Home The Quarterly 2017 The Wrap:- RACMA Winter Professional Development Forum

The Quarterly

The Wrap:- RACMA Winter Professional Development Forum Print E-mail

Incorporating the World Federation of Medical Managers, 14 - 16 June, Melbourne

Medical administrators, clinicians, and researchers from across Australia and internationally converged on the Langham Hotel in Melbourne for The Royal Australasian College of Medical Administrators’ (RACMAs’) Winter Professional Development Forum. This is a particularly auspicious occasion in 2017, as RACMA celebrates 50 years since its formation as a medical college. This year the Winter Forum also incorporated the World Federation of Medical Managers. There were exciting talks from across the globe, and opportunities for RACMA Fellows to establish international links and learn from colleagues in places like Britain, Canada, Hong Kong, South Africa, Sri Lanka, Myanmur, and the United Nations.
altThroughout the three-day event, a mix of energetic expert panel discussion and workshops provided opportunity for over 80 attendees to think and to talk through issues related to medical leadership. This has been particularly important for those contemporary healthcare services globally which face the challenges of medical and organizational complexity, and increasing costs versus tightening funding; these have made innovation and reform, driven by our medical administrators, a greater priority than ever before.
The highlights from the first day included discussion about the importance of building partnerships between doctors and medical administrators for change and reform. There was general agreement among both presenters and the audience that fostering medical engagement is a necessary precursor for true partnerships to form. Medical administrators, by virtue of their role as system leaders, often make the first steps to reach out to clinical staff, and actively involve and support them in organisational improvement activities.
Presenters and audience members then shared some of the best ways they have found to improve engagement with their doctors, from nominal incentives such as lunch provided at meetings, through to more ingrained practices of always ensuring people are listened to and provided feedback, even if a doctor raises an issue that cannot be addressed. Mr John Clark described the culture of engagement at the award-winning McLeod Regional Medical Centre in the United States. There, rather than change coming from “on high”, was a culture of “physician-led, data-driven, evidence-based change”, characterised by asking doctors what quality improvement issues they wanted to work on, and providing them the support and training to do so.
Innovation and reform was the major focus of day two. The metaphor “repairing the plane while flying” was employed repeatedly to highlight the unique difficulties faced by healthcare organisations, which can’t just “switch off” care delivery in order to change or improve services. Presenters relayed some of their own successes, as well as failures, to implement change in their organizations. Dr Gershu Paul, for example, described success and ongoing challenge with attempts to modernize healthcare in the emerging economy of Burma/Myanmar through a state of the art private hospital that emphasizes patient-centredness and a multidisciplinary approach in a previously hierarchical and doctor-centred system. Across the cases presented, fundamental to success was the need to engage the different healthcare professions, as well as the community and patients; not just at the beginning, but all the way through.
In the afternoon, reform and innovation through the implementation of organisational, inter-organisational and national information technoloaltgy (IT) systems were discussed. Dr Michael Cleary shared the success of the Princess Alexandra Hospital in Brisbane, which has been implementing a full digital system, while Dr Monica Trujillo relayed the strategies for engaging the Australian community in the development of the National Digital Health Strategy. Providing an international perspective, Dr Fung Hong described how an inpatient medication order entry system was implemented in only two years in public hospitals across Hong Kong; an innovation that led to reduced medication error and waste, and improved decision support and efficiency. Underpinning this success was the approximately 1,200 staff working in IT support, and the involvement of clinicians in the early stages of planning the project.
On day three, the topic of clinical governance took centre stage. In the morning, Dr Heather Wellington, informed by experience in medicine, law, and sitting on healthcare and other boards, advocated for conceptualizing clinical governance as distinct from quality and safety management. While day-to-day quality and safety activities are carried out by the organisation, governance should more broadly encompass the ongoing evaluation of system design and system architecture to ensure that safe and quality care can proceed. This, Dr Wellington said, is the remit of boards of management.
This was followed by an afternoon of debate about the role of medical administrators in clinical governance. These discussions will feed into RACMA’s development of a framework for clinical governance. Based on previews at the workshop, the framework promises to be well-suited to the shifting nature of care delivery, in which variation is sometimes an impediment to safety and quality, and occasionally, for complex cases and scenarios, highly necessary to achieve these goals.
Overall, attendees and presenters alike agreed that the Winter Forum provided an opportunity for thoughtful discussion of the roles and responsibilities of the medical administrator in engaging clinicians, patients and the community, and in reform, innovation and clinical governance. The Spring Forum in October 2017 will build on this momentum.
Dr Kate Churruca
Postdoctoral Research Fellow
Centre for Healthcare Resilience and Implementation Science
Australian Institute of Health Innovation
Macquarie University
Last Updated on Thursday, 29 June 2017 10:53