Managing Complex Healthcare Change: A Qualitative Exploration of Current Practice in New South Wales, Australia

• Main Authors: Le-Dao H, Chauhan A, Walpola R, Fischer S, Schwarz G, Minbashian A, Munro A, D'Arcy E, Allan J, Harrison R
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-12-01
• Series: Journal of Healthcare Leadership
• Subjects: transformation; leadership; capacity; capability; culture; change management
• Online Access: https://www.dovepress.com/managing-complex-healthcare-change-a-qualitative-exploration-of-curren-peer-reviewed-article-JHL

Huong Le-Dao,1 Ashfaq Chauhan,1 Ramesh Walpola,1 Sarah Fischer,2,3 Gavin Schwarz,4 Amirali Minbashian,4 Alice Munro,5 Ellie D’Arcy,5 Julaine Allan,6 Reema Harrison1 1School of Population Health, University of New South Wales, Sydney, New South Wales, 2052, Australia; 2Clinical Excellence Commission, New South Wales Health, Sydney, 2065, Australia; 3School of Psychology, Deakin University, Sydney, 3220, Australia; 4Business School, University of New South Wales, Sydney, New South Wales, 2052, Australia; 5Western New South Wales Local Health District, Bathurst, New South Wales 2795, Australia; 6School of Health and Society, University of Wollongong, Wollongong, New South Wales 2500, AustraliaCorrespondence: Reema Harrison Room 229, School of Population HealthUniversity of New South Wales, 2052, AustraliaTel [phone]Email [e-mail]: As the cost of healthcare continues to rise, healthcare organizations internationally are seeking long-term solutions to eradicate inefficiency, achieve value-based healthcare, and minimize hospital inpatient services. This requires transformational change in healthcare organizations, and associated change management and leadership capability at multiple levels. Despite the critical need for effective change leadership and management in healthcare, limited evidence exists that this currently occurs in addition to the capability and capacity for managing change in health systems.Methods: Semi-structured interviews were undertaken with 16 healthcare managers and leaders at a range of levels in nine healthcare organizations across the public health system of one Australian state (New South Wales), including metropolitan, regional and rural geographical areas. Thematic content analysis was undertaken with the emergent data.Results: Four key themes emerged from the data: 1) lack of adoption of frameworks and methods for change management for any scope or scale of change, 2) inadequate resources for delivering, managing and leading change, 3) insufficient leadership, capacity and capability in managing change, and 4) the need for support and culture that supports change at all levels of the system.Conclusion: Ensuring dedicated resources for change and sufficient capacity and capability amongst health professionals and managers at every level in a health system are required for effective management of change. An enabling culture for change, supported by adequate education and training in change leadership and management are critical in order for the benefits of health service and system changes to be realised.Keywords: transformation, leadership, capacity, capability, culture, change management