Towards a Safer Culture

The development of organisation-wide initiatives to review and strengthen governance and workplace risk strategies including identification, minimisation, prevention and reporting of risks with the ultimate goal to promote a workplace culture of respect and staff empowerment.

Governance

The TASC Strategy established a formal governance structure to direct development and implementation of the Strategy. The Advisory Group and Steering Committee had representation from relevant ACT public health workplaces and key stakeholders to ensure appropriate leadership and decision making. 

Nursing and Midwifery Leadership

Senior leadership across all ACT public health workplaces are committed to the TASC Strategy, noting a requirement to ensure leadership across nursing and midwifery was embedded, from individuals in small teams through to wards, and leaders at the operational level including leadership in senior administrative positions. The challenge would be to ensure modelling of positive leadership was occurring at all levels of leadership within organisations to facilitate a change in workplace culture and perceptions of safety.

A number of leadership deliverables were identified:

• Leadership webinars to share learning and knowledge across workplaces
• The Nurses and Midwives Leading a Safer Culture Charter
• A Nursing and Midwifery Leadership Pathway (under development)

Senior leadership included: ACT Chief Nursing and Midwifery Officer, Director and Deputy Director-Generals of the ACT Health Directorate and the Minister for Health.

TASC Strategy evaluation

ACT Health Directorate requested the Policy Design and Evaluation (PDE) Team, Chief Minister Treasury and Economic Development Directorate (CMTEDD), undertake an evaluation of the TASC Strategy in March 2021. An evaluation approach with process, implementation and impact evaluation components was developed and will soon be released by the ACT Minister for Health.

• Nurses and Midwives Towards a Safer Culture Strategy Evaluation Report

Stakeholder engagement

• World Café Report
• A Year in Review TASC Steering Committee Presentations highlighting 2020 and 2021
• TASC Overview Presentation

The TASC Project Team have engaged in a variety of forums to brief and consult with key stakeholders on the priority actions of the TASC Strategy, including:

• World Cafe
• ACT Nursing and Midwifery Network Leaders Meeting
• Culture Review Implementation Group
• Director General Forum
• Meetings with the Heads of Health Services
• Peak Carer and Consumer Bodies
• Work Health Safety Occupational Violence Community of Practice, CMTEDD
• ACT Public Advocate and Human Rights Commission
• Senior Nursing Forum Aged Care, St Andrews Village
• Health Services
  • New Graduates
  • Wards and Community Health Centres
  • Directors of Nursing and Midwifery Meetings
  • CHS OV Committee

Events

• Development, promotion and dissemination of TEN - The Essential Network for Health Professionals
  • The Black Dog Institute TEN – The Essential Network for Health Professionals is funded by the Commonwealth Government Department of Health and has been developed to help healthcare workers find resources and support to manage ‘burnout’ and maintain good mental health.
  • TEN flyer
  • TEN posters

Conferences

• ANMF Biannual Conference 2021
• Australian College of Nursing National Nursing Forum- 'Champions of Change'
• Australian College of Mental Health Nurses Conference 'Mental Health Nursing in a Climate of Change'
  • Held from 4 - 6 May 2022 at the JW Marriott Resort and Spa, Gold Coast. The TASC Project Team presented at the conference. View the draft program guide.
  • ACMHN Be Kind Campaign Conference
  • ACMHN Conference 2022 - Aiding the right response at the right time
  • ACMHN Conference 2022 - The Lone Ranger Creating Guidance for those working alone in the public health system
  • ACMHN Safewards Conference
• 2022 Comcare National Conference- 'Creating a Safer workplace together'
  • Held from 7 - 8 June 2022 at the National Convention Centre in Canberra. The TASC Project Team presented 'Towards a Safer Culture - The First Step'. View the program guide and presentation. 
• The National Nursing Forum- 'Nursing Leadership Unmasked'
  • Held from 17 - 19 August 2022 at the Darwin Convention Centre. The TASC Project Team presented 'Working Towards a Safer Culture for Nurses and Midwives'. View the presentation and poster.

Other

• Contributed to the Australian College of Nursing, Occupational Violence Taskforce, development of a Position Statement on Occupational Violence, launched in October 2021

The TASC Project Team welcome the opportunity to present and engage with individuals and organisations on aspects of the TASC Strategy and can be contacted at NM.SaferCulture@act.gov.au.

Implement a program of activities to develop and implement initiatives that address the issue of occupational violence in ACT public health workplaces, including the development of standards, guidelines and education and a community, consumer and carer information campaign.

Challenging Behaviour Guideline for ACT Health Services

The Guideline provides the framework for ACT public health care workers to manage and respond to challenging behaviours that if not addressed may result in occupational violence.

Isolated and Remote Worker Guideline

The Guideline supports ACT public health workplaces to identify, manage, and respond to risk when workers are located in isolated or remote work environments.

Safewards

The Safewards model and Interventions is an adaptable program of evidence-based nursing interventions that has been proven to be effective in reducing conflict and the use of containment (restrictive practices). These changes are important strategies for health care workplaces that are looking to reduce the occurrence and impacts of occupational violence (OV). Further, they support a broader culture change where respect, inclusion, and collaboration are embedded across workplaces.

ACT Health led the trial of the Safewards model and Interventions into ACT Public Health Services from January-June 2021.

• Safewards Model of Care Post Implementation Review

Managers Occupational Violence Incident Response Toolkit

Managing Occupational Violence (OV) is never easy, but with the correct support and guidance the process can be simplified. Staff look to their Managers for guidance on how best to respond and manage OV that occurs. This toolkit aims to help Managers recognise and respond to an OV incident, report an OV incident, support their teams and their own health and wellbeing, and engage staff in a review of the OV incident.

• Manager’s occupational violence incident response toolkit
  • Background - occupational violence factsheet 1
  • Manager’s OV incident response checklist - occupational violence factsheet 2
  • Occupational violence unpacked - occupational violence factsheet 3
  • Occupational violence psychological and physical trauma - occupational violence factsheet 4
  • Occupational violence triggers - occupational violence factsheet 5
  • Occupational violence risk identification and controls - occupational violence factsheet 6
  • Organisational barriers to practice change - occupational violence factsheet 7
  • Organisational responsibilities - occupational violence factsheet 8
  • Responsibilities when responding to an incident of occupational violence - occupational violence factsheet 9
  • Post Incident - make people or environment safe - occupational violence factsheet 10
  • Safety response - occupational violence factsheet 11
  • Recognising changes in workers’ wellbeing - occupational violence factsheet 12
  • Supporting others using the RUOK? model - occupational violence factsheet 13
  • Assessing your capacity to support workers’ wellbeing - occupational violence factsheet 14
  • Psychological first aid - occupational violence factsheet 15
  • Employee Assistance Program - occupational violence factsheet 16
  • Supporting self-care - occupational violence factsheet 17
  • Creating a self-care plan - occupational violence factsheet 18
  • Debriefing - occupational violence factsheet 19
  • Workers’ compensation - occupational violence factsheet 20
  • Support services - occupational violence factsheet 21
  • Resources - occupational violence factsheet 22
  • RiskMan reporting - occupational violence factsheet 23
  • Police engagement process post OV incident - occupational violence factsheet 24

Increased OV Visibility across organisation

The Incorporating WHS into Team Meetings information sheet was developed to assist managers, health and safety representatives (HSRs) or staff members to effectively develop and communicate WHS content for team meetings.

Staff Rights to a Safe Workplace Factsheet

Developed to improve staff understanding of their rights to a safe workplace and the help them better identify and report unacceptable behaviours.

• CHS Staff Rights to a Safe Workplace factsheet
• Calvary Staff Rights to a Safe Workplace factsheet
• ACT Health Staff Rights to a Safe Workplace factsheet

Community Awareness Campaign

Launched by the Minister for Health, the “Be Kind and Respectful to our Nurses and Midwives” campaign uses a story telling approach to inspire understanding and engage emotions by building  on the community’s appreciation for the valuable work nurses and midwives do and highlighting the impact of unacceptable behaviour on their capacity to provide care.

Statement of Mutual Expectations

Designed to be communicated with consumers when they engage with ACT public health workplaces, identifying how consumers and healthcare staff can best work together to reduce incidents of occupational violence.

• Mutual expectations for consumers, healthcare staff, students and volunteers

Aimed at developing new, or strengthening existing, practices, policies and guidelines that reduce or prevent bullying and/or harassment. Includes a focus improving leadership and developing and implementing workplace civility measuring and management guidelines.

Achieved with ongoing collaboration with the Culture Review Implementation Branch of the ACT Health Directorate to implement shared recommendations from the Independent Review into the Workplace Culture within ACT Public Health Services and the deliverables of the NM TASC Strategy.

*The Culture Review Implementation remit is to build positive workplace culture across the ACT public health system. This multiyear program is an evidence-based best-practice design structured to deliver ongoing long-term, positive results.

Embed best practice guidelines in the development of safe work practices, to ensure ACT health workplaces embed safe workplace design principles in new builds and redevelopment of workplaces. 

Nurse/Midwife-to-Patient Ratios

The Ratio Framework outlines safe work practices (e.g., the way that work is performed including the organisations vision/values, policies, procedures and guidelines which underpin work delivery).

The Ratio Framework has informed the commitment of the ACT Government to implement mandated minimum Nurse/Midwife-to-Patient Ratios in 2021/22.

Strengthening Rostering and Leave Allocation

The Discussion Papers and Review of Schedule 8 collectively present evidence-based guidance and recommendations to strengthen ACT public health services rostering practices and future staffing models in the context of improving nursing and midwifery safety.

• N & M Towards a Safer Culture Review 8 v2
• N & M Staffing Models Discussion Paper
• N & M Strengthening Rostering and Leave Allocation Guidelines Discussion Paper

Embedding Safe Workplace Design

Safe design includes consultation with nurses and midwives in the design phase of new builds and refurbishments as well as incorporation of reduction of occupational violence concerns as a key element in the design phase and adherence to the Australasian Health Facility Guidelines.

These documents are owned by the Infrastructure and Health Support Services, CHS and  have been strengthened with extensive consultation and input received by the TASC Steering Committee and other key infrastructure stakeholders. These have been shared, with permission, to all ACT health workplaces to create a consistent approach to consultation with end users when commencing any new build or refurbishment.

If you would like access these documents, please contact NM.SaferCulture@act.gov.au.