Expert Panel - Review of Elective Surgery and Emergency Access Targets under the National Partnership Agreement on Improving Public Hospital Services: Supplementary Annexure
3.8 Engagement and Communication
Stakeholder Views
Clinical engagement and leadership at the local level were considered crucial to avoiding perverse outcomes and countering gaming. Many stakeholders stressed that engagement needs to occur as early as possible in the reform process. As mentioned previously, stakeholders believed that allocating responsibility to the Expert Panel for ensuring an evidence-based approach to implementation would go a long way to improving engagement as it would help to foster the understanding that these are initiatives aimed at improving the safety and quality of patient care.It was noted that engaging stakeholders should involve a tailored communication strategy, stakeholder inclusion on hospital or Local Hospital Network (LHN) implementation teams, and the creation of targeted feedback mechanisms for these stakeholders. Clinician engagement would be enhanced by assurances that achieving data comparability and consistency is a key priority in the reform process – in particular to ensure the integrity of the process for determining reward/incentive funding.
While most clinicians were aware of ‘some kind of targets’, some expressed limited specific knowledge of the categories or timelines. Stakeholders acknowledged that clinicians working outside emergency departments are likely unaware of the new targets. It was noted that, given the consensus that access improvements necessitate hospital-wide reform, this awareness gap would need to be addressed.
The framing of the targets and their implementation as a quality of care issue have the potential to overcome much of this clinician concern and generate support among stakeholders. Messages need to focus on the patient and best clinical outcomes, not simply target numbers. Clinicians and other stakeholders were anxious for assurance that quality monitoring will accompany these reforms.
Communication should aim to distinguish the current emergency department target from its NHS counterpart, emphasising the lessons that have been learned, including the need to set the target at a safe level (not 98 per cent) and the need for the emergency department target to be just the headline of a suite of safety and quality indicators from the outset of the process.
Consumer Views
Consumers’ reactions to the targets suggested that there is little reason to expect publicising targets will lead to increased confidence in the health system. Rather, there was a high degree of scepticism towards planned or intended targets. Consumers viewed much more favourably information about tangible changes. Prospectively, this meant publicising information about increased resourcing and support for service improvements, and retrospectively in terms of actual improvements that have been achieved to date.Of greatest importance to them was information pertaining to their own health care experiences. The great fear of consumers was of being forgotten or overlooked while waiting for care – either in an emergency department or on an elective surgery waiting list. Where possible, consumers want to be given a reasonably accurate indication of how long they might be expected to wait. However, failing this, being regularly assured that they are still in line for treatment, and that a clinician is checking their condition is not deteriorating in the meantime, were seen as the minimum communication that consumers expect. Aspects of communication that were most important to consumers included that it be directly from a clinician, that it be regular to reassure them that they had not been overlooked, and that it be respectful.
