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Health LEADS Australia: the Australian health leadership framework

July 2013

HWA | Health LEADS Australia: the Australian health leadership framework2

This work is copyright. It may be reproduced in whole for study purposes. It is not to be used for commercial (private enterprise) purposes without explicit permission.

Health Workforce Australia acknowledges the Canadian LEADS in a Caring Environment Health Leadership Capability Framework and our growing collaboration with the researchers, authors and users of that work. The LEADS acronym in Health LEADS Australia is used with the knowledge and agreement of the Canadian LEADS Collaborative.

Subject to an acknowledgement of the source, reproduction for purposes other than those indicated above, or not in accordance with the provisions of the Copyright Act 1968, requires the written permission of Health Workforce Australia.

Enquiries concerning this report and its reproduction should be directed to:

Health Workforce Australia Post | GPO Box 2098, Adelaide SA 5001 Telephone | 1800 707 351 Email | hwa@hwa.gov.au Internet | www.hwa.gov.au

Suggested citation: Health Workforce Australia [2013]: Health LEADS Australia: the Australian Health Leadership Framework

HWA | Health LEADS Australia: the Australian health leadership framework3

Health leadership Leadership has similarities in all industries although health is recognised for its complexity and its purposes. Health leaders strive to improve clinical and quality of life indicators, and the wellbeing of the health system. Research shows ‘the quality of health leadership directly and indirectly affects the quality of patient care and is an important factor supporting best practice1.’ Leaders affect ‘people, their satisfaction, trust in management, commitment, individual and team effectiveness (and) the culture and climate of organisations2. While other factors are important, leadership plays a central role in mobilising people towards a common goal3.

Health leaders engage with others to influence health and well-being and the quality of care for birth, illness and the end of life.

Challenges

Australia’s health system faces many challenges. These include:

• Balancing the increasing burden of chronic disease with developing primary healthcare.

• Improving health outcomes for Aboriginal and Torres Strait Islander people and other groups.

• Addressing financial pressures that influence the timing, nature and length of care.

• Improving the distribution and sustainability of the health workforce.

• Ensuring a continuing focus on safety and quality at all levels of health care.

• Building respect and cooperation among the diverse professional and organisational approaches operating within the health system.

Adding to these challenges is the complexity and interconnected nature of the health system, which includes:

• Those who use it as patients, families, consumers and carers.

• Those who work in it as clinicians, practitioners, administrators, support workers, volunteers, researchers, policy makers, advocates and others.

• Private, public, not-for-profit health services including hospitals, pathology, aged care, GP clinics, dental clinics, allied health, maternal and child health, and many more.

• University and VET sector health education and training and professional colleges.

Connections between these are not always visible but a change to any part of the system may have implications for the whole.

1 HWA (2012) Leadership for the Sustainability of the Health System: Part 1 A Literature Review page 9. Available at: http://www.hwa.gov.au/publications

2 ibid

3 Ibid – multiple authors cited.

HWA | Health LEADS Australia: the Australian health leadership framework4

Leading for improvement Capable leadership, governance, and management are cornerstones of successful efforts to improve the quality of lives and to achieve the maximum impact from health investments. There are overlaps where context and situations influence which skills are needed but leadership, management and governance are not the same. The terms ‘leadership’ and ‘management’ are often used interchangeably. Many authors accept that ‘the purpose of leadership is to bring about movement and constructive change, while the role of management is to provide stability, consistency, order and efficiency4.

A Chief Executive Officer, consumer advocate, nurse manager, registrar, podiatrist and a hospital cleaner, may each impact the wellbeing and health outcomes of consumers.

Distributed leadership involves everyone with the capacity and desire to lead for improvement working to ensure a vibrant and realisable vision of a people centred health system that is equitable, effective and sustainable. In leading for improved health outcomes, everyone may show leadership in their area of influence.

Principles guiding Health LEADS Australia

1. Everyone owns leadership. The quality of leadership throughout any system is vital for its reform and achievement of purpose. In health, effective leadership is a public good for which everyone shares responsibility.

2. Developing capable leaders builds health leadership capacity. Personal and professional development is essential and lifelong. Health LEADS Australia is for leaders and potential leaders at any place in the system intent on improving their ability to engage with others to influence for better health outcomes. Leading in health, individually and together, requires courage, passion and the capabilities to follow through.

3. The person you are is the leader you are. People will express the capabilities in this framework differently in different contexts and in a manner consistent with their personality, style, strengths and role.

4 HWA (2012) Leadership for the Sustainability of the Health System: Part 1 A Literature Review page 14. Available at www.hwa.gov.au/publications

HWA | Health LEADS Australia: the Australian health leadership framework5

The goal

Leadership for a people focussed health system that is equitable, effective and sustainable.

• ‘People focussed’ aligns with evidence that the best healthcare has the person at its centre and workplace satisfaction leads to better clinical and consumer outcomes.

• ‘Health system’ includes all the organisations and people whose primary purpose is to improve health.

• ‘Equitable’ reflects evidence that health inequalities exist within populations, and hospitals and health care services can be sources of inequality for patients, clients and workers.

• ‘Effective’ means the best possible clinical, consumer, quality and team outcomes.

• ‘Sustainable’ focuses on meeting the health care needs of both current and future generations.

Health leaders show respect for all who use health services, their families and communities and for those who work in health services.

Health LEADS Australia – a national approach

Health LEADS Australia was developed through research and dialogue. It is built on existing and validated international work, and focusses on capabilities required to deal with contemporary Australian health issues. Over 700 individuals and organisations provided input during its development. In June 2013 the Australian Health Ministers’ Advisory Council approved Health LEADS Australia as a nationally agreed health leadership framework. Future validation work will evaluate the impact of having a national framework for health leadership.

Health LEADS Australia has five areas for focus: Leads self, Engages others, Achieves outcomes, Drives innovation and Shapes systems (L-E-A-D-S). Leadership can begin in any area.

Leadership requires reflection and improvement of self (Leads self), fostering growth in and influencing others (Engages others), and communicating a vision for the future and enabling decisions to align with the goal (Achieves outcomes). To achieve outcomes, leaders embrace the spirit of change and innovation (Drives innovation) and strategically understand and align complex systems with the goal (Shapes systems).

Health leaders need knowledge and skills relating to all five areas of Health LEADS Australia to be successful in generating and sustaining improvement.

HWA | Health LEADS Australia: the Australian health leadership framework6

Health LEADS Australia defines capabilities for leaders in all areas of the health system and provides a common language for health sectors across the country. It is a foundation for:

• Linking and strengthening health leadership training and development opportunities.

• Embedding leadership in health education, training and accredited continuing development.

• Strengthening and supporting development of Aboriginal and Torres Strait Islander health leaders.

• Promoting collaborative inter-professional leadership development and clinical practice.

• Enabling and improving quality and safety in all the parts of the health system.

As the national health leadership framework Health LEADS Australia is a visible symbol and practical expression of a shared commitment to strive to develop a more people

centred health system that is equitable, effective and sustainable.

Health LEADS Australia is a reference point for:

• Individuals: personal and professional development

• Organisations: leadership development work

• Professions, regulatory and accrediting bodies: practice and course accreditation standards

• National, state and territory agencies: leadership development and building portable capabilities

• Training and academic bodies: curricula to address leadership in the health system.

Health LEADS Australia will, over time, be supported with tools, stories, networks and programs. Individuals and organisations are encouraged to contact HWA at

HWALeadership@hwa.gov.au to request a free licence to use Health LEADS Australia.

HWA will connect people with like interests, support communities of practice and co-ordinate development of measurable behaviours and appropriate tools.

As programs are developed, news of these will be circulated.

HWA | Health LEADS Australia: the Australian health leadership framework7

Leads self Leaders are always a work in progress. They know their strengths and limitations and commit to self reflection and improvement. They understand and display self-awareness, self-regulation, motivation, empathy, and social skill. They demonstrate integrity in their role and context, and show resilience in challenging situations.

Capabilities Descriptors

Is self aware. Understands and manages the impact of their background, assumptions, values and attitudes on themselves and others.

Seeks out and takes opportunities for personal development.

Actively reflects on their performance as a leader and assumes responsibility for engaging in learning and growth.

Has strength of character. Is honest, trustworthy and ethical and models integrity, courage and resilience.

Health LEADS Australia: the Australian health leadership framework

HWA | Health LEADS Australia: the Australian health leadership framework8

Engages others Leaders enable people to engage with a vision or goal through stories and explanations that make sense of complexity. Leaders encourage others to see and accept opportunities to contribute, learn and grow.

Capabilities Descriptors

Values diversity and models cultural responsiveness.

Recognises first Australians and ensures all people, consumers and workers, are treated with dignity and respect in all healthcare settings.

Communicates with honesty and respect.

Is approachable, listens well, presents ideas and issues clearly, and participates in difficult conversations with consumers and colleagues with humility and respect.

Strengthens consumers, colleagues and others.

Inspires and enables others to share ideas and information, to take opportunities to grow and lead and to collaborate for high performing groups and teams.

Achieves outcomes Leaders are people who work to make a difference. They set a direction that is inspiring and motivating, they enable energy and effort to succeed, and they keep their eye on the goal. Health leaders work with compassion to influence the quality of care and the sustainability of the system.

Capabilities Descriptors

Influences and communicates the direction.

Collaborates with consumers, colleagues and others to identify, influence and set goals that achieve the vision.

Is focussed and goal oriented. Influences alignment of resources and decisions with goals and evidence to enable quality, people-centred health work and continuous improvement.

Evaluates progress and is accountable for results.

Continually monitors and improves, celebrates achievements and holds self and others accountable for individual and service outcomes.

HWA | Health LEADS Australia: the Australian health leadership framework9

Drives innovation Innovation in health is not just for a new product. It includes fundamental changes to business and models of care to achieve people-centred quality services. A key factor for successful innovation is passionate leadership, without which the status quo cannot be challenged5.

Capabilities Descriptors

Champions the need for innovation and improvement.

Inspires and leads others to question, recognise where change is needed, canvas possibilities, support fresh thinking, take risks and collaborate for improvement.

Builds support for change. Influences informed discussion on health issues in every encounter, encourages diverse voices and consumer involvement and advocates for better outcomes.

Positively contributes to spreading innovative practice.

Initiates and maintains momentum for assessing, sharing and celebrating changes for people-centred service and system improvement.

Shapes systems Health is a complex evolving system where all the parts, including services, legislation and funding, are interconnected. A change in one part has implications for the whole. Leaders who recognise patterns of interdependency are able to explain trends and facilitate strategies that achieve maximum benefits and minimise unintended harm or negative consequences.

Capabilities Descriptors

Understands and applies systems thinking.

Communicates system awareness and negotiates within and across health teams, services and sectors to improve individual and local health outcomes.

Engages and partners with consumers and communities.

Involves consumers and communities in decision making for health policy, education and training and health care delivery and improvement.

Builds alliances. Promotes understanding, respect and trust between different groups, professions, organisations, sectors and points of view to enable effective collaboration, enhance connectivity, and minimise unintended consequences.

5 Natalie Grazin Director of Knowledge Development, International Partnerships for Innovative Healthcare Delivery – www.ipihd.org/

HWA | Health LEADS Australia: the Australian health leadership framework10

Enquiries concerning this report and its reproduction should be directed to:

Health Workforce Australia Post | GPO Box 2098, Adelaide SA 5001 Telephone | 1800 707 351 Email | hwa@hwa.gov.au Internet | www.hwa.gov.au