Maximising left field career opportunities in your career
Associate Professor Amanda Rischbieth RN Grad Dip (Intens Care) MNSc PhD FGLF FAICD
Career chronology
• Left school after end Matriculation/year 12.. Age 16
• Carwash (casual)
• Myer (casual sales)
• Caltex (casual petrol attendant & mechanic assistant)
One conversation led to career choice….
• Royal Adelaide Hospital (nurse & ICU nurse)
• St Mary’s Hospital London (ICU nurse) …travel
• Wakefield Hospital (ICU Manager)… job‐share leap
• Wakefield Hospital (Resource Manager & student x 3)
• University of Adelaide (Lecturer & student)
• Calvary group (4 sites) (Director of research)
• Company Director (x5) author, business consultant/owner, entrepreneur, mentor, community leader
Parallel not linear
• Wakefield Hospital (ICU Manager)… job‐share leap + Post Grad study + HF Board 10 years
• Wakefield Hospital (Resource Manager & student) + University of Adelaide (Lecturer & phd student)
• Calvary group (4 sites) (Director of research) +
Company Director (x5) author, business consultant/owner, entrepreneur, mentor, community leader
Parallel not linear
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Governors Leadership Foundation (GLF) / PhD
ACCCN Board / Director of Research
Outcomes Australia / GLF Alumni / Climate change
Heart Foundation Treasurer / NFAC
SA Motor Sport Board
AICD CDC then Facilitation (Risk, Strategy & Board Reporting) and Fellow
Heart Foundation CEO / 4 directorships
SA Urban Renewal Authority
Queen Elizabeth Diamond Jubilee Trust
CI – NHMRC $1.8M Which II project [2013]
Collaboration with Prof Martin Seligman
Key left field opportunities
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Job‐share
Heart Foundation Treasurer
GLF
AICD
Outcomes Australia / Queen Elizabeth DJFT
CEO and Boards
http://news.bbc.co.uk/2/hi/uk_news/england/london/7168206.stm
Job sharing an ICU Nurse Manager role
Build an ICU – you have 13 weeks
ICU on a daily basis,
dynamic, never the
same...and then add
assorted emergencies/
resuscitation / complex
technology etc
• Traditional staffing models focus solely on labour hours
• E.g. ‘23 hours per patient day’.... Nurses are expensive...the costs are always scrutinised..yet skill and acuity are not accounted..
• So what happens when nhppd are ‘stable’ (under budget)....yet risk exposure is extreme from day to day?
It’s easy in ICU..one nurse and one patient...
Isn’t is that simple??...
60%
50%
40%
30%
20%
10%
0%
Always
Often
Sometimes
Rarely
Never
Unsure
How often is staff skill information available to Shift Lead Nurses who
make staffing decisions?
Rischbieth 2006
Other
Depends what support staff are available
Allocate least exper. nurse to sickest patient
Allocate most exper. nurse to sickest patient
Just allocate one nurse to one patient
Help from colleagues
Mandated hospital nursing hours
Mandated hospital nursing ratios
Mandated hospital dependency tool
Preset calculation (TISS)
Preset calculation (Excelcare)
Own system
Personal judgement
No system
0%
10%
20% 30%
40% 50%
How SLNs decide the nurse-to-patient
allocations for each shift
60% 70%
80% 90%
Existing systems
utilisation (hppd)
based - flawed
PhD led to development of a
decision support tool to map
and match skill to patient
acuity
Adverse events in
ICU decreased 80%
in pilot
= Patient outcome
and cost benefit
Commercialisation and
application to all areas of health
invited to test system in US and
AUS
Boys
• Mouthguards
• Washing machines
• How things can turn on a pinhead
Heart Foundation Strategy
The Facts
 Cardiovascular disease remains Australia’s most devastating killer, claiming 1 life every 11 minutes
 It adversely affects the quality of life of 1 in 6 people ‐ an astounding 3.38 million Australians
 The Heart Foundation seeks to reduce premature death from heart, stroke and blood vessel disease. Its work saves lives and improves health through funding world‐
class cardiovascular research, supporting health professionals, and promoting healthy lifestyles in the community McDonald’s …what were we thinking?
Public Health
Heart Foundation Chairman 2005
“I think you should be Treasurer, Amanda and sit on the National Finance Advisory Committee [$100m Balance Sheet]..”
Sponsorship vs Philanthropy
Sponsorship
Philanthropy
Objective
To sell more products/services; to increase
positive awareness in markets and among
distant stakeholders.
To be a good corporate citizen; to enhance
the corporate image with closest
stakeholders
Partner / Recipient
Events; teams; arts or cultural organizations,
projects, programs.
Typically cause-related, but can also be
cultural, artistic, or sports- related. Funding
may be designated for a project, program or
operating budgets.
Funding Source
Typically from marketing, advertising, or
communications budgets.
From charitable donations or philanthropy
budgets.
Accounting
A full business expense, like promotional
printing or media placement expenses. As a
result of write-offs, limited to 75% of net
income.
Accounting/tax considerations less likely to
influence the way a company designates
funding.
Publicity
Highly public.
Generally, little widespread fanfare.
Where the money goes …
Sports get the lion’s share of the sponsorship
dollars, likely more than 50%.
Education, social services, and health
sectors get 75% of charitable donations.
The Sponsorship Report; Philanthropy vs. Sponsorship What Gives? By Debra Kent Faulk; Published: January 2009
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The Outcomes Business Model
Research
Servicing Problems
$ Diluted Returns
Service Delivery
By giving
Contributors
Corporations
Small/Med Business
Private/HNW Politicians
Social responsibility
$
Good business
Community Benefits
• Fragmented
• Political Expediency
• Personal Agendas
Votes Individuals
Not‐for‐Profit Sector
Skills
Experience
Networks
SHARELIFE/
OUTCOMES
Compromised outcomes
Outcome Delivery
Solving Community Problems
• Best practice
• Uncompromised
• Outcome‐driven
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Cross functional team
Pro‐bono
Business principles
Leadership, creativity and innovation
Lessons from AOTA AC
2008 OECD Organ Donor Rates
7984
Source: Transplant Newsletter Vol 14 nº 1, September 2009
0
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
Donors per annum
Increase due entirely to DCD’s
MAT DONORS - TOTAL, BRAIN DEATH and CARDIAC DEATH
300
250
200
All Donors
150
DCD
BD
100
50
2007
2008
2009
2010
… yet Spain and US and others have increased donors
Donors per million people
40
If we had improved at Spain’s rate since
1989, we would have provided an extra
~20,000 transplants
Spain
30
US
20
10
Australia
0
89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06
Note: Reported US donors pmp not currently available however total US deceased donors declined from 7,593 in 2005
to 6,750 in 2006
Source: Spanish Ministry of Health and Consumption; Council of Europe; ANZODR; Organ Procurement and
Transplantation Network
Australia, France, Belgium, Netherlands, Spain & USA Stroke Deaths pCP
100.00
90.00
80.00
70.00
Australia
60.00
France
Belgium
50.00
Netherlands
40.00
Spain
USA
30.00
20.00
10.00
BENDORF
0.00
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
OECD Road Trauma Death Rates
35
30
25
Australia
Spain
20
France
Belgium
15
Italy
Portugal
Germany
10
5
0
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
BENDORF
IRODaT, 2008 Report
Build the business case, the role you want, and put yourself in it
Director of Research
NO SUCH POSITION EXISTED IN ANY OTHER PRIVATE HOSPITAL in SA – provided Calvary a market edge • The Director of Research (DoR) is responsible for facilitating all clinical research including the development and implementation of processes, governance and support systems for Calvary Health Care Adelaide (CHCA) hospitals.
• Ensures efficient/effective coordination of research.
• Fosters, coordinates and promotes research activity conducted by medical, nursing and allied health staff, and by other professional colleagues who have established formal relationships with CHCA.
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New interests
Climate Change Health Impacts
World Economic Forum Global Risks 2011 Sixth Edition An initiative
of the Risk Response Network
Engagement across the health community
Lancet/UCL Commission, May 2008
Modelled projections of warming, for six future greenhouse emissions scenarios
IPCC, Feb 2007: Wkg Gp I, Summary for Policy Makers
3 of the 6 GHG emissions scenarios
Potential error, to one SD
Warming in ‘pipeline’ from current GHG levels (~0.5oC)
A1F1
A2
1.8 ‐ 4.0 oC
A1B
B1
1980‐99 baseline
models
16‐21 models No. of used for each models
scenarioused
6 different GHG emissions scenarios
Projected Surface Temperatures in North America
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…The future will depend on the nature of human aspirations, values, preferences and choices…
Queen Elizabeth Diamond Jubilee Fund Trust
Three Key Causes of Blindness
39 million Blind
globally
1. Cataract
2. Trachoma
3. ARMD
Refractive
Error
Onchocerciasis
Glaucoma
Diabetic
Retinopathy
Others
Vitamin A
Deficiency
Treatable
Treatable & Preventable
Further Research Required
80% of blindness & vision loss can be prevented or treated
Source: The Elimination of Avoidable Blindness, Reaching the Goals of VISiON2020: The Right to Sight . Updated 2012 By Dr Richard Le Mesurier, Medical Director, The Fred Hollows Foundati
PART 2 - The Imperative - To eliminate
Trachoma
Where is Trachoma?
Close to Elimination
Countries
Algeria Libya
Mexico
Oman
Vietnam
High Burden countries
Burkina Faso
Ethiopia
Sudan
Southern Sudan Guinea
Kenya
Mozambique
Niger
Nigeria
Pakistan Senegal
Tanzania
Uganda
Zambia
Other countries
Afghanistan Australia
Benin
Botswana
Burundi
Cambodia
Cameroon
CAR
Chad
Cote d’ lvoire
Djibouti
Egypt
Eritrea
Fiji
Guatemala
Guinea Bissau
Iraq
Kiribati
Lao
Mali
Malawi
Mauritania
Myanmar
Nambia
Nauru
Nepal
Papua NG
Solomon Is
Somalia
The Gambia
Togo
Vanuatu
Yemen
Zimbabwe
Lessons I’ve learned
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Think parallel not linear
Get credit & credibility by giving it to others
Responsibility should be taken not given Offer to do the difficult/challenging tasks
Find fast track parallel solutions to career leap
Say yes … then follow through
Think about the second question… not just the first
Ask more questions than you get asked
Your leadership effectiveness is influenced by insight into your own work Turn obligations into advantages Support peer efforts ‐ coaching, feedback, role modeling to assist others
Acknowledge when you are wrong or ‘get it wrong’
Reflect…Use it to grow..
Find mentors and value volunteering
Self knowledge/reflection
• Who/what are you as an organisation
– Who are you?
– What do you do that’s unique or different?
– Why do you do what you do? – How do you do what you do?
• Elevator speech – 3 minute exercise
• Asset Audit
– What are you key assets or “package‐able” programs/events
• Asset valuation and benchmarking
– How valuable is your asset to the marketplace vs how many $$ do we need to run the event/program
– More this afternoon….
Thank you