Health

Review of District HETI Relationship Model

Health Education and Training Institute, 2017.

THE CHALLENGE

District HETI was established in 2012 with a remit for the rapid development of online education and training for the NSW Health workforce. This was a time of substantial reform for the health system in NSW, with Local Health Districts (LHD), Specialty Health Networks (SHN) and pillars all being established, and governance of health service delivery devolved from the Department to providers. The shift from a locally delivered to a centralised training model required evaluation.

THE OBJECTIVE

ARTD conducted an independent review of the District HETI Model to identify what if any changes were needed to improve the overall approach of the delivery of high-quality state-wide online education and training. Subsequently, we developed a multi-layered strategy for the monitoring and evaluation of the eLearning modules.

OUR APPROACH

The review collected evidence through interviews and surveys with key District HETI stakeholders. The review team interviewed seven senior staff members of HETI and District HETI, and six Chief Executives and eight Directors of LHDs and SHNs. All Districts/ Networks and pillar Chief Executives were surveyed, with selected questions for their direct response and other questions that could be delegated to a relevant Director. In developing the Strategy, monitoring and evaluation strategy, ARTD reviewed key policy and program documents consulted key stakeholders through interviews and a workshop with 19 HETI staff. We developed a logic model, protocols for monitoring processes and systems, quality indicators, and guidance for decision-making about the conduct of future periodic impact evaluations of selected eLearning modules.

IMPACT

The review identified achievements and opportunities to be realised. It also provided an understanding of District HETI model workforce needs into the future and an understanding of the perceived strength of partnerships. The evaluation strategy is used to monitor and evaluate the eLearning modules.

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Evaluation of the NSW Service Plan for People with Eating Disorders

NSW Centre for Eating and Dieting Disorders, 2018

THE CHALLENGE

In September 2013, the Mental Health and Drug and Alcohol Office (MHDAO) of the NSW Ministry of Health, launched the NSW Service Plan for People with Eating Disorders 2013–2018 (NSW Service Plan). This landmark document, produced by the Centre for Eating and Dieting Disorders (CEDD) in partnership with the Ministry, positioned eating disorders as core business for the NSW Health care system. The NSW Government, through the implementation of the Service Plan, supported changes in service delivery to support access to treatment and improve care for people with eating disorders, no matter where they
live in the state. The Service Plan identified the need for prolonged multifaceted integrated care. It required Districts to build capacity to provide assessment and treatment, with pathways to options for more intense and specialist treatment to be established.

THE OBJECTIVE

ARTD conducted an independent process evaluation of the implementation of the NSW
Service Plan.

OUR APPROACH

The evaluation focus was on the progress being made in the implementation of the Service Plan, not on outcomes. It used a mixed methods design drawing on existing data (performance monitoring, reports and patient data) and collecting new qualitative and quantitative data via surveys and semi-structured interviews with Service Plan stakeholders. Stakeholders include MHDAO, Steering Committee Chair, CEDD team, Local Eating Disorder Coordinators, clinicians who had completed clinical training packages, Local Health District (LHD) Mental Health Directors, LHD Medical Leads and a small sample of people
living with an eating disorder. There was consistency in findings across different data
sources, giving confidence in the findings.

IMPACT

The evaluation found that substantive progress had been made in implementing the NSW Service Plan, shifting the NSW Government’s health system response to eating disorders from ad hoc to a state-wide response. The Service Plan had two companion documents to operationalise its vision for change: The Implementation Plan, 2014-2018 and the NSW Workforce Development Plan for Eating Disorders (2016-2018). The Implementation Plan adopted a philosophy of locally-led services and workforce development, with state-level support.
Although a great deal of work had been done and much achieved across the State, the evaluation found over half of Districts were at an early stage of implementation of their Local Plans with considerable work to be done in establishing models of care, protocols for working across teams and clinical pathways.
The evaluation found that to achieve the Ministry expectation that eating disorder services will transition to become business as usual across NSW Health services during the next five years, that the work being done must be developed and sustained, with support for Districts to implement their Local Plans. Recommendations were made to support the next stage.

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