The Collective Question: Measuring behaviours in Public Health

Friday, May 15, 2020 at 11:43:21 AM GMT+10:00

WATCH: We speak to Michelle McKay, COO, Top End Health Service about measuring behaviours in the rapidly changing Public Health sector.


In the latest episode of The Collective Question series we speak to Michelle McKay, COO of the Northern Territory's Top End Health Services (TEHS), which provides health services to 70% of the Northern Territory’s population. TEHS includes Royal Darwin Hospital, Palmerston Regional Hospital, Katherine Hospital, Gove Hospital, Top End Mental Health Services and various other remote health clinics. 


Discussing how the health sector is coping under the strenuous circumstances of COVID-19 and the rapidly changing conditions, McKay says that the front line staff are being challenged as they do their best to “work in ambiguity”. Explaining this concept further, McKay highlights the need for agility and adaptability, especially considering the time restraints. The health sector no longer has the “luxury of time”, she says, and is having to pivot due to the “need for speed over perfection”.


McKay describes the workplace culture of health as a “siloed culture” where people gravitate into hierarchical groups. This presents a challenge for the sector, especially in placing the patient at the centre of care. Breaking culture down into both behaviours and values, McKay notes that often these two sides to the same coin are not aligned in the sector. Health workers may have “quite passionate rhetoric” about the value systems that they represent without these values translating into their workplace behaviours. 


In managing behaviours in order to align them to organisational values, McKay tells us that it is critical to be clear and articulate about the types of behaviours that are key to delivering workplace goals. In her experience working with the UK’s NHS Trust as it underwent a cultural change program, she watched an organisation transform by managing and measuring 4 explicitly defined workplace behaviours:


“By being able to demonstrate and articulate within teams and within workplaces how they would apply those behaviours  to improve the patient outcomes, it brought people together...”


Within 6 months, McKay noticed some cultural change starting to take place, and after a year, “fundamental change” was determined by a quality regulator assessment and by patient care metrics. 


In her current role at TEHS, McKay is focussing specifically on the leadership team and how they collectively work together “in a way that adds value”. The healthcare sector, despite understanding “the criticality of culture”, has been unsuccessful in evolving its culture to that of a collective, until this current COVID-19 crisis has demanded it. 


“This circumstance meant that there was no option for people not to engage in the change, because we suddenly had this much greater driver than what my own personal view about this might be.”


Naming accountability as the “only thing really that matters”, McKay highlights that personal accountability to demonstrate individual behaviours is “grounding” and critical to long lasting change. Reflecting on the changes to ways of working and the new systems that have been put into place, McKay aspires to not only maintain those but to continue to improve. The challenge now is to ensure that the cultural and behavioural learnings from the current pandemic are embedded into the structures of the organisation to allow this fundamental shift to continue on the other side of the crisis.


By Velvet-Belle Templeman, Boardroom.Media

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