By Sharee Johnson
The Victorian Auditor General tabled his report in March on his audit into Bullying and Harassment in the Health Sector. There are 12 recommendations made with the aim of improving the OHS of health workers and paramedics in Victoria. Here is a portion of Acting Auditor General Dr Peter Frost’s opening remarks:
“… we found consistent shortcomings. Stronger leadership and support is urgently needed to assist health sector agencies to fulfil their responsibilities as employers, and to effectively protect their staff.”
The impact of poor OHS is felt not only by the affected staff, but also by the patients they are treating.
Health sector organisations with strong staff safety cultures have fewer patient safety incidents, and the incidents that do occur are of shorter duration. Stronger management of bullying and harassment would benefit patients as well as staff. And, while my 2016 audit Patient Safety in Victorian Public Hospitals tabled today shows there have been improvements in patient safety at the hospital level, it also found that sector-wide leadership by DHHS has again been ineffective.” (p vii)
I note particularly the Auditor-General’s comments throughout the report about the need for leadership and a sustained focus and commitment in order to change these entrenched patterns. Music to many people in the health system’s ears I’m sure, as they are not new problems. I am curious about how this long term culture change can be achieved from the point of view of government and the various powerbrokers in the health system. As Einstein famously said “we cannot solve our problems with the same thinking we used to create them”. I listened to Dr Tony Bartone AMA Victoria President on our local ABC Gippsland radio recently talking about “everyone (AMA members I think) looking inward and examining their own behaviour’ and I note he is reported to have made similar comments in The Age. I am encouraged that the revised AMA position statement published in December 2015 comments on the need to include:
“skills in leadership, mentoring and management … in the curriculum for medical students and doctors in training and offered as continuing professional development courses for fellows.”
What does this mean?
All of this leaves me with two questions, one regarding the basic human qualities that often lead people to become health professionals, and one of a more practical nature.
There is reference occasionally to resilience in these reports and policy statements. There is little reference to kindness, empathy or care. What is a health system that has so little empathy, care or kindness for those who are asked to provide the empathy, care and kindness?
I wonder if the health sector can learn from other sectors about safety and good people management. What would be the impact of non-doctor coaches working with doctors? Could this ‘other’ perspective add some value to the development of doctors? And all health professionals. Such coaches are removed from the hierarchical system and do not have their daily work environment impacted by fear of career restriction and the like. Coaching in this way has been used in the Corporate Sector for at least two decades. I encourage those health professionals who are interested in more than introspection, blame and formal training, that is perhaps not ever integrated into your practice, to consider this model and find yourself a great coach or mentor who you can give permission to, to challenge your ideas and where you commit to speak freely and openly about your challenges at work without fear or favour.
This is important because the evidence is clear; there is a direct relationship between staff wellbeing and patient wellbeing. It is well understood that disruptive or intimidating behaviours by staff undermine team effectiveness and create barriers to cooperation. It increases burnout and turnover, and that means less good practitioners working with our community. See some of this research here.
There are wonderful challenges to the current culture of health underway right now. I was very excited to be a part of the 2016 Gathering of Kindness where 100 health professionals of all backgrounds re-imagined a healthcare system that has kindness, trust and respect as core components. That gathering has grown into a movement where health professionals, artists and community members across the country are working to harness their collective compassion for the good of their own health and the good of all patients and health carers. I commend the gathering of kindness in all its forms to you and I do hope you will join us.
Sharee is a psychologist and the founder of Good Practice Good Health Inc. whose purpose is to build better partnerships between all the people delivering and using the health system through shared education. She is a part of the planning group for the Gathering of Kindness.