltargets• AbsorptionofgrowthinEDandreductionsintransferstosecondaryhospitalsite• Increaseinpositivecommunityfeedback 0

0.5

1

1.5

2

2.5

3

3.5

4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Jul-13

Aug-13

Sep-13

Oct-1

3 No

v-13

Dec-13

Jan-14

Feb-14

Mar-14

Apr-1

4 May-14

Jun-14

Jul-14

Aug-14

Sep-14

Oct-1

4 No

v-14

Dec-14

Jan-15

Feb-15

Mar-15

Apr-1

5 May-15

Jun-15

Jul-15

Aug-15

Sep-15

Oct-1

5 No

v-15

Dec-15

Jan-16

Feb-16

Mar-16

Apr-1

6 May-16

EmergencyCareWorkUnitsperday(blue- LHS)andEDISTransfersperday(orange- RHS)

RuralMedicineAustralia201620October2016

Thechallengeofnature

• TownshiptookdirectimpactofTCMarcia• Benefitoflocalworkforce• Maintainserviceandperformancedespitedisaster

RuralMedicineAustralia201620October2016

Lessons

• Dedicatedresourcesandfocus• Clearperformanceobligations(KPIsorcontractualterms)

• Timeandspacetofocus(notsomeonere-taskedfromelsewhere)

• Differentthinkingandfreshideas• Systemdesignisessentialtoofferthebestpossibleopportunityforsuccessfulrecruitmentandworkforceretention• Rebuildingaworkforceisalong-termpropositionthattakes2-3yearsoffocusedeffort

RuralMedicineAustralia201620October2016

Questions

DrParbodh [email protected]

Mr [email protected]

RuralMedicineAustralia201620October2016