Dec 6, 2012

Why health professionals’ training needs a radical re-design

Fran Thorn, ex-Secretary of the Victorian Health Department, argued at the recent Health Workforce Australia conference that the education and trainin

Fran Thorn, ex-Secretary of the Victorian Health Department, argued at the recent Health Workforce Australia conference that the education and training of health professionals needed to be re-designed from the ground up.  HWA’s Robert Johnson has provided the following outline of her speech, which explains why she has come to this radical position.

A former leader of Victoria’s Department of Health has urged all health workers to take charge and lead the changes needed to build a better Australian health system.

Fran Thorn, in the closing speech of the recent Health Workforce Australia’s Inspire 2012 conference, told delegates they had to be leaders who understood it was their job to create and nurture the people who would make Australia’s health system fit for the future.

“You and thousands of others who work in health every day are the only ones with the real power to do something about it – to take charge and lead the changes that we know need to happen,” she said.

Ms Thorn, who has overseen a wide-range of government reform during her career, said Australia’s health system faces “amazing challenges”.

She said these challenges were well documented by the National Health and Hospital Reform Commission (NHHRC) in 2009, but many of the issues are still current.

“Australia’s health system is out of balance and focused almost exclusively on ill health, tensions between public and private provision, particularly around planned procedure,” she said.

“The system is provider focused and dominated, service delivery, teaching and research are not managed as a collectively reinforcing system and there are shocking inequalities in access to services.”

The health system is inefficiently organised and structurally complex, she said.

She told delegates there was a need to design, build and implement a health system that focuses on the patient, integrates services around the patient, shares expertise, was better at earlier interventions and understands that good healthcare is a team activity.

“Even though we understand the design elements we are not anywhere near fundamentally challenging the command, control and expertise dominating cultures that are a characteristic of health.”

Ms Thorn said the education and training of health professionals had to be redesigned from the ground up and at the same time work needed to be undertaken to bring about more attuned organisations.

But she stressed that change in the healthcare sector will never stop.

“We don’t change today and think ‘well, that’s done, now I can go back to my real job’, the job of leaders is change, renewal and improvement – and maintaining the appetite to continuously self reflect, correct and improve.”

And she had this final message for delegates about change and leadership.

“It is not black box rocket science, it is about purpose, values, consistency and determination. And for you in health, it is about taking the long view and working through that.”

Here’s Fran Thorn’s pocket guide to good change characteristics for systems and organisations:

  • Design change from the earliest moments of the creation of health professionals
  • reinforce the aspects of improvement in everything that’s done when people are in the workforce
  • be consistent as a leader
  • keep change simple – it has to be about the patient
  • break change down into achievable sections
  • always talk about change often; be resolute and brave
  • understand why people behave the way they do
  • understand change is never finished
  • never make change just a process in itself
  • leaders are created and developed – they don’t become leaders just because they are appointed to senior positions.



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