Prerequisites:Students must have attended Intensive Workshop 1, studied Modules 1 and 2, and completed Module 1 discussion activity.

Prerequisites:Students must have attended Intensive Workshop 1, studied Modules 1 and 2, and completed Module 1 discussion activity.

Watch this video and read the article together with the assignment materials and write 250 words

Video Link https://youtu.be/4TKYINZtEiYExplore the issue of integrated service provision in light of the proposed home care redesign for older adults.https://www.health.gov.au/topics/aged-care/aged-care-reforms-and-reviews/reforming-in-home-aged-careLinks to an external site.Explore the integration of home service provision in the existing design and delivery of aged care services in Australia. Analyze the purpose and utilization of home care services. Identify the caregivers responsible for providing such care. Consider how home care can contribute to a more integrated aged care system. Discuss potential metrics and methods to measure the effectiveness of home care services.

In your reflection, draw upon your understanding of organisational designs, purpose and alignment, performance, and innovations to provide thoughtful insights and analysis. Consider the implications of these concepts for improving the organization, leadership, and problem-solving approaches in the aged care sector.

Note: The reference to the ABC news highlights the real-world context and encourages you to apply your learning to a relevant and pressing issue in the field.

Please post your responded in the discussion forum. You are encouraged to reflect on peer activity as well.

Module 2: Discussion Activity

Madhan Balasubramanian.

Prerequisites:Students must have attended Intensive Workshop 1, studied Modules 1 and 2, and completed Module 1 discussion activity.

Go to this linkhttps://youtu.be/4TKYINZtEiYExplore the issue of integrated service provision in light of the proposed home care redesign for older adults.https://www.health.gov.au/topics/aged-care/aged-care-reforms-and-reviews/reforming-in-home-aged-careLinks to an external site.Explore the integration of home service provision in the existing design and delivery of aged care services in Australia. Analyze the purpose and utilization of home care services. Identify the caregivers responsible for providing such care. Consider how home care can contribute to a more integrated aged care system. Discuss potential metrics and methods to measure the effectiveness of home care services.

In your reflection, draw upon your understanding of organisational designs, purpose and alignment, performance, and innovations to provide thoughtful insights and analysis. Consider the implications of these concepts for improving the organization, leadership, and problem-solving approaches in the aged care sector.

Note: The reference to the ABC news highlights the real-world context and encourages you to apply your learning to a relevant and pressing issue in the field.

Note: I shared the readings with you earlier

Hi Experts

This assignment leads to my last project which is a major assignment.

My country is PNG, a Pacific Island up north of Australia. I work as director of nursing for many years in a 300-bed capacity provincial hospital serving half a mill population. A critically important action the hospital should do in solving problems is keeping records of every data ie in all aspects/practices so information can be valuable for decision makings/planning and etc but most often overlooked. A lot of times monthly, quarterly, and annual hospital operational reports are submitted to the big bosses but often nothing is done about it.

Assessment 1: Identifying and Analysing Complex Organisational Problems

Value: 20% Length: 1000 to 1500 words

In this assessment, you are asked to write a report aiming to identify and analyse a complex organizational problem in your organisation or an organisation you are familiar with. You will be required to apply organisational analysis tools and models to analyse the problem within the context of the organisational purpose and strategic directions.

This assessment is building on the online activities that have been completed to date. Subsequently, an in-depth analysis of the problem including links to theory and research will assist you greatly in the final assessment report to help you identify and justify solutions to the problem in your final assessment.

Please use the following guidelines for the report:

A) Putting the Organisation into Context (20%):- Discuss the organisation (the industry/market the organization is in and target customers, the organizational purpose and strategic directions).B) Identification of a Complex Organisation Problem (20%)- Describing the problem in its organisational context.- Explaining why it is a complex (or wicked) problem and justifying your answer.

C) Analysis of the organisational problem (40%)- Choosing and applying at least 2 organisational analysis tools and/or models that you would use to analyse the problem.- Justify why these tools would be appropriate.

In your analysis and discussion, please make sure that you:- Relate the discussion to the relevant management theories and concepts.- Include from 4 to 10 relevant references in your analysis and discussion.

D) Conclusions and recommendations: (20%)- Drawing conclusions summing up the main points of discussions.- Recommending a course of action based on the analysis performed.

Please use a recognised referencing method (e.g. Harvard) when discussing ideas and perspectives from the literature (books, journals, websites). The percentages for each section indicate the weighting (importance) attached to each component. You can use it as a rough guide for word length of each section. The upper word limit of 1500 words in total will be enforced. The word count does not include references, tables, illustrations or appendices. Although you should be open about your experiences and insights, please include only those aspects which you feel comfortable discussing. As in other topics, all submitted assignments are confidential and will only be read by the lecturer.

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Systems thinking enables you to see the connections between different areas and enables you to predict the behaviour of the systems. Using this concept, I can see that aged care is a Complex Adaptive System. Aged care is not a single service model- it has a range of programs and services (like the Health Care system overall), ranging from in home care through to residential care. It has two sources of funding- the Australian Government and the older persons contributions. It has one of the largest service industries in Australia, which encompasses a large workforce and over 3000 providers of care. Within these providers are different entities such as not for profits, community and privately owned entities, and the regulation of the industry is overseen by the Aged Care Quality and Safety Commission. (Commission, 2021)

A systems thinking approach considers all aspects of the problem including the context in which the issues are situated. (World Health, 2009)

Taking all these parts into consideration and applying the systems thinking theory it becomes apparent that the aged care industry is a complex adaptive system. De Savigny cited in World Health (2009) describes six Health System building blocks called the Framework for Action, which reflect the issues the Commissioner investigated during the Aged Care Commission. They covered the areas of service delivery, Health workforce, Health Information, medical technologies, health financing, and Leadership and Governance. Their report highlighted and addressed all these building blocks.

To improve the aged care system all these building blocks need to be addressed. Treating them individually will not improve the system. McDermott (1997) explained that if you want to change one thing, you must also change all the other interconnected parts.

The aged care report has drawn together and analysed all the issues within the industry and put forth 115 recommendations. These are what De Savigny (cited in WHO, 2009) would call the leverage points. He explained that the two highest leverage points are in governance and information and are the ones that usually receive the least amount of attention. This report has highlighted that leadership from the Government level is the most important leverage point. Horvat and Filipovic (2018) explain that the leadership is a crucial element of an organisations success and thus addressing the leadership level at the highest level will have the most impact on the problem.

Moving forward the Government must decide if it wishes to implement the recommendations. Issues that may arise include the underlying political agendas which will influence their decisions, and possible changes to the leadership and/or Government will have impact. The Government needs to decide what type of leadership style and influence it will use to solve the issue. Horvat and Filipovic (2017) explain that in a complex, non-linear model there needs to be adaptive leadership. The former administrative model which involves bureaucracy, hierarchy and control will not succeed with this type of wicked problem and the more parties involved in the problem the higher the need for high quality management and leadership. (Head and Alford, 2015) As there are many facets within the aged care industry, there are also within the Government. Political debate and individual values may inhibit decision making at the Federal level and impede the changes required.

REFERENCES

COMMISSION, A. C. R. 2021.Aged Care Royal Commission Final Report: Summary[Online]. Available:https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-executive-summary.pdfLinks to an external site.[Accessed 31 july 2023].

HEAD, B. W. & ALFORD, J. 2015. Wicked Problems:Implications for Public Policy and Management.Administration & Society,47, 711-739.

HORVAT, A. & FILIPOVIC, J. 2018. Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.Journal of Evaluation in Clinical Practice,24, 301-307.

MCDERMOTT., J. O. C. A. I. 1997.The art of systems thinking : essential skills for creativity and problem solvingLondon, Thorsons.

WORLD HEALTH, O. 2009.Systems Thinking for Health Systems Strengthening,Albany, SWITZERLAND, World Health Organization.

Leading organizations in health and aged care

ABC News highlighted a vital concern of the aged care crisis, which seeks to depict the organization of aged care in Australia and the challenges they face. Using the knowledge gained from the module, I will provide an insightful analysis of concerns such as organization, leadership, and the nature of problems faced in aged care.

Australia has a complex healthcare system organization for aged care with stakeholders such as caregivers, healthcare providers, government agencies, and older people. The organization operates from a dynamic setting due to the constant changes experienced by the aging population's needs and demands (ABC News (Australia). 2020). The aged care sector is an interconnected system where the whole organization can experience effects due to changes in one area. Decisions for a particular change require careful consideration to avoid potential risks of the organization collapsing.

The complexity of the health organization of aged care makes it challenging for the leadership to adapt to its nature. Leaders must deal with stakeholders with different opinions, priorities, and interests, such as funding limitations, government regulations, workforce shortages, and the well-being of vulnerable people (Dixit & Sambasivan, 2018). There is a need for an agile leadership style to be implemented that will adapt and address the numerous challenges. Leaders need to adapt to the complexity theory and understand that there is a need for collaboration, creativity, and innovation to get effective solutions.

The aged care crisis has numerous interconnected and systemic problems with funding limitations that can hinder aged people from getting quality care. In addition, there is little chance of innovative solutions due to a lack of collaboration between leadership and other stakeholders. The quality of care issues such as neglect and abuse are outstanding challenges in providing care to the elderly (Delaney, 2018). In addition, there needs to be more proper oversight by the leadership and a lack of consistent standards across diverse care providers. The problems should be part of larger interconnected whole and complex adaptive systems that must be solved through collaboration. The aged care crisis needs a holistic approach to be resolved.

References

ABC News (Australia). (2020).Government releases final report of the Royal Commission into Aged Care | 7.30[Video]. YouTube.https://www.youtube.com/watch?v=kuo0QuuMG5kLinks to an external site.

Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia.Collegian,25(1), 119-123.

Dixit, S. K., & Sambasivan, M. (2018). A review of the Australian healthcare system: A policy perspective.SAGE open medicine,6, 2050312118769211.

Aged care sector is a complex system with multiple stakeholders, including government bodies, healthcare providers, caregivers, and the elderly themselves. The sector is subjected to various regulatory frameworks, funding mechanisms, and service delivery models. This complexity can result in fragmentation and coordination challenges, impacting the overall quality of care (Woods and Michael 2022).A systems-based approach is essential for addressing the aged care challenge. This includes understanding the system's interdependence, in which subtle changes in one area can have reverberating consequences on the entire system. It also necessitates incorporating all stakeholders in decision-making processes and encouraging teamwork to build a shared vision for aged care.

The Aged Care Royal Commission Final Report released on 1 March 2021highlighted the importance of comprehending the current aged care system in order to envision a new one recommending the need to place people at the centreand a new aged care system including designing accommodation for quality of life, respecting uniqueness in aged care for Aboriginal and Torres Strait Islander people , fairness and flexibility in aged care in regional, rural and remote Australia, improving aged care through data, research and technology, good provider governance and many more. A holistic and flexible approach to leadership and problem-solving is required in light of this understanding. Cultivating a culture of learning and improvement can lead to more effective solutions.

The Royal Commission report also noted that, in comparison to other Australian mainstream health care organizations and foreign aged care services, senior managers in residential aged care lacked the leadership abilities and tactics. Being a leader in the elderly care industry is particularly difficult since there are so many different stakeholders, all with different objectives and interests. Leaders must prioritize the welfare of the most vulnerable people under their care while navigating a maze of rules, financial limits, and workforce concerns. Furthermore, leaders must be flexible and adaptable to meet the changing needs of an aging society. Effective leadership, together with a managers ability to provide strategic direction, is regarded as important in promoting quality in healthcare settings -Anderson, Issel, and McDaniel(2013)

Multifaceted strategy is necessary for wicked problems. Long-term approaches to funding, workforce development, and the changing requirements of the aging population must be considered by policymakers. This might entail experimenting with various care models and routinely assessing their efficacy. Utilizing data and technology can also support decision-making processes and enhance the effectiveness and standard of treatment.

In conclusion, to adequately care for older Australian citizens there is a need for fundamental shift in the approach to organization, leadership, and problem-solving. It is important that government implement the Royal Commission recommendation by adopting systems thinking, complexity theory, and embracing adaptive strategies, and support extensive policy reform that will support improved employment conditions, pay, training, and career routes.

References

Aged Care Royal Commission Final Report:https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-executive-summary.pdfLinks to an external site.ABC News (Australia). (2020).Government releases final report of the Royal Commission into Aged Care | 7.30[Video]. YouTube.

Dawes, Nathan, and Stephanie M. Topp. "A qualitative study of senior management perspectives on the leadership skills required in regional and rural Australian residential aged care facilities."BMC Health Services Research22.1 (2022): 1-11.

Montague, Alan, John Burgess, and Julia Connell. "Attracting and retaining Australias aged care workers: developing policy and organisational responses."Labour & Industry: a journal of the social and economic relations of work25.4 (2015): 293-305.

Woods, Michael, et al. "Sustainability of the Aged Care Sector: Discussion Paper." (2022).

ReplyReply to comment(1 likes)

How does your learning from Module 1 inform your understanding of the organisation of health and aged care in Australia, the leadership challenges faced in this sector, and the nature of problems encountered in aged care?

The Aged Care crisis is a massive concern currently for the Australian Government and its aged care residents, families and staff.

Issues in particular that have arose in Aged Care include (Delaney, 2018):

A workforce shortage. This is problematic as without adequate staffing in aged care facilities, this can lead to poor client centred care, and can also increase the risks of errors being made in these facilities, further leading to negligence of care. It is also rather concerning that many of the staff in aged care facilities are not adequately trained to manage such complex clients. This poor management of clients can also lead to abuse, which has been showed through camera footage in Aged care facilities. Abuse can come in the form of staff assaulting clients, or clients assaulting staff. Either way, there is a clear knowledge gap that needs to be addressed going forward.

Another issue consists of not enough allocated funding being provided to Aged Care facilities. Again this is problematic because this impacts the numbers of the workforce, equipment coming into aged care facilities and overall resources.

There needs to be more government regulation in relation to Aged care going forward. Australia is currently an aging population which also presents as a serious concern because this means that aged care facilities will be in higher demand than ever before. With this becoming a reality, it is essential that more funding is coming in to booster the workforce and training that staff receive to manage such high complex clientele.

The Aged Care Royal Commission Final Report was also met with dismay amongst communities, as many felt there was not enough done in this report to address the aged care crisis (Aged Care Royal Commission Final Report, 2021).

In terms of reflecting on the leadership challenges that arise in the context of aged care, it can be difficultmanaging and leading in a system that involves multiple stakeholders, regulatory frameworks, and the well-being of vulnerable individuals. It is essential as a leadership figure to always collaborate and demonstrate effective communication to all stakeholders and other individuals. Collaboration between everyone is important, as this can decrease the chances of errors, and miscommunications. It is also important that leadership figures in aged care provide education to staff regarding currently regulatory frameworks and the importance of these (Boffa, 2022).

Systems thinking is important because this allows for connections to be visualised between different areas. This can further allow people to predict the behaviour of systems. Based on the structure of an aged care, and how it operates/functions itis a Complex Adaptive System. This is because it is dynamic in regards to interactions within the organisation.

References:

Boffa, A. (2022). Aged care workforce must be dementia-ready.Australian Ageing Agenda, 16-16.

Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia.Collegian,25(1), 119-123.

Aged Care Royal Commission Final Report, 2021:https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-executive-summary.pdfReplyReply to commentThe ABC News film (ABC News (Australia), 2020) explores the aged care crisis in Australia, specifically focusing on aged care system, leadership challenges, and complexities therein. Applying concepts from Module 1, such as organisational theory, systems thinking, and complex adaptive organisations, improves our understanding of these elements and helps identify areas for improvement.

Organisational theory is valuable as it enhances comprehension of the structure and social dynamics of the service we are involved in and enables us to analyse the operating environment (Jones, 2013, p.31). The health and aged care sectors involve various stakeholders, such as government entities, care models, providers, healthcare professionals, carers, care recipients, and their families. Companies have different organisational structures, such as hierarchical, flat, divisional, and network-based systems, which affect decision-making, coordination, and communication. The news footage highlights the negative consequences of neglect and insufficient treatment, which can be exacerbated by organisational inefficiencies and misaligned incentives (ABC News (Australia), 2020).

Applying systems thinking to the aged care dilemma reveals the intricate interdependencies within the industry. The Institute of Medicine (2001) considers the use of a complex adaptive system framework in the context of health and aged care as it emphasises the interconnectedness of problems and the need for comprehensive solutions (Sturmberg & O'Halloran, 2012). Systems thinking allows for the analysis of complex relationships among various elements, highlighting the importance of addressing root causes rather than surface-level symptoms(Institute of Medicine, 2001).

The aged care industry faces various challenges, stringent regulatory frameworks, inadequate funding, shortages in the workforce, concerns regarding the quality of care, and the changing needs of the ageing population. The complex and interrelated nature of these issues poses a challenge for resolving them using conventional linear approaches. In order to address the growing problem, it is necessary to adopt innovative strategies that are suitable for the intricate nature of the sector(Sturmberg & O'Halloran, 2012). Experimentation, knowledge acquisition, and feedback loops are key when applying a complex adaptive system framework to improvement. Horvat and Filipovic (2018) suggest that implementing these methodologies can help companies in the aged care sector identify innovative solutions and respond efficiently to evolving demands.

The leadership challenges in the aged care sector stem from the involvement of multiple stakeholders, regulatory frameworks and the need to prioritise the well-being of vulnerable individuals (Pagone & Briggs, 2021). The ABC News emphasises leadership failures caused by inadequate monitoring, distorted incentives, and deficiencies in accountability procedures. For leaders to effectively address ethical and operational challenges they need to consider an approach that also promotes a culture that values compassion and excellence (Horvat & Filipovic, 2018). Financial reward schemes have limited efficacy in motivating performance in the health and aged care sectors due to their limited impact on long-term patient commitment to values and actions (Sturmberg & O'Halloran, 2012).By applying system thinking, leaders are more likely to understand the broader implications of their decision-making (Rosas, 2017). Leaders have the potential to bring about positive strategic changes in the aged care system by identifying and resolving fundamental systemic problems (World Health Organisation, 2009).

The intricate and interconnected nature of factors in aged care renders it a "wicked problem," a term initially introduced by Rittel and Webber (1973) describing the problems that are challenging to anticipate and whose definition evolves as potential solutions are explored or put into action. The aged care sector may require a comprehensive approach to address strategic misalignments. To address these challenges effectively, it is crucial to utilise adaptive and flexible strategies that can accommodate changing circumstances (Raisio, Puustinen, & Vartiainen, 2018).The limitations of traditional models and frameworks in dealing with complex and challenging issues are emphasised when examining wicked problems in the fields of strategic management and aged care. Traditional approaches are inadequate for addressing the complexity of wicked problems due to their reliance on assumptions of stable environments, linear cause-and-effect relationships, and predictable outcomes (Raisio, Puustinen, & Vartiainen, 2018).

Gaining a new perspective is vital for effectively implementing a strategic approach that aligns with the needs of the aged care sector. Collaborative approaches and innovative strategic methods would be better suited to achieve this goal (Horvat & Filipovic, 2018) by effectively addressing complex and challenging issues in the sector. To effectively address the complex and evolving challenges in the aged care industry, it is crucial to acknowledge the limitations of traditional methods and prioritise collaboration, workforce empowerment, and adaptability (Horvat & Filipovic, 2018).

Emphasis is now on incorporating organisational theories, systems thinking and complex adaptive systems in the field of aged care. The integration of these concepts is crucial for recognising systemic inefficiencies, improving leadership approaches, and finding effective solutions for the complex challenges in the aged care industry (Pagone & Briggs, 2021).

References

ABC News (Australia). (2020). Government releases final report of the Royal Commission into Aged Care. Retrieved July 28, 2023, from https://www.youtube.com/watch?v=kuo0QuuMG5kHorvat, A., & Filipovic, J. (2018). Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.Journal of Evaluation in Clinical Practice, 24(1), 301-307. doi:https://doi.org/10.1111/jep.12789Institute of Medicine. (2001).Crossing the Quality Chasm : A New Health System for the 21st Century.Washington: National Academies Press.

Jones, G. R. (2013).Organisation Theory, Design and Change(7th ed.). Harlow: Pearson Education Limited. Retrieved August 04, 2023, from https://industri.fatek.unpatti.ac.id/wp-content/uploads/2019/03/085-Organizational-Theory-Design-and-Change-Gareth-R.-Jones-Edisi-7-2013.pdfPagone , G., & Briggs, L. (2021).Royal Commision into Aged Care Quality and Safety Final Report - Care, Dignity and Respect: Volume 1.Commonwealth of Australia. Retrieved August 4th, 2023, from https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-volume-1_0.pdfRaisio, H., Puustinen, A., & Vartiainen, P. (2018). The Concept of Wicked Problems, Improving the Understanding of Managing Problem Wickedness in Health and Social Care. In W. Thomas, A. Hujala, S. Laulainen, & R. McMurray (Eds.),The Management of Wicked Problems in Health and Social Care.Routledge. Retrieved from https://books.google.com.au/books?hl=en&lr=&id=eUNvDwAAQBAJ&oi=fnd&pg=PT21&dq=the+management+of+wicked+problems+in+health+and+social+care&ots=PMB-Ij1JBy&sig=aU8N7hhCClKRp3QcZwujhNh1lRo#v=onepage&q=the%20management%20of%20wicked%20problems%20in%20health%20Rittel, H. W.

, & Webber, M. M. (1973). Dilemmas in a general theory of planning.Policy Sciences, 4, 155169. doi:https://doi.org/10.1007/BF01405730Rosas, S. R. (2017, April). Systems thinking and complexity: considerations for health promoting schools.Health Promotion International, 32(2), 301-311. Retrieved August 5th , 2023, from https://academic.oup.com/heapro/article/32/2/301/2950984

Sturmberg, J. P., & O'Halloran, D. M. (2012, January 05). Understanding health system reform a complex adaptive systems perspective.Journal of Evaluation in Clinical Practice, 18, 202-208. doi:https://doi.org/10.1111/j.1365-2753.2011.01792.xWorld Health Organisation. (2009).Systems Thinking for Health Systems Strengthening.(D. de Savigny, & T. Adam, Eds.) World Health Organisation.

Aged Care definition: Aged care is a support provided to older people in their own home or in an aged care (nursing) home (DOHA, 2020).

AIHW (2023) states approximately 407,000 people are using residential aged care, home care or transition care in Australia. This comprises 188,000 people using permanent or respite residential aged care, 216,000 using home care and 3,500 using transition care.

The royal commission findings from the final report is targeting 188,000 people who are in a residential aged care. They reviewed whether the residential aged care is delivered in a sustainable way out of many considerations, to me the innovative models of care, and investing in aged care workforce will assist in improving the aged care sector. However, the findings also raised some concerns of whether the service provided by aged care sectors for people receiving Australian Aged Care do meet the Aged Care Quality and Safety Commission standards that intend to protect and improve the safety, health, wellbeing, and quality of life. Also can older Australians believe that their needs are met according to those standards (ACQSC 2021).

World, Ho (ed), 2009, use this illustration according to WHO Framework for action on health system that describe health system Building blocks that together they complete the system.

Also indicate that health system may be understood through the arrangement and interactions of its parts and how they enable the system to achieve the purpose of which it was designed. figure 1.1 and figure 1.2 show that the building blocks alone do not constitute a system, but it is a multiple relationships and interaction among the blocks. They continue elaborating by indicating how this blocks convert into a system. by stating that a pile of bricks constitutes a functioning building. Does mention that the evaluation of a system and its subsystems is based on criteria such as efficacy, effectiveness, efficiency, ethics, elegance/aesthetics, and environmental impact (WHO 2009).

Australia aged care is assessed and monitored by Aged Care Quality and Safety Commission who have come with some recommendation to improve the care provided in residential aged care. The Australian Government received the Royal Commission Final Report. According to the Media release 1 March 2021 the Government addressed the identified concerns regarding governance, diversity, dementia food and nutritions. Also, immediate funding is allocated to enhance the capacity of Aged Care Quality and Safety Commissions and regulation for the use of restraints in care (DOHA 2021).

The Question come: Is this enough to address the Aged Care crisis?

References:

AIHW (Australian Institute of Health and Welfare) (2023), Accessed 06 August 2023. https://www.aihw.gov.au

ACQSC (Aged Care Quality and Safety Commission), 2021, reviewed 01July 2021 https://www.agedcarequality.gov.au/about-us

DOHA (Department of Health and Aged Care) (2021) reviewed 6 August 2023https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/respect-care-and-dignity-aged-care-royal-commission-452-million-immediate-response-as-government-commits-to-historic-reform-to-deliver-respect-and-care-for-senior-australiansLinks to an external site.DOHA (Department of Health and Aged Care), (2020), accessed 04 August 2022.https://www.health.gov.auLinks to an external site.World, HO (ed.) 2009, Systems Thinking for Health Systems Strengthening, World Health Organization, Albany. Available from: ProQuest Ebook Central. [6 August 2023]..How does your learning from Module 1 inform your understanding of the organisation of health and aged care in Australia, the leadership challenges faced in this sector, and the nature of problems encountered in aged care?

The 2021 Royal Commission into Australias aged care sector highlighted many key issues instigating the present aged care crisis. The findings of this report were damning, emphasising several challenges which collectively stem from years of poor organisational and system management by the Australian Government. The issues faced are multifaceted, with key stakeholders involving elderly patients, primary caregivers, healthcare providers and government policy/decision makers. The aged care sector is a complex system that relies on the interdependence of all components to ensure the correct and desired function of the system is upheld.

The report called for fundamental change to the aged care system, where Royal Commissioners Tony Pagone QC and Lynelle Biggs AO, provided an extensive list of recommendations to instigate must needed reform(Pagone & Briggs 2021). At the centre of this reform is the need to provide greater emphasis on a patient-centric model of care(Delaney 2018). The current poor standard of care is resultant of declining quality in some aged care providers and legislative focus on funding aged care providers as opposed to the elderly themselves(Pagone & Briggs 2021). These recommendations target leadership and legislation directly.

Leading organisations or departments in the context of age care is considerably challenging when considering the many moving parts of key stakeholders and their specific interests. Overall, it is important to reflect upon a system thinking approach when considering improvement to the aged care sector. A systems approach allows leaders to conceptualise the impact of interdependencies of the different components of the system, highlighting the need for effective communication and collaboration to ensure optimisation of care delivery(Leischow et al. 2008). Furthermore, the dynamic nature of challenges encountered in the aged care sector provides reason for leaders to view the sector as a complex adaptive system, where parameters such as patients, caregivers and regulations, and other components are continually changing(Leischow et al. 2008). Leaders should approach issues from a flexible viewpoint, by embracing challenges and promoting adaptability and innovation, to empower their employers to drive adaptive change in their organisation.

As alluded to in the Royal Commission, the issues faced by the aged care sector are multifaceted. Among the 148-strong list of recommendations provided by the Commissioners, it was determined that inadequate funding, workforce shortages, lack of quality control and inadequate government regulations and legislation were central to the issues encountered(Pagone & Briggs 2021). These issues are typical of complex/wicked problems faced by organisations(Raisio, Puustinen & Vartiainen 2018). As leaders, we should approach such issues with an innovative mindset that values collaboration between stakeholders to embrace and drive necessary change in an ever-changing health environment.

Overall, it is essential for health and aged care leaders to consider systems thinking and complexity theory when managing systems. These concepts will in turn, identify system deficiencies and provide adequate solutions to challenges presented. It is crucial to implement communication and collaboration, in conjunction with transformational leadership, to ensure effective management in aged care systems.

References:

Delaney, LJ 2018, 'Patient-centred care as an approach to improving health care in Australia',Collegian, vol. 25, no. 1, pp. 119-23.

Leischow, SJ, Best, A, Trochim, WM, Clark, PI, Gallagher, RS, Marcus, SE & Matthews, E 2008, 'Systems thinking to improve the public's health',Am J Prev Med, vol. 35, no. 2 Suppl, pp. S196-203.

Pagone, T & Briggs, L 2021, 'Royal Commission into Aged Care Quality and Safety Final Report: Care, Dignity and Respect', vol. 1, p. 340.

Raisio, H, Puustinen, A & Vartiainen, P 2018, 'The Concept of Wicked Problems : Improving the Understanding of Managing Problem Wickedness in Health and Social Care', in.

ReplyReply to commentHYPERLINK "https://canvas.flinders.edu.au/courses/9675/discussion_topics/97214" o "Mark as unread"

Collapse Sub discussionDaniel SofiaDaniel Sofia (He/Him)16:407 Aug at 16:40

Manage discussion entryThe royal commission into aged care in Australia was a long and lengthy process, initiated by repeated stories of harm and neglect, as well as pressure for consumer and professional groups to undertake a review. The ABC report mentioned the Oakden nursing home case, in which a government run nursing home was found to have breached standards of care in inhumane ways over a prolonged period of time (Lander 2018). The failings at Oakden were serious enough to close the facility. The findings of the South Australian Independent Commissioner Against Corruptions report helped make the case for a national royal commission.

The report from the commissioners (Pagone & Briggs 2021) discussed the depth and breadth of their investigation: 2 years, with over 10,000 submissions into the commission. The stakeholders involved give a useful insight into the interconnected systems and processes that make up the larger aged care system: consumers, families, staff working in aged care, businesses administering aged care, external healthcare organisations and providers, regulatory bodies, the federal government and the Aged Care Quality and Safety Commission. This is not an exhaustive list of the interconnected systems that make up the aged care system.

The report commented on all aspects of aged care, including the system as a whole. I found Waddell, Jones and George (2011)s definition of systems theory enlightening as I read the royal commission report a system is the relationship between internal subsystems of an organisation, and the broader external environment. I thought of this meaning as I learnt that despite aged care taking 4.2% of the total federal budget, only recently was the portfolio of Aged Care elevated to cabinet as a stand alone portfolio perhaps a reaction by the government of the day to preliminary findings of the royal commission. This illustrated to me that from the very highest level of government, there was a lack of clear leadership, direction and strategy for one of the largest governmental spends in Australia. A failure to have a clear strategy for managing chronic health conditions was also observed by van Wietmarschen, Wortelboer and van der Greef (2018), noting that the focus on specific strategies for single diseases is driving health costs to government higher, beyond the rate of inflation. This financial pressure was also noted in the royal commission, who predicted that aged care spending would be 5% of the federal budget spend by 2030. The commissioners noted that the aged care system is too centralised, in contrast to other Australian health systems which are more localised, which led to issues with accessing care. van Wietmarschen, Wortelboer and van der Greef (2018) used complexity theory to put forward a strategy where instead of governments using their levers of change (financial incentives, legal directives) for single disease interventions, they target interventions to increase links within networks or interconnected systems. An example of applying this theory to the findings of the royal commission could include building referral pathways and links to allied health for aged care facilities, where consumers and care providers can make links with established services. Jorgensen et al. (2020) discuss the impact of a policy change in Australian aged care that led to reduced access to services for people accessing home care packages. Their research showed that the new system increased complexity which in turn decreased demand. The aged care royal commission held this up as an example of system failure, which was supported by the research undertaken by Jorgensen et al.

The report also criticised the overall governance of the aged care system. There are over 800 individual businesses currently providing aged care services, each with their own strategies and values based on whether or not they are government run, operated by faith based not for profit organisations, or are run for profit. The ABC video highlighted that the biggest private provider BUPA had 1/3 of its nursing homes at risk of failing accreditation. A lack of consumer voice into the system was an aspect of governance raised by both the ABC and the commission report. This goes against long held theories and practices in business Deming (cited in Kreitner and Kinicki (2012)) demonstrated the importance of ensuring that the users of systems are part of the system design and function. Complex adaptive system theory helps provide a potential strategy to be part of the solution the use of shared values across systems (Sturmberg, O'Halloran & Martin 2012). Shared values across systems give consumers, practitioners and administrators a common ground to design workflows and establish ways of analysing and interacting with systems. The commissioners attempted to provide a vision in their report The purpose of the aged care system must be to ensure that older people have an entitlement to high quality aged care and support and that they must receive it. Such care and support must be safe and timely and must assist older people to live an active, self-determined and meaningful life in a safe and caring environment that allows for dignified living in old age (Pagone & Briggs 2021). This is a good starting point for shared values and ways of working.

There are multiple challenges ahead for the aged care system in Australia. The royal commission spent considerable time examining the systems and processes that make up the aged care system, which demonstrates the need to embed evidence-based systems management approaches as one of the strategies to improve aged care delivery in Australia. I hope that the aged care system will one day be mature enough to foster innovation a hallmark of functioning systems so that we could see something like the dementia villages seen for aged care facilities in the Netherlands (Planos 2014).

References:

Jorgensen, M, Siette, J, Georgiou, A & Westbrook, JI 2020, 'The effect of home care package allocation reforms on service uptake, use and cessation at a large Australian aged care provider',Australasian Journal on Ageing, vol. 39, no. 2, pp. e210-e4.

Kreitner, R & Kinicki, A 2012,Organizational Behavior, McGraw-Hill US Higher Ed USE Legacy, NY, UNITED STATES.

Lander, B 2018,Oakden: A Shameful Chapter in South Australia's History, South Australian Government, viewed 07/08/2023 2023, <https://www.icac.sa.gov.au/publications/published-reports/oakdenLinks to an external site.>.

Pagone, T & Briggs, L 2021,Royal Commission into Aged Care Quality and Safety Final Report: Care, Dignity and Respect, viewed 07/08/2023 2023, <https://agedcare.royalcommission.gov.au/publications/final-reportLinks to an external site.>.

Planos, J 2014, 'The Dutch Village Where Everyone Has Dementia',The Atlantic.

Sturmberg, JP, O'Halloran, DM & Martin, CM 2012, 'Understanding health system reform a complex adaptive systems perspective',Journal of Evaluation in Clinical Practice, vol. 18, no. 1, pp. 202-8.

van Wietmarschen, HA, Wortelboer, HM & van der Greef, J 2018, 'Grip on health: A complex systems approach to transform health care',Journal of Evaluation in Clinical Practice, vol. 24, no. 1, pp. 269-77.

Waddell, D, Jones, G & George, J 2011, 'Evolution of management', in D Waddell, G Jones & J George (eds),Contempory Management, McGraw-Hill Australia, North Ryde NSW, pp. 36 - 61.

ReplyReply to comment

Prerequisites:Students must have attended Intensive Workshop 1, tuned in to the relevant segment on ABC news video titled "Government releases final report of the Royal Commission into Aged Care | 7.30", and completed the required reading materials for Module 1.

https://youtu.be/kuo0QuuMG5kReflect on the following question in light of the aged care crisis recently highlighted by ABC news: How does your learning from Module 1 inform your understanding of the organisation of health and aged care in Australia, the leadership challenges faced in this sector, and the nature of problems encountered in aged care?

Consider the knowledge and insights gained from Module 1, which focused on organisational theory, systems thinking, and complex adaptive organisations. Apply this understanding to critically analyse the organisation of health and aged care in Australia, particularly in relation to the challenges and issues highlighted by the aged care crisis.

Reflect on the leadership challenges that arise in the context of aged care, including the complexities of managing and leading in a system that involves multiple stakeholders, regulatory frameworks, and the well-being of vulnerable individuals. Consider how the concepts of systems thinking and complexity theory can shed light on these challenges and inform potential solutions.

Furthermore, explore the nature of problems encountered in aged care, taking into account the systemic and dynamic nature of the sector. Consider the various factors that contribute to the complexities and wicked problems faced in aged care, such as funding limitations, workforce shortages, quality of care issues, and the evolving needs of an ageing population.

In your reflection, draw upon your understanding of organisational theories, systems thinking, and complex adaptive systems to provide thoughtful insights and analysis. Consider the implications of these concepts for improving the organization, leadership, and problem-solving approaches in the aged care sector.

Note: The reference to the ABC news highlights the real-world context of the aged care crisis and encourages you to apply your learning to a relevant and pressing issue in the field.

Please post your responded in the discussion forum. You are encouraged to reflect on peer activity as well.

General-20230728_090556-Meeting Recording 1

July 28, 2023, 3:35AM

3h 29m 19s

576072292608Hincksman, Natalie (Health) 0:08They're not single organ issue patients that often multi have multiple complex care needs and I think so having nursing in the educare facilities is a good thing, but probably need a bit more than what they've got at the moment.

576072292608Madhan Balasubramanian 0:25OK.Yeah, that's that's very.That's very interesting and well thought thought through, so a very good points coming out from your group.You did, uh, reflect on medication management, so that's that's one thing which I found it interesting coming out from the user of anti psychotic drugs from the ABC News.Not sure to what extent they have come out with solutions to address this and also just for our international students, for those who are new to these health and aged care systems, especially aged care systems in Australia, uh, they are unique in some ways.But one thing which makes it quite unique in Australia is the residential escape facilities, which which are just where less than 5% of the older people reside that that accounts for 750,000,000 that accounts for almost 95% of the HTK does a budget.So much of the funding goes into the residential age gap is ladies, but but 95% of the older people, they are still in retirement homes.They are still in respite care.They are still in temporary care.They're using Home Care Services.They are independently living.That's something that you might actually want to go.And see.So that's very interesting.The fact that the amount of funds the residential edge cases ladies take in terms of uh, now services and the budgets as well, uh.Another thing which is quite interesting is that the the use of Home Care Services as the ABC News rightly identified, with 100,000 people aren't waiting list when it comes to uncast services.So that's one.And also as you can see the demographics of the aged care in Australia, the demographics of the older people in Australia is considerably changing, you know, so just over the last 10 years, there has been a significant increase in the number of migrant good adults coming from South Asia from Southeast Asia, from Middle East.So that health perceptions that attitudes are considerably different, that's compared to, you know, a the non migrants, so does really in white population or maybe the former migrants from Europe, from from Italy, Greek still they are the dominant migrants in terms of all the people.If you look into the Australia, the most dominant group in terms of non English speaking backgrounds are those from Italy and Greece and of course UK.But but they are not English speaking.But if you're looking at other culturally and linguistically diverse groups, it has substantially increased from South Asia and that perceptions, attitudes, their health seeking behavior is not the same as you might expect from the people who have been here for a considerable period of time.They tend to stay at home with the families.They tend to want for services to come to them.They don't go to GP's to seek quite often that helps service uses considerably different and that practice activity and what they want to do is considerably different because the perceptions their cultural needs are different.That's, that's where another challenges and Home Care Services really don't matter to them.The services that we have for now are predominantly based on research.Has been done maybe 10 or 20 years back, but lots of things that change in terms of the demographics of the population right now, which would probably you know as you go on to be leaders in health and aged kinds situations, you need to understand the demographics of the population and how Australia is also trying to cater with these diverse cultural needs.So Yep.So any other any other points?Uh, those those?Uh, those are online.Uh, did that raise any concerns for you?Uh Group One and Group 2 uh.Before we get on to our face, uh Group One over here.Any other points?He said.I'll just go on to Group One.So they had a lot of discussion, I think, I think.Uh, so.So let's let's let's go on with with.With the group, I think we have a lot of concerns about each gas.So.So let's let's let's let's start hearing from them.I just want to back home.We don't have aged care and all these we with family look after older people and it's quite it's the general being a nurse, you know, caring for people is like when I saw the video it was it's really, really bad.But I was just wondering, you know, it just reflects some leadership at the from the middle management.You know you identify incident, you fix it quickly.No.Instead of going as far as you know, getting worse and reaching authorities, you can, you know, manage it at your level by reporting incidents and all this.So it reflects the type of leadership or their leadership capabilities if it, you know, middle managers, can you know fire identify issues if it then it training staff need training it, train them.You know, use the system to get support and all this and that.That's a very good point.It grows back to diagnosis.Yeah.So module one, the first thing you need to do is you need to diagnose the problem and how you might do it.Get the right people, as you said, in terms of middle managers, you might also actually work with stakeholders in terms of carers and nurses.You need to understand the composition of the workforce in the hcac facility.So I think that that will be quite important to involve all the stakeholders and there will be a few role models for sure and it's good to really get them involved and really try to understand the problems and it's a good point in terms of P&G in terms of rural systems, in terms of HTK, because daycare is a concept for us, we we actually call it as a respite care but not necessarily the daycare concept hasn't necessarily evolved in Australia that much.We have respite care where we have older people visiting to a facility for temporary accommodation.You know, for example, Burrows Valley, there might go there just to enjoy the wine region for about 3 months and then come back to the whole like, you know, the retirement home or the American there come back to the residential aged care facility they are, you know, they were primarily based.But the concept of daycare is far more involved in developing countries.No.Uh.In for example in South Asia.Sorry, in the Indian subcontinent, uh, they have about 80% of the population living in the villages and in the villages, you know are migration is a major issue.Uh, so you you usually find a younger adults migrating to the cities and the the older people are usually left by themselves at home even though they come up with the weekend or they actually come in the evenings to take care of them.They want to be captured and all the people you know, there's a very interesting research which is going on internationally.I visited that just early this month.You know, I was in India in a place called Manipal, which is rural town, a very interesting research going on in terms of what the rural older people expect.I mean, they don't want the children to take care of them.It's very interesting.I mean, I thought they always want children to take care of them, but unfortunately that perceptions are different.It has changed as evolved.They want freedom.They want themselves to go to different places.They want themselves explore.They want to actually have some sense of independence, so that's changing as well.So that perceptions on what the Community feels, the taboo or the OR the issues that might feel over there, it's not necessarily that's seen as sort of like a culturally biased issue, but that's not the case.So research, currently the research is telling us that the older people across many of the developing countries, especially in the villages, they want some freedom.They want to go to many of these daycare centers, which is run by these Panchal.It's or the local organizations they want to have their own freedom, but the problem is they don't have anyone to take them to, you know?So they're stuck in the home because there is no transfer facilities.You know the daycare center is probably about one or two miles from the home.They have no transmit facilities to take them.So you see, there are lots of challenges and very interesting concept of daycare coming up from developing countries, which maybe a bit more evolved than many of the developed context in here, Australia or UK or maybe even the US.So I'm.I'm.I'm sorry. You actually.Uh, I actually cut you off.You actually have to say something.Yeah, lots going on the discussion.The 22nd version of what we talked about was uh.We talked about this, but you know some of the system challenges and like how we got to where we where we talked about how caring is in a historically always been a very female dominated profession.So we've talked about like the impacts of like you know the culture of Australia the past few decades, sexes and all that sort of stuff and how that's impacted on the resourcing and the working conditions.We also talked about the importance of like quality, good job design for aged care.So you know, increasing the staff in aged care would hopefully lead to the ability for the nurses and the careers in those places to be able to stretch and flex and provide that additional.Ad hoc cares and all that sort of stuff that, you know, people in aged care homes need.Yeah, and yeah, talk to very, very interesting topical problems.Of course, you know staffing shortages, very important just for those, you know, uh, who are uh from international context.So careers, aged care, aged, a careers, working in aged care, they are the backbone of the aged care industry and then you have the nurses careers you know they come from different backgrounds and many of them they come with a nursing background but still yet to receive the formal nursing qualifications as such.But the work is careers and you get a whole gamut of different, you know, people actually working at careers within the industry.And it's the issue of starting shortage and issue of salaries at unity punched out major issues in Australia and also getting the right workflows mixes well.But you know, having said that, you know, I think the point which, yeah, Katie was talking about in terms of models of care, what works and what not works.Lot needs to be done.Lots of innovative solutions needs to be done.Say for example there was a very innovative solution.You know, whole of Australia uh, that is a clinic in Randwick.It's called Monterrey.Uh Calhoun.So in the whole of Australia, it's the only only aged care facility that has the dental clinic that has the dental facility.You know inbuilt within within an HTTP sender.I mean there was the 1st that was the 1st.I'm not sure if you have started anything new, but it was the first stage guest entered to actually have a dental facility inbuilt and you also have.So that's mainly a Jewish presence.Which causality?So it's a.Religious based organization and it's quite a well developed H capability and interestingly they came out with a solution and how to tackle them to carries you know.So they have.They came out of the very interesting solution looking at the global research on how to apply silver fluoride.So that is a solution called Silver Diamond fluoride, which applied to the carries.That stops dental caries.So that's it hasn't been tested a lot in Australia, but interestingly that's and very a very time consuming solution that could be a effectively done by a career or a nurse or maybe an order that therapist but not necessarily a dentist.So all these innovative solutions also need to come into place and telemedicine.As such, we will be discussing that more when we go into the next module.So I think everyone's getting impatient.Now let's break for lunch.Everyone's showing me grumpy faces, so might be the reason for that.So let's break for lunch and come back at 2:00 o'clock uh at 2:00.O'clock I Adelaide time so 45 minutes.Lunch and the next session we might just try to work on a time management skills a bit and try to do that in about an hour or so.An hour, maybe an hour and a half.So very ambitious for the next session.I'll see you soon.

576072292608Nomajama Ganya 12:33What's the time now in Adelaide?

576072292608Madhan Balasubramanian 12:36The time here is 115, so 45 minutes.

576072292608Nomajama Ganya 12:38OK.Thank you.

576072292608Madhan Balasubramanian 12:42Didn't see you soon.

576072292608Christopher Dong 12:44Thanks.See you soon.

621792274320Christopher Dong left the meeting621792274320Matthew Tropea left the meeting621792274320Christopher Dong joined the meeting576072292608Madhan Balasubramanian 55:04Probably another minute or so.Give it another minute.OK.So we'll come back, don't segment nearly there middle of the day, another six or seven hours.

621792274320Matthew Tropea joined the meeting576072292608Madhan Balasubramanian 56:00We are done.Sorry, just until five.So let's let's aim to complete this one a bit faster.You know, because this is covers module 2, the module 2 hasn't been opened yet as you might see in Canvas Module 2 will be open soon, but this will give you insights into into the module.It's mainly looking into organizational structure designs and measuring performance, so we will be looking into that very interesting topic.Hopefully we can keep you awake after lunch.So what we would be doing here for this module is that we will be looking into, as I said, various organizational structures, how organizations are traditionally been designed, various types of models, some of the newer models like a Halo organization or a virtual organization.So we would be, you know, during a bit moving to these organizational structures and also to see how an organization is aligned to its mission statement because it's fundamental for us to really understand what the organization is contributing.Uh, and also eventually towards the end we be looking at organizational performance and how we measure performance of an organization and we would break down into two problem based learning for this module as well.One we'll be looking at universal health coverage and healthcare.A major challenge is been explored in pretty much all context being being being a champion by The Who and also by the very famous HealthEquity studies by Sir Michael Marmot.So it's been lots going on in terms of university, let's coverage and how you might reinvent ourselves and we'll be looking at one particular discipline in Australia, 1 particular disciplinary area when it comes to university, let's coverage in health.So that's that's a problem based learning one and second problem based learning.We'll be looking at artificial intelligence emerging into the lots of interest going on in artificial intelligence, large language models, I mean, like, are we going to be totally rendered incompetent in some way or another as compared to various different artificial intelligence models coming up today, we are going to be looking into artificial intelligence and healthcare and where they are contributing and what sort of leadership challenges are going to actually emerge for us as healthcare managers.So that's that's the two key things that we I actually want to cover.I also wanted to have an extended coffee session to have some time for you to actually bond as a group because I think this is the chance that you actually get before the group presentation and it's very important that you get to know your group members and just to actually avoid any sort of uh, you know, a challenges that you might face down the road because the group presentation, I think it's 20% and the group presentation and it also help you to work together in many of the online activities as well, which contributes another 20%.So it's overall if you look into collaborative activity as such online participation and group discussion is 40%.So it's very helpful to work together as a group and I hope let's see if you get the time.Otherwise, you know, let's actually reduce maybe shorten it down to 10 minutes or five minutes or so.Uh, and I'll come back to the evening sessions to talk about these different organizations context later on.Seeing how we go in terms of time, it's already 2:00 o'clock.So let's go on.So, uh organizational design and before we venture into an organization now, as we actually start our stepping our early phases in an organization is good for us to understand how an organization is designed.So what are the traditional structures?What is the mission statement?What are the objectives of the organization?What is the?What are the various strategies in place within an organization?And of course, how are these people measuring performance?So this is where I think I'll be introducing 2 concepts.One is the mechanism genesis and others balanced scorecard.These two things will be using it in many of your your assignments, and I think it's it'll be quite important to actually drill down into this module too, because it will set the pace for you to really plan your your organizational performance design in terms of how you do it in terms of your project management design towards your final assignment as well.So these are the three things that we'll be looking into module 2, organizational design, the purpose and alignment of an organization to vision, mission strategy and objectives.And three, measuring organizational performance.What are the various tools being used in measuring organizational performance?What works and what doesn't work?But going very quickly in terms of organizational designs, I mean like, but I'm I'm all of you would have seen an organization hierarchy chat you know you know the guy that had the boss and and all the other heads down and it's all going down all the way you know very big chat.I mean, I've.I've I've seen this starts a long back, but those kind of chats don't exist.You know, in a lot of places, I think the systems have changed.Uh, I've been it was at the University of Adelaide and it was doing my PhD there quite some time ago.They they had a major revamp and bringing all the faculties together into the Faculty of Health Sciences.So they also changed the organization structure as well from a vertical structure to a horizontal structure.So it was quite interesting for me when I went, you know, when I used to often complain to the head of the school and the Dean that his systems are not very good and he really needs to actually buckle up and try to address some of the student concerns.But then what he used to say is that it's it's good that you're pointing me out.We haven't been able to address these issues in terms of software, vertical organization structure, but the fact that you are able to reach me and tell it's easily you just say it's the changes that we're actually happening in within the university.So Avinor stational design, it's very important.And these systems are constantly changing, and even when I start telling you horizontal designs are such, you might wanna think how these horizontal designs apply to some of the newest structures, like a virtual organization or like a modular organization or like a Halo organization, one which outsource.So these are some of the concepts that we will be getting in over here, but it's very important to know that not all managers are actually happy with these hierarchical vertical approach.You know they want to move bit more hands on horizontal layered approach, but they could really understand what's going on and they want a list, a list, bureaucratic structure, probably at least in private organizations, in public organizations, things are changing of course.But in many of the developing context, for example, Papa New Guinea or Nigeria or Indonesia, or even India, perhaps you'd still find many of these traditional hierarchical vertical organizational structures.And it's very hard to get in.I mean, just to give you an example, my mother was looking to get a pension and it took three years to actually get it processed.So going through the different vertical organizational structures and to try to actually convince each one of them, because one group is not going to talk to another group, state systems are different from the national systems.This is actually in India and of course that sort of organizational structure is so ancient, especially public organizational structures are so ancient, and it opens for lots of corruption as well to a good way of dealing with it would be to have an horizontal structure where information passes very fluidly across the different structures or different governance.You know leaders.So.So let's so let's get on to these different organizational structures.As I mentioned, some of the organizational designs like hollow organizational design, modular or virtual water, these I'll actually get that to you in a minute.So this is basically a functional design.So can anyone point out what what this is?What is the functional design?Looking at this diagram?Very quickly, I mean if if I could help you, a functional design is mainly organized around the functions of a certain department.Say for example that nursing division and medical division of Physiotherapy division, a paramedics division, an ambulance division.So so you actually get all these divisions which are organized on a functional structure, so you know, once you go into the nursing division, you know they are dealing with nursing care.Once you go into the ambulatory division, you know these guys are dealing with emergency services.You know?Uh.So yeah.Uh, so so that's that's that's that's how you get to know if it's a functional organization structure.And so it's one way of going about how to deal with your organizational structure another way is this divisional design.So a divisional design is that you you look into each of these division, it's not necessarily a functional based functional could be a subset of these divisions.But if you look down into medicine, you get all these various subdivisions of medicine.Uh, pretty much ancient hierarchy structure of how medical schools are organized.You might go into medical school.You might find all these departments organized in different different units.You might find not sure why they are forgot the population health division.OK, uh, the Community medicine division, not they.They know they're not worried about it there.So so this is this is, of course, uh.The divisional way of you know going about your organization structure and if you go down a bit towards the left, you'll find a more detailed uh.You know, I've been.You have this divisional design going quickly forward is a product market design.So you'd find some organizations which are more driven towards marketing the products sales based organizations.You would find a structure where the focus on, you know, say for example Samsung.

621792274320Brooke Edwards left the meeting576072292608Madhan Balasubramanian 1:05:43They might actually focus on the HomeGoods Division mobile division.They might have.What else that in the Samsung mobile?So this is television.What home?So lots of different things.It's not coming in top of mind.They have heaps of things.Isn't it?And they they recently released a lots of their mobile products as well.So lots of this is mainly a product market based design.There is a the food is a metrics based design.So if you look at the matrix based design towards the right, you might see the functional units and you would also find different structures you know different different areas like quality control project, clinical Information, Systems project, the business systems project or human resources management.And you would find these two actually going across these various functional units.So so you might find each of the functional units also have HR manager.He might be sitting differently, or you might sitting within the same functional unit.You might have each of the unit also having a quality control and quality assurance.However, you might call them quality control person or a quality assurance manager or whatever the organization decides to call in.So each of these units goods across the metrics they might be, they might be intersecting or they might be also sitting in both the places.So you do understand what I mean when they intersecting, there might be separate divisions across, but they might also intersect very well across all these full functional divisions or they will have a person or a delegate off this certain quality division also representing the each of the functional units.So how they do it?It's dependent on these organizations, so metric structure and of course a holler design.What?What is a hollow design?Howley design is mainly outsourcing design.You know the organization wants to focus just on the core competencies.We'll just do this.You know, we're not gonna be bothered about, you know, all the customer service.Let's just outsource to the Indians.Uh, you know, gonna be bothered about with all the manufacturing gets outsourced to the Chinese.So that's that's, that's the, you know the the the key thing.So they are just going to look into just the core competencies of what they actually want and the outsource, all the non essential components to maybe it's not nonessential, it's not the right word, outsource the things that they don't want to necessarily take hold on.They will also to different people, you know, so that's a hollow organizational structure.You might also outsource accounting and finance and legal as well.Virtual design is something which is becoming more and more common nowadays.You know, virtual organizations, it's getting.Many of us are starting to work in a virtual virtual environment and because of kovid and everything, the more virtually we are.I mean, we see a lot of people online, but it it's still appears to me that they are just here.So we're just gotten used to it.You know, I mean, if they could turn on the videos, they would still be more closer to me over here.But still I could make sure that someone there.I know that they are able to share me and I know the virtual design structures actually work.You know, it's very easy to organize meetings.It's very easy to come together.You can work in your home.You could work.But your own liberty at your home and at the same time you're able to contribute to people from multiple, diverse geographical locations.So that's that's that's a very, very a fast leap, a very lots of thinking going on, especially happening during the COVID and lots of people you know they they work in different countries but they contribute to organizations based across globally, multi nationally.So very interesting concepts are emerging for you to actually tackle this visual leaders.So organizational design, yes, any questions and organizational design?Anybody online, we might lose a few people online at 3:00 PM.I think I think if you are actually going and a few might join us after that as well.So the the difference might not be that prominent, though.Let's go on to organizational purpose and alignment.So what?What do you mean by organizational purpose and alignment?We are talking about the main function of an organization, healthcare organization.Its main function is to provide healthcare.So likewise, every organization is defined by its visionist mission and objectives.Of course, you would have learned it in your 910-1910 as well, but it's important to actually understand what the organization serves for and to see how well it is aligned to what it's actually serves as well.So I mean the concepts.What?What the organizations service for and it's alignment, it's important for us to measure performance.So that's the reason organizational purpose and alignment is quite important.And when you start talking about organizational performance, you are talking about mission statement, Vision statement, a vision, mission statement is a broad expression of an organizational purpose and a vision statement is a statement of strategic intent.So I hope you're all familiar with this mission and vision statement because you would have seen it in heaps of organizations, private nonprofit trust, public organizations as well.They always have the mission and the vision statement, and it is important for them to actually come out with this vision and mission statement because without these we really can't measure, measure what?What are they doing in terms of organizational performance?

621792274320Brooke Edwards joined the meeting576072292608Madhan Balasubramanian 1:11:07Of course, after the vision statement, they might actually have lots of other things in terms of strategies, in terms of the objectives made of subprojects, and how it's all articulated together.So there's alignment that you get within the different organizational sub objectives, students overall emissions and mission statement is quite important.So that's that's the reason to have a broad vision statement.Sit down at 1st and what the what?The vision is so this is this is Mayo Clinic.Uh, so Mayo Clinic.The mission is to inspire, hook and contribute to health and well being by providing the best care to every patient through integrated clinical practice.Education and research.Interesting how they use the word integrative clinical practice, but uh, that's the mission statement.The mission statement is Mayo Clinic will provide an unparalleled experience as the most trusted partner for healthcare.You see there is there is Mayo Clinic is a private organization, right?It's based in the US, am I right?So there is no need for them to actually say on different types of population groups.There is no need for them to actually point out towards uh, uh.The cost of care, there's no need for them to actually point out to US copy responsibility.These are all additive and used that they might consider, but then it's quality.It's for them.It's experience.So you see, as a private organization, the way in which they define the mission and vision statement is quite different to actually what what a public organization might do.So this would be dependent on what you mean.Objectives are so say for example, if it's a nonprofit institution which is functioning in Nigeria, then then they might actually consider reaching the different disadvantaged groups in population.You know, you know capturing a providing services to the homeless or say for example in Papua New Guinea or in India or even in Australia if the services are directed towards a certain segment of the population, they it will be captured very well in the mission and vision statement.So you see, once you have a bird's eye view and the name of the organization, the vision and the mission, you get an idea at least some idea on what the organization is and what it cackles for.For so you actually get where I'm going with it.They they do say over here the patient comes first, of course, but so are the costs and other in terms of the access.But Mayo Clinic is extremely well on clinic very, very well researched and some of the best quality doctors and health professionals and models of care.As being uh, I rich photo ground for research activity across the world as well the next.The next thing for us to look into is, as I said, why mission and vision statement.It's for us to really understand organizational purpose and alignment.So you you would need to understand the alignment of an organization because if if the organization's alignment is social service, there is no point in actually measuring performance through cost of services through the measuring profits, because it's a social organization.It's a social indivior to actually meet the needs of the population that might be different organization objectives, and it so when you're writing your assignment, when you're looking into your organization, take into account of what kind of organization you're dealing with.Hey, so are the mission objectives.So when you look into your balance scorecard measurements, which I will come back to it later, so think of how well it is aligned to your organizational mission, mission and objectives and see whether you're using these instruments.You're making these 7S or other organizational performance like the balance score card.See, you're using them in the right context, so that's the reason why alignment is quite important.Umm.Yes.Yeah, yeah, sure.Let's get on the mic.So people online can hear.Umm, part of my role in quality improvement.At the moment, in preparation for a credit short notice accreditation, but hopefully sustained, ongoing is where there's a team of three of us going to each service like each ward or unit or service within the entire witch and and getting them to define what quality care is for their particular area and that we're sort of forming these quality statements which are essentially like their vision.And then from that we say, you know we've said well, how do you do that like you know under the you know when you say that you prioritize Multidiscipline Multicare, what does that mean?And then overall aim is to get build up that ground level kind of vision for each service particular to their consumers.But to then identify that purposeful data for monitoring why it's so, but it's kind of uncharted territory and we're not sure if we're approaching it in the right way, but we're just giving it a try.But no, that's yeah.It's interesting though, that's very, but we need resource to sustain that.That's where I'm struggling to.Otherwise, it's just words on paper.Yep, yeah.

576072292608Nomajama Ganya 1:16:19They can.I say something on that.

576072292608Madhan Balasubramanian 1:16:21Yes.

576072292608Nomajama Ganya 1:16:24Yes, you just kind of nail it because I was gonna say what's challenging then in the in the world is more the resources to sustain it.The sustainability is more the resources.Do we have a capacity to really align our our resources to the purpose of the of the organization and it becomes a major challenge?

576072292608Madhan Balasubramanian 1:16:46I'm hoping to do is to take to the executive team, you know, a list of, you know, this is what they're what our clinicians and unit managers are saying at the ground level.This is what's important to them.Resource it I don't know.Wish me luck.Wish us luck.But then yeah, yes, a very sound approach.I mean, what you're doing is that you're not using any of these traditional models because these things, what we actually have in terms of a balanced scorecard or seven is framework, lots of other performance measures or these are meant for certain contexts, but you're trying to explore the perceptions, you know what, what the, the health professionals, what that perceptions or their underlying meaning, which they actually bring to terms of quality and care.So that's a sort of like a grounded approach.So it's you're actually more looking into uh, you know, going into the field and doing qualitative research.So it's more powerful than using any of these methods, so you would potentially need to ground this to a framework.I think that's important.So you might look into thematic analysis, because how you reduce the bias is quite important.Uh, how do you determine your sample?How you get into?Because this would be classified as an internal quality control research, so not necessarily going to the spectre of, you know, publishing it probably not to that extent for now, at least unless you're actually going to get on to do your thesis or some research work on it.But I think for now it's putting it down in a context which is quite strong enough in terms of qualitative research and trying to capture the rich experiences in terms of that perception.So the actual codes which each of these people bring in and how they contribute to the thematic framework, you know this, this would be a very, very strong analysis.If you have captured, you know they say the normal strength.If the sample is quite homogeneous, I think 15 should do.If it's quite heterogeneous, if you're going across different worlds talking to different groups of people, you might need a bit more.Uh, but, but to uh to improve its validity and reliability of the findings you to bring the codes together across the thematic framework and it's very powerful for terms of I've researched foundational it might lead to several of these other things in balance score cards and things later on maybe even a survey later on.I think it's a very interesting thing you're doing.Maybe a great to share about that.Yeah, it might be your assignment as well.Maybe your research paper that you might write.OK, so let's, let's let's, let's are there any other points?JAMA I think a flickering there.

576072292608Nomajama Ganya 1:19:32Ohh not anymore.

576072292608Madhan Balasubramanian 1:19:33OK, good.So.So let's so let's move on.Uh, the main thing is 7 is framework.What?What is this making these seven stream?But I've seen a lot of people use it.Uh, in terms of really understanding organizational problems and also the performance management, it comprises mainly of soft and hard elements, which measures performance.And the idea is to get both these hard and soft concepts in terms of communications, in terms of people skills and also hard concept in terms of operational design, finances, all of them at the right place.So going on further, does 3 hard elements, their strategy structures such as organizational charts and systems, and these are quite relatively easy to find in an organization.If you're looking at strategy, it's quite easy to find structures.It's quite easy to find and systems as well.You is very easily to reflect on and once you go on reading into these, making these seven is guide and the reading material which is available for you in the library of resources you might get to know you will get to know more about how you go about understanding you know these these hard elements and soft elements is mainly shared values, skills, stuff and style.It could be harder to describe unless you do some qualitative research as she's doing in terms of understanding the soft values.So this might be something interesting you might want to consider and makenzy framework, but that's a bit further down the step, but I'm not gonna.I don't want to push you towards this frame of as such, but I think qualitative research by itself it's a very sound argument for what you're doing.This is probably bringing everything together.You know it's it's just a.It's probably a next step of really understanding, organization, alignment and performance.It can be harder to describe soft elements, less tangible, and the more influenced by organization culture, but at the same time, it's still it's still very important as the hard elements of the organization.So these these are so this is the 7S framework.So that's why we call 7S.So staff style, skills, strategy, structure systems and shared values.So it's just gives you a framework for you to really understand and organization. Yeah.So once you go about really trying to decipher what what the organization is doing for you really understand you take on to some of the key management rules or you actually put into a position of a senior executive or the CEO of an organization, then you might need to really understand it.And these are some of the tools that helps you to understand about organizational performance, organizational design, organizational structures, the people, their behavior.So if this really helps you, and I've seen a lot of people using this in different contexts in different organizations and it gives a decent appraisal of what an organization is going on to the last aspect of it, organizational performance.

621792274320Christopher Dong left the meeting576072292608Madhan Balasubramanian 1:22:21OK.So organizational performance, I mean, as the word actually implies, it's just to what extent the organization achieves this purpose.And when I say purpose, you're reflecting on the the Vision mission statement, the strategy and the objectives because that's where you know you can really measure organizational performance because if you don't have these broad objectives of what these organizations are, then you really can't measure organizational performance.So this would differ each and every organization as to how they define their objectives, and it very vastly death of a public, publicly funded organizations, private organizations and as it said over here, the bottom line is to maximize the shareholders or stakeholders.I would say their values and also to contribute to health and well being, environmental sustainability and if it's a product based, excellent products and services.So looking at performance and data, so we we need to do it correctly.So a study was done by Cicero a few years ago and the identified some common problems in performance and data.There was a lack of alignment of what is measured to the strategic intent of of the organization.The information was largely limited to operational level and financial level.Routine reports didn't provide the information managers needed for decision making.There was inconsistency in measurement between different activities and reports.There was a poor understanding by managers on what variations signify, and there was also a pro presentation of data as well.So, uh, even though this research is probably a while ago, maybe 20 years, maybe a bit too old right now it it identifies some of the key challenges that historically many Australian organizations have been through.So you would need to really understand how important alignment is and how important it is to get this range of activities.You know the back end financial, the operational financial as well as functional governance, health system and clinical activities.So getting all of them together and trying to see how well all these diverse activities and services are aligned to the organizational mission statement, the mission statement is quite important.Uh, so I'll, I'll I'll move on.So in what?What we what many of the the academics, or perhaps I wouldn't say academic.So what many industries uses is something what we call as a balance score, card balance score card is it's just a performance measuring tool with some key indicators to help you guide a high level strategic planning process.So this this is a balance, uh, scorecard.I'm sorry, it really hasn't come out that well, but if you can read it so you, you can look into, you know, keep teams like financial or stewardship, customer and stakeholder, internal processes, organizational capacity or learning growth.And you you could potentially try to understand or device a measuring tool based on these 4 broad constructs.So that is what we call as a balance scorecard.And there are different ways of measuring financial performance, resource allocation, and the various questions that you implement could be a jet from a generic template or you might modify based on.But what is the underlying things over here is that it helps you achieve your objectives or KPIs and it also helps you achieve benchmark it based on certain measures that you set at the organizational level or some of the performance measures that have been preexisting based on similar organizations of public and private sector data which is available.So there's more information on the balance code data, different templates, different applications that use in your learning resources.And I'll be also sending you some further examples as well.Could be one one of the menu that you actually used to measure organizational performance.So yeah, that's that's right.On time, half an hour.This is brilliant.So now, so now let's actually go to a problem based learning, but having a before I go to that.So the the short lecture I gave today and module one, it's just an intro for you.I mean, I would expect you to go on a knowledge seeking venture, you know, so go around, go and search for information, go to look for you know what actually what is the balance score card go about seeing about?Are there any other things in terms of like a Mackenzie seven is model uh go into the reading resources, go to the library.I hope everyone of you know how to use the library resources.If not, just go to the Flinders.I have a segment in canvas as well on how to explore library and see databases grow on your own knowledge seeking activity and we are there to help so I'll be there to actually guide you to figure out or understand to see what's more relevant for you because not all of us would be interested in organizational design.You might say I'm just going to look into a hello organization.I just want to outsource everything, so that's what my organization is going to be.I'm going to be doing in depth exploration on that.Uh, let's say no, no, no.I'm actually going to be doing something on a virtual organization, so you might dwell want that and build your interests on that certain area.So it's that level of detail that I want you to go to and start exploring and knowledge seeking on it.You know, so that will be lots of information available for you in canvas that we will make it available as we go on.So it's that it's that self seeking it's it's, you know, it's mainly like it's kind of an adventure going to a forest.I mean, I'm just there as a tour guide and there sometimes sometimes and then not.You know, I just, I actually get distracted by lots of emails.But you you are that explore yourself, you know.So there's lots of things available for you in the forest.Is just go and see the right direction you want to and there's lots of knowledge that's to be explored.So let's get on to problem based learning.One, I want you all to go and and open this.Open this conversation article I put a PDF for you also in team site so it's available, so it should be the teams site.Uh, typically the team site files OK, just go to files.Ah, just go down.Go down.Should be PDF.There, umm.Used to be having it.Uh, can you just click this link for now?Does it work?Ohh, we see if they can put the PDF should be here.Recordings.Get the.Actually it should be also available in teams now in Greens, so I'm I'm going to give you a couple of minutes to read it.It's a short article, so it shouldn't take that much time.Very interesting article here.Uh, something which talks about universal health coverage and looking at some of the services, dental, vision and hearing, you know, these are not essentially covered by Medicare.And I think this this article looks into one certain service called Dental and I think it'll be quite interesting to see what you might feel in terms of the leadership challenges facing this certain this particular discipline and what they mean by universal, that's coverage and the challenges which the various governments have been facing and what do the Greens want over here.So let's let's get on to it and I'm going to put you into the groups over here and and we'll come back to it in about, say, say about 5 minutes 55.It's a 1:45.Sorry.Uh, 2:45.

621792274320Emma Pitkin left the meeting621792274320Matthew Tropea left the meeting621792274320Sarah Bamunu Arachchige left the meeting621792274320Morgan, Kathryn (Health) left the meeting621792274320Nomajama Ganya left the meeting621792274320Brooke Edwards left the meeting621792274320Hincksman, Natalie (Health) left the meeting621792274320Rhianna Dillon left the meeting621792274320Matthew Tropea joined the meeting621792274320Adewale Adewuyi left the meeting621792274320Matthew Tropea left the meeting621792274320Adewale Adewuyi joined the meeting576072292608Madhan Balasubramanian 1:35:11It might be just sitting over there and each other.Not at 2:45.Just give me another minute.Like the group is already discussed, you guys still reading the for the good?OK, OK.So that that's fine.So I I actually give you enough shot thing as well.So I'm gonna call everyone back again.Say make sure we don't run out of time into the next two articles.They are.

621792274320Matthew Tropea joined the meeting621792274320Nomajama Ganya joined the meeting621792274320Sarah Bamunu Arachchige joined the meeting621792274320Emma Pitkin joined the meeting621792274320Rhianna Dillon joined the meeting621792274320Morgan, Kathryn (Health) joined the meeting621792274320Hincksman, Natalie (Health) joined the meeting621792274320Brooke Edwards joined the meeting576072292608Hincksman, Natalie (Health) 1:39:12Oh. Oh hello.

576072292608Emma Pitkin 1:39:13Ooh.

576072292608Hincksman, Natalie (Health) 1:39:15I I thought I lost you there, OK.

576072292608Madhan Balasubramanian 1:39:18Now, welcome back everyone.So sorry, I hope you had some time to to reflect even there is not a lot of time, but we just want to push on just to make sure that we cover some ground in the afternoon session and let me let me take you back through some of my thoughts on this article.

576072292608Hincksman, Natalie (Health) 1:39:19Uh.

576072292608Nomajama Ganya 1:39:20Alright, no. Yeah.

576072292608Madhan Balasubramanian 1:39:40So the case study of what you put through this is focused on Medicare and the Greens.What the Greens suggest in terms of dental care needs to be incorporated as part of the universal coverage so that it was there is that election agenda and it's been there for quite some time.I believe the Greens is probably a minority party and.And, but it's, as Leslie Russell points out in the conversation article, it it is a sound argument put forth by the Greens, and it requires it.Attention, it requires public attention and it's important for us to start the debate on having some of these these services, like dental, is just one of them.You might also have vision.You might have hearing lots of allotted services which could potentially be incorporated under the Universalist coverage and Medicare.So so this this is just an example of 1.One such disciplinary issue to to bring to highlight today and key things would articles say, and you might see another another similar article which was put up by Stephen Duckett.The universal scheme would call an extra 5.6 billion, but what did this article say 65?Is it so it's, uh, it's just an extra 5.5 billion and uh, there are different assessments going on around as well.That's not good.That debate, so looking also globally as well.Uh to uh Australians are less likely to visit a dentist than people in many compatible countries.So you can see Australia, you can see it's it's it's considerably a smaller proportion percentage of others visited a dentist past 12 months as compared to many of the other countries.Above this line you know you can find even Slovenia as a higher percentage of visiting Poland, Slovakia, Iceland, Luxembourg into Kingdom.All of these countries seems to have a higher percentage of visits.Uh.Also look at the costs of dental care individual out of pocket expenditure is pretty much around 60% is individual out of pocket expenditure in Australia and private insurance is considerably even though it accounts for some of it, but not all.It's really inside private insurance for dental coverage is an issue for us to consider and the Commonwealth spend, some funds and state government as well which goes on into the primary care essentially school services and public hospitals for below poverty line people and also for children and for senior citizens.Uh, some dental prescriptions and hospitals services as well as costs is the most important reason for people to skip dental care in Australia.So if you look at the ABS data, 2018, almost a majority of the people cost was the highest reason coming out of this survey.Interesting, of course, you might go to the reason this actually reflects the reason that almost 58 or nearly 60% of the devil expenditure is actually out of pocket.Dental visits per year.You you could see you could see the poorer people visit dentist less often to if you go down over here, be this income ranges, the poorer people, the visits are considerably less than compared to high income people.It's very much similar to the international situation as well, so I am probably not going to be going too much into statistics, but I'm going to just dig on and go on to the next slide and open the floor for discussion.So start with the groups online.Probably probably.A Natalie and Group first I think I I I I sort of interrupted you in a very interesting conversation.So I maybe I'll start with Natalie and group.

576072292608Hincksman, Natalie (Health) 1:43:23I'm sorry, but I'm we barely had.Well, if there was a conversation, I was on the phone.So I'm I'm sorry.I was kind of off having a look at it.Umm I I can't.No, I don't know that I could answer.Why dental cares not covered in Medicare, apart from the cost?Because it is costly.The chat there are challenges with it not being covered.In terms of like put dentition can lead to our healthcare problems anyhow.So one of the things that I, you know kind of wonder is if you if you were to look at the cost and I in an isolated manner, it maybe is prohibitive.However, if you look at the effects of poor dentition on health and what costs that costs the health system, you might wanna offset it and consider that.You know, in when you're looking at that kind of a proposal?

576072292608Madhan Balasubramanian 1:44:23It's very interesting what the Greens propose, isn't it?They they, I mean, if you look at the car, I mean, even though Australia doesn't offer any coverage for all the population group, still they do provide considerable services, especially for children under 18.So all the services ask covered on their public health services and there's three or of course and I do believe there is evidence if child health.So this is a a properly or adequately managed and then it reduces the need to avail services on a more regular basis than you're an adult.So that's considerable evidence that direction.But at the same time, uh, because Australia, you know, has a larger proportion of migrant populations.And also there are considerable people from disadvantaged social uh.Assure you economically disadvantaged and non English speaking backgrounds, so that also you know changes the situation a bit in terms of the demographics and not necessarily the the new the types of services that are available and the large waiting lists in public hospitals.That's an issue for for us to address in terms of dental care systems.So if I'll be, I'll pointing towards a lecture, especially the Chief dental officer here, a Stewart Marshall, he reflected on the challenges of the southwest in South Australian dental service bit later.But these long waiting lists and also when it comes to services.As such, when it comes to the workflows, it's that is a considerable shortage of workforce personal the same time major issues that terms of silos as there because the dental professionals as not necessarily optometrist ophthalmologists and hearing specialists they that's started to integrate more often into the nursing Care alliance services.But dentistry oral health seems to be 11.Discipline that is seems to be a bit outside the Primary Health care system and that seems to really complicate things for us in terms of services.How care could be provided and who provides care as well?Because if you can see the global burden of, this is almost the major.The major issues in order health are preventable, and these preventable dental caries, periodontal disease.Uh can can very much be treated by someone lesser or a mid level provider like a social worker or maybe a a an A lido's worker can be very well treated by them.It doesn't need a highly specialized dental than five years dated degree and three years of specialization to give in treat some of these very basic preventable diseases.So it's a major challenge of integration as well for you to consider.So let's go on to group group.What?What's the other group?Is the Group One or two online?There.Uh. What?A Group One.Sorry.Uh.A group 2 online so so the room 1.Any comments coming from Room 1?Thank you.Part of me was it.I think Natalie is a room too, isn't it?As room.I'm sorry, Natalie.

576072292608Hincksman, Natalie (Health) 1:47:58Yeah.

576072292608Madhan Balasubramanian 1:47:58I oh, yeah.

576072292608Emma Pitkin 1:48:03I'm confused by the groups, but that's OK.

576072292608Hincksman, Natalie (Health) 1:48:04Yeah, just I think, Chris.

576072292608Nomajama Ganya 1:48:06Yeah.It's like, are you?

576072292608Emma Pitkin 1:48:08You're going to love it.

576072292608Nomajama Ganya 1:48:09Trunk continue.

576072292608Hincksman, Natalie (Health) 1:48:09Emma or Rhianna, nor.

576072292608Emma Pitkin 1:48:11Got it.So we had a bit of a, A well.We had obviously had a read through.Uh, and the the the first thing that sort of jumped out at all of us was the, you know, the fact that there was no structure put forward or it was just basically an outline As for why dental care isn't covered in Medicare.I agree that it would be to do with the expense of it the the system needed for follow up and all that kind of thing.It would be like it would be like setting up the GP service all over again through Medicare.I think it will be.It will be a a really large umm project, but I think there's also not enough.I don't think there's enough dentists out there.I don't think there's enough staff within dentistry to be able to service the entire population through Medicare, and I do sort of see that's probably why they are looking at increasing the amount of dental student strip uni by making that a free.

621792274320Matthew Tropea left the meeting576072292608Emma Pitkin 1:49:16Umm course would have been nice if the nurses course is very but anyway, so I do.I do sort of get that as well.I don't know why she's challenges preventing oral.Umm, that's pretty much probably all we got to when it came to our umm, our discussion, dental care and different population groups and different age groups.It's also, I do agree with the kids up to the age of 18.

621792274320Christopher Dong joined the meeting576072292608Emma Pitkin 1:49:50I which I found with my my own children having access to dental care.It's just gonna.It gets really a little bit grey as to what is included, what isn't included.

621792274320Matthew Tropea joined the meeting576072292608Emma Pitkin 1:50:01So there just wasn't enough information to probably properly make a proper, umm, informed decision on whether or not it will be able to be done or not the problem.

576072292608Madhan Balasubramanian 1:50:12That's that's logical.I mean, that's very good.Your videos seems to be again stuck.Emma, I will just need to figure out, like, you know, I was.

576072292608Emma Pitkin 1:50:21Uh, sorry was.I had did have issues connecting it today it's and it's a new MacBook so I don't really know what I'm doing with it.

576072292608Madhan Balasubramanian 1:50:25That's all.

576072292608Emma Pitkin 1:50:27To be perfectly honest.

576072292608Madhan Balasubramanian 1:50:28That's alright.We had the blue, you know, rectangles, so I was able to figure out who was talking.So that's perfectly fine.So very, very good argument, because you don't have enough information.Evidence data is very important as leaders to to see how you could solve some of these problems, because if you're going to be a CEO or at some point in time in the future of as they health and of course there are challenges for you to consider in terms of different components or different uh, you know a a divisions within as they health and you might actually see or health or maybe even a vision hearing or other non Medicare related services for you to actually cover.So it gives you an interesting perspective and getting information and seeking For more information.I think it's quite important, and of course the Greens document is a good starting point for us.I think what it does it gives you an idea as to what these major problems are.And before we go on to the next problem based learning, I think a few people are leaving at three, so I just want to, you know, tell you that we are going to be creating these groups in teams as well.

576072292608Nomajama Ganya 1:51:23OK.

576072292608Madhan Balasubramanian 1:51:32So if you are familiar with teams, it gives you an option to actually go and you know have you discussions there or you could find any other way of discussing yourself for the group.Also, can you please nominate group leader whom I could actually communicate with you?And can the group leader come back to me giving the names of the group members?I have it with me, but can you give the names of the the group members as well so we can have it in the system and you might be approached by two or three more students because they don't have a group and I might put them into a Group 3 so it is room two, Group 3 uh and yeah.So, uh, hopefully if I have a contact point in each of these groups, so please email me.And I was also hoping if anyone of you would want to be a representative of the whole code as such.So I I've also called for a class representative as well, so if anyone wants to volunteer, please email to me and it'll be great to actually have a a representative who could bring in some of the concerns which I necessarily might not know.So please feel free to actually, you know, come to me at any point in time, especially for those, well, you know, leaving early.And also if you if anyone could volunteer to be a class representative and you could get back to me, it'll be it'll be excellent.OK, so uh, let's see you.All those who wanted to leave at three.I'll, uh, I'll keep a watch on the assignment.I'll keep a watch on the assignment recordings because it would give you the due dates as well.I I remember a number of people asking the due dates, so keep a watch on that.Not a problem, so let's let's move on to the next.The next issue that I wanna talk about which is which has been really fascinating, which is being creating lots of lots of lots of vibrant discussions and raising a lot of concerns for us in terms of artificial intelligence, large language models and in terms of healthcare, how it's going to be used and what are the major challenges ethical challenges for us.So I'm going to be introducing you to the video and what I would want you to reflect.One is to see how how you might go about dealing with this aspect of organizational change and how this really affects the organization structure, our design and thinking behind it.So this is I want you to spend some time.

621792274320Rhianna Dillon left the meeting621792274320Christopher Dong joined the meeting576072292608Madhan Balasubramanian 2:03:57Thing and and emerging scenario in terms of artificial intelligence in health and aged care, I think it's an issue that all of us has leaders in health and aged care need to address.So I'm going to give you the opportunity to reflect and only three over here as a group.So I think it's a much more you know the discussion and those are online.So it takes some time to think about AI because this is this is lots of interest happening in terms of AI and the developments are quite exponential.Uh, so it's going on a very fast, rapid rate.So we would need to catch up with all these changes happening and need to find appropriate solutions, or at least the issues that we potentially need to address.So I I I'm going to put you to the groups and ask you to reflect on on AI and and we'll come back.

621792274320Christopher Dong left the meeting576072292608Madhan Balasubramanian 2:04:54Say I'm gonna give you about 10 minutes and we'll come back soon.

621792274320Morgan, Kathryn (Health) left the meeting621792274320Emma Pitkin left the meeting621792274320Sarah Bamunu Arachchige left the meeting621792274320Matthew Tropea left the meeting621792274320Brooke Edwards left the meeting621792274320Hincksman, Natalie (Health) left the meeting621792274320Adewale Adewuyi left the meeting621792274320Nomajama Ganya left the meeting621792274320Matthew Tropea joined the meeting621792274320Matthew Tropea left the meeting621792274320Matthew Tropea joined the meeting621792274320Matthew Tropea left the meeting621792274320Oscar Mare joined the meeting621792274320Matthew Tropea joined the meeting621792274320Oscar Mare left the meeting621792274320Emma Pitkin joined the meeting621792274320Matthew Tropea joined the meeting621792274320Adewale Adewuyi joined the meeting621792274320Hincksman, Natalie (Health) joined the meeting621792274320Sarah Bamunu Arachchige joined the meeting621792274320Morgan, Kathryn (Health) joined the meeting621792274320Brooke Edwards joined the meeting576072292608Emma Pitkin 2:15:26No.

621792274320Nomajama Ganya joined the meeting576072292608Madhan Balasubramanian 2:15:33We want that that we were having a very four.Yeah, that's a good one.We were talking about what really constitutes a I I think they're very foundation argument in terms of there are different parameters as to what what is an AI and how it's how it's integrated.For example, if you do something like a multivariate, you know regression model or maybe a predictive model that that could potentially be called as an AI as well, because it's part of a larger deletion support system.So that's probably a, you know, we could argue as what we are being used to.You know many statisticians or planners are public health experts.They they they use this predictive models to really understand public health policies.You know what sort of policies work and what doesn't work?Evaluation models.So that's also segment of AI.And also we discussed about clinical decision support systems as well.It's very much, uh, you know, contributing to how we could account for different types of data, you know, coming from multiple sources in order to inform decision support at the right time in the hospital in and say in an ICU or an emergency department or in a cardiovascular.Yeah, uh, a unit.So clinical decision support systems as of now, the systems are quite, very much of the roof entry stage.I would believe in Australia and it it takes information from limited number of sources, mainly hospital practice activity and patient information as to what's available in what's what's been used in Australia.But he start talking about the extent of AI and how it could go into assisting clinical decision support system.Is it's massive in terms of the genetic information, socially, environmentally information.So if getting it all together and we were talking about the different databases and having a whole data warehouse to actually store your information and to train the AI to really understand these patterns, uh, you know, billions and billions of mathematical permutations and combinations.I think it makes it really extremely interesting to see how AI goes about how we manage AI.So I just go on to group two.There is room.One uh just to see if you have any.You know, interesting points we discussed.So I think it's a Sara Chris Matthew JAMA group, JAMA.

576072292608Hincksman, Natalie (Health) 2:18:06Yep, that's nuts as well.Uhm guys, do you want me to speak?So I so we we reflected on a a little bit on the AI some it's an area that I've actually been working in quite a bit AI and healthcare, but not really how we sort of imagine chat chubby or anything some of the things that we've been exploring is machine learning and large language models the benefits of having a a single electronic patient record for the state is actually helpful for us because it means that we can look at you know things like predicting discharge using language.

576072292608Nomajama Ganya 2:18:15Experience.

576072292608Hincksman, Natalie (Health) 2:18:51I that's documented within the patient record and we can also look at, you know, who you have a consultant has seen a patient based on the language and the patient medical records has quite interesting the things that you can do and predict and look sort of in terms of forward looking when we come to AI, what we don't use health, we don't use it yet.

576072292608Nomajama Ganya 2:19:18Stop.

576072292608Hincksman, Natalie (Health) 2:19:20But I think it's something as kind of exciting people always worried about the risks of, you know, AI in terms of, you know, how that sharing of information, what information is in electronic patient records anyhow.And you can apply the same principles and safety measures to AI, but what you can use with AI, which is really exciting, is rather than just having an AI doctor, you could actually use AI to support decision making.And there's some really nice little evidence coming out now that supported decision making using AI is actually really beneficial because it allows the doctor to consider, UM, all of the options and also options that maybe there hadn't considered based on past medical history based on, you know, things that they may have not considered because they haven't read all of the notes, but they've just had a poor historian.So, umm, you know the I think in terms of quality, we could probably improve the quality of diagnosis, safety of patients based if we have alerts that AI allow us to use.Umm, the biggest challenge that we certainly are facing in the environment that we're in is how do you apply AI machine learning?A large language models.You really need the workforce to be able to initiate that, which means you need your data text and they need to not be sitting remote, which in hospitals they generally do.They sit quite remote from clinicians, but in order to be able to do really effective.

576072292608Nomajama Ganya 2:20:43Like.

576072292608Hincksman, Natalie (Health) 2:20:48A A large language models and things like that.You need them to be with the clinicians learning from the clinicians and the clinicians having input into how to.Umm how to look up something and we've shown in the virtual care services here in South Australia when you link your, your, your digital and tech guys and you actually have them sitting almost next to your clinicians, you get it, you get a much better outcome and we've been testing some of our systems against like you know with the doctors, the doctors have and we've actually shown some really, really good outcomes in terms of our modeling and our AI.And so that's not to say we don't replace them, but it's more about that's supported decision making.

576072292608Madhan Balasubramanian 2:21:36How that's brilliant, Natalie.Any other points you want to add jamma or you are telling something as well.

576072292608Nomajama Ganya 2:21:43Ah, no, no, it's all.

576072292608Madhan Balasubramanian 2:21:45Brilliant.So I think it's a very good summary and thank you for the the rich discussions going on in the group.I totally agree with you in terms of how we use these Lange large language models and especially the example on the virtual cache center.The, as you mentioned, Natalie, there you have the technical people looking more closely with the clinicians.I think it's really a very good example for us to understand what these models are capable of the same time work clinicians want and how they might use these large language models.

621792274320Christopher Dong joined the meeting576072292608Madhan Balasubramanian 2:22:16Machine learning algorithms in in day-to-day practice, so if that's brilliant, any any other thoughts from room 2A?Group 3.That's Maria Katie rianna group.

576072292608Morgan, Kathryn (Health) 2:22:33Yep, we we talked about the complexities of AI and then the healthcare system and we talked about things such as Hakeem maintained confidentiality and who would have access to the the systems and how would you maintain that access and making sure that that remains safe.And we talked about training for large groups of people and constantly upgrading them as new versions come through.And you talked about consent.Who?What happens if there are patients who don't want to be as using this system?How would we go around that?And we talked about the legalities of it.What happens if it was to go wrong?Who would be responsible?Is it the person who developed it or is it the person that delivers it?Well, there is it.The end stage.Use it if where do you decide where it's gone wrong and can it actually cope with all aspects of inputs?And as humans, we have six cents about our patients and we can see with our eyes what's going on with them.How can an AI model replicate those sorts of things?They were the type of things we were talking about.

576072292608Madhan Balasubramanian 2:23:53Very.Uh.Very innovative ideas are very interesting, especially when you said valid goes wrong, the person you.Is it the creator or is it the user?Or is it a or the person who receives it?Very interesting thoughts and I I do think all of these things becomes very important.As healthcare leaders, it's it's very important for us to to understand as we were discussing with the group here is to see whether we have the necessary regulatory measures, the the necessary legal and regulatory processes in terms of use of ethical use of AI in health and aged care.So I think it becomes quite important.As of now, I don't think we have an AI framework.It might be something for you to explore to uh, it's it's uh, it becomes a important for us, especially considering the exponential growth of AI to see what is the ethical use of AI and in what types of services and in what manner and how it could be used.And as leaders, it's these are some of the emerging challenges that you would you would face as the systems are constantly evolving and as AI based ethical regulations.I I are being set and ethical standards are actually being set, so it's it's it's very interesting case study for for you to for you to reflect on and I think it it brings module 2 into a full circle so as the module 2 opens on Monday it should give you a good head start and modules one and two should be sufficient for you to address assignment one which we would get there.Uh, in a couple of minutes.And also it should be sufficient for you to to plan your group activity as well.So, uh, excellent.So let's move ahead.And uh, Yep.So let's move ahead to the next part of it before we do that.So let's take a short break like 10 minutes and let's come back around 3:40.Uh, be just running.We might just need to concise the next two sessions within one hour 45 minutes, so we might not have another break after this.I was hoping this break would be a group bonding exercise, but you know, I think we all knew our groups right now very well.So that's good.So let's cut short.Let's cut short to five to 10 minutes and let's come back at 3:40.Yep.UH-340 at late time.OK, so I think we'll start with the wasting much time because I think we have some important things to cover in the last session, especially on assignments, which I think I'll give some time for us to look at.You know the final segment because there's been a lot of questions in terms of how to go about your assignments.So I think will give some time and it's being recorded so others will be able to get to it as well if they have missed that session.So let's let's go on to the last segment.Welcome everyone.Good to see all of us are hanging here, so it's brilliant.The food segment here, very interestingly, we're gonna be looking into two different organizational contexts.So one both of these are, you know, are actually presenters who have been here at Flinders and we have discussed their organizational issues with us.The challenges that they have faced and also they had expressed some of the major concerns they have in in addressing some of the emerging issues and challenges within their organization.One the South Australian dental service, Stewart Marshall, is a good friend and he was here awhile ago, reflecting on the different issues and emerging challenges which the South Australian Dental services space and 2nd we'll be looking at the ACH Group and the Ache Group.As you know, it's aged, uh, aged, aged, aged cottage, so aged, I think, is aged.Care housing, aged care, housing group or aged Cottage group.It was, I'm not sure.I think of aged care and housing group, aged care and housing group, so they are the largest edge care providers and in so the stralia and they they have come out with several innovative solutions in order to address aging and so the Australia especially aged, they go about dealing with rural and remote aged care facilities and also Home Care Services as well.So we'll be looking into that as a Ivy was here with us a while ago and she reflected on some of the challenges faced by ACH Group and Ivy is the general manager of service design and we'll be looking at some of the issues that she actually highlighted.So with that wasting much time, let me first go into the first thing.Uh, which Stewart highlighted in terms of the South Australian Dental Service and leadership challenges in public oral health services.So Stewart is the chief dental officer with a was moved down from uh from Scotland to here.Uh, it's been here for quite some time and he reflects some of his experiences here in Australia and also the difference is that he actually found in terms of the NHS in UK and Australia and some of the challenges that he's facing in dental care in South Australian dental service there.Uh, getting on into it very quickly.So the South Australian Dental Service in terms of how it's organized, it provides public services mainly to people who are actually below the poverty line, but also the children and senior citizens.Uh, and uh, it's it's.It goes on through uh Assad and and the experiences of being achieved.Intel Officer is quite unique, so Chief Medical Officer, it's quite similar because he would need to really understand what's happening at the clinical perspective and being able to document and able to.A A gathered through the different opinions of the clinical practitioners around so as a clinical leader, as a clinical being with the clinical leadership team, these are some of the challenges that you really need to address.The core group that you're actually dealing with, the clinical practitioners and bring them towards the main service, if you looking into public dental care in Australia, I think this is something that I highlighted earlier.So in terms of in terms of public order, health care funding, state funding, Commonwealth schemes, mainly the child dental benefits schedule and also other family, you know, they're schemes in terms of older people.Uh, and also other schemes are available at different models.Are there in Australia if you start looking into rural and remote areas, if you start looking into how these services are actually catered to them so you get different models across different states, you get public public owners services scheme scheme which caters towards you know, rural and remote areas with limited sector of oral health providers being given the permission to train their under supervision.

621792274320Oscar Mare joined the meeting576072292608Madhan Balasubramanian 2:39:08So you get all the practitioners and people coming from diverse backgrounds and also international packages as well.So that's the public sector oral health scheme is quite similar to the medical scheme as well, but it's different in the sense that they did, they just get about three years and still they would need to come back to, to take up the final examination in terms of licensing examination.So if you look at the senior leadership team, so you do have the structure of the organization, it's it looks like quite an horizontal organization structure, I believe.I mean, I'm not sure what you would say.It looks to me like an horizontal or maybe it's still vertical because the cheap dental the executive director is the one who's looking at, you know, managing the statewide services.You have the business support and you have the the clinical person and you have the Director of clinical operations.So you have an operational expert.You have a clinical expert and you have the business improvement and support and I think the team is fairly horizontal and the functioning is doesn't seem to be reflected very vertical.It seems like a functional arrangement in terms of the structure you know, in terms of the metrics that you that you have seen earlier, it seems to be a function of that a a functional structure in terms of sets and look at the statewide, it's in terms of the budget and how they actually operate.So they they do function across a the 11 local health networks and also the percentage of the staff working and the FDES which is being provided.Of course, you might actually see a number of them were part time and uh, they are the annual budget of it and the various services and the Chaz, which are available in correctional services, remote visits and also hospital based services as well and approximately about 275,000 client visits per year just gives you a general idea and overview of the organization and very good outreach in terms of school services.Think it's quite important when you start talking about health promotion, wishing to the schools and community organizations is very important and dental.And because it is, it is a non Medicare covered service, you know treating children as they are, it's very important.So having having mobile service provision in terms of vans to the schools in terms of catering, different types of overlap providers and the vans and providing free services to children has been an ongoing exercise with SATS in the University of Adelaide and also there is there is another.That is another service based bayala as well, with a major University of Adelaide clinic working with sets and reaching out to all the the rural and remote areas.It's a very quickly, uh, the challenges.So these are the challenges which are identified by by the Chief Dental officer and the leadership.It's it's impact in managing the impact of Commonwealth funding because as you see many of these these non Medicare covered state based organizations, they still have faced a reduction in Commonwealth funding and that's been it's been just not just relevant in SA but it's happening elsewhere in other states as well.So managing the impact of this reduced Commonwealth funding is something which was discussed, flexible workforce, how do we work within the scope of practice and also how do we train new types of allied that providers to cater to different patients.I think that was also very important.Closing the gap with with children and adults was also discussed because children, they they they receive free care, but at the same time the waiting list are quite enormous are quite huge.Sorry, they're quite huge in SA, so if you go and want to seek a care, even though it's free and it's available to you in a theoretically, you might have to wait for three months just to extract the teeth.You know which might all which might be decidious, and it might fall down eventually.You know, you know by the time you wait.So.So that's a major issues also in terms of addressing rural and remote areas as well.We don't have enough practitioners to visit us to visit rural and remote areas very similar to what's happening in terms of medical professionals in terms of nursing professionals in terms of other allied groups as well.The and also addressing priority groups.This advantage populations where the burden of oral health disease is considerably high.Indigenous groups, where the burden of oral disease is considerably high and also their literacy rates, and that sugar consumption and the food and beverage consumption is the patterns are considerably different as compared to the other population, which eventually is seen in that oral status there, there there is lots of things going on and also they work very closely with the University of Adelaide and one of the things which the South Australian Dental Service wanted to do is improve the allied health services as he knew the the dental profession.You know, as as you might know, they they have the dental specialists.I mean, it's a whole unique group by itself.They have the dental specialists, they have 10 different specialties.You know dental specialities and then they have dentists such who do A5 year training and after five year training you need to do another three to four years of specialization to become a dental specialist.And then, of course, they have that midlevel providers, oral health therapist who do three year training and they are eligible to treat mostly children and work on private as well as public sector.And then you have dental therapists.You have dental hygienists, a dental hygienist worked mostly in private setting, and they provide scaling services, preventative and health promotion services.You have dental therapists, you know, mainly school based providers or, you know, dental therapists and oral therapists.As I mentioned, they are a combination of dental hygienist and dental therapist and with the very well formed university degree which is being offered at the University of Adelaide at the first time it was offered at the University of Adelaide.It's a major.It is a major cause in the University of Sydney, which caters to about 130 students per semester and fortunately at the University of Sydney.Sorry at the University of Adelaide, where the school was founded on the first university, it started the course.They weren't able to get any financial incentives and and they this goes is pretty much not not functional right now at the University of.So this is a challenge for the University of Valley and one of the main reasons is that the University of Athlete and the University of Queensland are the only two dental medical schools which cater for school living students to take up the Bachelors in Dental.Or maybe the bachelors in medicine, all other universities need to have a bachelor's degree to start with your medical or dental training.But only University of Adelaide in Queensland, they still have, are still using the old common with the approach of school leavers being able to enter into dental American degrees.Maybe that's the reason.Maybe that's the reason why students prefer to do dental degrees rather than over the therapist course, which is where the demand is.So we have been University of Adelaide, which was pretty much the founding story of the oral therapy course.This seems to be totally redundant right now.That's the major challenge.And of course, let's look into some of the strategies.Uh, some of the strategies which?Uh.Which they they they are.They have been successful clinical clinician that strategies consultation is was very important ability to use the state wise approach and and ability to use said in the systems constraint monitoring, feedback, encouragement.So it's because it is a health care service understanding what clinicians want is quite important and it's reflective not just in dentally, it's reflective in all the other healthcare services.It's very important to work closely with the clinical lead who might be achieved until Officer or Chief Medical Officer or a chief nursing officer.It is important to work with them to understand the key challenges.So clinician, let's services are very important and strong clinical leadership structure essential for the success of any organization.Sorry, I'm going a bit fast.I'm just new, I have to cover a couple of things and developing future leaders as well.So it's just a I'm just going to keep all these things and I'm also going to skip G as well.And these are some of the emerging stories which are in sat in terms of special needs dentistry in terms of geriatric care, in terms of aged care and the reflection of the Royal Committee and aged care Soft Royal Commission into aged care quality and safety, the report that we reflected today morning and it's implications to oral health and some of the things that we looked into and impacts of COVID and this, this this was one such concern which came out is that you do have a a national medical you you do have a a national chief medical officer you do have a chief nursing officer nationally but seems like they don't have I mean even though I don't see it as a major issue but it seems to be it's actually just a major leadership challenge across uniting dental services across the different states in this particular discipline so that's something you that is something that came out and and I hope all of you are available.

621792274320Oscar Mare left the meeting576072292608Madhan Balasubramanian 2:48:03Actress akra, for those from an international context, AKA is the registrating.It's a national registration body is called Australian Health Practitioner Regulation Agency.So before 2010, so Aqra came into existence in 2010.So before 2010, all health professionals need to register within the state based organizations.That is a state general.You know you have the state general councils, you have the state dental boards.So all the activity used to happen there, but 2010 Australia moved into a national regulation system, so there was a major, major initiative, lots of activity, lots of research work.So I was, you know, I just started my PhD in 2010 and lots of things happening around at the time.And it really changed the landscape of my PhD as well to some extent, because I was looking at health practitioner activity and the way we we go about collecting data and the way we actually went about trying to understand things after that also considerably changed because we couldn't go to the state booths anymore.We have to go to doctor and there was also health purpose, Australia as well.Lots of new players came into place at that time, so Yep, so these are some of the issues and challenges.So I would I would.I would want to leave it over there in terms of South Australian Dental service, so this is just one particular organization context.Of course, we will be looking into lots of other examples as well, and we would see if we could actually capture and give you a gist of, you know, maybe a few comments from Stewart.I'll see if you can get it and give it to you as a video as well, you know, made available, but I'm not sure if I'll be able to get it before this week or next week.So let's see how I go about it.So you'll be getting lots of different, you know, but you will be getting lots of different organizational examples and this is something for you to reflect on because the more the more organizations you're exposed to, the more you actually know what are the key challenges and if you have potentially placed in one of these organizations as in health care leader.So it gives you a better context as to how to grow about moving around these different organizational objectives that that, that you know that performance and what their priorities are and how you really understand these different interests and stakeholders because each organization they reflect, they have different stakeholders and they have different sensitivities.You know, surrounding as to what's important and how to go about things.So it's good to get exposed to all those things and I'll, I'll send you a lot of case studies as well as different journal articles as well which help us to explore more.The without wasting much time, I think I've really doing very good in terms of going fast, so well done. Me.I'm going to be also talking about ACH group, so ACH Group is a very close collaborator for Flinders University and we have been working with them probably since we have started, their CEO Frank Weitz is a very good collaborator and the people they've been working there and the research which has been happening in Ashe Group has been lots of evidence coming on from our centers, mainly Aria, the aged care research and Industry Innovation Australia also the the Carryings Future Institute.So lots of you know, cutting edge research being done and contributed to in terms of the ACH group.And we are working with the ACH group as well in terms of how to actually provide services for culturally and linguistically diverse older adults.So it's an ongoing study that that I'm actually doing with ACH group.And as I said earlier, in terms of CALD is what we call as culturally and linguistically diverse CALD communities.So it's mainly people who are born outside Australia and those who speak a language other than English.That's the definition for CALD.Culturally and linguistically diverse, so it's and it's a further development of non English speaking background.But here Cal is the right terminology we use nowadays.We don't call them migrants or we don't call them as not English speaking background people, we call them as called culturally and linguistically diverse.The CALD older adults, as I said earlier, that their health attitudes that perceptions are considerably different as compared to non CALD people and the health seeking behavior is also considerably different.So it's each group is and as well as other aged cafe is leading this better.They're quite keen to really address the concerns of this call.Population CALD older adults, especially because as I said earlier, I hinted earlier that the proportion of the older people migrating from South Asian countries, Southeast Asian countries like India, Vietnam and Cambodia, Philippines, China has substantially increased over the last 10 years and also people migrating from the Middle East has substantially increased.Older adults and the necessity to cater different types of services and models for them has become has becoming a major leadership challenge in ACH group is pretty much undercutting edge or or.I wouldn't necessarily say cutting edge.They are using evidence based methods.They're trying to find different solutions to the problem, so that's that's a very interesting, you know, development before that I would just you know like to point out a few things about the ACH group as such.Uh, mainly, you know, this is their purpose.So it's good to know it's an edge care organization, that vision and mission statement for you to know.You know, a really understand what they're doing because you need to get to know in order to understand the organization, you need to know the vision and mission.So this is the vision and mission.I will leave it to you to learn this a bit to to actually read it in beat mode.Detailed a bit later.Good lives for all the people.Interesting.So that's, that's the the logo and the the the statement, the social purpose statement, the number of staff gives you a bird's eye view.Even what an organization is and in terms of connected communities in terms of the various types of services they provide, residential care, home care, assisted living, retirement living and also people are independently living as well.The the idea is defined ways to integrate all the communities together, so the concept of connected communities seems to be quite central to ache philosophy.So it seems to be integrated into that vision mission and the organizational objectives.So it's something when you go about dealing with it, it's it comes out in much of the discussions, but many of the, the leadership group in his hedge, they want they.So this is how they differentiate themselves.They want the older people to be connected.It's not just those in residential aged capabilities, but also those were living in the whole gamut of other aged care services in terms of home care, in terms of retirement villages.They would want to have this connected experience and how they do it in terms of technology, in terms of models of care, in terms of different services that are available for them.So that's, you know that different approaches which they use so also in terms of service designers build you know they are positioning themselves for tomorrow but leave it over there.And in terms of the governance structure, in terms of the Royal Commission recommendations and how they've incorporated them, so these are all the Royal Commission recommendations, so especially the video which you saw in the morning or maybe early afternoon, which you know the Green Book.Uh, the green Bible or, you know, probably not the Bible.There's been lots of royal commissions earlier, so the green Book the Royal Commission reported to HR called the and safety and these are some of the recommendations in terms of governance, quality services and this is how ache Group has incorporated many of the recommendations proposed by the Royal Commission into that day to day activities.So that's quite interesting to know.It's a good read, so I will leave this to you to read it and the government's response to royal Commission as well.Uh, and I believe you to read this and the the 17.7 billion plan, the five pillars which ACH Group wants to address, you can see pillar one is home care, quite interesting Home Care Services especially considering called if you start looking at ACH Group they they have that they have the a very specialized a Vietnamese uh chica service in the northeast but they still criminally catheterize the Italian and the Greek which is on the West.So they have some concentrated areas where some of the groups are more predominant.You know, for example, if you look at the North, Northeast, either you find the Vietnamese populations to be very predominant to the data as compared to the western areas.You find the Italians and the Greeks and you would find the others in terms of the Chinese population to be a bit more towards the eastern uh.I'm a metropolitan, so there are some specific areas which they are which they have designed the services in order to meet with their CALD or culturally and realistically diverse communities.And that's where they want to take home care.So that's the reason you can see home care is pillar one.They would want to take services to the people rather than asking people to come here, they would want to design services that are more culturally design services that are more culturally appropriate, directly coming from the Royal Commissions recommendation.So it comes directly from the Green Book and it's in terms of Home Care Services.There's been lots of, as you would say, there are about 100,000 people waiting vodcast services.So this was just a couple of years ago and the list has gone up.It's even more right now it's even 150,000 to 200,000, perhaps not so Home Care Services is an emerging area of research and lots needs to be done.There are two types of forecast services.There is a Commonwealth supported forecast services and the home care packages that are full levels of home care packages and each one of them caters to a certain extent and you you can get more information and uh and I would make more information available to you in terms of these you know, special home cast services and how different groups that addressing these emerging challenges in your canvas soon.So I in terms of workforce, it's a major challenge as we pointed out in several of the lectures, you know the segments today and I would want you to reflect on this sometime.You know when you get the time.So this is the road map as to how they actually go forward in terms of really addressing and I think I think we have come here, I think it's July, June, September and they're they actually pretty much in, you know having lots of strategies being done.That's still lots to be done in terms of in terms of, uh, I health records in terms of in terms of digital, in terms of digital technologies, in terms of home support programs, there's still lots of work needs to be done, but it's very interesting if you can see how it's going on in terms of home captivities, residential care, it's a, it's a very interesting thing for you to reflect upon the trends, uh quality and standards because pricing is an issue because you can't provide illegal services unless of course, if you if you implement a levy, a, a levy, a a charge, some additional prizes in order to provide them, it's not all the capabilities are able to do it.It's not.It's not all hcac facilities are faith or religious based organizations where they might have history support.For example, the monetary aged care homes which I said in Randwick was able to get a 50 Cent lady from all the older people and this accounts for providing some services on a regular basis.So.So so you see, there are some reason doing it and let's get on for the terms of reform and all the major challenges I would tend to you know, I would ask you to go and read this in terms of how they are dealing with these different challenges.Uh, I would just leave it as that.So any other questions in terms of this aged care group, like how did you find it?Like, did you really understand the organization?You know, all aged care of invasions in Australia have a similar sort of structure.You know it.Maybe it may be a nonprofit and maybe a private organization.It may be a fade based or a religious based organization.Each of these have actually faced demands considerable demands, especially since COVID and after the Royal Commission, and almost all of them are working towards reinventing themselves and trying to cater to the different emerging challenges.So so you see, this would give you a bird's eye view, I believe.Believe I I do understand it's too much of information.I'm just feeding.You are putting or maybe trusting you with too much of information, but that's the purpose of this intensive session.I mean, I mean, once you go home and sleep together, you know, tomorrow morning everything will be fresh.So yeah, I hope.I hope you know it's it's and as you start reading your canvas and we'll be there to actually help you.So I hope you got an idea of an aged care organization.You've got an idea on how to go about reading what an chat organization does.What are the challenges and aged?Cannot organization face into the Australia or an Australian general and how they how they are reinventing themselves based on these?You know cameras that issues going in terms of royal Commission or the funding issues, health, workforce shortages and also providing different models of cat older people.OK.So are there any questions?It's very hard to find out whether people online are awake or asleep.

576072292608Emma Pitkin 3:01:40Where do I?

576072292608Sarah Bamunu Arachchige 3:01:41You.

576072292608Nomajama Ganya 3:01:42Uh, we still have.

576072292608Madhan Balasubramanian 3:01:44Food and food.

576072292608Nomajama Ganya 3:01:46Can I just add this ACH group is is it in other in Adelaide, South Australia?

576072292608Madhan Balasubramanian 3:01:52Yes, yes, this is inside Australia and the head office is is very close to my home actually at my land and have a number of centers across.

576072292608Nomajama Ganya 3:01:58I can.

576072292608Madhan Balasubramanian 3:02:02So there's three and it's the largest age care provider in South Australia.

576072292608Nomajama Ganya 3:02:08OK.Interesting.And through.

576072292608Madhan Balasubramanian 3:02:19Central Italy local edit I I would believe so.Because uh, because statewide services would need to.

576072292608Nomajama Ganya 3:02:25Like.

576072292608Madhan Balasubramanian 3:02:28Please correct me if I'm wrong I.I.Because I think central Adelaide local network is bad, the key hospitals are because you know, Roy delude you have much of the major tertiary care teaching hospitals.So to make sense that statewide service is a part of it, and if you and and I, am I right, right.So it's it's, it's part of central Italy.

576072292608Hincksman, Natalie (Health) 3:02:56Say what services are under Central Adelaide Local health service.However, the public Health Network isn't.That's in the department.

576072292608Madhan Balasubramanian 3:03:06OK.Thank you.Excellent.So any questions or comments before we go to the assignment part of it?And I think we really good doing good in terms of time.So if you other question, we just go to the final segment and we'll spend some time on on it's uh uh, think a lot of you are very anxious in terms of the dates of the assignment and also what need to write as well.So let's let's get on to the last segment.OK, so uh, there are mainly 4 assessments.Uh assessment task one and assessment and assessment task two uh are basically one big assessment, but put together as two different paths.Uh, so the first assessment task is for you to identify and analyze a complex organizational problem.And second, as it's been task, just get out of second.This is the major.This is your major assignment and over here you develop an organizational change plan aiming to address the complex problem that you identified in assignment one.So so it's it's sort of a continuation, uh, so I mean it, it would be expected that you you get into a problem that you're most comfortable with.Uh aligned to your organizational interest, so your your subjective preference and try to go into it into considerable depth.So for assignment task one you would be asked to write a report.So mainly take a paper or report format.I really don't mind, but I report format would mean that you write it to an audience.Maybe and executive audience, that would be quite useful.So having something a summary towards either you tackle it as executive summary or summary towards the front and have different respects, I wouldn't necessarily want that for assessment task one because assessment task one you have a very short.It's just about a thousand 2500 words.So I mean, I would like you to stick to the word limit to to to some extent if you can, because otherwise if you go about 3000 words, it makes it actually makes my task much more harder.I have to read through the.You know, I'd have to read 3000 words, but you know, having said that, this is just 20% of the overall value and it's it's important for for you to apply the various organization analysis tools and models that you have learned, especially modules 1/2 and some extent module 3.But I wouldn't necessarily want to go to the that extent.Uh, and this is due at the end of 4th week.Usually.So it's the foot, it's teaching week four, so Saturday 11:59 teaching week four.I can get the actual dates to you soon, but it's usually it's.It's due on the 4th week.And uh, so it mainly builds on online activities as well.So the various reading modules you know reading activities, the discussion items, but having said that, it all depends on what, what sort of context you want to bring into the assignment.So it's important for you to go back, do some homework as to what organizational problem you're going to deal with, and how you go about in trying to understand this problem and what are your comfortable?This is going to be AI.It's going to be health workflows is going to be discipline specific.It's going to be emergency admissions is going to be covered based scenario or is it going to be disadvantaged groups, depends on whatever your interests are already in mind, but you will need to have really dealt or gone into a problem in depth.So has selecting an organization that you're comfortable with this quite useful?So that would be my first suggestion.Uh and going on to how to write this this assignment, so you would need to put your organization into context.Discuss the organization.Uh, the industry market and organization is target customers.Identification of complex organizational problem.What the problem is?Uh, so essentially, you're trying to really understand the problem within your organization and going about assignment two.You're trying to build a plan in order to address this problem, so assignment one, it's mainly telling us a bit more about the organization and about the problem that you wish to address.So it's identification, so it's mainly the diagnosis aspect.You know what you actually got in your model with one and two is mainly the diagnosis aspect, exploring the various bigger problems.Uh, you know, bringing as much context as you can from the various learning material as well as some of the new contemporary journal articles that relates to your your assignment.You know your area of interest.Analysis of this organizational problem to some extent.I think it's important to to also really tell us why this is a problem.You could, uh, if you could look at some of these tools that you that you use to analyze you could you could use something like a Mackenzie model perhaps or you could use maybe even qualitative interviews as you actually suggested in your organization.You could use adore qualitative interviews or it could be any other secondary data that you actually bring.So already don't mind, it doesn't need to be a set or an established tool.It could be even research evidence as well that you bring in uh.You just have to justify.Why are you you are actually using it in order to analyze in order to analyze the organizational problem.Uh have have at least 10 references, so my take home in terms of referencing is that for every 1000 words you have 10 references.So that's the standard.So that's sort of like academic standard and always have a mixture of references.Don't just go on into websites and reports.Look into contemporary journal articles.Look into recent journal articles so your evidence for recent you know.So just try to.And see what are the relevant you know, work what's been done over the last five years or so and see how it relates to because we don't want to.We starting with.Yeah, much of the work has been done over the last two or three years at the same way.You know, you'd have to look into all the other areas as well and to see what are the most contemporary research going on and you might reflect on also other countries, you know, international examples as well.And international examples usually really heavily, you know, graded by examiners.You know, I'm not sure if I might be, you know, grading it or it might be someone else, but examiners, usually they like international examples, so it may not be possible to add international examples in assignment task one, because it's just about 1100 words.But it's very important when it comes to assessment task to when you're trying to build up your change management strategy and conclusions and recommendations.So this this is just an outline, I am not looking for you to stick to this outline as such, so I don't expect you to come out with these same subheadings and having to populate content across each of these subheadings.You know, you could take your own original approach, but I would when I go about as the thing these things I would be looking into these areas.So and also want to point towards the use of AI as well so.As you know, all assignments.So I'll be sending out a separate announcement on that.So a responsible use of AI is important.So if you're using something like chat, GPT or bad, or lots of other things like writer or a view Sonic, write Sonic so they the university has a policy, you know, I would share that policy on responsible use of BI.But you know, but I would expect it all take an original assessment.So all the assessment would be uh, fed into AI deduction tools.So if we get to know that the user AI is beyond a certain level, we would come back to you and ask you to reframe it.So I think all of those things I to keep in mind and I I will be sending you some announcements on responsible use of AI as well for in terms of managing these these assignments.

576072292608Hincksman, Natalie (Health) 3:12:19Met him.You got a question online?

576072292608Madhan Balasubramanian 3:12:21Yep.Uh, yes, I do.I Diwali.

576072292608Adewale Adewuyi 3:12:30Yeah, I was trying to ask for a precise date.So you already clarified that already.

576072292608Madhan Balasubramanian 3:12:36Yeah. I'm.I'm sorry I didn't get you.

576072292608Adewale Adewuyi 3:12:39Umm, I was trying to ask for a precise date, but the assessment do this.

576072292608Madhan Balasubramanian 3:12:48Uh.Uh.The due date OK for assessment one.It's the 4th week, so I think we are currently teaching one, isn't it?

576072292608Nomajama Ganya 3:12:54OK.

576072292608Madhan Balasubramanian 3:12:56So I and I would make the exact due dates available to you soon.

576072292608Adewale Adewuyi 3:13:02Yeah.

576072292608Madhan Balasubramanian 3:13:03Uh, uh, but uh, a generally, it's the 4th week, so if you calculate it now so it's four weeks from now, Saturday 11:59.So I get back to you.So if what's the due date for this?Yeah, I'll actually make it available for you in canvas, the exact duties, but I think this gives you an idea as to what the duty it is.

576072292608Adewale Adewuyi 3:13:25Yeah.Have a nice thank you.

576072292608Madhan Balasubramanian 3:13:26Yep.OK, so as I spent 2.The way name the organization.I don't wanna you switch if you want you can because these are not going anywhere.Yeah, I mean, this is just a for a learning purposes.They are confidential, so it doesn't matter.So just stays with US assessment task two, it's it's it's a major assignment 40% and it's a continuation of your assessment task one where you identify your problem here you are developing a plan to address the complex problem.So this would be based on modules 3-4 and five uh.And usually the deadline is the 13th week, so it's one week after the the teaching week ends.So the teaching week there, there are 12 weeks for teaching, so the week following that it's due, I will send out the exact dates to you soon in terms of I think it might fall towards the last, the middle of October I believe.So umm yeah so.In fact, I think home we might be putting out those due dates for you very soon.And so this this is what is expected for assessment task two.In fact, I would touch base this on our next workshop as well, and maybe I'll remind you over the last workshop, just in time before you submit it.So please don't get too much into this details, but generally I would expect this to take a report structure in terms of you writing it to an executive committee.So, or maybe to the senior leadership, so it's designed as a change management.Our problem I changed management plan.Uh being written to the executive committee or the hospital or the healthcare administer the healthcare management?Someone like CEO key people reading this.So it's been designed as that.So doesn't take the approach of a scientific article, but mainly a report style writing.So that's what the expected to use.Simple terminology is clear, precise address to a professional audience.The same time, I would expect references.As I said, you know the normal, you know, A10 references per the 1000 words is the normal benchmark.But if you find it hard to get references, get back to us.We can also help you in terms of that to scope references and we have a very good library in who you work with for healthcare management and also business, a hospital management Health Administration was very, very good when it comes to going about literature reviews, so might be able to help you and you can also go to the website in terms of the canvas, just go to library resources and you might be able to fix an appointment with the librarian and there's, you know she might be able to narrow down a set of articles once once we have narrowed down to your area of research and interest, I think it's very useful to set up an appointment with the librarian as well.Highly recommended.Summary.Everyone, obviously there's some exec summary would be kept quite high level.Yep, which I'm terrible at and concise, but the rest of it not so much.Like it's more in depth shaming.Yeah, the execute the exec summary think it it's it's pretty much the first thing that I'll read or the examiner will read.So the most simple it is high level it is gets easier to attract the examiner.I totally agree.I mean, it's not there is no need to provide references in the summary, just telling what it means.What are the key points?How you you went about it?Short paragraphs not more than a page.Nothing would be very, very handy.Uh, and in terms of the other aspects, I I would expect you to go to some depth.I think it is expected that you bring in all the learning materials.Are you know you actually bring in all the learnings that you have had over the last 12 weeks because it's the whole course is such modules one to five, so we would expect you to have, you know, covered considerable ground across these and reflected upon the readings and at the same time found your niche area because we are actually trying to find your niche area.Yeah, because not all of us are from a certain discipline.That's how diverse Healthcare is.So you want each one of you to decide where you're most comfortable with variable.And you might be working with the nursing background.You might be interested in the nurse attrition.You might be interested in job satisfaction.You might be interested in, you know, emergency admissions.You know, someone might be interested in uh emergency care.Uh.A paramedic.You know, issues there might be few will be interested in specialist care provisions, health workforce, AI.So the issues are enormous.So we would want you to find a space that you're comfortable with and try to apply the various learning theories epistemologies the that the various you know issues in terms of philosophies that we bring to the course into your own area.So that's what we're trying to do and very flexible, because in how you go about it, uh, and there's always, uh, you know, this is, uh, 50% skill and 50% craft in terms of how you go about dealing with it.So it's it's good to get to know your resources, but also have the creativity as well as to how you really address the problem.So it's it's quite important.And so I get back to us, you know, assignment to in our next workshop as well.So that'll be moving to it.There'll be some more detailed things to go about it, but I think as of now focus on assessment task one, which I think is due in fourth week.Uh, and also an assessment task 3, which is a group presentation.So we would we would want you to work together.So there are three groups now.Uh, you know I uh, based on my experience, I think three groups is fine.You know, unless, of course, we, we had, we have another group.So having five or six members, yes, Adewale, I think you have a question.Or was it the one earlier?

576072292608Adewale Adewuyi 3:19:57Yeah, that was the one earlier.

576072292608Madhan Balasubramanian 3:19:59No worries.Yeah.So group presentations are a very good way of, you know, getting yourselves together with the group and have this collaborative because we all come from different disciplines and philosophies are perspectives, might actually really coming together as a group and building up a group presentation, even though it's 20%.I mean, I've seen students coming up getting very high market group presentations because they all work together as a group.So it's actually important to in this group activity and as you are working together with the group, you might come up with new thoughts, you know, new ways of going about, you know, different solutions, understanding problems and different contexts in different countries.I think it's it's very important and the group presentation it's it's it's due on the second.I think it's the second book.Sorry, it's the third workshop to so.It's the the third intensive workshop I can get back to you on the exact date of the group presentation.

576072292608Nomajama Ganya 3:20:56The.

576072292608Madhan Balasubramanian 3:21:02So and also the time.So uh, so it's the third workshop, I believe, because second workshop, it's too early.Uh, yeah, that's true.I can clarify this with you, whether it's the second workshop or the third workshop, but based on my experience last year, we wanted people.Yeah.We wanted to give people considerable time to be working with the groups, so that's the reason why you put it on the third workshop.It gives us time to cover modules 3-4 and five in workshop two and workshop three would be the final group presentation and also discussing some of the generic issues in terms of addressing the final assignment.So in terms of the group presentation, what we would want you to do is to describe the organization and complex problem discussed, the change management process that occurred and how the change was managed.So you are trying to, uh, trying to see a look into a historical lens over here.So rather than trying to address the problem by yourself, you are trying to see what problems have been addressed by the organization earlier.So you're looking at a historical lens, I think.Uh, that's that's the that's the difference between this and A and A and assessment.Three uh.And you also trying to evaluate as well, uh and uh.Pleased to get back to me as a group.Uh, you know, you're welcome to identify your problem.You've had lots of different varied problems across the last semester.We had people choosing in rural and remote workforce shortages, people choosing health education sector.Uh, a few talking about emergency departments. Kovid.So it's it's up to you and you know I find something which you can tackle, find something which is achievable and you could also come together as a group, have a discussion with the group and see what sort of challenges you wanna tackle and and how you go about this.Uh, and in sort of the expected that everyone participates.I mean, I'm happy to have all of them present, but of the group size is very, very big.You might.Yeah, you might.You might take a call at that time that few will present in few will answer the questions, but having all of them involved, I think it's very important from my perspective and it is expected that you have a handout and you also present as well for the group presentation.And for the submission, I think one of them, the group leader, submits it on behalf of the team.Yep.OK.And this is participation.And as you all know, I've seen all of you to be very active.Uh, I mean, attendance is regularly monitored by Hongmei, so he's very quiet, but she's always there.She monitors attendance.She monitors participation.She monitors activity as well, so she is the teaching, such as she's my teaching assistant, role to doing her PhD as well.And so please, so please be active when it comes to are taking part in discussion forums make you mean as we are moved to Canvas now it's not inflow anymore because we had this experience with flu of being involved.So now we have multiple other news to collaborate.We have teams you could participate that as well in terms of groups or you could also participate in canvas as well.So it's it gives you different options to actually collaborate.So, uh, I mean I I do see managing time is quite important.I mean, uh, we have covered.I mean, we have given you a head start today with this intensive workshop.We have covered modules one and two, so this this this mainly covers all weeks one to four because every module I think what we look for is 2 weeks.We cover a module.That's the idea, and it's expected that you spend at least 10 hours per week, you know, covering the reading materials.But uh, maybe pens on your speed and what you and how you go about it and a a I would really expect you to go on your own adventure search. Different articles.Search your own knowledge, use whatever we provide as a a sort of like a foundational foundational argument, and you would need to build different layers of evidence on top of it.And that's what we expect you in this knowledge seeking adventure and we are here to help and we are here to learn with you.Nobody knows everything, so we're here to help you and learn with you and go across this journey for the next 1213 weeks.That's that's pretty much it for today and uh, I'll, I'll, I'll, I'll.I'll pass it on to you for any questions.There are no doubts.I'm very happy was going to be no email sent to me as well, so I can just close my emails.

576072292608Nomajama Ganya 3:26:27OK.

576072292608Hincksman, Natalie (Health) 3:26:29Wait 10 minutes and you'll get an email, I'm sure.

576072292608Madhan Balasubramanian 3:26:38So please feel free to write to me.You know, I might be a bit late because of my multiple responsibilities as the research lead and HDR.Uh advisor as well, but I usually am fairly quick and addressing emails I I get back to you in about at least a day or so, but if I if you see that have a bit late, please give me a call to my office or you can message me in teams.That is usually much more faster.If you just send a chat message in teams, I usually get back to it much earlier than an email.So if you want any, see how we're going about in terms of pacing your your assignments, if you want an extension or so, this is not the time to think about it.So let's aim to because it's a fairly straightforward assignment compared to 910.This is relatively straightforward and simple, and I don't see any issues you know, especially considering your diverse backgrounds and expertise.There should be a fairly straightforward thing for you to tackle.OK, so if there aren't any questions you might close down maybe half an hour earlier.I I'm surprised we were running late, but the finished half an hour earlier.Well done.

576072292608Hincksman, Natalie (Health) 3:27:54Umm.

576072292608Nomajama Ganya 3:27:56Hmm.

576072292608Hincksman, Natalie (Health) 3:27:57Thank you, madhan.

576072292608Madhan Balasubramanian 3:28:00Thank you so much everyone.It's so nice to see you here today and look forward towards this with OK.

576072292608Hincksman, Natalie (Health) 3:28:03Kiss.OK.

576072292608Hincksman, Natalie (Health) 3:28:06Thanks. Cheers.

576072292608Nomajama Ganya 3:28:07Thank you.

576072292608Madhan Balasubramanian 3:28:07And then I think I have.

576072292608Nomajama Ganya 3:28:08Thank you everyone is a good today.

621792274320Hincksman, Natalie (Health) left the meeting576072292608Adewale Adewuyi 3:28:10Thanks, bye.

576072292608Christopher Dong 3:28:10Thanks a lot. Bye.

576072292608Sarah Bamunu Arachchige 3:28:10Thank you.

621792274320Matthew Tropea left the meeting576072292608Brooke Edwards 3:28:14Thank you. Bye.

621792274320Christopher Dong left the meeting621792274320Morgan, Kathryn (Health) left the meeting621792274320Adewale Adewuyi left the meeting621792274320Nomajama Ganya left the meeting621792274320Brooke Edwards left the meeting621792274320Emma Pitkin left the meeting621792274320Sarah Bamunu Arachchige left the meeting576072292608Madhan Balasubramanian 3:28:26Yeah, I think, uh, I can.The team leader send the the the team names to me in an email because I think that will be much more simpler for me if you have it in a paper, I'll very easily miss it.

Systems thinking enables you to see the connections between different areas and enables you to predict the behaviour of the systems. Using this concept, I can see that aged care is a Complex Adaptive System. Aged care is not a single service model- it has a range of programs and services (like the Health Care system overall), ranging from in home care through to residential care. It has two sources of funding- the Australian Government and the older persons contributions. It has one of the largest service industries in Australia, which encompasses a large workforce and over 3000 providers of care. Within these providers are different entities such as not for profits, community and privately owned entities, and the regulation of the industry is overseen by the Aged Care Quality and Safety Commission. (Commission, 2021)

A systems thinking approach considers all aspects of the problem including the context in which the issues are situated. (World Health, 2009)

Taking all these parts into consideration and applying the systems thinking theory it becomes apparent that the aged care industry is a complex adaptive system. De Savigny cited in World Health (2009) describes six Health System building blocks called the Framework for Action, which reflect the issues the Commissioner investigated during the Aged Care Commission. They covered the areas of service delivery, Health workforce, Health Information, medical technologies, health financing, and Leadership and Governance. Their report highlighted and addressed all these building blocks.

To improve the aged care system all these building blocks need to be addressed. Treating them individually will not improve the system. McDermott (1997) explained that if you want to change one thing, you must also change all the other interconnected parts.

The aged care report has drawn together and analysed all the issues within the industry and put forth 115 recommendations. These are what De Savigny (cited in WHO, 2009) would call the leverage points. He explained that the two highest leverage points are in governance and information and are the ones that usually receive the least amount of attention. This report has highlighted that leadership from the Government level is the most important leverage point. Horvat and Filipovic (2018) explain that the leadership is a crucial element of an organisations success and thus addressing the leadership level at the highest level will have the most impact on the problem.

Moving forward the Government must decide if it wishes to implement the recommendations. Issues that may arise include the underlying political agendas which will influence their decisions, and possible changes to the leadership and/or Government will have impact. The Government needs to decide what type of leadership style and influence it will use to solve the issue. Horvat and Filipovic (2017) explain that in a complex, non-linear model there needs to be adaptive leadership. The former administrative model which involves bureaucracy, hierarchy and control will not succeed with this type of wicked problem and the more parties involved in the problem the higher the need for high quality management and leadership. (Head and Alford, 2015) As there are many facets within the aged care industry, there are also within the Government. Political debate and individual values may inhibit decision making at the Federal level and impede the changes required.

REFERENCES

COMMISSION, A. C. R. 2021.Aged Care Royal Commission Final Report: Summary[Online]. Available:https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-executive-summary.pdfLinks to an external site.[Accessed 31 july 2023].

HEAD, B. W. & ALFORD, J. 2015. Wicked Problems:Implications for Public Policy and Management.Administration & Society,47, 711-739.

HORVAT, A. & FILIPOVIC, J. 2018. Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.Journal of Evaluation in Clinical Practice,24, 301-307.

MCDERMOTT., J. O. C. A. I. 1997.The art of systems thinking : essential skills for creativity and problem solvingLondon, Thorsons.

WORLD HEALTH, O. 2009.Systems Thinking for Health Systems Strengthening,Albany, SWITZERLAND, World Health Organization.

Leading organizations in health and aged care

ABC News highlighted a vital concern of the aged care crisis, which seeks to depict the organization of aged care in Australia and the challenges they face. Using the knowledge gained from the module, I will provide an insightful analysis of concerns such as organization, leadership, and the nature of problems faced in aged care.

Australia has a complex healthcare system organization for aged care with stakeholders such as caregivers, healthcare providers, government agencies, and older people. The organization operates from a dynamic setting due to the constant changes experienced by the aging population's needs and demands (ABC News (Australia). 2020). The aged care sector is an interconnected system where the whole organization can experience effects due to changes in one area. Decisions for a particular change require careful consideration to avoid potential risks of the organization collapsing.

The complexity of the health organization of aged care makes it challenging for the leadership to adapt to its nature. Leaders must deal with stakeholders with different opinions, priorities, and interests, such as funding limitations, government regulations, workforce shortages, and the well-being of vulnerable people (Dixit & Sambasivan, 2018). There is a need for an agile leadership style to be implemented that will adapt and address the numerous challenges. Leaders need to adapt to the complexity theory and understand that there is a need for collaboration, creativity, and innovation to get effective solutions.

The aged care crisis has numerous interconnected and systemic problems with funding limitations that can hinder aged people from getting quality care. In addition, there is little chance of innovative solutions due to a lack of collaboration between leadership and other stakeholders. The quality of care issues such as neglect and abuse are outstanding challenges in providing care to the elderly (Delaney, 2018). In addition, there needs to be more proper oversight by the leadership and a lack of consistent standards across diverse care providers. The problems should be part of larger interconnected whole and complex adaptive systems that must be solved through collaboration. The aged care crisis needs a holistic approach to be resolved.

References

ABC News (Australia). (2020).Government releases final report of the Royal Commission into Aged Care | 7.30[Video]. YouTube.https://www.youtube.com/watch?v=kuo0QuuMG5kLinks to an external site.

Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia.Collegian,25(1), 119-123.

Dixit, S. K., & Sambasivan, M. (2018). A review of the Australian healthcare system: A policy perspective.SAGE open medicine,6, 2050312118769211.

Aged care sector is a complex system with multiple stakeholders, including government bodies, healthcare providers, caregivers, and the elderly themselves. The sector is subjected to various regulatory frameworks, funding mechanisms, and service delivery models. This complexity can result in fragmentation and coordination challenges, impacting the overall quality of care (Woods and Michael 2022).A systems-based approach is essential for addressing the aged care challenge. This includes understanding the system's interdependence, in which subtle changes in one area can have reverberating consequences on the entire system. It also necessitates incorporating all stakeholders in decision-making processes and encouraging teamwork to build a shared vision for aged care.

The Aged Care Royal Commission Final Report released on 1 March 2021highlighted the importance of comprehending the current aged care system in order to envision a new one recommending the need to place people at the centreand a new aged care system including designing accommodation for quality of life, respecting uniqueness in aged care for Aboriginal and Torres Strait Islander people , fairness and flexibility in aged care in regional, rural and remote Australia, improving aged care through data, research and technology, good provider governance and many more. A holistic and flexible approach to leadership and problem-solving is required in light of this understanding. Cultivating a culture of learning and improvement can lead to more effective solutions.

The Royal Commission report also noted that, in comparison to other Australian mainstream health care organizations and foreign aged care services, senior managers in residential aged care lacked the leadership abilities and tactics. Being a leader in the elderly care industry is particularly difficult since there are so many different stakeholders, all with different objectives and interests. Leaders must prioritize the welfare of the most vulnerable people under their care while navigating a maze of rules, financial limits, and workforce concerns. Furthermore, leaders must be flexible and adaptable to meet the changing needs of an aging society. Effective leadership, together with a managers ability to provide strategic direction, is regarded as important in promoting quality in healthcare settings -Anderson, Issel, and McDaniel(2013)

Multifaceted strategy is necessary for wicked problems. Long-term approaches to funding, workforce development, and the changing requirements of the aging population must be considered by policymakers. This might entail experimenting with various care models and routinely assessing their efficacy. Utilizing data and technology can also support decision-making processes and enhance the effectiveness and standard of treatment.

In conclusion, to adequately care for older Australian citizens there is a need for fundamental shift in the approach to organization, leadership, and problem-solving. It is important that government implement the Royal Commission recommendation by adopting systems thinking, complexity theory, and embracing adaptive strategies, and support extensive policy reform that will support improved employment conditions, pay, training, and career routes.

References

Aged Care Royal Commission Final Report:https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-executive-summary.pdfLinks to an external site.ABC News (Australia). (2020).Government releases final report of the Royal Commission into Aged Care | 7.30[Video]. YouTube.

Dawes, Nathan, and Stephanie M. Topp. "A qualitative study of senior management perspectives on the leadership skills required in regional and rural Australian residential aged care facilities."BMC Health Services Research22.1 (2022): 1-11.

Montague, Alan, John Burgess, and Julia Connell. "Attracting and retaining Australias aged care workers: developing policy and organisational responses."Labour & Industry: a journal of the social and economic relations of work25.4 (2015): 293-305.

Woods, Michael, et al. "Sustainability of the Aged Care Sector: Discussion Paper." (2022).

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How does your learning from Module 1 inform your understanding of the organisation of health and aged care in Australia, the leadership challenges faced in this sector, and the nature of problems encountered in aged care?

The Aged Care crisis is a massive concern currently for the Australian Government and its aged care residents, families and staff.

Issues in particular that have arose in Aged Care include (Delaney, 2018):

A workforce shortage. This is problematic as without adequate staffing in aged care facilities, this can lead to poor client centred care, and can also increase the risks of errors being made in these facilities, further leading to negligence of care. It is also rather concerning that many of the staff in aged care facilities are not adequately trained to manage such complex clients. This poor management of clients can also lead to abuse, which has been showed through camera footage in Aged care facilities. Abuse can come in the form of staff assaulting clients, or clients assaulting staff. Either way, there is a clear knowledge gap that needs to be addressed going forward.

Another issue consists of not enough allocated funding being provided to Aged Care facilities. Again this is problematic because this impacts the numbers of the workforce, equipment coming into aged care facilities and overall resources.

There needs to be more government regulation in relation to Aged care going forward. Australia is currently an aging population which also presents as a serious concern because this means that aged care facilities will be in higher demand than ever before. With this becoming a reality, it is essential that more funding is coming in to booster the workforce and training that staff receive to manage such high complex clientele.

The Aged Care Royal Commission Final Report was also met with dismay amongst communities, as many felt there was not enough done in this report to address the aged care crisis (Aged Care Royal Commission Final Report, 2021).

In terms of reflecting on the leadership challenges that arise in the context of aged care, it can be difficultmanaging and leading in a system that involves multiple stakeholders, regulatory frameworks, and the well-being of vulnerable individuals. It is essential as a leadership figure to always collaborate and demonstrate effective communication to all stakeholders and other individuals. Collaboration between everyone is important, as this can decrease the chances of errors, and miscommunications. It is also important that leadership figures in aged care provide education to staff regarding currently regulatory frameworks and the importance of these (Boffa, 2022).

Systems thinking is important because this allows for connections to be visualised between different areas. This can further allow people to predict the behaviour of systems. Based on the structure of an aged care, and how it operates/functions itis a Complex Adaptive System. This is because it is dynamic in regards to interactions within the organisation.

References:

Boffa, A. (2022). Aged care workforce must be dementia-ready.Australian Ageing Agenda, 16-16.

Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in Australia.Collegian,25(1), 119-123.

Aged Care Royal Commission Final Report, 2021:https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-executive-summary.pdfReplyReply to commentThe ABC News film (ABC News (Australia), 2020) explores the aged care crisis in Australia, specifically focusing on aged care system, leadership challenges, and complexities therein. Applying concepts from Module 1, such as organisational theory, systems thinking, and complex adaptive organisations, improves our understanding of these elements and helps identify areas for improvement.

Organisational theory is valuable as it enhances comprehension of the structure and social dynamics of the service we are involved in and enables us to analyse the operating environment (Jones, 2013, p.31). The health and aged care sectors involve various stakeholders, such as government entities, care models, providers, healthcare professionals, carers, care recipients, and their families. Companies have different organisational structures, such as hierarchical, flat, divisional, and network-based systems, which affect decision-making, coordination, and communication. The news footage highlights the negative consequences of neglect and insufficient treatment, which can be exacerbated by organisational inefficiencies and misaligned incentives (ABC News (Australia), 2020).

Applying systems thinking to the aged care dilemma reveals the intricate interdependencies within the industry. The Institute of Medicine (2001) considers the use of a complex adaptive system framework in the context of health and aged care as it emphasises the interconnectedness of problems and the need for comprehensive solutions (Sturmberg & O'Halloran, 2012). Systems thinking allows for the analysis of complex relationships among various elements, highlighting the importance of addressing root causes rather than surface-level symptoms(Institute of Medicine, 2001).

The aged care industry faces various challenges, stringent regulatory frameworks, inadequate funding, shortages in the workforce, concerns regarding the quality of care, and the changing needs of the ageing population. The complex and interrelated nature of these issues poses a challenge for resolving them using conventional linear approaches. In order to address the growing problem, it is necessary to adopt innovative strategies that are suitable for the intricate nature of the sector(Sturmberg & O'Halloran, 2012). Experimentation, knowledge acquisition, and feedback loops are key when applying a complex adaptive system framework to improvement. Horvat and Filipovic (2018) suggest that implementing these methodologies can help companies in the aged care sector identify innovative solutions and respond efficiently to evolving demands.

The leadership challenges in the aged care sector stem from the involvement of multiple stakeholders, regulatory frameworks and the need to prioritise the well-being of vulnerable individuals (Pagone & Briggs, 2021). The ABC News emphasises leadership failures caused by inadequate monitoring, distorted incentives, and deficiencies in accountability procedures. For leaders to effectively address ethical and operational challenges they need to consider an approach that also promotes a culture that values compassion and excellence (Horvat & Filipovic, 2018). Financial reward schemes have limited efficacy in motivating performance in the health and aged care sectors due to their limited impact on long-term patient commitment to values and actions (Sturmberg & O'Halloran, 2012).By applying system thinking, leaders are more likely to understand the broader implications of their decision-making (Rosas, 2017). Leaders have the potential to bring about positive strategic changes in the aged care system by identifying and resolving fundamental systemic problems (World Health Organisation, 2009).

The intricate and interconnected nature of factors in aged care renders it a "wicked problem," a term initially introduced by Rittel and Webber (1973) describing the problems that are challenging to anticipate and whose definition evolves as potential solutions are explored or put into action. The aged care sector may require a comprehensive approach to address strategic misalignments. To address these challenges effectively, it is crucial to utilise adaptive and flexible strategies that can accommodate changing circumstances (Raisio, Puustinen, & Vartiainen, 2018).The limitations of traditional models and frameworks in dealing with complex and challenging issues are emphasised when examining wicked problems in the fields of strategic management and aged care. Traditional approaches are inadequate for addressing the complexity of wicked problems due to their reliance on assumptions of stable environments, linear cause-and-effect relationships, and predictable outcomes (Raisio, Puustinen, & Vartiainen, 2018).

Gaining a new perspective is vital for effectively implementing a strategic approach that aligns with the needs of the aged care sector. Collaborative approaches and innovative strategic methods would be better suited to achieve this goal (Horvat & Filipovic, 2018) by effectively addressing complex and challenging issues in the sector. To effectively address the complex and evolving challenges in the aged care industry, it is crucial to acknowledge the limitations of traditional methods and prioritise collaboration, workforce empowerment, and adaptability (Horvat & Filipovic, 2018).

Emphasis is now on incorporating organisational theories, systems thinking and complex adaptive systems in the field of aged care. The integration of these concepts is crucial for recognising systemic inefficiencies, improving leadership approaches, and finding effective solutions for the complex challenges in the aged care industry (Pagone & Briggs, 2021).

References

ABC News (Australia). (2020). Government releases final report of the Royal Commission into Aged Care. Retrieved July 28, 2023, from https://www.youtube.com/watch?v=kuo0QuuMG5kHorvat, A., & Filipovic, J. (2018). Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.Journal of Evaluation in Clinical Practice, 24(1), 301-307. doi:https://doi.org/10.1111/jep.12789Institute of Medicine. (2001).Crossing the Quality Chasm : A New Health System for the 21st Century.Washington: National Academies Press.

Jones, G. R. (2013).Organisation Theory, Design and Change(7th ed.). Harlow: Pearson Education Limited. Retrieved August 04, 2023, from https://industri.fatek.unpatti.ac.id/wp-content/uploads/2019/03/085-Organizational-Theory-Design-and-Change-Gareth-R.-Jones-Edisi-7-2013.pdfPagone , G., & Briggs, L. (2021).Royal Commision into Aged Care Quality and Safety Final Report - Care, Dignity and Respect: Volume 1.Commonwealth of Australia. Retrieved August 4th, 2023, from https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-volume-1_0.pdfRaisio, H., Puustinen, A., & Vartiainen, P. (2018). The Concept of Wicked Problems, Improving the Understanding of Managing Problem Wickedness in Health and Social Care. In W. Thomas, A. Hujala, S. Laulainen, & R. McMurray (Eds.),The Management of Wicked Problems in Health and Social Care.Routledge. Retrieved from https://books.google.com.au/books?hl=en&lr=&id=eUNvDwAAQBAJ&oi=fnd&pg=PT21&dq=the+management+of+wicked+problems+in+health+and+social+care&ots=PMB-Ij1JBy&sig=aU8N7hhCClKRp3QcZwujhNh1lRo#v=onepage&q=the%20management%20of%20wicked%20problems%20in%20health%20Rittel, H. W.

, & Webber, M. M. (1973). Dilemmas in a general theory of planning.Policy Sciences, 4, 155169. doi:https://doi.org/10.1007/BF01405730Rosas, S. R. (2017, April). Systems thinking and complexity: considerations for health promoting schools.Health Promotion International, 32(2), 301-311. Retrieved August 5th , 2023, from https://academic.oup.com/heapro/article/32/2/301/2950984

Sturmberg, J. P., & O'Halloran, D. M. (2012, January 05). Understanding health system reform a complex adaptive systems perspective.Journal of Evaluation in Clinical Practice, 18, 202-208. doi:https://doi.org/10.1111/j.1365-2753.2011.01792.xWorld Health Organisation. (2009).Systems Thinking for Health Systems Strengthening.(D. de Savigny, & T. Adam, Eds.) World Health Organisation.

Aged Care definition: Aged care is a support provided to older people in their own home or in an aged care (nursing) home (DOHA, 2020).

AIHW (2023) states approximately 407,000 people are using residential aged care, home care or transition care in Australia. This comprises 188,000 people using permanent or respite residential aged care, 216,000 using home care and 3,500 using transition care.

The royal commission findings from the final report is targeting 188,000 people who are in a residential aged care. They reviewed whether the residential aged care is delivered in a sustainable way out of many considerations, to me the innovative models of care, and investing in aged care workforce will assist in improving the aged care sector. However, the findings also raised some concerns of whether the service provided by aged care sectors for people receiving Australian Aged Care do meet the Aged Care Quality and Safety Commission standards that intend to protect and improve the safety, health, wellbeing, and quality of life. Also can older Australians believe that their needs are met according to those standards (ACQSC 2021).

World, Ho (ed), 2009, use this illustration according to WHO Framework for action on health system that describe health system Building blocks that together they complete the system.

Also indicate that health system may be understood through the arrangement and interactions of its parts and how they enable the system to achieve the purpose of which it was designed. figure 1.1 and figure 1.2 show that the building blocks alone do not constitute a system, but it is a multiple relationships and interaction among the blocks. They continue elaborating by indicating how this blocks convert into a system. by stating that a pile of bricks constitutes a functioning building. Does mention that the evaluation of a system and its subsystems is based on criteria such as efficacy, effectiveness, efficiency, ethics, elegance/aesthetics, and environmental impact (WHO 2009).

Australia aged care is assessed and monitored by Aged Care Quality and Safety Commission who have come with some recommendation to improve the care provided in residential aged care. The Australian Government received the Royal Commission Final Report. According to the Media release 1 March 2021 the Government addressed the identified concerns regarding governance, diversity, dementia food and nutritions. Also, immediate funding is allocated to enhance the capacity of Aged Care Quality and Safety Commissions and regulation for the use of restraints in care (DOHA 2021).

The Question come: Is this enough to address the Aged Care crisis?

References:

AIHW (Australian Institute of Health and Welfare) (2023), Accessed 06 August 2023. https://www.aihw.gov.au

ACQSC (Aged Care Quality and Safety Commission), 2021, reviewed 01July 2021 https://www.agedcarequality.gov.au/about-us

DOHA (Department of Health and Aged Care) (2021) reviewed 6 August 2023https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/respect-care-and-dignity-aged-care-royal-commission-452-million-immediate-response-as-government-commits-to-historic-reform-to-deliver-respect-and-care-for-senior-australiansLinks to an external site.DOHA (Department of Health and Aged Care), (2020), accessed 04 August 2022.https://www.health.gov.auLinks to an external site.World, HO (ed.) 2009, Systems Thinking for Health Systems Strengthening, World Health Organization, Albany. Available from: ProQuest Ebook Central. [6 August 2023]..How does your learning from Module 1 inform your understanding of the organisation of health and aged care in Australia, the leadership challenges faced in this sector, and the nature of problems encountered in aged care?

The 2021 Royal Commission into Australias aged care sector highlighted many key issues instigating the present aged care crisis. The findings of this report were damning, emphasising several challenges which collectively stem from years of poor organisational and system management by the Australian Government. The issues faced are multifaceted, with key stakeholders involving elderly patients, primary caregivers, healthcare providers and government policy/decision makers. The aged care sector is a complex system that relies on the interdependence of all components to ensure the correct and desired function of the system is upheld.

The report called for fundamental change to the aged care system, where Royal Commissioners Tony Pagone QC and Lynelle Biggs AO, provided an extensive list of recommendations to instigate must needed reform(Pagone & Briggs 2021). At the centre of this reform is the need to provide greater emphasis on a patient-centric model of care(Delaney 2018). The current poor standard of care is resultant of declining quality in some aged care providers and legislative focus on funding aged care providers as opposed to the elderly themselves(Pagone & Briggs 2021). These recommendations target leadership and legislation directly.

Leading organisations or departments in the context of age care is considerably challenging when considering the many moving parts of key stakeholders and their specific interests. Overall, it is important to reflect upon a system thinking approach when considering improvement to the aged care sector. A systems approach allows leaders to conceptualise the impact of interdependencies of the different components of the system, highlighting the need for effective communication and collaboration to ensure optimisation of care delivery(Leischow et al. 2008). Furthermore, the dynamic nature of challenges encountered in the aged care sector provides reason for leaders to view the sector as a complex adaptive system, where parameters such as patients, caregivers and regulations, and other components are continually changing(Leischow et al. 2008). Leaders should approach issues from a flexible viewpoint, by embracing challenges and promoting adaptability and innovation, to empower their employers to drive adaptive change in their organisation.

As alluded to in the Royal Commission, the issues faced by the aged care sector are multifaceted. Among the 148-strong list of recommendations provided by the Commissioners, it was determined that inadequate funding, workforce shortages, lack of quality control and inadequate government regulations and legislation were central to the issues encountered(Pagone & Briggs 2021). These issues are typical of complex/wicked problems faced by organisations(Raisio, Puustinen & Vartiainen 2018). As leaders, we should approach such issues with an innovative mindset that values collaboration between stakeholders to embrace and drive necessary change in an ever-changing health environment.

Overall, it is essential for health and aged care leaders to consider systems thinking and complexity theory when managing systems. These concepts will in turn, identify system deficiencies and provide adequate solutions to challenges presented. It is crucial to implement communication and collaboration, in conjunction with transformational leadership, to ensure effective management in aged care systems.

References:

Delaney, LJ 2018, 'Patient-centred care as an approach to improving health care in Australia',Collegian, vol. 25, no. 1, pp. 119-23.

Leischow, SJ, Best, A, Trochim, WM, Clark, PI, Gallagher, RS, Marcus, SE & Matthews, E 2008, 'Systems thinking to improve the public's health',Am J Prev Med, vol. 35, no. 2 Suppl, pp. S196-203.

Pagone, T & Briggs, L 2021, 'Royal Commission into Aged Care Quality and Safety Final Report: Care, Dignity and Respect', vol. 1, p. 340.

Raisio, H, Puustinen, A & Vartiainen, P 2018, 'The Concept of Wicked Problems : Improving the Understanding of Managing Problem Wickedness in Health and Social Care', in.

ReplyReply to commentHYPERLINK "https://canvas.flinders.edu.au/courses/9675/discussion_topics/97214" o "Mark as unread"

Collapse Sub discussionDaniel SofiaDaniel Sofia (He/Him)16:407 Aug at 16:40

Manage discussion entryThe royal commission into aged care in Australia was a long and lengthy process, initiated by repeated stories of harm and neglect, as well as pressure for consumer and professional groups to undertake a review. The ABC report mentioned the Oakden nursing home case, in which a government run nursing home was found to have breached standards of care in inhumane ways over a prolonged period of time (Lander 2018). The failings at Oakden were serious enough to close the facility. The findings of the South Australian Independent Commissioner Against Corruptions report helped make the case for a national royal commission.

The report from the commissioners (Pagone & Briggs 2021) discussed the depth and breadth of their investigation: 2 years, with over 10,000 submissions into the commission. The stakeholders involved give a useful insight into the interconnected systems and processes that make up the larger aged care system: consumers, families, staff working in aged care, businesses administering aged care, external healthcare organisations and providers, regulatory bodies, the federal government and the Aged Care Quality and Safety Commission. This is not an exhaustive list of the interconnected systems that make up the aged care system.

The report commented on all aspects of aged care, including the system as a whole. I found Waddell, Jones and George (2011)s definition of systems theory enlightening as I read the royal commission report a system is the relationship between internal subsystems of an organisation, and the broader external environment. I thought of this meaning as I learnt that despite aged care taking 4.2% of the total federal budget, only recently was the portfolio of Aged Care elevated to cabinet as a stand alone portfolio perhaps a reaction by the government of the day to preliminary findings of the royal commission. This illustrated to me that from the very highest level of government, there was a lack of clear leadership, direction and strategy for one of the largest governmental spends in Australia. A failure to have a clear strategy for managing chronic health conditions was also observed by van Wietmarschen, Wortelboer and van der Greef (2018), noting that the focus on specific strategies for single diseases is driving health costs to government higher, beyond the rate of inflation. This financial pressure was also noted in the royal commission, who predicted that aged care spending would be 5% of the federal budget spend by 2030. The commissioners noted that the aged care system is too centralised, in contrast to other Australian health systems which are more localised, which led to issues with accessing care. van Wietmarschen, Wortelboer and van der Greef (2018) used complexity theory to put forward a strategy where instead of governments using their levers of change (financial incentives, legal directives) for single disease interventions, they target interventions to increase links within networks or interconnected systems. An example of applying this theory to the findings of the royal commission could include building referral pathways and links to allied health for aged care facilities, where consumers and care providers can make links with established services. Jorgensen et al. (2020) discuss the impact of a policy change in Australian aged care that led to reduced access to services for people accessing home care packages. Their research showed that the new system increased complexity which in turn decreased demand. The aged care royal commission held this up as an example of system failure, which was supported by the research undertaken by Jorgensen et al.

The report also criticised the overall governance of the aged care system. There are over 800 individual businesses currently providing aged care services, each with their own strategies and values based on whether or not they are government run, operated by faith based not for profit organisations, or are run for profit. The ABC video highlighted that the biggest private provider BUPA had 1/3 of its nursing homes at risk of failing accreditation. A lack of consumer voice into the system was an aspect of governance raised by both the ABC and the commission report. This goes against long held theories and practices in business Deming (cited in Kreitner and Kinicki (2012)) demonstrated the importance of ensuring that the users of systems are part of the system design and function. Complex adaptive system theory helps provide a potential strategy to be part of the solution the use of shared values across systems (Sturmberg, O'Halloran & Martin 2012). Shared values across systems give consumers, practitioners and administrators a common ground to design workflows and establish ways of analysing and interacting with systems. The commissioners attempted to provide a vision in their report The purpose of the aged care system must be to ensure that older people have an entitlement to high quality aged care and support and that they must receive it. Such care and support must be safe and timely and must assist older people to live an active, self-determined and meaningful life in a safe and caring environment that allows for dignified living in old age (Pagone & Briggs 2021). This is a good starting point for shared values and ways of working.

There are multiple challenges ahead for the aged care system in Australia. The royal commission spent considerable time examining the systems and processes that make up the aged care system, which demonstrates the need to embed evidence-based systems management approaches as one of the strategies to improve aged care delivery in Australia. I hope that the aged care system will one day be mature enough to foster innovation a hallmark of functioning systems so that we could see something like the dementia villages seen for aged care facilities in the Netherlands (Planos 2014).

References:

Jorgensen, M, Siette, J, Georgiou, A & Westbrook, JI 2020, 'The effect of home care package allocation reforms on service uptake, use and cessation at a large Australian aged care provider',Australasian Journal on Ageing, vol. 39, no. 2, pp. e210-e4.

Kreitner, R & Kinicki, A 2012,Organizational Behavior, McGraw-Hill US Higher Ed USE Legacy, NY, UNITED STATES.

Lander, B 2018,Oakden: A Shameful Chapter in South Australia's History, South Australian Government, viewed 07/08/2023 2023, <https://www.icac.sa.gov.au/publications/published-reports/oakdenLinks to an external site.>.

Pagone, T & Briggs, L 2021,Royal Commission into Aged Care Quality and Safety Final Report: Care, Dignity and Respect, viewed 07/08/2023 2023, <https://agedcare.royalcommission.gov.au/publications/final-reportLinks to an external site.>.

Planos, J 2014, 'The Dutch Village Where Everyone Has Dementia',The Atlantic.

Sturmberg, JP, O'Halloran, DM & Martin, CM 2012, 'Understanding health system reform a complex adaptive systems perspective',Journal of Evaluation in Clinical Practice, vol. 18, no. 1, pp. 202-8.

van Wietmarschen, HA, Wortelboer, HM & van der Greef, J 2018, 'Grip on health: A complex systems approach to transform health care',Journal of Evaluation in Clinical Practice, vol. 24, no. 1, pp. 269-77.

Waddell, D, Jones, G & George, J 2011, 'Evolution of management', in D Waddell, G Jones & J George (eds),Contempory Management, McGraw-Hill Australia, North Ryde NSW, pp. 36 - 61.

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