Leading Change in Healthcare: A Strategic Report for QAS

This report examines strategic healthcare issues within the Queensland Ambulance Service (QAS), focusing on ambulance ramping, workplace health and safety (occupational violence), information technology capabilities, and patient care quality. It analyzes these issues through a SWOT analysis an...Read More

1Running head: HEALTHCARE
Leading Change in Healthcare
Name of student:
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Introduction
Research indicates that a number of issues of concern in the healthcare system across
communities are coming into limelight which is to be addressed at the earliest. Healthcare
management in the contemporary era is marked by the application of a number of a strategic
management framework that aims to address the diverse issues in the workplace (Duckett &
Willcox, 2011). Humanistic management model focuses on the ‘humans’ as the most crucial
resource of a health setting. When integrated as an element of strategic management
framework it promises to bring about positive changes in the care settings within a short span
of time (Mele, 2016). The present report is a review of four strategic health care issues within
the current work place which is Queensland Ambulance Service. The strategic health issues
considered for the report are are Ambulance Ramping, Enhancement of Workplace Health
and Safety –Occupational Violence, Developing Better Information Technology Capabilities
and Proving High Quality Patient Care. The strategic issue identified are key concerns since
they influence the QAS pertaining to the operational functioning at present and would
continue to do so in the future. The report would put forward a critical analysis of the
humanistic management model and demonstrate how it influences present practices. Lastly,
the report would demonstrate the strategic management framework and how this would
addresses the identified health concerns.
Description of care setting
The current workplace setting is the Queensland Ambulance Service (QAS) that is a
part of the Queensland Health (QHealth). The organisation is a reputed statutory ambulance
service functioning within Queensland (QLD). It is notable for providing non-emergency and
emergency pre-hospital care in addition to disaster response and transport services to the

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community. The expectations from the setting are set high as the community considers this
service as reliable and convenient.
The current position held in the QAS is that of a Senior Operations Supervisor (SOS)
within the Metro-North Local Ambulance Service Network. The position requires on to
provide management and coordination of ambulance personal and resources and real time
operational supervision. At this position, one is required to provide logistic solutions to
challenges faced in operations through tactical management aids. An essential role is also
played in establishing and sustaining a strong relationship with chief stakeholders within the
QHealth Hospital and Health Services and QAS Operations Communication Centre.
Explanation of managerial duties
Holding a senior position in a healthcare service setting one is expected to
demonstrate a set of competencies and core skills that are aligned with the objectives and
mission of the organisation. At present the managerial responsibilities and duties held include
supervising, leading and managing different domains of workforce performance and
operations. The objective is to ensure adequate service delivery that is aligned with the set
operational plans as well as the legislative requirements. It is also a part of the duty to engage
in effective communication with the external stakeholders for maintaining a strong
professional relationship. In addition, it is required to provide operational support that directs
major incidents within the setting. Suitable leadership skills are to be showcased in this
regard in the real-life scenarios. The position of SOS is one that demands te individual to
look after diverse areas in the business for ensuring that the decision making process is
guided by best management models, legislative procedures and policies.

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Strategic issues pertinent to the health sector
For identifying the present strategic health issues faced within the QAS, it is desirable
to conduct a SWOT analysis. Through this assessment, a number of chief concerns became
prominent, of which four would be considered for the present paper. These strategic issues
related to ambulance ramping, improvement of occupational violence, development of better
information technology capabilities and provision of high quality patient care. All of these
highlighted issues are to considered as strategic since they require managerial interventions
for coming up with resolutions to these concerns. Certain styles of management are
elementary for addressing these situations, and the role of the manager is more prominent in
here (Grant et al., 2011).
Ambulance ramping- Ambulance ramping is the situation in which the patients
transported to the Emergency Department (ED) through an ambulance suffers a delay in
offload from the trolley of the ambulance to the treatment area of the ED. Usually, the delay
in an ambulance offload into the ED of half an hour or more is considered as ambulance
ramping. At the QAS it has been noticed that ambulance ramping is gradually becoming a
strategic health concern and this is more evident in the last one decade. QAS is largely
effected by this situation pertaining to providing a suitable and timely response to the
community. As opined by Perry and Carter (2017) ambulance ramping is related to a
significant measurement of adverse patient morbidity as well as mortality. The primary cause
of ambulance ramping is overcrowding of the ED that is caused by multifaceted and complex
reasons, including high demands for ED services, and processing insufficiency.
Improvement of workplace health and safety (Occupational violence)- Occupational
violence is the second prominent strategic issue at QAS. It has been found that the healthcare
workers at this setting are continually being subjected to occupational violence since they
come across individuals who are stressful and unpredictable. Since these individuals are in

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volatile situations, service providers at QAS are subjected to violence and aggression. The
issue is strategic since the employees are confronted by certain ethical dilemmas regarding
personal safety and patient care obligations. Moreover, combating this issue requires
interventions that are broadly focused and based on shared responsibilities of the employees.
Leadership is essential for addressing the issue in all functions.
Enhancement of better information technology- In light of the advancement brought
about in rapid implementation of information technology systems across healthcare service
domains, it has been reported that QAS in lagging behind in this arena. There is an urgent
need of implementing better and adequate information technology systems in the setting that
would enable successful storage and analysis of a large pool of health information. The
concern is strategic since it requires the employment of competent personnel and additional
resources (Kellermann & Jones, 2013).
Provision for high quality patient care- For a healthcare service provider it is essential
to provide optimal quality patient care. QAS has been recently showing deviation from this
motto as the patient satisfaction scores are not high. The patient's outcomes are not aligned
with the guidelines of clinical practice in this setting. Quality health care perceived to be an
overarching umbrella beneath which the aspect of patient safety resides. The issues need
strategic interventions in the form of interaction between the human and non-human
resources. Processes that are variable are to be eliminated, and enhancement of provider
competencies and education is crucial through training and supervision. Monitoring and
evaluation processes when integrated into the functioning of the setting leads to
improvements (Mohammed et al., 2016).

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Critical analysis of humanistic management model
As highlighted by Pirson (2017) the humanistic management model is a noteworthy
management and administration theory that has is now being considered for application
across different healthcare settings for achieving best outcomes. The model, in the present
era, has become a preferred and dominant management paradigm for healthcare services. The
management model gives prime importance to ethical foundations of the organisation and
thus the management as a whole. As per this model, an organisation must perceive the
‘humans’ that is the employees as the most crucial resource. The approach has the emphasis
on the need for managers to stimulate the activity, motivation and creativity of the employees
to work in collaboration and achieve the set goals of the organisation. The models stress to a
large extent the requirement for human aspects to be considered as fundamental for suitable
management processes. Through showing concerns and care for the wellbeign of the
individuals managers can suitabley addresses all challenges coming up in due course of time.
The elements of human welfare that are encomapassed in this model are human dignity,
comprehensive knowledge, wholeness, common good, development, stewardship-
sustainability and transcendence.
Pirson (2014) highlighted that integrated into the humanistic model is the set of
humanistic principles that respect individual’s concerns and provoke their enthusiasm. Such
an approach enables collaboration between employees and managers which is very much
required for bringing in key developments nin the setting. Humanism is perceived from an
individual’s standpoint of the indispensable concerns related to the organisation’s motto, its
demands, and its purpose. Mele (2016) argues that the humanistic model has some key
disadvantages that make it not appropriate for application in healthcare settings. The
argument put forward is that the model is too positive pertaining to human behaviour. The
model has the underlying principle that humans would choose the positive path under all

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circumstances and that motivation can be augmented for all individuals in a group through
one stimulus, which is not true for all cases. Carr et al., (2017) further opposed that the
approach is not scientific and lacks a strong foundation of evidence. Nevertheless, the
importance of humanistic model cannot be ignored since it is a people-oriented management
model and looks for benefits for human ends.
Application of humanistic management practices as part of the practice and a strategic
management framework
The humanistic management model, as established by Brousseau et al., (2017) is a
pioneer of modern-day management practices that aim to bring developments in the planning,
staffing, organisation and control process of a healthcare system. Thoughtful observation and
research identify that potential that this management approach holds to carry out a change in
the system. If QAS is to reformulate management practices based on the humanistic
management model, a set of managerial practices are to be embedded in the operations and
functioning. The manner in which humanstic management practices can be integrated as a
part of the strategic framework can be elaborated under the following aspects-
Establishment of institutional statements- Institutional statements for QAS must be
rooted in the ideas of the setting being committed to what holds more value for the
employees. What the employees do, meaning the mission, what they want to be in future,
meaning the vision, and what they value more, meaning the corporate values, must be
relevant to the permanent element of human wellbeing. Along with technical elements
humanistic values such as ethics and dignity are also to be included (Ozcelik et al., 2014).
Leadership- There exist different definitions for leadership with the common aim of
influencing employees in a positive direction through a collaborative approach. For a proper
functioning of a healthcare system, it is essential to set common goals and determine what is

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to be done under different situations. A humanistic approach would imply that QAS
organisational structure has power evenly distributed over all levels of employees to the
extent feasible. In contrast to paternalistic management modules, leadership model would
ensure that all stakeholders are given equal importance and are treated as collaboraters. It is
needed that the human condition of being free and independent is acknowledged and human
dignity is given prominence. An interactive dialogue and relationship between the healthcare
leaders and the followers would ensure that the need for personal and professional growth of
the employees at QAS are taken care of (Cameron & Green, 2015).
Communication- The managers at QAS are required to engage in informal
communication along with formal communication so that two-way transmission of feelings,
values and thoughts are promoted. Dissemination of decisions of the managers at all levels is
pivotal so that relevant messages are shared to all employees. The first humanistic and ethical
requirement is to avoid manipulative information and lies since this would foster respect for
human values. Managers and leaders are to sustain truthfulness in all forms of
communication that have transparency as its prime feature (Grant et al., 2011).
Organisational structure- An organisational structure refers to the set of
responsibilities and roles for individuals in an organisation that considers processes, policies,
resource allocation, supervision, technology and finances at the core. Though there is no
perfect humanistic organisational structure, the humanistic model demands respect for all
people within the organisational structure. The minimum requirement is to avoid poor
treatment of individuals as receptors of orders, to show eagerness to guide and to give
feedback and suggestions at all levels (Kaplan, 2014).
Coordination and control- Controlling the complexity of a care service owing to
diverse scope and functionality are difficult under certain environment. A humanistic

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approach entails harmonisation, synchronisation and unification of different elements of
management practices to generate a congruent outcome. Motivation is perhaps at the heart of
such an approach that requires the managers to constantly provide motivation and
encouragement to come up with their best initiatives. At QAS there is a requirement for
managers to enagage in conflict resolution and eliminate dysfunctional aspects that impair the
overall functioning of the centre.
Decision making- The previous approach to decision making by managers in
healthcare systems focused on the sole role of managers in this process. It is to be relaised
that decision making needs to firstly consider the need of defining the nature of the problems
before a plan is made for solving them. The human dimension that prevails in this regard is
how the problems and needs influence individuals. Humanistic management style focuses on
long-term benefits of the employees rather than short-term benefits of the organisation.
Against this background, it is to be stated that the managers at QAS must involve the
employees at all major decision making processes and have an insight of the possible social
reactions that would possibly come up as a result of the decisions taken (Buchbinder &
Shanks, 2016).
Application of strategic management framework for addressing the issues
As opined by Buchbinder and Shanks (2016) health service providers must manage to
effectively bring about change in their systems, strategies, products and services for surviving
the challenges coming up for external as well ass internal forces. Only an application of a
robust and evidence-based strategic framework is capable of addressing the four issues
highlighted within the context of QAS.
Developing human resources would be the key aspect of strategic management model
to be applied at QAS. The idea would be to enhance the capability and skills of the healthcare

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professionals. This step would be two-dimensional, encompassing increase in skills of
individuals and change in the skill mix of these professionals. QAS must consider conducting
training sessions that have a positive impact on the professionals. Counselling sessions when
conducted with the professionals ensure that they lead to better client satisfaction. Training
also augments better information transmission and decreased complaints from service users.
At QAS, this approach can combat the concern of ambulance ramping to a moderate extent.
Division of roles and responsibilities among the different workers reflct the proper
distribution of tasks. Changing the skill mix permits resolution to conflicts and
misunderstandings among professionals. Reviews point out that tasks done by one group of
professionals can yield better and comparable results when done by a different group. QAS
can consider changing roles in forms of delegation, substitution and innovation. Changing
interface between key services would also be beneficial (Ginter et al., 2013).
Walston (2014) highlighted a set principle strategic approaches that would be
beneficial when applied to the QAS context. The activities that QAS must carry out in the
near future must include the introduction of regular evaluation and monitoring cycles,
workshops for identification of employee concerns and training activities. The results would
ensure more rational utilisation of funds due to better planning; enhanced coordination and
integration of programs; better working methods; enhanced morale of staff and increased
worker participation. For improving the current status of health IT system at QAS,
infrastructure is to be made better that can support modern and advanced IT systems. QAS
can consider pooling in resources from different healthcare systems that can be beneficial for
both quality patient care and high technology. Recruitment of professionals who are a pro in
the field of IT would be the key strategic step. Experts of the health IT domain are to be made
a part of the system who can successfully collect and manage health information and
maintain it on a regular basis. Increasing the human resource would surely bring in

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improvement within a short span of time. Occupational violence at QAS can be combated
through suitable leadership skills demonstrated by all managers. Governance and leadership
enable individuals to report against occupational violence so that appropriate measures are
taken. When support is received from the higher authorities, employees will come forward to
report all incidents of harm and injury suffered by the employees at QAS (Ginter et al.,
2013).
Patient care quality can be improved through establishment of relationships.
Employees are to be guided to work in collaboration with each other for delivering
comprehensive care. The requirement for teamwork is to be felt at all levels. The managers
must come forward to instil an essence of teamwork and solidarity fostering healthcare
(McCalman & Potter, 2015). Along with this comes the need of a robust monitoring process
that accurately identifies the gaps in care delivery. Without such a monitoring system QAS
would not be able to move forward regarding quality. The monitoring system can encompass
a number of tools available that are effective in collecting subjective as well as objective data
regarding service provision. Based on the data collected QAS can outline a plan that
corresponds to the breaches identified in adhering to service guidelines (Walston, 2014).
Conclusion
The requirement for safety and quality improvement initivates pervades health care
services at QAS. The extent to which the services provided to the individuals enhance the
chances of suitable health outcomes, and are aliged with the professional guidelines, is to be
changed for the better. Interventions for improving quality must lead to changes in the
completeset of primary end points and must contribute to results in different sections of the
system. Through a humanistic management model, the wholeness of the individuals can be
taken into account with a comprehensive knowledge of each of the members. Through an

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emphasis on human flourishing QAS can achieve its key goals and objectives. QAS must
give focus on the creation of institutional statements based on humanistic approach as
deemed fit for the organisation. A strategic management framework would ensure that the
organisation is prominent in control and coordination of activities, enabling valuable
allocation of resources. In here, resources refer to both materials and personnel. Formal and
informal communication, leadership and efficient decision making would be elementary to
such a strategic management system’s application. It is to be anticipated that management
practices oriented towards employee welfare, in amalgamation with chief strategic
management practices, would be instrumental in achieving best possible patient care
outcomes at QAS.

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