C.8 Learning and development

Learning and development outcomes

An organisation-wide system is in place for the development, implementation and regular review of learning and development in ACT Health. This includes the ACT Health Learning Development Framework and reporting and associated policies, which support a learning culture to enhance staff capabilities, competency and legislative compliance. The Education Activity Register monitors executive approval for programs, annual evaluation and revision. A comprehensive calendar of learning opportunities is provided to staff on the intranet and the learning management system and annual data demonstrates a high degree of uptake of education and training.

In 2012‑13 achievements included:

  • Australian Council on Health Care Standards (ACHS) 2012 accreditation rating of EA (Extensive Achievement) for learning and development
  • revision and implementation of the ACT Health Learning and Development Framework and assessment tool based on learning organisation principles
  • significant revision of the essential education policy (mandatory training) and procedures. This policy also enunciates requirements for students, volunteers and contractors
  • an extensive evaluation and revision of clinical programs to comply with the National Safety and Quality Health Service Standards and
  • an increase in competency-based training to comply with the National Safety and Quality Health Service Standards, including revision or development of education and piloting of new assessment tools—for example, in life support programs and in aseptic technique.

ACT Health is committed to ensuring the quality of its education and training. This includes:

  • auditing of the Education Activity Register, which monitors programs on the ACT Health learning management system to ensure they are reviewed, updated annually, linked to evidence-based practice and approved by an executive director. In 2012‑13, 153 programs were listed on the Education Activity Register
  • maintaining compliance with the Standards for NVR Registered Training Organisations 2011, with two nationally recognised programs offered in 2012‑13
  • evaluating learning and development programs—assessing outcomes and reporting to stakeholder groups
  • providing professional development and networking for staff across the organisation engaged in work-based training and education initiatives, student clinical supervision, graduate support, and competency assessment to support the provision of safe, quality health care, as shown in the table below.

 

Program Enrolments and attendees 20122013
TAE40110 Certificate IV in Training and Assessment 72 enrolments from nursing, midwifery, allied health, technical and administrative roles
Clinical support and supervision essentials 67 attendees (54 nursing and 13 allied health staff)
Trainers and Educators network 158 attendees over 5 meetings

 

Leadership and culture programs

  • The ACT Health Leadership Network is composed of around 100 employees identified by the Health Executive as leaders and potential leaders who could most benefit from the network and contribute to its objectives.
    The three workshops held during the 2012 calendar year had leadership themes of identifying and focusing on strengths, positive organisational stories, ethical decision making, collaboration/teamwork and courageous leadership. Inspiring and informative guest speakers included Michael Milton (Paralympian), John Hill (St James Ethics Centre), Rechelle Hawkes (former Hockeyroos captain), Andrew Kefford (Deputy Director-General, Workforce Capability and Governance Division & Commissioner for Public Administration, ACT Public Service), and Margie Warrell (CEO, Global Courage Institute), with Health executive and staff also contributing strongly. Participants were encouraged to develop their individual and group thinking on these topics as well as to continue forming constructive partnerships with each other and across the organisation.
  • The People Manager Program, developed and commenced in 2012‑13, aims to develop knowledge and skills in people management, underpinned by Health’s values. The PMP is for clinicians and non-clinicians in frontline supervisor and middle management positions who have people management responsibilities. It has received excellent evaluations from participants, who have appreciated the Health-focused examples and contexts used.
  • The Critical Care Leadership Program is an inter-professional leadership program attended by Intensive Care Unit and Emergency Department clinical staff from the Canberra Hospital and Calvary Hospital. In 2012‑13, two programs were attended by 50 staff.
  • The Clinical Leadership and Communication Skills Development Program targets participants from graduate programs, nursing night duty, clinical development nurses and midwives, and upcoming nursing team leaders. The program was developed in response to evaluation and needs analysis of these groups. A total of 293 staff attended these sessions, which received positive evaluations.
  • Managing and preventing bullying, harassment and discrimination training is available to all managers and all staff. More than 4,600 staff in the ACT Health workfoce have been trained since the program begun in 2011.

 

All-staff workshops Managers’ seminar Total number of staff trained in 2012‑13
1,385 101 1,486

 

The number of Respect Equity and Diversity (RED) contact officers at 30 June 2013 was 90. RED contact officers include nurses, allied health professionals, administrative staff and staff who work outside traditional business hours.

  • ACT Health’s combined efforts on RED training, policy development, case management and other initiatives resulted in it being shortlisted for an ACTPS Award for Excellence in the Respect category.

Recruitment and transition to practice programs

ACT Health implements highly successful programs to transition new nurses from student life to practice, including a Graduate Registered Nurse program, Enrolled Nurse program, and Allied Health Graduate Program. The programs provide a high level of clinical and professional support, care, feedback and guidance during the transition year. The evaluations demonstrated that the programs met participants’ expectations and those of the clinical areas.

Participants’ comments in evaluations included the following:

‘Learning a lot about nursing in a practical capacity and becoming responsible for my own learning and my own actions. I also feel that I have made a positive contribution to other people’s lives, and it is nice to know that my career can do this for people’.

‘being able to work as a nurse, learning nursing skill from all different areas of the hospital and experiencing different types of nursing such as ward and clinic’.

‘Gaining so many valuable skills whilst being supported’.

 

Program Number of participants Completions Retention rate (stay in
ACT Health after completion)
RN Graduate program 2012 99 over 3 intakes 98 (99%) 92 (93%)
RN Graduate program 2013 103 over 4 intakes Program ongoing Program ongoing
EN Graduate program 2012 17 over 2 intakes 6 completed
9 ongoing
5 employed, others ongoing because of maternity etc.
EN Graduate program 2013 5 commenced Program ongoing Program ongoing

 

The Allied Health Graduate Program was developed and piloted in 2012 to support new allied health professionals to integrate into the workforce with an interprofessional focus. The full program commenced in February 2013, with 27 participants, and will conclude in July 2013.

Nurse and Midwives Re-entry Programs and Overseas Qualified Nurse Programs: The re-entry programs recruit and provide educational support to nurses and midwives who have not worked in acute health care for up to 10 years. The Overseas-Qualified Nurse Program provides education and support for internationally qualified nurses to obtain registration in Australia and the possibility of obtaining a position in ACT Health. Both programs are accredited with the Nursing and Midwifery Board of Australia

 

2012‑13 Completed Currently participating Recruited to ACT Health
Registered nurse re-entry 7 3 4
Midwifery re-entry 3 1 1
Overseas qualified 12 4 6

 

Essential Education programs

Safety education programs

 

Program Description Staff Trained
Manual Handling Education A range of programs provided for clinical and non-clinical staff, students and volunteers 2,913 staff face-to-face 133 volunteers, 271 nursing and allied health students 30 medical students and interns 2,882 e-learning completions
Predict, Assess and Respond to Challenging or Aggressive
Behaviour (PART)
Helps staff in high-risk areas to respond to challenging client behaviour safely and effectively in order to reduce the risk of harm to both clients and staff 111, nurses, allied health, administration staff and wardspersons
Chemotherapy safe handling Provided for staff looking after patients who are receiving chemotherapy to comply with the Clinical Waste ACT, the Poisons and Dangerous Drugs Act, the Workplace Health and Safety Act and the Hazardous Chemicals and Dangerous Goods Act. 66 nurses

 

Child protection training

This is provided at three levels for staff according to their contact with children and young people and is delivered across all Health organisations and sections, including both Calvary Health Care hospitals and non-government agencies that receive funding from ACT Health. ACT Health volunteers are also provided with training. E-learning options are available for level 1 child protection training and the level 2 refresher training.

ACT Health continues to partner with the Community Services Directorate to provide What About Me, a series of workshops for government and non-government organisations aimed at increasing staff confidence and ability to work with vulnerable children and families.

Number of ACT Health staff attending child protection training 2012‑13

 

Level of training Total number trained*
Level 1 (face-to-face) 278
Level 2 797
Level 2 refresher (face-to-face) 121
Level 3 454
Level 3 refresher 212
Level 1 e-learning 719
Level 2 e-learning 569
Total 2012‑13 3,150
Total 2011‑12 2,830

 

*Staff may attend more than one level of training—for example, level 1 and level 3. The participant total reflects the full number of attendees at education sessions. These figures include all staff trained in ACT Health (and Calvary Bruce and Calvary John James).

Life support programs

Life support programs are provided in line with the requirements of the National Safety and Quality Health Service Standards (Standard 9). In 2012‑13, all life support programs were revised in consultation with stakeholders to strengthen alignment with current guidelines, improve availability and access, and increase the numbers of accredited trainers and assessors. Programs in 2012‑13 increased the use of simulation and scenarios to help solidify knowledge and skills.

The table below shows the training provided and the number of staff who attended:

 

Training No. of participants
Basic Life Support—433 programs 3,354
Advanced Life Support—13 programs 167
Advanced Life Support Refresher—12 programs 113
Neonatal Life Support—9 programs ACT Health—151, Calvary—45
Update Neonatal Life Support—6 programs ACT Health—80, Calvary—11
Paediatric Life Support—8 programs facilitated by Advanced Paediatric Life Support (Victoria), held in Canberra 130
Paediatric Life Support Refresher, Canberra Hospital—4 programs 12

 

Note: The Basic Life Support program is now included in 13 Advanced Life Support programs, in which 167 staff were assessed on Basic Life Support.

Early Recognition of the Deteriorating Patient Program (COMPASS)

This program supports implementation of standard 9 of the National Safety and Quality Health Service Standards and is designed for nurses, midwives, physiotherapists, doctors and undergraduates, and is delivered by the Early Recognition of the Deteriorating Patient team. The COMPASS education program is used by facilities in every state and territory in Australia, and internationally. The COMPASS programs offered in 2012‑13 are set out in the table below.

 

COMPASS Program Number of sessions Number of participants
Adult 29 475
Paediatric 5 11
Maternity 5 20
Adult refresher 48 997
Paediatric refresher 24 116
Maternity refresher 20 62

 

A monthly Modified Early Warning Score (MEWS) and Medical Emergency Team (MET) forum is held to discuss case studies, audits and a topic of the month.

New junior medical staff undertake COMPASS in the annual January medical orientation for junior doctors.

A new family-activated escalation program, Call and Respond Early (CARE) for patient safety, has been developed. This training included a 1.5-hour in-service for ward nursing staff, and an eight-hour CARE skills day was developed and delivered in conjunction with Organisational Development for CARE responders and senior ward nurses. There were 50 CARE in-services for 458 participants and five CARE skills days for 51 participants.

The Neonatal Early Warning Score (NEWS) pilot training has commenced for staff in the maternity unit. This training, developed by the NEWS project team, was led and delivered by neonatal and maternity clinical support nurses and clinical development nurses. To date there have been seven two-hour sessions for 48 participants.

Clinical programs

ACT Health provides a large number of clinical education programs. Some key programs are described below.

Night Duty Program

Night Duty Program is offered once or twice a month for 11 months of the year for nursing staff working night duty. The program includes professional issues, clinical education, invited guest speakers and competency assessment for clinical education. The Night Duty Program was conducted on 30 occasions during the year, with 962 staff attending.

Introduction to Perioperative Nursing Program

The Introduction to Perioperative Nursing Program was first developed to attract and retain nurses in response to staffing shortages in the Perioperative Unit.

In February 2012, 16 nurses commenced the program, including eight graduate nurses and nurses from other areas in Canberra Hospital and regional New South Wales hospitals. The program is 12 months long and is completed in the following February, in line with the new graduate program. All graduate nurses elected to continue to work in the perioperative area. The 2012 program was extensively evaluated, indicating that the course had delivered orientation, provided basic skills and knowledge, and retained staff in the perioperative nursing specialties. Feedback from regional hospital participants was very positive, and places will continue to be offered to them.

In February 2013, 13 nurses (including eight graduate nurses) commenced the program, including two participants from regional New South Wales. The program will continue until February 2014.

Perioperative Team Leader Program

The Perioperative Team Leader (TL) Program was developed to attract and educate nurses to fulfil the role of Scrub TL after hours. Following evaluation the program was changed to deliver a broader, team-orientated approach, providing education modules encompassing all perioperative nursing specialties. These include Scrub, Anaesthetics, the Extended Day Surgery Unit (EDSU) and the Post-Anaesthetic Care Unit. Perioperative level 1 registered nurses with a minimum of two years experience (12 months for EDSU) or level 2 perioperative registered nurses who have not yet worked as a team leader are the target groups for this program. Twelve nurses attended the first four modules and seven nurses attended the final module. The revised 2013 program was well received.

Paediatric Foundation Program

The Paediatric Foundation Program is aligned with the Nurse Graduate Program. The program allows the novice paediatric nurse to develop and consolidate their skills through workshops and learning modules.

In 2013, there were two intakes and a total of eight graduates. In August 2013, the first intake will complete the program. The second intake is due to complete it in November 2013.

Child and Adolescent Mental Health Program

This three-day program is run in conjunction with the Child and Adolescent Mental Health Service and provides health professionals with knowledge and management skills used in the care of the child and young person with an acute mental health problem. In 2012, 18 participants completed the program and paper-based evaluations demonstrated 100 per cent satisfaction, with ratings of ‘good’ to ‘very good’. This program is re-scheduled for September 2013.

Peripheral Intravenous Cannulation Program

The program is for registered nurses and midwives, medical students and medical officers and radiographers, and third year student nurses in their final placement may also apply. In 2012‑13, 10 workshops were conducted, with 159 participants, and 13 per cent completed all requirements. The focus is now on revising the content to more closely align with the 10 National Safety and Quality Health Service Standards, ACT Health policy and current literature, and on the development of an e-learning program for the theory component to encourage a higher rate of completion of all aspects of the program requirements.

Central Venous Access Devices Workshop

This program provides an overview of ACT Health policy and procedures in the care and management of central venous access devices and is available as a workshop and e-learning package. In 2012‑13, 21 participants attended workshops and 69 staff completed the e-learning program.

Postgraduate Certificates for Nurses and Midwives

Two Postgraduate certificates are offered to nurses and midwives through the Australian Catholic University (ACU) in partnership with ACT Health. The ACU delivers an online component for two units, and an educator in the

Staff Development Unit teaches an approved curriculum for the remaining two units. This education model combines theory and experiential learning. The advantages for ACT Health of using this model are that postgraduate study is tailored to work area need, students can work and study at the same time, and there are no fees for the ACT Health component.

Graduate Certificate in Neonatal Nursing: In 2012, four students completed the online component through the Australian Catholic University. In 2013, nine students were enrolled in the ACT Health program, including the four students who completed the online subjects in 2012. Two students have continued on to study for a master’s degree.

Child and Adolescent Health Graduate Certificate: The course curriculum was revised and approved by the ACU in 2013. In 2012 six students were enrolled, five specialising in acute paediatrics and one in maternal and child health. All students completed the course and five went on to study for a master’s degree. A further three students started in mid-semester, two specialising in acute paediatrics and one in maternal and child health.

In 2013, 11 students enrolled, five specialising in acute paediatrics and six in maternal and child health. Three students completed the course at the end of semester 1, 2013, with two going on to a master’s degree.

E-learning

Seven new e-learning programs were implemented in 2012‑13 to support clinical and non-clinical areas and a further six are in final development. Ten programs were reviewed and updated as a result of evaluation feedback and changes to legislation or clinical practices. These developments with e-learning are set out in the table below.

 

Programs implemented 2012‑13 Programs in final development and piloting
Finance Module 1 (basic finance processes) B. Braun (infusion pumps)
Finances Practicalities (practical application of finance tools) Ketamine (administration of pain management medication)
Tobacco Intervention Respecting Patient Choices (patient choices regarding care)
Open Disclosure Personal Safety and Conflict
Magnetic Resonance Imaging (to enable log on) Patient ID and Procedure Matching
Certificate IV in Training and Assessment (supplementary) Intrathecal Morphine (pain management)
Incident Management (Riskman)  
E-learning updates as a direct result of evaluations
Child Protection Level 1 Australian Charter of Healthcare Rights
Child Protection Level 2 Refresher Medication Packaging
Work Health and Safety Act 2011 Ethics, Fraud and Integrity
Consent PCA Competency Test
Health Procurement Aboriginal and Torres Strait Islander Awareness

 

The Secondary School Work Experience Program is a four-day placement offered to year 10, 11 and 12 students attending a high school or college in the ACT. The aim of the program is to give students a realistic idea of what it is like to work in health care and encourage them to choose career paths in health. In 2012‑13, Health placed 251 secondary students. Positive feedback was received from students, teachers and workplaces.

Secondary students’ comments included the following:

  • ‘I got the chance to see a very broad range of professionals within the ward, which was interesting and beneficial.
  • I also got to interact a lot with patients and was able to do many activities with them.’
  • ‘I loved the people who I worked with because they were so friendly, accommodating and willing to educate me.’
  • ‘When the patients showed improvements, the excitement expressed by them was great. The therapist/patient relationship. The patients were really friendly. The personality of the nurses and observing the daily requirements and abilities a nurse is expected to provide. The nurses are such beautiful women and men who were continuously devoted and always shared such friendly smiles and words together.’

The Student Placement Unit assists with the management of clinical placements for nursing, midwifery, medical and allied health students. It provides a platform for pre-placement preparation, including e-learning programs for legislative compliance prior to clinical placement commencement. The student placement management system also assists with the reporting requirements of Health Workforce Australia in relation to student clinical placement activity. In 2012‑13, there were 523 allied health placements. In the same period, 23,770 clinical placement days were provided to nursing and midwifery students. Clinical placement opportunities were offered in a variety of acute and primary health care areas.

The Allied Health Student Clinical Placement Mapping project commenced in 2012 to assess and identify capacity for growth in student numbers and clinical placements up to 2014 in allied health professions deemed to be in need of more clinical placements due to increased student numbers. This work was initiated to assist the Clinical Training Placements Reference Group, a subcommittee of the Integrated Regional Clinical Training Network (IRCTN). The project’s initial focus has been on the collection of information relating to current and planned clinical placement activity and student numbers in physiotherapy at both ACT Health and Calvary Health Care ACT (public). The project has included the identification of barriers and enablers to increasing the number of placements offered, and highlighted the resources required to maintain and enhance the quality of the placements offered. The project will be finalised in late 2013.

Scholarships for allied health, nursing and midwifery

Allied health

The Office of the Allied Health Adviser supports and promotes ACT Health’s commitment to ongoing learning and development through the Allied Health Postgraduate Scholarship Scheme. Scholarships are awarded to support recipients in their pursuit of further learning in clinical practice, education and training, research and/or management and leadership. Scholarships are awarded annually over academic (calendar) years, with the budget spread over two financial years.

The 2012‑13 budget committed $71,345 to support 25 recipients completing their Semester 2, 2012, postgraduate study. However, actual payment for this study period was $50,194 due to the withdrawal of seven recipients. In Semester 3, 2012, a total of $18,277 was committed to seven recipients. However, following two withdrawals, actual payment made was $15,311. In the 2013 academic year, allied health postgraduate scholarships were awarded to 13 new applicants and 13 continued their study from 2012. Of the postgraduate courses being undertaken by the 2013 recipients, five are at Graduate Certificate level, one is at Graduate Diploma level and 20 are at Master’s level. Twenty-five recipients commenced their study in Semester 1, 2013, representing a commitment of $62,326 and resulting in a total investment of $127,832 in allied health postgraduate scholarships for 2012‑13.

Nursing and midwifery

The Nursing and Midwifery Post-Registration Scholarship Scheme, offered since November 2000, provides financial assistance with course tuition fees to support studies in a clinical, education, research and leadership or management area for enrolled and registered nurses and midwives, through the following scholarship programs:

Aboriginal and Torres Strait Islander Enrolled Nursing Scholarships

Joanna Briggs Institute Clinical Fellowship Scholarships

Aboriginal and Torres Strait Islander Enrolled Nursing Scholarship

Jennifer James Memorial Honours Degree Scholarship

Nursing and Midwifery Travel Scholarship.

There has been a 25 per cent growth in post-registration scholarships and, in 2012‑13, a record number of registered nurses, midwives and enrolled nurses received scholarship support.

ACT Health total learning and development activity

Learning and development activity for face-to-face programs and completion of e-learning programs by health division as recorded in the ACT Health learning management system, Capabiliti, from July 2012 to June 2013

 

Health division No. of attendances Hours Salary E-learning completed
Office of the Director-General 937 3,265 $147,804 656
DDG Strategy and Corporate 2,631 7,302 $296,665 1,628
DDG Canberra Hospital and Health Services 54,847 130,578 $4,899,055 16,351
Calvary* 54 N/A N/A N/A
Special Purpose Account 100 191 $7,455 58
TOTAL 58,569 141,336 $5,350,979 18,693

 

*Calvary hours and salary costs are not available.

ACT Health staff undertaking whole-of-government learning and development

Study assistance

In 2012—13, study assistance was provided to 212 employees to allow them to access paid leave and complete external study to develop capabilities that can be applied in the work environment. In addition to study leave, a total of $41,124 in financial assistance was provided to ACT Health staff.

ACTPS calendar of training

In 2012‑13, 203 ACT Health staff attended training from the ACTPS training calendar, at a total cost of $73,588.29

 

Initiative No. of participants
ACTPS Graduate Program 2
Young Professionals’ Network (YPN) N/A*
Future Leaders Program 4
Executive Development Program 1
PSM Program N/A*
Sponsored Training for First-time and Frontline Managers N/A*

 

*In 2012‑13, the Public Sector Management Program, first-time and frontline Managers Program and YPN activities were not coordinated centrally, so there is no data available to report.

Future learning and development priorities

Key future learning priorities as determined by ACT Health executives are:

  • education to support implementation of the National Safety and Quality Health Service Standards
  • change management
  • customer service
  • dealing with difficult behaviours
  • people management
  • effective communication
  • partnering with the tertiary sector for delivery of the nursing refresher and overseas qualified nurse programs.