Better Skills, Best Care - Workforce Design Strategy
To support the Workforce Redesign Strategy, a number of workshops and other initiatives will be advertised as they become available.
Introduction
The availability of a suitably skilled workforce is essential if the Department of Human Services (DHS) is to sustain an effective human services system into the future. The Better Skills, Best Care strategy seeks to encourage health services to explore new and redesigned work roles and provide support to pilot and roll out initiatives. The emphasis is on developing roles that will provide better outcomes for patients, promote greater work satisfaction for staff and contribute to more efficient and sustainable health services.
Poster - Better Skills, Best Care Overview - 2007 (PDF 80k)
Victoria's Workforce Redesign Toolkit - Request for tools and case studies
The Service and Workforce Planning Branch, Department of Human Services is calling for health and community services to contribute tools, documented processes and case studies of redesign experiences for inclusion in a ?Redesign toolkit? that can be accessed by health and community services across the State.
Workforce redesign innovations and initiatives have been underway in Victorian health and community services for a number of years. Capturing and sharing the existing practical and technical tools, processes and examples will assist in paving the way for the industry to formalise best practices, and will assist those undertaking workforce redesign in avoiding duplication of effort across the state.
In 2008-09 the department is facilitating the process of consolidating existing resources into a central depository that can be accessed widely by Victorian health and community services. The particular focus of this piece of work is on support roles and advanced practice roles.
Contributions are due by Friday 10 July 2009.
Please refer to the attached guidelines for assistance in how to submit case studies or tools.
For tools and case studies that are owned by the health and community service, a signed licence to enable the department to use, reproduce and publish the material is also required, to ensure the organisations? intellectual property and copyright is respected. An example of this pro forma licence deed is attached for your information. This process will only be initiated for material that is selected for inclusion in the toolkit.
Industry participation is crucial to the quality and success of this project, and we would strongly encourage your agency to consider submitting tools and/or a case study for this project. The department views this as an exciting opportunity to promote awareness of the important innovations taking place in Victoria.
Case studies and tools can be submitted via email to workforce@dhs.vic.gov.au or posted to Grainne McCullough, Policy Adviser, Workforce Innovation, Level 20/50 Lonsdale St, Melbourne 3000.
Workforce Redesign Toolkit Guidelines
Workforce Redesign Submission Form
Workforce Innovation Grant Program
In November 2008 the Department of Human Services invited submissions for health workforce innovation and reform projects under the Workforce Innovation Grant Program. The Workforce Innovation Grant Program was developed to explore, identify and trial innovations that improve workforce capacity and utilisation and the sustainability of service delivery while maintaining and improving quality of outcomes, efficiency and worker satisfaction. This was a much broader focus than the previous stages and was well responded to by the sector. Submissions were received from a broad range of service settings including hospitals, community health, disability, aged care, indigenous health and primary health, in both a variety of metropolitan and rural areas. Several submissions were received from alliances or services joining together to undertake collaborative projects.
The projects were assessed against national workforce priorities and key Victorian workforce priorities and directions, including: increasing the use of the support-level workforce; addressing inter-professional boundaries and traditional functional hierarchies in health; recruitment and retention strategies for all ages and education levels in a time of a shrinking and ageing workforce; the use of a volunteer workforce, and building alliances and partnership approaches to workforce solutions.
17 projects were selected from across Victoria to be implemented in 2009 under the Workforce Innovation Grant Program. The successful proposals fell under one or more of three primary themes of workforce reform: workforce redesign (new and amended roles), workforce restructure and workforce planning. They comprise a range of practical solutions to existing or projected workforce shortages. They address the barriers to innovative change identified in earlier BSBC projects and include key elements of success. The projects were selected to test innovation at the local level but have state wide applicability. Rural initiatives are well represented amongst the selected projects.
Workforce redesign is implemented through supporting work in new health assistant roles and advanced practitioner roles in physiotherapy, radiography and nursing to explore new models of care and have significant sector implications (for the workforce and access to services).
Workforce restructure includes exploration of models of delegation and supervision in innovative interdisciplinary and trans-disciplinary ways and the use of technology to fully realise potential workforce capacity.
A number of projects support innovative approaches to workforce planning and/or workforce capacity building. Several will test alliance or partnership approaches to workforce that are suitable to different organisational settings and sizes.
Specific details on each of the successful projects are provided below:
An Information Management (IM) / Information and Communication Technology (ICT) Feasibility Study
Doutta Galla Community Health, North Yarra Community Health and the Western Region Health Centre will utilise an innovative partnership approach to explore joint IM/ICT facilities across the three organisations. A feasibility study will be conducted to explore, identify and if appropriate trial, an innovative workforce configuration in an area of significant skills shortage. The approach will focus on resource sharing, workforce configuration and human resource management, which if feasible, will feed into future workforce utilisation and retention strategies and result in increased capacity to provide a broader/more varied experience to staff as well as improved career pathways and peer support. It is an innovative approach to human resource practice which will make the health and community sector a more attractive place in which to work and to build a long term career.
Health and Community Services Career Pathways for Year 10 Students
i-GAIN Quality Learning Inc, in collaboration with the Baw Baw Latrobe Local Learning and Employment Network, will develop a partnership between eight agencies and across the Community, Disability and Education sectors in the Gippsland region to promote the health and community sector as a preferred career and/or pathway option for the future. This will be achieved through a strategy of collaboration, promotion and the provision of supported work placements for Year 10 students in 10 secondary schools. The project will address health and community services sector workforce shortages by attempting to increase the number of students entering the sector by providing exposure and ?hands on experience? within the health and community service sector through facilitated work placements as well as providing the opportunity for students to undertake a unit of study on preparing for work in the Community Services Industry? under i-GAIN?s Certificate II Community Service Work Training Package.
The Impact of Rapid Roaming User Access on Workforce Efficiency and Attitudes to On Line Documentation in Aged Care
The Centre for Health Innovation and Samarinda, a publicly funded aged care service, will develop a partnership to implement and pilot 'a rapid roaming user' to enable clinical staff to quickly access sessions using a digital smart card and unique pin log in. The project will evaluate the cost benefit of using the system as an alternative to the current practice of manual logins to shared computers by numerous staff. The current practice can take up to three to four minutes for each log in, resulting in time pressured clinical staff using generic logins to save time. This prevents the uptake of e-health systems such as e-ordering or e-prescribing that require a unique login (digital signature) as well as renders audit trails useless. The rapid access addresses this by providing a log in time of sub 10 seconds. This project has the potential to minimise staff time on non-clinical activities, provide significant savings to health services, remove a significant barrier to the uptake of electronic documentation for mobile clinicians and be widely applicable across the sector.
Development of a Patient Support Service Model
Echuca Regional Health (ERH) will develop a contemporary model of staffing that meets the requirements of patients, ERH and the regional setting. A standardised model for support services based on best available evidence that is transferable to other regional settings will be developed. The staffing model will outline the education and training requirements for support roles and build increased flexibility allowing support staff to be utilised in a range of roles and clinical settings both in-hours and after hours, as well as ensure consistently high quality patient outcomes. It will also provide clarity regarding roles and functions. The roles will be complimentary to and integral with the broader health care team and can be applied to other regional services. Lorne Community Hospital (LCH) will develop a model of remote x-ray usage and remote x-ray licensing by nurses that is underpinned by a clinical governance framework to support safe x-raying. The project will upskill four nurses in remote x‑ray usage and develop clinical networks and 'remote diagnostic capacity, infrastructure and governance between LCH, Barwon Health and/or private radiography services. A clinical governance framework will be developed to support safe x-raying including clinical guidelines, clinical audits and review of a random selection of x-rays. In addition, robust referral, remote diagnostic and quality processes will be developed and established. An evaluation to determine the impact of the model in addressing a determined community need will be undertaken.
Nurse Remote X-ray Project
Lorne Community Hospital (LCH) will develop a model of remote x-ray usage and remote x-ray licensing by nurses that is underpinned by a clinical governance framework to support safe x-raying. The project will upskill four nurses in remote x‑ray usage and develop clinical networks and 'remote diagnostic capacity, infrastructure and governance between LCH, Barwon Health and/or private radiography services. A clinical governance framework will be developed to support safe x-raying including clinical guidelines, clinical audits and review of a random selection of x-rays. In addition, robust referral, remote diagnostic and quality processes will be developed and established. An evaluation to determine the impact of the model in addressing a determined community need will be undertaken.
Kyabram Employee Entrance Program - KEEP
Kyabram and District Health Services will use a volunteer workforce to support the recruitment and retention of new staff (allied health professionals, nurses, doctors etc) and students on placement through an induction and mentoring program that orientates the incoming recruit to both the organisation and the community. This program aims to address the issue of social and cultural isolation and improve recruitment and retention across professions. The program will provide recruits and new students with diverse information about the town and services available and initiate partnerships to create a feeling of connectedness with the community. Volunteers will become personal orientation partners for new recruits (and their partners) and will address issues of social inclusion. Community focused orientation kits that incorporate culturally specific information where required will also be developed.
Physiotherapy Orthopaedic Pilot Project
The St Vincent's Hospital Physiotherapy Orthopaedic Pilot Project will pilot a new model of care delivery through the use of advanced musculoskeletal physiotherapists in the post operative review process of total standard knee and hip replacements at 6 weeks, 3 and 6 months to ensure greater efficiency and targeted use of the time of orthopaedic surgeons for new and complex cases. Reviews will follow agreed protocols and patients identified as requiring consultation with an orthopaedic surgeon will be referred on. The project will utilise the skills of advanced musculoskeletal physiotherapists in non-complex procedures to improve the patient journey and to provide a care coordination role.
An Advanced Musculoskeletal Physiotherapist in the Post Operative Orthopaedic Outpatient Review Clinic.
The Alfred will identify and articulate the potential role of an advanced musculoskeletal physiotherapist in the Post Operative Orthopaedic Outpatient Review Clinic, in order to improve access and patient flow. The project will review the current post operative review process and identify those activities which need to be undertaken by the orthopaedic surgeon, those which could be undertaken by an experienced musculoskeletal physiotherapist and those activities that should be undertaken by administrative and other support staff. An identification of required training and credentialing as well as opportunities for implementation and service improvement within the clinic will occur and a new more efficient post operative review process, incorporating these elements, will be established.
Extending the Good Food Matters Program
The Brotherhood of St. Laurence will build on the Good Food Matters project (A Certificate III Meal preparation program for Personal Care Attendants (PCAs) to improve the nutrition of the aged in the community) to develop a new role by training culturally and linguistically diverse mature aged workers with hospitality or cooking experience as Community Meals Attendants (Certificate III). The project aims to investigate and improve service sustainability and workforce capacity with the development of a new care model that enables people with hospitality and cooking experience to gain employment providing nutritional care to older people with complex care needs who are at risk of or are malnourished. The role will be piloted and compared with the PCA model to explore how the Home and Community Care (HACC) Active Service Model can be embedded into the nutritional care service. It is intended to roll out the model to HACC providers and services throughout the sector.
Advanced practitioner radiographer role in BreastScreen Victoria
BreastScreen Victoria will evaluate the feasibility of expanding the role of radiographers to include reporting on screening mammograms in the BreastScreen Victoria Program. Currently, each mammogram is reported by two radiologists, requiring over 7,000 hours of radiology time for film reporting alone each year. The project will address current radiologist workforce shortages at the same time as issues relating to job satisfaction and retention for radiographers. The project will map the current status of the radiology and radiography workforce in BreastScreen Victoria, Victoria and Australia and its current and predicted impact on service delivery; explore the acceptability of the adoption of this role redesign by key stakeholders; develop a business case for a training model for radiographer readers; and provide recommendations on future action for role redesign for radiographers.
Rural allied health workforce retention in Victoria ? measuring the benefits of increased length of stay and reduced staff turnover
Monash School of Rural Health will conduct a state-wide workforce planning study trialling a methodology for measuring the retention of allied health professionals (AHPs) in rural health services in Victoria and determining the true costs of poor retention. The study will compare the retention of allied health professionals in rural communities differing in geographic and population characteristics, ascertain the main determinants underpinning poor rural health workforce retention among AHPs and clearly identify the main determinants of workforce retention that can be influenced by management policy and programs. The study will clearly identify successful retention strategies and model the effects of incentives on workforce retention with an accompanying cost benefit analysis.
Northern Mallee Workforce Project
Sunraysia Community Health Service will establish a partnership between ten local health and community agencies to develop a joint model that will focus on recruitment and retention strategies across all agencies. This will support collaborative and efficient use of workforce and resources across the agencies. The project will build on, and implement the recommendations of the Northern Mallee Workforce Project (NMWP) which undertook extensive research into workforce needs over the past three years in the region and recommended that the recruitment and retention of workforce in the health sector require ongoing attention. A model will be developed for a single universal body, supported by pooled agency resources that will provide specialist recruitment services on behalf of Member agencies and implement the staff retention strategies identified in the NMWP.
Nail Care Service ? the use of foot care assistants
Robinvale District Health will develop a training package and supporting policies and procedures in nail care and train interested community members (including aged care, hostel and nursing staff) as foot care assistants to provide safe, cost effective nail care to low risk client as part of their routine care. This enables more effective use of podiatrists in high risk and complex cases and supports workforce restructure to use allied health professionals in consultative/overseeing role while providing footcare in a timely manner. The foot care assistants will work under the indirect supervision of podiatrists and referral, assessment and intervention procedures and sterilisation processes will be developed. Reducing the demand for this service on podiatrists will free up podiatrist time to provide specialist podiatric care, early intervention and health promotion and education.
Foot Care Clinic; Dysphagia and high risk nutritional needs; chronic disease framework
The West Wimmera Health Service recognises the need for appropriate services within the Hindmarsh, Yarriambiack and West Wimmera Shires. This project establishes and trials transdisciplinary models of practice in three specialist service streams to improve access and management for patients with chronic conditions in the West Wimmera, Yarriambiack and Hindmarsh Shires. The service streams comprise:
1) nutrition and hydration
2) podiatry services
3) chronic disease management framework (initially targeting diabetes)
Stream 1 will create a transdisciplinary dysphagia and high risk nutritional needs clinic through developing a transdisciplinary training and E-learning package in swallowing and prescription of high risk special nutritional requirements to service the organisation and neighbouring health services unable to access speech pathology and dietetic services. Nurses and Personal Care Attendants will be trained in dysphagia screening.
Stream 2 will develop a training package and establish three footcare clinics staffed by trained Allied Health Assistants under clinical supervision, guidance and governance by a podiatrist in a regional centre.
Stream 3 will develop a chronic disease management framework across the regional netwo