Governance and Leadership for Allied Health

Summary

The video explores the importance of governance structures within Australian health services, focusing on the Allied Health workforce's role. With around 27 professions, Allied Health is divided into Therapy and Science groups. It discusses two primary governance models: the 'Collective' model, where Allied Health is managed by a single director, and the 'Dispersed' model, where practitioners report to various clinical service units. Key questions explored include whether these structures give Allied Health a voice in decision-making, place the right people in right roles, and support better patient care solutions. The video highlights the models' pros and cons, encouraging Allied Health professionals to engage in shaping governance structures to enhance patient care and organizational efficiency.

Highlights

• Understanding governance is crucial for Allied Health professionals 🕵️‍♂️
• Two main models of governance: 'Collective' and 'Dispersed' 🏢
• The 'Collective' model unifies Allied Health under one director 🙌
• The 'Dispersed' model integrates Allied Health into clinical units 🔄
• Key evaluation questions: voice, placement, and problem-solving 🤔

Key Takeaways

• Governance is key to effective health service delivery 💼
• Allied Health can be managed collectively or dispersed across units 🏥
• Key questions guide evaluating governance structures ❓
• Collective model offers unified voice; dispersed emphasizes clinical expertise 🗣️
• Allied Health professionals should actively participate in governance discussions 💬

Overview

Governance structures in health services significantly impact how care is delivered, affecting everything from strategic decisions to day-to-day operations. In this video, the role of Allied Health professionals, who make up a significant portion of the healthcare workforce, is examined in light of different governance models. These models influence how effectively Allied Health practitioners can perform and innovate, ultimately affecting patient outcomes.

The video categorizes Allied Health into a 'Collective' model, with centralized management, and a 'Dispersed' model, where practitioners integrate into various clinical services. Each model has its strengths and weaknesses. The collective approach centralizes communication and decision-making but requires a deep understanding of all professions. Conversely, the dispersed model promotes clinical expertise but may dilute the Allied Health voice in executive decisions.

Engagement from Allied Health professionals in governance discussions can drive positive changes in organizational structures. By considering whether current models provide a voice in decision-making, appropriate workforce placement, and support for innovating patient care solutions, professionals can advocate for structures that enhance health services' efficiency and effectiveness. Reflecting on these aspects can lead to leadership improvements and better healthcare outcomes for all.

Chapters

• 00:00 - 00:30: Introduction to Governance in Allied Health This chapter introduces the concept of governance in Allied Health, emphasizing its significance in shaping work processes. It highlights that Australian health services comprise three major workforces: Doctors, Allied Health professionals, and Nurses & Midwives, all collaborating to provide exceptional patient care. The chapter acknowledges the Allied Health workforce for their intelligence, communication skills, and creative problem-solving abilities, noting that they actively contribute to the entire healthcare system, with around 27 distinct professions within Allied Health.
• 00:30 - 01:00: Categories and Governance Structures of Allied Health The chapter discusses the categorization of allied health professions into two main groups: Allied Health Therapy and Allied Health Science, as observed in Victoria.
• 01:00 - 01:30: Historical Overview of Governance Models The chapter provides a historical overview of governance models in hospitals during the 1960s and 70s, focusing on the 'traditional medical model.' This model had departmental leadership primarily by medical professionals, including a Director of Medical Services and a Director of Nursing on the executive team. Allied Health professionals reported to Deputy Medical Directors, who worked under the Directors of Medical Services.
• 01:30 - 02:00: Emergence of New Governance Models In the 1980s, governance models evolved due to influences like managerialism, Thatcherism, and the purchaser-provider split. This led to the emergence of new and hybrid governance models. Simultaneously, allied health therapy professions began to develop a unified 'allied health' identity, collaborating across clinical areas within the health service. The primary change across these models was seen in the governance and reporting structures for allied health professionals.
• 02:00 - 02:30: Understanding Governance from Allied Health Perspective There are two governance structures from the Allied Health perspective: 'Collective' model where workforce is managed by a Director of Allied Health, and a traditional medical model where practitioners are managed by Directors with medical or nursing background in their respective units.
• 02:30 - 03:00: Analysis of Governance Models and Their Advantages Chapter on 'Analysis of Governance Models and Their Advantages' discusses different governance structures within health services, specifically focusing on Allied Health. The chapter introduces the 'Dispersed' model and implies the existence of hybrid models. It contrasts how Allied Health Therapy professionals tend to be organized within the Collective model, whereas Allied Health Science professionals lean more towards the Dispersed model. Furthermore, it poses critical questions about whether these structures provide Allied Health with a voice at the decision-making table, emphasizing the importance of representation in governance.
• 03:00 - 03:30: The Role of Allied Health in Decision Making This chapter explores the significance of Allied Health professionals in organizational decision-making processes, examining different governance structures. It poses key questions about whether these structures enable Allied Health to have a voice in decision-making, thereby contributing to budgeting, policy, and strategic direction. The chapter also discusses the importance of direct communication between CEOs and the Allied Health workforce to enhance patient care strategies.
• 03:30 - 04:00: Collective Model in Governance The chapter discusses the 'Collective Model in Governance', focusing on its application in the Allied Health sector. It highlights how this model facilitates seamless communication between the Allied Health workforce and the Executive through the Director of Allied Health. This communication line is crucial for implementing rapid improvements within the Allied Health services, leading to enhanced workforce quality, organizational efficiency, and patient outcomes. However, for the 'Collective' model to be fully effective, it is essential that the Director of Allied Health possesses a thorough understanding of all professions within Allied Health to advocate effectively on their behalf.
• 04:00 - 04:30: Dispersed Model in Governance The 'Dispersed' model in governance involves Clinical Services Units (CSUs) collaborating effectively. However, there's a communication gap at the Executive level where the Allied Health workforce may not be as represented as their Medical and Nursing counterparts, often due to the medical or nursing backgrounds of Executives. For optimal functioning, it's essential for each CSU Director to cultivate strong relationships.
• 04:30 - 05:00: Putting the Right People in the Right Place The chapter titled 'Putting the Right People in the Right Place' discusses the importance of having a flexible and responsive Allied Health workforce that aligns with the changing needs of an organization. It emphasizes the necessity for an organizational structure that allows for the optimal placement of resources to maximize the use of Allied Health skills, ensure budget efficiency, and provide excellent patient care. The chapter also introduces the 'Collective' model, which provides a strategic overview and supports the adaptability of the workforce.
• 05:00 - 05:30: Supporting Allied Health for Better Patient Care The chapter "Supporting Allied Health for Better Patient Care" discusses two models for healthcare management: the 'Collective' model and the 'Dispersed' model. The 'Collective' model emphasizes the importance of good relationships between the Director of Allied Health and the Directors of Clinical Services Units to function effectively. Meanwhile, the 'Dispersed' model, while it encourages clinical expertise, might lead to Directors of Clinical Services Units being less attentive to the professional needs of the Allied Health workforce and less adaptable to the organization's changing needs.
• 05:30 - 06:00: Opportunities in Changing Governance Structures The chapter titled 'Opportunities in Changing Governance Structures' explores the potential advantages of restructuring governance to better support Allied Health in improving patient care. It emphasizes the 'Collective' model, a framework where knowledge and skills development within and across Allied Health professions is facilitated through practice and research. This model fosters innovation in care models, which can be swiftly adopted across the organization, leading to enhanced patient outcomes.
• 06:00 - 06:30: Empowering Allied Health Professionals The chapter discusses the 'Dispersed' model in healthcare, highlighting its effectiveness in facilitating individual clinical expertise. However, it emphasizes the need for this model to enhance the development and sharing of knowledge and skills across the Allied Health workforce to improve patient care. The chapter also notes that changes in the governance structures of health services over the years present opportunities for improvement and adaptation.
• 06:30 - 07:00: Reflecting on Governance Structure Questions The chapter focuses on understanding and influencing the governance structure within an organization. It emphasizes the importance of determining the most suitable governance structure for your workforce, organization, and patients. The chapter encourages discussing these structures with peers and suggesting improvements to senior management. It highlights that while medical and nursing professionals may confidently address these governance-related questions, it is a valuable opportunity for Allied Health professionals to also engage in these discussions and contribute effectively.

Governance and Leadership for Allied Health Transcription

• 00:00 - 00:30 This is a learning tool to understand the importance of governance structures on ways of working. Australian health services have three Patient Care workforces; Doctors, Allied Health professionals, and Nurses and Midwives. Together delivering great care for their patients. The Allied Health workforce is well known to be smart, good communicators, and creative problem solvers who contribute across the whole system. There are around 27 Allied Health professions.
• 00:30 - 01:00 And in Victoria we think about these professions in two groups. Allied Health Therapy and Allied Health Science. Health services come in different sizes and have different governance structures, which means that the Allied Health workforce can be organised in many different ways. This film will help you get the most out of your health service’s existing organisational structure. As well as prepare you to influence in times of change… So that you can find satisfaction in your work, as you contribute to an efficient organisation and deliver great care for your patients.
• 01:00 - 01:30 Let’s start with some history. In the 1960's and 70's hospitals almost universally used the 'traditional medical model' of organisational governance. This model has departments that are led by professionals with a medical background and has a Director of Medical Services and Director of Nursing on the executive team. Where did Allied Health live in this model? Directors of Medical Services were supported by Deputy Medical Directors who had allied health reporting to them.
• 01:30 - 02:00 In the 1980’s we saw the rise of managerialism, Thatcherism and the purchaser - provider split. From all of this governance models began to change. New and hybrid models emerged. At the same time, allied health therapy professions were moving towards a more collective 'allied health' identity. In all models, Allied Health professionals work across different clinical areas throughout the health service. What changes in the different models are the governance and reporting structures.
• 02:00 - 02:30 In essence, there are two ways to think about governance structures from the Allied Health perspective. In the first, the Allied Health workforce is managed by a single Director of Allied Health who is usually a senior Allied Health practitioner. We’ll call this the ‘Collective’ model. In the second, Allied Health practitioners are dispersed across the Health Service and managed by the Director of their Clinical Services Unit who is likely to have a Medical, or Nursing background. This is most like the traditional medical model.
• 02:30 - 03:00 We’ll call this the ‘Dispersed’ model. You’ll see many hybrids of these models in our health services. Allied Health Therapy professionals are more likely to be organised in the Collective model. While Allied Health Science professionals are more likely to be organised in the Dispersed model. To understand the different advantages of governance structures, there are three key questions we can ask: Does the structure give Allied Health a voice at the decision making table?
• 03:00 - 03:30 Does the structure allow the organisation to put the right people in the right place? And finally, does the structure support Allied Health to find better solutions for patient care? So how do the ‘Collective’ and ‘Dispersed’ models answer these questions? Let’s have a look. The first question is, does the governance structure give Allied Health a voice at the decision making table? That’s where the Allied Health workforce can contribute to important decisions such as the budget, policy, and strategic direction. It also means that CEOs can talk directly to the Allied Health workforce to better understand
• 03:30 - 04:00 and work with this important group. In the Collective model… The Allied Health workforce can easily communicate with Executive through the Director of Allied Health. This also means that the health service can quickly make improvements across Allied Health leading to a better workforce, a better organisation, and better patient outcomes. However, for the ‘Collective’ model to work at its best… The Director of Allied Health needs to have a comprehensive understanding of all the professions to speak confidently on their behalf.
• 04:00 - 04:30 In the ‘Dispersed’ model... Each Clinical Services Unit works closely together and they communicate well with each other. However the Allied Health workforce may not have their voice heard at the Executive level in the same way that their Medical and Nursing colleagues can, because their Manager or Executive is likely to have a medical or nursing background. So for the ‘Dispersed’ model to work at its best… The Director of each Clinical Services Unit must foster good relationships with their
• 04:30 - 05:00 Allied Health workforce and understand their broader practice. The second question is, does the structure allow the organisation to put the right people in the right place? This means that the organisation has the flexibility to put the right resources where they are needed, resulting in: The best use of Allied Health skills, A budget working at its best, And patients getting excellent care. In the ‘Collective’ model... The organisation has a strategic overview, and the ability to build an Allied Health workforce that is flexible and responsive to the organisation’s changing needs.
• 05:00 - 05:30 To work at its best, the ‘Collective’ model relies on the Director of Allied Health having good relationships with the Directors of the Clinical Services Units. The ‘Dispersed’ model naturally encourages clinical expertise. However in the ‘Dispersed’ model, Directors of Clinical Services Units may be less aware of the professional needs of the Allied Health workforce. And this model isn’t as responsive to the organisation’s changing needs.
• 05:30 - 06:00 The third question asks, does the structure support Allied Health to find better solutions for patient care? This is where Allied Health can develop knowledge that leads to better models of care and better patient outcomes. In the ‘Collective’ model, the Allied Health workforce can easily share and build knowledge, and skills, through practice and research, both within Allied Health professions as well as across professions. And, in the ‘Collective’ model, when Allied Health develops innovative models of care, the improvements for patients can be quickly implemented across the whole organisation.
• 06:00 - 06:30 We know that the ‘Dispersed’ model effectively facilitates individual clinical expertise. But this also means that the ‘Dispersed’ model must work harder at developing and sharing the knowledge and skills across the Allied Health workforce for the benefit of patient care. The governance structure of every health service can evolve many times over the years. That change is your opportunity.
• 06:30 - 07:00 You can influence and shape the conversation, as well as the decisions, when you can: Understand which governance structure is best for your workforce, your organisation, and your patients. Then discuss the best structure with your peers. And then put forward suggestions to your senior management. Your medical and nursing colleagues can often confidently answer these questions for their professions. This is an opportunity for you, as an Allied Health professional, to get the most out of
• 07:00 - 07:30 your current governance structure and contribute in times of change. So take a moment to reflect. Consider again these three key questions about your organisation’s governance structure… Does it give Allied Health a voice at the decision making table? Does it allow the organisation to put the right people in the right place? And finally, does it support Allied Health to find better solutions for patient care? By answering these questions we can help create more effective leadership for all Allied Health professionals and build a better health system for Victorians.