learning from action

Learning from Learning from ActionAction

Researching with Aboriginal Health Researching with Aboriginal Health Care ManagersCare Managers

Judith Dwyer, Cindy Shannon and Judith Dwyer, Cindy Shannon and Shirley Godwin Shirley Godwin

Funded by the Cooperative Research Centre Funded by the Cooperative Research Centre for Aboriginal Health, conducted in for Aboriginal Health, conducted in

partnership with QAIHCpartnership with QAIHCResourced by La Trobe, Flinders and Resourced by La Trobe, Flinders and

Queensland UnisQueensland Unis

2Learning from Action

Shirley and CindyShirley and Cindy


Outline and Outline and acknowledgementsacknowledgements

GoalsGoals MethodMethod FindingsFindings DiscussionDiscussion

Thanks to Lizzie Adams, Valerie Craigie, Thanks to Lizzie Adams, Valerie Craigie, Bronwyn Fredericks, Sheryl Lawton, Mary Bronwyn Fredericks, Sheryl Lawton, Mary Martin, Mark Moore, Janelle Murphy, Martin, Mark Moore, Janelle Murphy, Justin Saunders, Bronwyn Smith, Mick Justin Saunders, Bronwyn Smith, Mick Gooda, Ian Anderson, David Legge, Gooda, Ian Anderson, David Legge, Christine Bright and many othersChristine Bright and many others


Project GoalsProject Goals

Work with senior managers of Work with senior managers of ACCHS’s to:ACCHS’s to: develop understanding of management develop understanding of management

challenges and practices in ACCHSschallenges and practices in ACCHSs to share and build knowledge and skillsto share and build knowledge and skills to use this project as the basis for further to use this project as the basis for further

research and development – learning research and development – learning approaches; management methods approaches; management methods tailored to the needs of the Aboriginal tailored to the needs of the Aboriginal health sectorhealth sector

Research

Learning

Devel’t


Our approachOur approach

Rather than focus on ‘difference’, we Rather than focus on ‘difference’, we investigated the challenges and strategies, investigated the challenges and strategies, aware of contextaware of context

Intention to inform further applied researchIntention to inform further applied research And development of the sectorAnd development of the sector

And provide participant-defined view of And provide participant-defined view of challenges in contested policy environmentchallenges in contested policy environment

As well as contribute to learning and As well as contribute to learning and development for participantsdevelopment for participants


Overall ProgramOverall Program

Worked with 13 senior managers in Worked with 13 senior managers in Queensland Aboriginal and Islander Health Queensland Aboriginal and Islander Health ServicesServices

4 workshops (3 days, 2 days, 2 days, 3 days)4 workshops (3 days, 2 days, 2 days, 3 days) Learning set meetings Learning set meetings Formal teaching, seminarsFormal teaching, seminars Option for academic credit Option for academic credit

Equivalent to 25% of a Grad. Cert. in HSM Equivalent to 25% of a Grad. Cert. in HSM Formal recognition of participationFormal recognition of participation


Complying with ethical Complying with ethical guidelinesguidelines

“..ensuring that research outcomes include equitable benefits of value to Aboriginal communities or individuals”

Benefits are defined as “…enhancement of capacities, opportunities or outcomes that advance interests …”

“.. beyond the project, eg through skills and knowledge or broader social, economic or political strategies..”


Learning Set methodLearning Set method At each meeting, each person presents a real, At each meeting, each person presents a real,

current management problem they are trying to current management problem they are trying to solvesolve

Everyone asks questions to clarify the problem, and Everyone asks questions to clarify the problem, and offers suggestions about strategiesoffers suggestions about strategies

The person who owns the problem sums up, says The person who owns the problem sums up, says what they’re going to do (each problem takes about what they’re going to do (each problem takes about 45 minutes)45 minutes)

Next meeting – each person gives an update on what Next meeting – each person gives an update on what happened, and brings a new problem or situationhappened, and brings a new problem or situation

We ran two sets of 6 members eachWe ran two sets of 6 members each Two team members acted as facilitatorsTwo team members acted as facilitators And two people took detailed notes on laptop And two people took detailed notes on laptop

computerscomputers


SeminarsSeminars Half-day or more each meetingHalf-day or more each meeting Topics determined by participantsTopics determined by participants Formal teaching and discussion/case studies Formal teaching and discussion/case studies

on:on: Managing moneyManaging money Managing peopleManaging people Managing organisational strategyManaging organisational strategy Managing systems and reading policyManaging systems and reading policy

Delivered by the team, plus two guest speakersDelivered by the team, plus two guest speakers Mr Mick Gooda, CEO, CRCAHMr Mick Gooda, CEO, CRCAH Professor Ian Anderson, Head, Onemda (Uni of Professor Ian Anderson, Head, Onemda (Uni of

Melbourne)Melbourne)


Data Data

We had 37 stories from 13 participantsWe had 37 stories from 13 participants Our aim was to gather data about their Our aim was to gather data about their

management experiencesmanagement experiences, (rather than , (rather than their their opinions about managementopinions about management) and ) and analyse, reflect on and discuss them with analyse, reflect on and discuss them with our co-researchersour co-researchers

We collected comparison data from a We collected comparison data from a mainstream learning set at the same time mainstream learning set at the same time 21 stories from 6 participants21 stories from 6 participants


Analysing the dataAnalysing the data

37 stories in 9 groups (by primary problem)


‘‘Theming’Theming’

Each story gave rise to multiple themesEach story gave rise to multiple themes No stories can be told in the results – No stories can be told in the results –

confidentiality confidentiality Structured summariesStructured summaries

issue, underlying factors, strategies, enablers, barriersissue, underlying factors, strategies, enablers, barriers We used excel spread sheets to sort and manage We used excel spread sheets to sort and manage

datadata And the process was iterative (develop, check, And the process was iterative (develop, check,

further develop categories as new data further develop categories as new data incorporated)incorporated)


ValidationValidation

Story summary and ‘themes’ were Story summary and ‘themes’ were returned to participants at the following returned to participants at the following workshopworkshop

We presented a collated cumulative We presented a collated cumulative summary of the themes at each workshop, summary of the themes at each workshop, for discussion and for discussion and amendment/endorsementamendment/endorsement The discussion was valuableThe discussion was valuable

Sideline: I kept a journal, not consistently, Sideline: I kept a journal, not consistently, and it was very useful as a referenceand it was very useful as a reference


Nine groups of storiesNine groups of stories Managing staff (8 stories)Managing staff (8 stories) Managing the organisation (6 stories)Managing the organisation (6 stories) Managing relations with Board (6 stories)Managing relations with Board (6 stories) Working with external partners (5 stories)Working with external partners (5 stories) Managing self in job (4 stories)Managing self in job (4 stories) Managing finances and funding (3 stories)Managing finances and funding (3 stories) Managing Aboriginal Health Worker roles Managing Aboriginal Health Worker roles

(2 stories)(2 stories) Managing non-Indigenous staff (2 stories)Managing non-Indigenous staff (2 stories) Working with culture and race (1 story)Working with culture and race (1 story)


Comparison with Comparison with mainstream set: main mainstream set: main problem in each storyproblem in each story

Managing staff Managing staff 88

Managing the org Managing the org 66

Managing Board Managing Board 66 External partners External partners

55 Managing self in job Managing self in job 44 Managing moneyManaging money 33 Managing AHW roles Managing AHW roles 22 Managing non-Indigenous Managing non-Indigenous

staffstaff 2 2 Working with cultureWorking with culture 11

Managing staff Managing staff 99

Org strategy/structureOrg strategy/structure 44 [only 1 worked to a [only 1 worked to a

Board]Board] External relationshipsExternal relationships 11 Managing job/careerManaging job/career 55

WorkforceWorkforce 22

This project Mainstream Set


4 workshops

37 stories, sorted into 9 groups

Underlying factors152 themes in 12 categories

Enablers57 themes in 12 categories

Barriers81 themes in 13 categories

Managers’ problems and actions

Context or organisation factors

Consolidated results in 7 main categories

Strategies97 management strategies in 11 categories


Results in 7 headingsResults in 7 headings

Workforce and people management are major Workforce and people management are major challengechallenge

Organisations need infrastructure and systemsOrganisations need infrastructure and systems Community engagement is a strength but Community engagement is a strength but

difficult to structure and manage welldifficult to structure and manage well Managers need better supportManagers need better support Being a ‘partner’ to the biggies is a challengeBeing a ‘partner’ to the biggies is a challenge Funding is complex and short-termFunding is complex and short-term Working across cultures is difficult, racism gets Working across cultures is difficult, racism gets

in the wayin the way


Policy implicationsPolicy implications Managers lack a system for support and Managers lack a system for support and

development – career structure, staff development – career structure, staff development, mentoring etcdevelopment, mentoring etc

Size matters – critical mass for health care, and Size matters – critical mass for health care, and for organisational effectivenessfor organisational effectiveness

The sector needs infrastructure that matches its The sector needs infrastructure that matches its critical role in PHC (corporate support critical role in PHC (corporate support +quality+IT+service development capacity)+quality+IT+service development capacity)

The services have grown and become more The services have grown and become more complex, and may have gotten out of sync with complex, and may have gotten out of sync with some of the methods used to implement the some of the methods used to implement the principle of community control.principle of community control.


After the Research:After the Research:

QAIHC received funding from OATSIH to QAIHC received funding from OATSIH to implement management executive training implement management executive training programprogram Partnered with Griffith University Partnered with Griffith University 16 senior managers enrolled in the program16 senior managers enrolled in the program

Training for 100 managers in Business Training for 100 managers in Business Management was funded by OATSIHManagement was funded by OATSIH

The Overburden project took up the issue of The Overburden project took up the issue of funding and regulation of the sectorfunding and regulation of the sector

One Aboriginal researcher went on to study One Aboriginal researcher went on to study medicinemedicine


ConclusionsConclusions

Learning sets work in this settingLearning sets work in this setting We think they could be used more for We think they could be used more for

developmentdevelopment And for researchAnd for research

Challenges for governments Challenges for governments (stewardship, better funding and (stewardship, better funding and contracting) and for the sector contracting) and for the sector (workforce, governance)(workforce, governance)

learning from action

Documents

management challenges

current management problem

queensland aboriginal

aboriginal communities

mainstream learning

management experiences

new problem

research outcomes