St Vincent’s Health Australia – Australia’s largest not-for-profit provider of health and aged care services – is partnering with the Australian Institute of Health Innovation at Macquarie University to assess its innovative approach to addressing entrenched cultural problems in the health sector.
The St Vincent’s Ethos program has been developed over the past 12 months. It was first introduced at St Vincent’s Hospital in Melbourne in July 2017 and is being rolled out nationally across all St Vincent Health’s Australia’s hospitals. The program aims to embed safe, respectful and professional behaviour and provide a consistent, transparent and equitable way to address staff conduct that undermines patient or staff well-being.
The partnership has successfully secured a National Health and Medical Research Council partnership grant of $1.2M to evaluate the program nationally over four years.
St Vincent’s Health’s Chief Medical Officer and Group General Manager of Clinical Governance, Dr Victoria Atkinson, said the partnership grant would facilitate world-first research looking at the impact of the Ethos program on staff behaviour and patient experience.
“It’s well known that bullying, discrimination and harassment are significant problems in Australia’s healthcare sector and St Vincent’s Health is not immune,” said Dr Atkinson.
“The Royal Australasian College of Surgeons found that around half of the College’s fellows and trainees had experienced bullying, discrimination or sexual harassment. Other professional colleges have found similar disturbing rates of unacceptable behaviour.
“These cultural issues impact negatively on the well-being of doctors and other health professionals. It’s part of the reason why risk of suicide in doctors is substantially higher the general Australian population.
“But while the sector is struggling to respond effectively to entrenched bad behaviour what St Vincent’s has done is take a very public stand against it, and we want to bring all of our staff with us: in healthcare, administration, and support services; everyone in every role, across the entire organisation.
“Sometimes staff may feel ill-equipped or unable to speak up when they witness or experience disrespectful behaviour. They might feel that if they report the problem, it won’t be addressed; or perhaps they’re afraid of repercussions? Or maybe it’s just because – in the unit or department they work – there’s an acceptance that inappropriate behaviour is somehow ‘normal’?
“Ethos is designed to overcome these barriers and contribute to making staff and patients feel welcome, valued and safe.”
The Ethos program includes:
- an accountability pathway which outlines a consistent, transparent and equitable way to provide feedback to staff about their behaviour;
- a reporting tool which provides a safe avenue to report incidents of either positive behaviour or negative behaviour that undermines staff or patient safety. Reports can be submitted by any staff member using an online tool which is private, confidential and safe.
- a package of capability building and training to equip leaders and staff with the skills they need to role model safe and respectful behaviour.
“Ethos allows us to recognise staff who exhibit positive behaviour and are exceptional role models; it removes barriers to speaking up and makes it easier and safer to do so; and it allows us to respond quickly and equitably to incidents of behavior that undermine patient and staff safety,” said Dr Atkinson.
“It needs to be said that in most healthcare organisations, serious bad behaviour is perpetrated by only 2-3% of people. We acknowledge that the majority of staff model behaviours that are focussed on patient well-being and founded in integrity.
“There’s also been no lack of desire among healthcare providers to address the entrenched cultures within healthcare that allow disrespectful behaviour to be tolerated. Safety efforts such as clinical care bundles, checklists, root-cause analyses, procedures, protocols and guidelines and staff programs that promote well-being have achieved a measure of success but not the degree anticipated.
“This is because without addressing behaviour, improved systems alone aren’t enough. Achieving safe, reliable, high quality care requires well-designed systems and well-functioning teams.
“SVHA recognises that culture change of this magnitude can’t be undertaken in isolation so in addition to introducing Ethos, we are building partnerships across the sector to create a coalition to improving the culture in healthcare.
“We have begun this process with an MOU with the Royal Australasian College of Surgeons and we aim to establish MOUs with professional and regulatory bodies and partnerships with health services across the nation,” said Dr Atkinson.