Adaptive lasting change: in-house organisational capacity building in remote and Aboriginal health

Abstract:

Learning objectives and outcomes relevant to aims: Awareness of the known challenges of project implementation Identification of relevant seminal literature underpinning organisational capacity building Understanding how integrating Reconciliation Action Plans with organisational capacity building strategies leads to sustainable adaptive change; inclusive workplaces; and culturally proficient service delivery. Understanding the importance of innovation in obtaining cross-organisational ‘buy-in’: Case study approach Evidence that the practice achieved its objectives: Increased staff satisfaction amid change and uncertainty; reduced turnover rate; Increased proportion of staff identifying as Aboriginal and/ or Torres Strait Islander 25% to 32% of total workforce in six months; and increased productivity and efficiency. Practical implications: Rapid and frequent reform to health; aged care and disability services has led to increased contestability; short-termed funding agreements; and increased funding and job uncertainty. Organisations such as North and West Remote Health as a not for profit company limited by guarantee has responded by seeking to increase organisational capacity through a long-term in-house approach to increasing efficiency, cultural proficiency and workforce development in remote and Aboriginal primary health care. Originality and innovation Integrating the NWRH Reconciliation Action Plan (ratified by Reconciliation Australia) with an organisation capacity building strategy. Adopting an internal sustainability approach through an in-house train-the-trainer program. Obtaining buy-in through an Expression of Interest approach across the whole organisation with criteria based upon cross-level representation; cross-region representation; and cross-cultural representation. Preparedness to listen to confronting feedback as an executive and board group; and facilitating cross-site travel for face-to-face meetings. Avoiding off-the-shelf products. Lessons learned: The fundamental lesson is the need to take a long-term approach through an in-house train-the-trainer model for organisational learning and sustained improvement in staff retention. We have learned the practical importance of agile project management methodology and the importance of obtaining board and executive support and commitment. Implementation is challenging and Implementation science as a new area of research has subsequently been identified as applicable to this project and will be considered in future stages.