Textbook of Medical Administration and Leadership

Foreword
Acknowledgements
Contents
About the Editors
1: Making Sense of Healthcare
	1.1	 Introduction
	1.2	 Healthcare Delivery
	1.3	 Evidence-Based, Safe, Quality Health Care
	1.4	 Safe and Quality Healthcare Delivery in Complex Times
	1.5	 Leadership
	1.6	 Engagement and Values
	1.7	 Patient Engagement and Shareholder Value
	1.8	 Cultures that Support Safe Quality Healthcare
	1.9	 Measuring (Safety) Culture
	1.10	 Safety Culture Assessment Approaches and Modes
	1.11	 Diagnosing the Safety System
	1.12	 Crossing the Frontier of Competence
	1.13	 Conclusion
	References
2: Management and Medical Leadership
	2.1	 Introduction
	2.2	 Organisations and the Need for Management
		2.2.1	 The Evolution of Theories of Organisations
		2.2.2	 A Theoretical Framework for a Healthcare Organisation
	2.3	 Leaders and Managers
		2.3.1	 What Is in a Word?
	2.4	 Doctors and Leadership
	2.5	 Medical Leadership
	2.6	 Medical Leadership for Medical Engagement
	2.7	 Engaging Doctors in Leadership
	2.8	 The Case of Australian Doctors and Their Role in the Leadership and Management of Health Services
	2.9	 What Kind of Medical Leadership?
		2.9.1	 Systems Leadership
	2.10	 Role of the Manager
		2.10.1	 Healthcare Managers and Clinical Managers
	2.11	 Why Are Clinicians (Medical Practitioners) Hard to Manage?
	2.12	 Professional Control
	2.13	 The Clinical Manager
	2.14	 Coordinating the Patient Care Process
	2.15	 Inter-Professional Collaboration
	2.16	 Change Management
		2.16.1	 Frameworks of Planned Change
		2.16.2	 Planned Change in Health Care
		2.16.3	 Six Sigma and Lean Methods
		2.16.4	 Sustaining Change
	2.17	 Conclusion
	References
3: Continuing Professional Development
	3.1	 Introduction
		3.1.1	 Why Do CPD?
		3.1.2	 From CME to CPD
	3.2	 Effective CPD
		3.2.1	 Adult Learning and CPD
		3.2.2	 Reflective Practice in CPD
		3.2.3	 Measuring the Success of CPD Activities
	3.3	 Regulation of CPD
		3.3.1	 Reregistration, Revalidation, Recertification
		3.3.2	 CPD Providers and the Role of Professional Associations
		3.3.3	 Global Regulations
			3.3.3.1	 Regulation in Australia and New Zealand
		3.3.4	 CPD Programme Standards
		3.3.5	 Issues in Regulating CPD
	3.4	 CPD Activities
		3.4.1	 The Social Context of CPD
		3.4.2	 Professional Development Plan
		3.4.3	 Continuing Medical Education
			3.4.3.1	 Re-Examination
			3.4.3.2	 Targeted Learning
		3.4.4	 Assessing a Doctor’s Performance in Practice
		3.4.5	 The Measurement of Patient Outcomes
			3.4.5.1	 Identifying an Issue
			3.4.5.2	 Developing or Selecting Standards
			3.4.5.3	 Collecting Data
			3.4.5.4	 Analysing Results
			3.4.5.5	 Implementing Changes
			3.4.5.6	 Reauditing to Assess Success
	3.5	 Recertification and the Underperforming Doctor
	3.6	 Conclusion
	Further Reading
4: Medical Workforce Management
	4.1	 Credentialling and Defining Scope of Clinical Practice
		4.1.1	 Introduction
		4.1.2	 Policy Framework
		4.1.3	 Approaches to Defining the Scope of Clinical Practice
		4.1.4	 System for Credentialling and Defining Scope of Clinical Practice
			4.1.4.1	 Principles
			4.1.4.2	 Governance
			4.1.4.3	 Governing Body
			4.1.4.4	 Accountable Executive
		4.1.5	 Credentialling and Scope of Clinical Practice Committee (the Committee)
		4.1.6	 Policy and Procedure
		4.1.7	 Process of Credentialling and Defining Scope of Clinical Practice
		4.1.8	 Documentation
		4.1.9	 Information for Credentialling That Must Be Provided by the Medical Practitioner
		4.1.10	 Information Usually Required in Curriculum Vitae That Can Be Then Validated by Reference Checks
		4.1.11	 Declarations About Relevant Past Conduct and History
		4.1.12	 Recredentialling
		4.1.13	 Information Required for Recredentialling
		4.1.14	 Emergency Credentialling
		4.1.15	 Temporary Credentialling
		4.1.16	 Appeals Process
		4.1.17	 Process of Appeal
		4.1.18	 Introduction of New Technology or Clinical Practices: Implication for Credentialling
		4.1.19	 Review of Scope of Clinical Practice
		4.1.20	 Unplanned Review of Scope of Clinical Practice
		4.1.21	 Credentialling of Junior Medical Staff
	4.2	 Performance Enhancement or Performance Development
		4.2.1	 Multisource (360°) Feedback
		4.2.2	 The Performance Development Meeting
		4.2.3	 Setting Goals
		4.2.4	 Pitfalls in the Performance Enhancement Process
	4.3	 Performance Management
		4.3.1	 Factors Contributing to Underperformance
		4.3.2	 Health as a Contributory Factor of Underperformance
		4.3.3	 Health-Related Behaviours and Attitudes in the Medical Profession
		4.3.4	 Personality as a Contributory Factor to Underperformance
		4.3.5	 Work-Related Factors Contributing to Underperformance
		4.3.6	 Burnout as a Contributory Factor to Underperformance
		4.3.7	 Principles of Managing Underperformance
		4.3.8	 Process of Performance Management
		4.3.9	 Possible Outcomes of the Performance Management Process May Include
		4.3.10	 Conclusion
	4.4	 Appropriate Workplace Behaviour
		4.4.1	 What Is Inappropriate Behaviour?
		4.4.2	 Disruptive Behaviour
		4.4.3	 Factors Contributing to Disruptive Behaviour
		4.4.4	 Individual Factors
		4.4.5	 Environmental Factors
		4.4.6	 Other Types of Inappropriate Workplace Behaviour
		4.4.7	 Managing Inappropriate Behaviour
		4.4.8	 Conclusion
	4.5	 Managing Mental Health and Well-being of Doctors
		4.5.1	 Understanding Workplace Health and Well-being
		4.5.2	 Mental Health and Well-being of Doctors
		4.5.3	 Creating a Mental Health and Well-being Strategy
		4.5.4	 Support Employees with Mental Illness
		4.5.5	 Prevent Mental Illness in at Risk Employees
		4.5.6	 Protect Mental Health of Healthy Employees
		4.5.7	 Promote Mental Health and Well-being
		4.5.8	 Conclusion
		4.5.9	 Reflections
	References
5: Clinical Governance and Risk Management for Medical Administrators
	5.1	 Structures, Systems and Processes for Clinical Governance
		5.1.1	 Principles of Implementing Clinical Governance at a Health Service Level
		5.1.2	 Roles and Responsibilities
		5.1.3	 Clinical Governance Committee Structures
			5.1.3.1	 Board-level Clinical Safety and Quality Committee
			5.1.3.2	 Executive Level Quality and Safety Committee
			5.1.3.3	 Cross Organisation Quality and Safety Committees
			5.1.3.4	 Division Level or Unit Level Quality and Safety Committees
		5.1.4	 Enablers of Exemplary Clinical Governance
		5.1.5	 Data Management to Support Clinical Governance
			5.1.5.1	 Key Performance Indicators
		5.1.6	 Benchmarking
		5.1.7	 Implementing a Clinical Governance System
		5.1.8	 An Integrated and Consistent Approach to Clinical Governance
		5.1.9	 A Specific Comment on Accreditation for Medical Administrators
		5.1.10	 Clinical Risk Management for Medical Administrators
		5.1.11	 Risk Register
		5.1.12	 Policies and Procedures
		5.1.13	 Incident Management System
		5.1.14	 Sentinel Event Reporting
		5.1.15	 Clinical Review Panels
		5.1.16	 Legislative Compliance
		5.1.17	 Medico-Legal
		5.1.18	 Complaints or Concerns About Clinicians
		5.1.19	 External Reviews
	5.2	 The Medical Administrator as the Executive Oversight for Clinical Governance
	5.3	 Areas of Clinical Governance with Relevance for Medical Staff
		5.3.1	 National Standards
		5.3.2	 Clinical Audit
		5.3.3	 Clinical Unit-Based Morbidity and Mortality
		5.3.4	 Clinical Registries
	5.4	 Medical Engagement in Clinical Governance
		5.4.1	 Senior Medical Staff
		5.4.2	 Junior Medical Staff
		5.4.3	 Committee Involvement
	5.5	 The Inter-Relationship of Clinical Service, Scope of Practice and Patient Outcomes
		5.5.1	 Links Between Evidence-Based Measurement and Quality Improvement
		5.5.2	 Ready Reckoner
	References
		Further Reading
6: Data in Healthcare and Quality Improvement
	6.1	 Introduction
	6.2	 What Is Data?
	6.3	 Types of Data
	6.4	 Data Sources and Storage
	6.5	 Data Provenance and Data Quality
	6.6	 Data and Learning Loops
	6.7	 Data and Information
	6.8	 Data and Multi-Disciplinary Teams
	6.9	 Data and Quality Improvement Tools
		6.9.1	 Pareto Chart
		6.9.2	 Last 10 Patients Data Collection Tool
		6.9.3	 Run Chart
	6.10	 Statistical Process Control (SPC) Chart
	6.11	 Quality Improvement in Healthcare
	6.12	 Quality Improvement and Data
	6.13	 QI in Health: Methodologies
	6.14	 Quality Improvement, Data, Information and Decision Making for Health Leaders
	6.15	 Statistical Process Control Charts (SPC)
	6.16	 Astronomical Data Point
		6.16.1	 Shift
		6.16.2	 Trends
	6.17	 Quality Improvement Challenges and Systems Thinking
	6.18	 Summary
	References
7: Strategic Planning in Healthcare
	7.1	 What Is Strategic Planning and Why Is It Important?
	7.2	 Governance of the Planning Process and Confirming the Vision, Mission and Values of the Organisation
	7.3	 Reviewing the Previous Plan
	7.4	 Developing a New Strategic Plan
		7.4.1	 Models for Strategic Planning
		7.4.2	 Stakeholder Engagement and Input
		7.4.3	 Tools to Support the Development of a Strategic Plan and Its Related Goals
		7.4.4	 Development of Goals and Objectives
		7.4.5	 Alignment with Organisational Plans and Operations
	7.5	 Implementation of the Strategic Plan
		7.5.1	 Communications and Launch
		7.5.2	 Monitoring and Reporting on the Strategic Plan
	7.6	 Key Success Factors for Strategic Plans in Health and Why Strategic Plans Fail
	7.7	 Reflections and Things to Try
	References
		Further Reading
8: Clinical Service Planning
	8.1	 Introduction
	8.2	 Definitions
	8.3	 Regulatory, Policy and Funding Context
	8.4	 The Governance and Process of Clinical Services Planning, Include the Involvement of Key Stakeholders
		8.4.1	 Governance of Planning Process
		8.4.2	 Planning Guiding Principles
		8.4.3	 Evaluation of the Current State
		8.4.4	 Understanding Future Clinical Service Requirements
		8.4.5	 Consultation Process
		8.4.6	 Defining Future Models of Care
		8.4.7	 Prioritisation
	8.5	 The Key Internal and External Information Required Including Key Factors Such as Self-Sufficiency, Capacity, Capability Frameworks and Models of Care
		8.5.1	 Current Clinical Service Profile of Health Service
		8.5.2	 External Context
		8.5.3	 Planning Frameworks and Data
		8.5.4	 Determining Self-Sufficiency
		8.5.5	 Determining Capacity
		8.5.6	 Capability Frameworks
		8.5.7	 Future Model of Care
			8.5.7.1	 Model of Care Components
		8.5.8	 Support Service Planning
	8.6	 Finalisation and Implementation of Plan
		8.6.1	 Site Planning
		8.6.2	 New Facility Capital Planning
	8.7	 Clinical Service Planning: Introduction of a New Technology or Clinical Service
	8.8	 Conclusion
	References
9: Health Policy and Advocacy
	9.1	 Objectives
	9.2	 What Is Health Policy?
	9.3	 Values, Vision, Politics, and Ideology
	9.4	 Policy Development
	9.5	 Non-Health Policies and Healthcare
	9.6	 Culture and Policies
	9.7	 The Role of Government and Interest Groups in Setting the Health Policy Agenda
	9.8	 Developing Health Policy
	9.9	 Implementation of Government Policy
	9.10	 The Medical Leader, Policy and Policy Implementation
	9.11	 Advocacy
	9.12	 Advocacy as a Medical Competency
	9.13	 Advocacy Training
	9.14	 Advocacy Toolkits
	9.15	 Advocacy in the Age of Social Media and Misinformation
	9.16	 Media Training for Medical Administrators
10: Health Crisis Planning
	10.1	 Introduction
		10.1.1	 Definition
		10.1.2	 Terminology
		10.1.3	 Principles
	10.2	 Health Planning
		10.2.1	 Legal and Ethical Framework
		10.2.2	 State and National Emergency Management Organisations
	10.3	 Comprehensive Emergency Management
		10.3.1	 Prevention
		10.3.2	 Preparedness
			10.3.2.1	 Surveillance
			10.3.2.2	 Hospital Preparedness
			10.3.2.3	 Personal Protective Equipment
			10.3.2.4	 Surge Capacity
			10.3.2.5	 Communications
			10.3.2.6	 Training
		10.3.3	 Response
			10.3.3.1	 Coordination
			10.3.3.2	 Triage
			10.3.3.3	 Patient Identification and Tracking
			10.3.3.4	 Decontamination
			10.3.3.5	 Hospital Response Teams
			10.3.3.6	 National Teams
			10.3.3.7	 Emergency Department Management
			10.3.3.8	 Hospital Management
			10.3.3.9	 Radiology and Laboratory Services
			10.3.3.10	 Paediatric Patients
			10.3.3.11	 Burns Patients
			10.3.3.12	 Infection Control, Isolation, and Quarantine
			10.3.3.13	 Mental Health
			10.3.3.14	 Mass Fatalities
			10.3.3.15	 Other Issues—Volunteers, Public Communication, Security
		10.3.4	 Recovery
	10.4	 Other Issues
		10.4.1	 Media Management
		10.4.2	 Special Considerations—Chemical, Biological, or Radiological
		10.4.3	 Other Events—Internal Failures, Contamination, and Shortages
		10.4.4	 Business Continuity Planning
	10.5	 Aftermath
	10.6	 Reflections
	References
		Further Reading
11: Health Economics, Healthcare Funding including Activity-Based Funding: What a Medical Manager Needs to Know
	11.1	 Introduction
		11.1.1	 Board-Level Reporting
	11.2	 Health Economics
		11.2.1	 Healthcare as a Luxury Item
		11.2.2	 Healthcare Expenditure Growth Over Time
			11.2.2.1	 The Economic Impact of Artificial Intelligence, Robotics and Automation
		11.2.3	 International Comparisons
			11.2.3.1	 Data Sources
		11.2.4	 Public vs Private
		11.2.5	 Value = Quantity and Quality
			11.2.5.1	 Historical References: It’s Not New!
			11.2.5.2	 Value-Based Healthcare
			11.2.5.3	 “Low Value” Care
		11.2.6	 Insurance Pooling and “Universal” Healthcare
			11.2.6.1	 Individual Patient Payment
			11.2.6.2	 Provider-Based Funders
			11.2.6.3	 Health Maintenance Organisations (HMOs)
			11.2.6.4	 Insurance Separate from Provider
			11.2.6.5	 Single-Payer “Universal” Healthcare
	11.3	 Health Funding/Revenue Models
		11.3.1	 Funder and Provider Aggregation
		11.3.2	 “Intermediate Products” and the “Vending Machine” Metaphor for Healthcare Production and Funding
		11.3.3	 The Five Funding Models
			11.3.3.1	 Aside: The “Zombie” Options
		11.3.4	 Funding Models Vs. Purchasers
			11.3.4.1	 Funding the Funders
			11.3.4.2	 Providers as Purchasers?
			11.3.4.3	 Summary
	11.4	 ABF: A Deeper Dive
		11.4.1	 ABF History
			11.4.1.1	 New Zealand
			11.4.1.2	 Australia
		11.4.2	 Four Criteria for a DRG System
		11.4.3	 ICD-10-AM Coding
		11.4.4	 ABF: The Fundamentals
			11.4.4.1	 Episode Volume
			11.4.4.2	 Current Australian Classification Systems
			11.4.4.3	 Cost and Revenue Weightings
			11.4.4.4	 Outliers as Equivalent Inliers: Acute Care
			11.4.4.5	 Output Measure: WIES Becomes WAU
		11.4.5	 Private Practice in Public Facilities: An IPBF Fly in the ABF Ointment?
		11.4.6	 NEC and NEP
		11.4.7	 Activity-Based Funding Calculation
		11.4.8	 AR-DRGs
			11.4.8.1	 Structure and Nomenclature
			11.4.8.2	 Splits
		11.4.9	 The Importance of Good Documentation
	11.5	 Conclusions and Summary
	11.6	 Further Reading
	References
12: Managing Budgets, Costs, and Variances: A “How-to” Guide for Medical Managers
	12.1	 Introduction
	12.2	 Funding Versus Budgeting
		12.2.1	 A Budget Is Just a Plan
		12.2.2	 Private Sector Funding
		12.2.3	 Public Sector Funding and Budgets
		12.2.4	 A Typical (Annual) Budgeting Process
		12.2.5	 Variance Reporting
		12.2.6	 Tips for Medical Managers
	12.3	 Expenditure-Based Funding (EBF)
		12.3.1	 Financial Risks for the Provider Under EBF
			12.3.1.1	 Labour Vs. Non-labour
			12.3.1.2	 Leave Liabilities
		12.3.2	 Quality Risks to Be Managed Under EBF
		12.3.3	 Reporting Systems Required to Manage Under EBF
	12.4	 Intermediate Product-Based Funding (IPBF)
		12.4.1	 Financial Risks for the Provider Under IPBF
		12.4.2	 Quality Risks to Be Managed Under IPBF
		12.4.3	 Reporting Systems Required to Manage Under IPBF
	12.5	 Activity-Based Funding (ABF)
		12.5.1	 Financial Risks for the Provider Under ABF
		12.5.2	 Quality Risks to Be Managed Under ABF
		12.5.3	 Reporting Systems Required to Manage Under ABF
	12.6	 Condition-Based Funding (CBF)
		12.6.1	 Financial Risks for the Provider Under CBF
		12.6.2	 Quality Risks to Be Managed Under CBF
		12.6.3	 Reporting Systems Required to Manage Under CBF
	12.7	 Population-Based Funding (PBF)
		12.7.1	 Financial Risks for the Provider Under PBF
		12.7.2	 Quality Risks to Be Managed Under PBF
		12.7.3	 Reporting Systems Required to Manage Under PBF
	12.8	 Navigating the Clinical Map of Value
		12.8.1	 Generic Approaches to Managing Variances
		12.8.2	 Obtain a Full Set of Reports
		12.8.3	 Request Benchmark Data
		12.8.4	 Explore all Budget/Revenue Opportunities
		12.8.5	 Review Expenditure
		12.8.6	 Maintain Quality
	12.9	 A Medical Administrator’s “How to” Guide to Managing Cost and Revenue Variations
		12.9.1	 How to Optimise EBF Budgets/Revenue
		12.9.2	 How to Manage EBF Cost Drivers
		12.9.3	 How to Optimise IPBF Budget/Revenue
		12.9.4	 How to Manage IPBF Cost Drivers
		12.9.5	 How to Optimise ABF Budget/Revenue
		12.9.6	 How to Manage ABF Cost Drivers
		12.9.7	 CBF and PBF Variances
		12.9.8	 How to Optimise CBF or PBF Budget/Revenue
		12.9.9	 How to Manage CBF- and PBF-Type Cost Drivers
	12.10	 Conclusions and Summary
	References
13: Health Law and the Specialist Medical Administrator
	13.1	 Introduction
	13.2	 Part 1: Patient Care
		13.2.1	 Adverse Events, Negligence, and Complaints in Health Care
			13.2.1.1	 Adverse Events
			13.2.1.2	 Negligence
				Duty of Care
				Standard of Care
				Damage and Causation
				Compensation
			13.2.1.3	 Disclosure of Adverse Events
			13.2.1.4	 Independent Health Care Complaints Entities
		13.2.2	 Consent to and Withdrawal of Medical Treatment
			13.2.2.1	 General Issues of Consent and Capacity
			13.2.2.2	 Advance Care Directives
			13.2.2.3	 Substitute Decision Making
			13.2.2.4	 Withdrawal of Treatment
		13.2.3	 Voluntary Assisted Dying
		13.2.4	 Organ Donation
		13.2.5	 Wills
		13.2.6	 Statutory Declarations
		13.2.7	 Reporting Deaths to the Coroner
		13.2.8	 Child Abuse Mandatory Reporting
	13.3	 Part 2: Professionals
		13.3.1	 Registration of Medical Practitioners
		13.3.2	 Notifications Under the National Law
		13.3.3	 Credentialling and Defining Scope of Clinical Practice
		13.3.4	 Medical Indemnity Insurance and Claims Management
		13.3.5	 Professional Standards Applying to Medical Administrators
	13.4	 Part 3: Organisations and Systems
		13.4.1	 Service Standards and Accreditation
		13.4.2	 Medical Records
		13.4.3	 Privacy and Health Records Legislation
		13.4.4	 Access
		13.4.5	 Qualified Privilege/Statutory Immunity
		13.4.6	 Whistleblower Legislation and Protections
		13.4.7	 Anti-competitive Legislation
		13.4.8	 Workplace Relations
		13.4.9	 Workplace Health and Safety
		13.4.10 Human Rights Legislation
		13.4.11 Bullying and Harassment
		13.4.12 National Agreements
		13.4.13 National Healthcare Agreement
		13.4.14 National Health Reform Agreement
	13.5	 Ready Reckoner
		13.5.1	 Patient Care
		13.5.2	 Professionals
		13.5.3	 Organisations and Systems
	References
14: Private Health and Insurance
	14.1	 Introduction
	14.2	 Private Hospitals in Australia
		14.2.1	 Value Proposition for Private Hospitals
		14.2.2	 Characteristics
		14.2.3	 Activity
		14.2.4	 Determining Case Mix
		14.2.5	 Conditions Treated (Table 14.3)
		14.2.6	 Ownership Structures
		14.2.7	 Distribution of Private Hospitals
			14.2.7.1	 Licensing
			14.2.7.2	 Sources of Funding
			14.2.7.3	 Growth and Marketing
			14.2.7.4	 Billing and Payment of Private Hospitals
		14.2.8	 Hospital Payments
		14.2.9	 Pre-approval
		14.2.10 Prosthesis
		14.2.11 High-Cost Medications
		14.2.12 Pathology and Radiology Investigations
		14.2.13 Medical Services
		14.2.14 Emergency Department Presentations
		14.2.15 Second-Tier and Default Rates
		14.2.16 Certificates
		14.2.17 Audit
			14.2.17.1	 Data Reporting
		14.2.18 Benchmarking
			14.2.18.1	 Medical Staffing and Clinical Governance
	14.3	 Billing Health Funds
		14.3.1	 Public Hospitals
		14.3.2	 Comparing Public and Private Hospitals
		14.3.3	 Challenges Faced by Private Hospitals
			14.3.3.1	 Value Proposition
			14.3.3.2	 Clinical Governance
			14.3.3.3	 Falling PHI Participation
			14.3.3.4	 Integration with Medical Staff
			14.3.3.5	 Maximising Revenue
			14.3.3.6	 Public Patients in Private Hospitals
			14.3.3.7	 Transparency
			14.3.3.8	 Impact of COVID-19
	14.4	 Private Health Insurance
		14.4.1	 Overview
		14.4.2	 Private Health Insurers
		14.4.3	 Products
	14.5	 Hospital Treatment
		14.5.1	 Gold, Silver, Bronze and Basic
	14.6	 General Treatment (Ancillary)
		14.6.1	 Designing an Insurance Product
		14.6.2	 Government Mechanisms to Increase Uptake of Private Health Insurance
			14.6.2.1	 Medicare Levy Surcharge
			14.6.2.2	 Australian Government Rebate
			14.6.2.3	 Lifetime Health Cover
			14.6.2.4	 Age-Based Discounts
		14.6.3	 Regulation of Private Health Insurance
	14.7	 CHIP Requirements
		14.7.1	 Community Rating
		14.7.2	 Coverage Requirements
		14.7.3	 Benefit Requirements
		14.7.4	 Waiting Period
		14.7.5	 Portability Requirements
		14.7.6	 Prudential Requirements
			14.7.6.1	 Australian Prudential Regulation Authority
			14.7.6.2	 Private Health Insurance Ombudsman
			14.7.6.3	 RISK Equalisation
			14.7.6.4	 Rate Rises
			14.7.6.5	 Mandatory Communications
			14.7.6.6	 Fund Rules
			14.7.6.7	 Informed Financial Consent
			14.7.6.8	 Private in Public
			14.7.6.9	 Overseas Student Health Cover (OSHC)
			14.7.6.10	 Reciprocal Health Care Agreements (RHCA)
		14.7.7	 Challenges and Issues
			14.7.7.1	 Compounding Cost and Demand Growth
			14.7.7.2	 Ageing Population
			14.7.7.3	 Impact of COVID-19
			14.7.7.4	 Appropriate, Efficient and Effective Care
			14.7.7.5	 Uneven Risk Distribution
			14.7.7.6	 Preclusion from Providing Integrated Services
			14.7.7.7	 Disparate Funding Streams
			14.7.7.8	 Risk Equalisation and Reduced Incentive for Prevention
			14.7.7.9	 Shift from Passive Payer to Active Funder
			14.7.7.10	 Lapse Rates
			14.7.7.11	 Aggregators
			14.7.7.12	 Financial Pressures and Downgrading
			14.7.7.13	 MBS Item List
			14.7.7.14	 Prosthesis Pricing
			14.7.7.15	 Public Hospitals
			14.7.7.16	 Ready Reckoner
	References and Other Useful Resources
15: Digital Health and Its Evolution in Australian Hospitals
	15.1	 Introduction
	15.2	 A Brief Walk Through the Archives of Health Information Technology
	15.3	 So, Where Are We at Today?
	15.4	 Drivers for Health Information Technology-Enabled Change and Consumer Focus
		15.4.1	 EMR-Enabled Outcome Examples in Australia
			15.4.1.1	 Academic Research
			15.4.1.2	 Health Service Published Outcomes
	15.5	 Challenges for Digital Health and Health Information Technology – Enabled Change
	15.6	 The EMR Journey: Preparation
	15.7	 The Call for Change, Creating a Vision and a Strategic Approach
	15.8	 Establishing Critical Roles: The CMIO or CCIO
	15.9	 Establishing Early Clinical Governance
	15.10	 Determining Initial Scope and Phasing
	15.11	 Preparing a Successful Business Case
	15.12	 Procurement Approaches
	15.13	 Vendor Evaluation and Selection
	15.14	 Best of Breed Versus Integrated Solution Vs Modular Ecosystem Considerations
	15.15	 Vendor Contracting
	15.16	 The EMR Journey: Before Go-Live
	15.17	 Implementation Governance Considerations
	15.18	 Establishing Clinical Workgroups
	15.19	 Chartering the Course of Design, Build and Test
	15.20	 The EMR Journey: Go-Live
	15.21	 The EMR Journey: Post Go-Live
		15.21.1 Fostering an Ongoing Team
		15.21.2 Evaluating Success
		15.21.3 Optimisation and Continuous Improvement of the EMR
	15.22	 Case Study: Medical Leadership in Rollout of Australia’s First Fully Integrated Digital Hospital
		15.22.1 Background
		15.22.2 Project Clinical Governance
		15.22.3 Medical Engagement
		15.22.4 Pre-implementation: Phase 1
		15.22.5 Implementation or Go-Live: Phase 2
		15.22.6 Post-implementation: Phase 3
	15.23	 Why Is Digital Health Important to Medical Administrators?
	15.24	 The Future of Digital Health
		15.24.1 EMR Trends
		15.24.2 Digital Health and Technology Trends
	15.25	 Ready Reckoner
	References
		Further Reading
16: Population and Public Health
	16.1	 Introduction
	16.2	 Definition of Public Health
	16.3	 Definition of Population Health
		16.3.1	 Demographics
		16.3.2	 Ageing Population
		16.3.3	 Population Structure
		16.3.4	 Socioeconomic Disadvantage
		16.3.5	 Why Is Public Health Important for Medical Managers?
	16.4	 Public Health
	16.5	 Communicable Diseases
	16.6	 Infection Prevention and Management
	16.7	 One Health
	16.8	 Tobacco, Alcohol and Illicit Drugs
	16.9	 Environmental Health
	16.10	 Occupational Health
	16.11	 Chronic Diseases
	16.12	 Regional and Rural Health
	16.13	 Indigenous Health
	16.14	 Gaps in Health
	16.15	 Reflection
	16.16	 Ready Reckoner
	References
		Further Reading
17: Politics, Policies and Media
	17.1	 Introduction
		17.1.1	 Australian Political System [1–3]
		17.1.2	 Government and Public Service
			17.1.2.1	 Prime Minister
			17.1.2.2	 Premiers and Chief Ministers
			17.1.2.3	 Ministers and Assistant Ministers
			17.1.2.4	 Cabinet
			17.1.2.5	 National Cabinet
			17.1.2.6	 Public Service
	17.2	 Health Politics
		17.2.1	 Health System: Roles and responsibilities [4–8]
		17.2.2	 Healthcare Funding
		17.2.3	 Commonwealth and State responsibilities [8–10]
			17.2.3.1	 COVID-19
	17.3	 Key People [11–16]
		17.3.1	 The Health Minister
		17.3.2	 The Cabinet
		17.3.3	 Members of Parliament (MPs)
		17.3.4	 Parliamentary Committees
		17.3.5	 Ministerial Office and Advisers
		17.3.6	 Public Service
		17.3.7	 Chief Medical Officers and Chief Health Officers
		17.3.8	 Government Agencies
		17.3.9	 The States and Territories
		17.3.10 Private Healthcare
		17.3.11 Professional, Consumers and Patient Groups
		17.3.12 External Consultants
	17.4	 Health Policy [7, 11, 17]
		17.4.1	 Policy Cycles
		17.4.2	 Policy Design and Process
		17.4.3	 Working Together: Commonwealth and the States and Territories
	17.5	 Communication with the Minister
	17.6	 Media [18–22]
		17.6.1	 Print and Broadcast Media
		17.6.2	 News
		17.6.3	 Digital News
		17.6.4	 Social Media
		17.6.5	 News Cycle
		17.6.6	 The Daily Media Cycle
		17.6.7	 Health Media
			17.6.7.1	 Health and Electronic Media
		17.6.8	 Engaging with Media
		17.6.9	 Communication During a Crisis
		17.6.10 Ready Reckoner/Reflections
	References
		Further Reading
18: Mental Health
	18.1	 Introduction
	18.2	 Magnitude of the Issue
	18.3	 History of Mental Health and Services
	18.4	 Policy Initiatives and Frameworks
	18.5	 Current and Future Policy Framework
		18.5.1	 The Fifth National Mental Health and Suicide Prevention Plan
		18.5.2	 Productivity Commission Inquiry into Mental Health
		18.5.3	 National Suicide Prevention Adviser Final Advice
		18.5.4	 Vision 2030: Blueprint for Mental Health and Suicide Prevention
		18.5.5	 Royal Commission into Victoria’s Mental Health System
		18.5.6	 Royal Commission into Aged Care Quality and Safety
		18.5.7	 National Mental Health and Suicide Prevention Plan
	18.6	 Structure of Mental Health Service
		18.6.1	 Federal Australian Government
		18.6.2	 State and Territory Governments
		18.6.3	 Shared Responsibility
		18.6.4	 Private Sector
	18.7	 Pertinent Issues for Medical Administrators
		18.7.1	 Psychological Distress
		18.7.2	 Co-morbidity
		18.7.3	 Mentally Ill in General Hospital
		18.7.4	 Emergency Departments and Mentally Ill
		18.7.5	 Common Terms Used in Mental Health Services
		18.7.6	 Mental Health Issues Within Aboriginal Population
		18.7.7	 Homelessness and Mental Health
		18.7.8	 Mental Health and Suicide
		18.7.9	 Impact of COVID-19 on Mental Health
	18.8	 Mental Health Workforce
	18.9	 Activity-Based Funding (ABF) for Mental Health Services
	18.10	 Mental Health Legislation
		18.10.1 Involuntary Treatment
		18.10.2 Capacity to Consent
		18.10.3 Less Restrictive Ways
		18.10.4 Electroconvulsive Treatment (ECT)
		18.10.5 Emergency ECT
		18.10.6 Seclusion
		18.10.7 Restraint
	18.11	 Reflections
	References
19: Medical Education
	19.1	 Introduction
		19.1.1	 Australasian Differences
	19.2	 Medical Student Education
		19.2.1	 Selection
		19.2.2	 Curriculum-Teaching
		19.2.3	 Assessment
		19.2.4	 Evaluation
		19.2.5	 Student Involvement
		19.2.6	 Student Support
		19.2.7	 Funding and Scholarships
		19.2.8	 Medical Education Research
		19.2.9	 Educating the Teachers
	19.3	 Prevocational Education
	19.4	 Vocational Education
	19.5	 Continuing Medical Education
	19.6	 Summary
	19.7	 Reflections
	References
		Further Reading
		Useful Overview Journal Articles:
		Useful Introductory Medical Education Texts:
20: Research Governance
	20.1	 Introduction
	20.2	 Definition
	20.3	 Ethics and Good Clinical Practice
	20.4	 Research Management
	20.5	 Safety and Quality
	20.6	 Data Sovereignty
	20.7	 Research Involving Indigenous People
	20.8	 Risk, Probity, Misconduct and Fraud
	20.9	 Research Benefits
	20.10	 Conclusion
	Bibliography