How one development program changed everything for patients

21 Oct 2018

The missing piece of the puzzle 

Back in 2010, when we first started working with Lolita in the hospital’s emergency department, our team was making progress on our mission to build nursing capability and improve patient experiences. But it was hard, and we knew that, with the right leadership and political will, we could achieve so much more for the hospital’s nurses and patients.

The main problem? There was no director of nursing at the hospital. Despite nursing staff accounting for close to 50% of the hospital workforce, there was no dedicated nursing leadership.

Lolita had proven herself to be a natural leader in the emergency department and was passionate about her work – she had taken herself to Indonesia to earn her nursing degree and returned to establish herself as a respected Nurse Educator. And so, our team recommended the hospital’s leadership appoint Lolita as the hospital’s director of nursing and midwifery.

One little change with a huge impact

Initially, there was uncertainty among the hospital’s leadership team about whether they needed a nursing directorship role and whether Lolita, someone without any obvious leadership aspirations, was the right person for the job. Indeed, even Lolita doubted her suitability.

However, it soon became clear that Lolita was the perfect choice. She was as passionate about driving positive changes as we were, and she had the respect of her colleagues and the innate leadership skills required to make things happen.

With the support and guidance of our team on the ground in Timor Leste and back in Australia, Lolita embraced the huge challenge of her new role and initiated some big changes.

Some were initially unpopular. Some meant challenging the status quo. Some looked like they might not happen. But through a rare combination of tenacity and pioneering spirit, Lolita not only developed solutions to problems, but drummed up support at all levels – including with the Ministry of Health – to drive a series of initiatives and programs to fruition across the hospital.

Helping Lolita realise her potential

In addition to helping Lolita develop the processes and pathways to implement her change initiatives, we also developed the Executive Development Program just for her, starting with a six-pronged capability matrix, to help her grow into her directorship role.

Director of nursing and midwifery: Key capabilities:

• Leading for mission
• Professional practice
• Clinical leadership
• Leading people
• Quality management
• Financial and resource management

Lolita conducted an honest self-assessment against the six key capabilities, which enabled our team to create a tailor-made development program for her, comprising mentoring from our team in Timor-Leste, training workshops, masterclasses, academic study and a ‘director shadowing’ placement at St John of God Geelong Hospital in Australia.

Bringing the hospital’s values to life

With the dedicated support of our team in Timor- Leste and Australia, Lolita has made – and continues to make – major improvements in systems and healthcare delivery that are transforming the patient experience and saving lives.

Just as importantly, by promoting and affecting change at every level, Lolita has created a new, progressive culture at Hospital Nacional Guido Valadares that will ensure a new generation of nurses continue to improve healthcare delivery – a culture where the hospital’s values are no longer just words on a page, but lived and breathed by nurses throughout the hospital.

Key Impact: 

More nurses providing better patient experiences

With the knowledge and support Lolita gained from our team, she was able to successfully lobby for a major increase in nursing staff, boosting the nursing team by 140 (around a third) – another vital change that has transformed patient care.

Key Impact:

Hospital-wide bedside handovers

While normal in Australia, clinical handovers (where nurses transfer responsibility and accountability during shift changes, at each patient’s bedside) had never been part of the nurses’ role at Hospital Nacional Guido Valadares. This resulted in disjointed care and increased the risk of mistakes being made.

Now, thanks to Lolita, handovers are fast becoming standard practice throughout the hospital, with a recent audit showing clinical handovers happen at the bedside more than 90% of the time.