Voice of the Clinician: the case of an Australian health system

Abstract

PurposeThe Voice of the Clinician project commenced during an era when practitioner burnout, dissatisfaction, and turnover became an increasingly global health workforce concern. One key problem is clinical staff not being empowered to voice their concerns to decision-makers, as was found in this case study of an Australian public health organization. The following research question informed the present study: What is a better committee system for clinician engagement in decision-making processes? The paper aims to discuss this issue.Design/methodology/approachThe Mid North Coast Local Health District in New South Wales aspired to improve engagement between frontline clinicians and decision-makers. Social network analysis methods and mathematical modeling were used in the discovery of how committees are connected to each other and subsequently to other committee members.FindingsThis effort uncovered a hidden organizational architecture of 323 committees of 926 members which overall cost 84,729 person hours and AUD$2.923 million per annum. Furthermore, frontline clinicians were located far from centers of influence, just 37 percent of committees had terms of reference, and clinicians reported that meeting agendas were not being met.Practical implicationsIn response to the findings, a technological platform was created so that the board of directors could visually see all the committees and the connections between them, thus creating ways to further improve communication, transparency of process, and – ultimately – clinician engagement.Originality/valueThe breakthrough idea is that all organizational meetings can be seen as a system of engagement and should be analyzed to determine and describe the points and pathways where clinician voice is blocked.

The effects of leaders’ abusive supervision on employees’ work engagement: a moderated-mediation model of employees’ silence and employees’ proactive personalities

“…Organisations should provide active channels of communication for health employees to report abuse. According to Lock et al (2017) health-care organisations need to identify pathways where clinicians’ voices are blocked. Grievance procedures should be spelt out to help employees to voice out.…”

The Link between Environment and Organizational Architecture for Decision-Making in Educational Institutions: A Systemic Approach

“…Our subsequent hypothesis delves into the potential of OE and associated technologies to enhance Market Performance [29,30]. Simultaneously, OA technologies improve productivity, resource efficiency, and decision-making [31,32]. Hypothesis H4: Decision-Making mediates the relationship between Organizational Architecture and Market Performance leading to an improvement in MP.…”

“I feel I have no voice”: hospital doctors' workplace silence in Ireland

“…Learning from the voices of frontline staff is key for responsive health services and competitive healthcare organisations and is particularly important in the context of the COVID-19 pandemic where healthcare systems and organisations need to act and learn as fast as possible ( Bohmer et al , 2020 ; Daphna-Tekoah et al , 2020 ). However, studies of health workers across the world show that their concerns can often go unheard or unexpressed ( Hughes, 2019 ; Landgren et al , 2016 ; Lock et al , 2017 ). This research builds on existing work on organisational voice in a healthcare context, examining the reasons why hospital doctors in Ireland are reluctant to voice their concerns about their working conditions.…”