Leadership Collaboration during Health Reform: An Action Learning Approach with an Interagency Group of Executives in Tasmania

By Harpur, Siobhan M. A. | Australian Health Review, May 2012 | Go to article overview

Leadership Collaboration during Health Reform: An Action Learning Approach with an Interagency Group of Executives in Tasmania


Harpur, Siobhan M. A., Australian Health Review


Implementing a reform agenda

Providing publicly funded health services is complicated and getting more so.1 Health service professionals, be they practitioners or administrators, vary significantly in their responsibilities and perspective and it is not unusual to have conflicting priorities, interests and organisational structures for the delivery of care.2 Health systems are often fragmented, with discrete sectors of care and treatment provided by private, public and community agencies, funded by state or federal governments and often within narrowly defined roles and definitions of provision. There is increasing demand for public health services to partner more with each other, and with other agencies and sectors including universities, general practice, the community sector, local government and the public. Typically the relations between health service providers at the professional, service and organisational level are under-developed or, at times implicitly, and sometimes explicitly, competitive.3

Tasmania's Health Plan,4 launched in May 2007, is designed to develop better integration of the provision of healthcare across this wide range of service, agencies and regions in a state with a small (500 000) but dispersed population. It especially focusses on the expected increasing importance of the delivery of care for an aging population, with an increased burden of chronic diseases and those for whom integration and continuity of care are critical. This is at a time when there is increasing expectation of improvement to safe, efficient healthcare provision, set against the growing constraints of an aging and generally poorly prepared workforce. Better integration is seen as a means to achieve the experience of 'seamless' care for consumers, to contribute to the sustainability of public health services by reducing duplication and improving efficient use of financial and human resources, as well as providing staffsatisfaction and therefore, improved retention.

Central elements of the ambitious plan include the improved coordination between clinical expertise, the establishment of tiered services and the improved integration between hospitals and primary and community care, as well as a commitment to greater collaboration between agencies that influence or provide healthcare. In addition, there is a commitment to population based planning, and to foster community engagement and approaches to the provision of services across the continuum that are based on principles of self management, health promotion, and partnership between health service providers and patients, or consumers and their communities.

The Tasmanian Health and Human Services Departmental Executive (Tasmania's most senior decision making committee chaired by the Secretary of the Department ) was keen to harness and develop the leadership capabilities within its own hospitals and health centres, and the health and community sector organisations that it works with or funds. Six months after Tasmania's Health Plan was launched, it was agreed that an executive leadership group would be formed, comprising senior leaders from inside the state health department, the university, general practice and the community sector. The purpose was to encourage and speed the implementation of Tasmania's Health Plan, especially in regard to better integration between services, within a context of several other workforce, system and organisational development strategies.5 Traditionally, settings for the delivery of healthcare have been determined largely by their source of funding, and there is increasing recognition of the need to ensure patient access is unimpeded by funding or organisational boundaries. The integration agenda is defined as linking two or more service providers or agencies to address the individual's or family's preventive, treatment, maintenance and support needs in a more coordinated and comprehensive manner.

The author of this paper, a Director in the State Health Department, took on the responsibility to design and facilitate the leadership group project6 using a framework of action learning. …

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