Developing competent health service managers: how much do we know and how much have we done? Dr Zhanming Liang A/Prof Godfrey Isouard A/Prof David Briggs Prof Sandra Leggat A/Prof Peter Howard Outline An overview of the Australian health service management workforce Competency and Competency-based education and training approach: definitions and application Are we addressing the competency development needs of health service managers? example of the Australian higher degree programs Implications and conclusions 2
Australian HSM Workforce - Overview A sizable and growing HSM workforce in Australia: 22,400 managers in 2011 (11.5% growth since 2006). (Matins & Isouard, 2014) Definition of health manager used by the ABS as per ANZCO (Australian and New Zealand Standard Classification of Occupations Includes managers who work in hospitals and medical and other health services; Excludes managers who work in pharmacies outside hospital; Excludes senior nurses in-charge and others whose primary function is to provide patient care or services are not part of the definition, this would apply to others including many allied health services The size of the HSM workforce has been underestimated! 3 Australian HSM Workforce an underestimate No clear definition; Some managers do not identify themselves as health managers i.e. who carry dual roles (clinical/ managerial) Some managers may work outside of the ABS defined categories (I.e. outside of aged care, hospitals or health services) Some managers may have been through frequent career changes move from one specialised area to another area of management 4
Australian HSM Workforce - Challenges Ageing HM workforce; No clear definition existing for a health manager No universally accepted competency standards established No universally accepted training and qualifications requirements. Some health managers may not be sufficiently trained to be competent in managing HS delivery. Health labour workforce is complex and comprising overlapping clinical and other professional roles, including those of health managers Some managers may work outside the ABS defined categories 5 Developing a competent Australian HSM Workforce Confusion in the training and development of health service managers: skills, knowledge, ability, capability and competency Competency-based education and training approach Endorsed across the health profession for nearly three decades (Calhourn, Dollett et al. 2008); Implemented in formal health service management training in many prominent universities for more than a decade (Griffith 2007, Bradley, Cherlin et al. 2008, Calhourn, Dollett et al. 2008, Landrey, Stowe et al. 2012). Recommended by NHHRC (2009) 6
Management Competency A descriptive tool that identifies the skills, knowledge, personal characteristics, and behaviours needed to effectively perform a role in the organisation and help the business meet its strategic objectives (Lucia & Lesinger, 1999 p. 5). the combination of skills, abilities and knowledge need to perform a specific task (Welton, 2007)(p81) Competency is associated with a job rather than individual Competency is context sensitive Capability is what a person can brings a person s ability to demonstrate the required competencies on their job 7 Developing the Australian HSM Workforce Higher Degree Education Perspective Many forms: in-service training; offsite intensive training; seminars and conferences, and formal education and study; Postgraduate qualification as predictor; Higher degree education and training to health service managers in Australia 13 Master-level programs in NSW, Qld, VIC, SA, WA; 2 Bachelor-level programs; 2 programs are tailored for health executives; 2 programs are for clinical managers; 4 programs affiliated with RACMA; 11 programs affiliated with ACHSM 8
Higher Education Perspective Competency-based? How consistent are these programs in their training focus? Competency-based: 3 programs Skills and Knowledge: 8 programs Ability: 2 programs Concept of core management competencies 10 1. Leadership; 2. Professionalism; 3. Political awareness; 4. Leading and managing change; 5. Self management and resilience; 6. Evidence-Informed Decision Making; 7. Public and industrial relations and networking; 8. Operations Administration & Resource Management; 9. Knowledge of healthcare environment and the organisation; 9 10. Interpersonal, Communication qualities and Relationship Management Higher Education Perspective Competency-based? The Managerial Competency Assessment Project (MCAP) Six core competencies with 79 behavioural items Management Competency Assessment Tool 360º Subjective Assessment Case study-based Objective Assessment The MCAP journey and vision 2011-2013 2013-2014 2015-2017 10
HSM Postgraduate Programs Core subjects Required by # of programs Leadership 9 Health care system and reform 9 Health care quality 8 Health resource management / financial management 7 Human resource management 6 Planning and evaluation / project management 4 Evidence-based practice 4 Health policy 4 Law and Ethics 3 Epidemiology & Statistics 2 Health economics 2 Health information management 2 Population health 1 Project/practicum 7 11 M C A P Core Competencies Identified by programs All 9 Interpersonal, communication qualities and relationship management Knowledge of healthcare environment and the organisation Leading People and Organisation (Leaderships) 9 Operations, administration & resource management 7 Evidence-informed decision making 4 Enabling and managing change (Change 2 management) Public and industrial relations and networking 4 Self management and resilience Inadequate info Political awareness Professionalism Inadequate info Inadequate info 12
Implications and Conclusions: Why we need to work together Federation White Paper - Our government systems are not serving us well Contested responsibility between States and CW Focus on the structure not on care, service or access Focus on managing up Move towards the market Require a return to democracy- Localism, Sweden, UK and the Federation White Paper Competent and Capable Managers and Leaders Require managers and leaders who can Make sense of and interpret public policy into practice Engage locally with communities and stakeholders Work across the professions in teams, networks and across sectors Manage down and out Be skilled in and utilise a social determinants approach to community development, health literacy, self responsibility Be able to market, contract and purchase and understand the impact of technology Be self composed and emotionally and intellectually intelligent
How much do we know and how much have we done? Need to understand the past and present to SHAPE the future Liang et al Martins & Isouard Leggat et al Briggs SHAPE Declaration Engage with the health sector but be aware of conformity and stereotyping - Intellectual competence VET sector, CS&HS Council and MOOCs Collaborate through research, products and use technology MCAP Potential for SHAPE to demonstrate leadership Thank you http://mcap.cloudapp.net/