Discussion
The success of the project was dependent on Prison Health Service staff engagement and expertise to implement complex change management within their service. The Prison Health Service face challenges in that care is delivered in a Queensland Corrective Services facility with all prisoner (patient) movements carefully managed. This impacts on Prison Health Service's ability to deliver healthcare.
Lessons learned were that effective communication and engagement with staff were key to successfully implementing complex change management. The strengths were the passion and commitment of staff to improve healthcare access for prisoners (patients), the weaknesses were the complex operating environment and infrastructure limitations, the opportunities were to engage with Prison Health Service staff as subject matter experts to identify solutions that would work within the constraints of their service delivery environment and to encourage Prison Health Service staff to think outside the status quo. In terms of what could be done differently, we would not underestimate the complexity, and magnitude of implementing change in a niche service such as the Prison Health Service.
The complexity of service, complexity of delivery environment and infrastructure restrictions impacted solution design and implementation, however through engagement with Prison Health Service staff as subject matter experts, these challenges were identified and where possible overcome.
This project was targeted to a very specific service delivery type, healthcare in adult correctional centres. In addition to this, the project preceded the rollout of the Prison electronic Medical Record (PeMR). In terms of the recommendations implemented and the outcomes, these would be limited within Queensland Health, however the lessons learned in implementing complex change management could be shared with other niche services within Queensland Health.
References
Project Management and Clinical Service Redesign Project Methodology
