Dietitians Association of Australia Health Workforce Australia (HWA) Health LEADS Australia February 2013 The Dietitians Association of Australia (DAA) is the national association of the dietetic profession with over 5000 members, and branches in each state and territory. DAA is a leader in nutrition and advocates for better food, better health, and wellbeing for all. The DAA appreciates the opportunity to provide feedback on the HWA Health LEADS Australia consultation Contact Person: Tania Passingham Position: Professional Services Manager Organisation: Dietitians Association of Australia Address: 1/8 Phipps Close, Deakin ACT 2600 Telephone: 02 6163 5200 Facsimile: 02 6282 9888 Email: tpassingham@daa.asn.au Response to the consultation paper 1. Health LEADS Australia encapsulates the leadership capabilities needed to achieve the best outcomes for consumers, health workforce reform and the health system as a whole. The Health LEADS Australia framework builds on several other frameworks used around the world with heavy reliance on the Canadian LEADS system. While there are many similarities between Canada and Australia, in particular the federated vs province type organisation, it remains to be seen whether this framework will address the culture and idiosyncrasies of the Australian Health Care System. The Dietitians Association of Australia has integrated leadership and management into it s entry level competencies. These not only cover leading others, but set out at a very early stage the need to lead self through self reflection and directed learning. This extends into the first year of practice (provisional year) and continues to be an option for Accredited Practising Dietitians continuing professional development (CPD) choices. As a self regulated profession, DAA have also developed a framework to acknowledge advanced practice. Through the Advanced Accredited Practising Dietitian (AdvAPD) and Fellow DAA (FDAA) credentials, DAA have identified characteristics that identify and demonstrate leadership. Many dietitians place great significance on the advanced credentials and practitioners in various practice settings have applied successfully. 1
The AdvAPD program (and the Fellow using a similar framework) is described as: Area of Competency/Unit Leadership & Influence Professional Competence Research and Evaluation Education, Supervision & Mentoring Strategic and Reflective Competency Standard Demonstrates leadership and strategic thinking to influence outcomes Exerts influence and is recognised and respected in their field Leads and fosters research and incorporates research into everyday practice Demonstrates effective education, supervision and mentoring Approach to Practice Applies strategic and reflective approaches to deliver efficient and effective services Below each competency standard there are elements and performance criteria. DAA also has a clearly defined process for assessment. See Attachment 1: Application process for AdvAPD. On comparing the Health LEADS with AdvAPD framework we can see a number of similar concepts, although the DAA framework is more extensive. The Health LEADS bundles some concepts and we suggest this be changed. Also, there is very little in LEADS on professional competence, which would be relevant to all workers in the health care system, and application across all health workers was the intention of this framework. However, as an aside, it should be noted that while the workshop suggested leaders could be interpreted very broadly at every level of the health system, practitioners don t see this. DAA has evaluated and reviewed the AdvAPD program and some have indicated they do not identify that they need an advanced credential and they don t see the need to spend the effort in obtaining it. The LEADS model incorporates the concepts of internal drive to enable moving forward with innovative ideas, with the engagement of others to affect outcomes that change and develop systems. Inherent in this is evaluation and appropriate use of resources. The LEADS model and the DAA AdvAPD program share synergies. As such, DAA do feel it encapsulates an appropriate pathway of leadership certainly for health systems. However the DAA framework is more a continuum i.e. entry level competency standards address leadership but this is developed further with AdvAPD program. 2. Health LEADS Australia will work with frameworks and leadership development activity relevant to your area and / or profession. Acceptance of this framework across educational institutions and then more broadly health services will be a significant challenge. That said, DAA strives to instil strong leadership skills in the APD program, from early teaching at University to the AdvAPD (as described above) and the Fellow. DAA supports any endeavour to foster professional development both for individual practitioners and for the profession in leadership; however DAA does have a robust framework with already with well defined process However, if workplaces were introducing a refined version of this and individuals wished to pursue/maintain AdvAPD or FDAA then there are enough synergies to be able to do that without being burdensome. 2
3. Health LEADS Australia should be incorporated into early career education and training, and into accreditation for continuing professional development. This implies that leadership applies only to professionals but the workshop suggested it was intended to be broader. If that is true then more needs to be done to demonstrate who the framework is for high level management or every level in the system, from learn on the job to higher degree. Leadership already forms part of the DAA entry level competencies and these are built upon by APDs as they progress through their career. If the LEADS framework is to be incorporated into any career education and training it needs to address the following points: Portability: training, CPD events or self directed learning needs to be transferable between organisations. A person should be able to move from position to position and take with them a passport of activity that is recognised by other employers. Flexibility: The framework needs to be flexible enough to cater to the diverse range of professionals and non-professionals for which it is designed. In Dietetics alone APDs can work in many different areas that while not directly linked to health services, impact on the health of populations and individuals. Sustainability: The costs of any such training need to be manageable and affordable. A sustainable mentoring program should be considered (much like the DAA program) to support all levels of engagement in the framework at entry and higher levels. Marketability: employers need to see their ROI on this framework, HWA needs to provide evidence of how employers (and employees) benefit from better leadership, more broadly consumers need to see that funds are used appropriately and effectively to bring about better health outcomes. Modality: The framework needs multiple modalities; it should be accessible online, through mentoring, reading and teaching. It should contain a mixture of self assessed and externally assessed hurdles. In such a large country, the internet and video/teleconferencing methods of content delivery and assessment should be considered. Yes, incorporated to allow early exposure to concepts and career pathways to allow all the opportunity to develop leadership skills. There needs to be consideration for profession specific path ways that use LEAD as its framework. Profession accreditation has more value that leadership accreditation as this may be too broad. 4. From your perspective, what resources or further development are required to optimise the usefulness of this framework. State and Territory Health Departments have some of this in place (with programs or occasional workshops through staff learning and development). NGOs or private companies may not have any framework and it is unclear as to how other government departments who employ health professionals such as education and community services approach this issue. Therefore, this might be useful to those situations provided a process is described and enough resources invested on a sustainable basis to ensure continuity. 3
If this was to be implemented long term then the framework would need more work to refine the capabilities and behaviours. And to run education sessions and to support people on an ongoing basis will require time and money. Considerations that would assist in the integration of the framework are contained in point 3. above. Further development of this framework within a multi-jurisdictional environment like Australia will be challenging. DAA drives innovation in practice across all areas, not just Leadership. DAA is often at the forefront of innovation, moving the profession forward. HWA funding, targeted at forward thinking organisations like the DAA, or sites willing to test the framework, is the best option in the current environment. The DAA would welcome any such involvement in the framework if it believed it would build further on its own leadership framework and offer better opportunities for Dietitians to enter leadership positions. 5. The name Health LEADS Australia works well. Yes. The phrase lends itself to leadership. The term framework could be revised as this is not especially helpful in selling the concept it implies something inflexible and fixed. 6. The goal (healthy Australians and a caring sustainable health system is one I am happy to work for This is a worthwhile goal and having this as the overarching reason for this work is commendable. However, evaluation of this goal will be complex. What are the indicators for success? Perhaps the LEAD goal should be more one of incorporation of concepts into professional accreditation and career pathways. 4
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