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We worked with regulators to reimagine their engagement approach and drive better patient safety outcomes

Our Work | Case Study

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The Australian Health Practitioner Regulation Agency (Ahpra) and the Nursing and Midwifery Board of Australia (NMBA) safeguard Australians when they receive healthcare, including through regulating the nursing and midwifery professions.

Regulators were seeking to connect with employers

There are more than 475,000 nurses and/or midwives across Australia in settings including hospitals, residential health care and midwifery group practices. To do their job effectively, Ahpra and NMBA need good engagement with employers of all healthcare workers.

They asked us to work with them to develop an engagement strategy to better reach and connect with employers so they can work together for public safety.

Engagement involves more than communicating or distributing information. It is a tool to share insights about risks in the healthcare system, to help ensure the delivery of safe clinical care, and to build knowledge, confidence and competence to meet regulatory requirements.

It also draws on expertise from different sources to better identify and manage risks and ultimately contribute to safe and quality outcomes for the public.

Good engagement relies on deeply understanding:

  • when engagement is valuable for different parties
  • what information needs to be shared
  • attitudes and expectations about engagement
  • stakeholder needs and preferences, including formats, channels and timing to increase the likelihood of interaction
  • the existing landscape for engagement to avoid duplication of efforts and leverage existing channels.

We developed the strategy through human-centred design

Getting engagement right depended on the organisations understanding their regulator persona – that is, the posture they take and the way they relate to the entities they regulate. We worked with the organisations to help them understand what the posture of being a supportive and collaborative regulator would involve.

With that in mind, we supported the organisations to determine on whom they should focus their attention and what information stakeholders needed in order to understand their obligations and be confident and competent to manage risks to patient safety and care.

This work informed the engagement strategy, which we developed using human-centered design. This involved consulting with stakeholders across Ahpra and the NMBA, as well as with national, state and territory government agencies, such as Chief Nursing and Midwifery Officers. We co-designed with employers of nurses and midwives, including, hospitals, GP clinics and Aboriginal community-controlled health organisations, as well as peak bodies.

We developed an engagement strategy that included engagement principles, recommendations and an implementation roadmap. We supported the organisations to think deeply about how they should execute engagement in a way that was genuinely useful, fostered trust and reinforced their desired regulator persona.

The implementation roadmap organised activities across three time horizons (starting within three months, starting in three-to-six months, starting beyond six months), each with a clear goal, strategies and timeline.

The strategy is a blueprint for future activities

Our final insights report highlighted challenges, information needs and engagement preferences for employer groups, including differences for metropolitan, regional and remote communities, and different employer types.

Ahpra and NMBA are using the strategy as a blueprint for engagement activities over the next three years.

What you can learn from this project

Start with a focus on your objectives and regulatory posture, given a regulator who desires to be ‘punitive’ rather than ‘collaborative and approachable’ may have very different tone and approach to the way in which they engage.

Spend time understanding what information people need – some people seek to understand their responsibilities while others need to be convinced that the regulator is accountable as well.

Work out which priority groups you need to give special attention, as there can sometimes be a correlation between isolated stakeholder groups and risk.

Make good use of engagement intelligence by considering how the insights generated through two-way engagement can inform other regulatory activities.