A five-year change management road map to improve the patient experience


When one of the largest local health districts in NSW embarked on a transformation project designed to make it the safest in the state, it had to bring a lot of people along for the ride.

With over 15,000 staff serving a population of about one million residents, South Western Sydney Local Health District’s ambitious ‘Transforming Your Experience’ (TYE) is a culture change program at scale.

The task is certainly considerable. Home to metropolitan and rural communities in seven local government areas, last financial year SWSLHD provided care for more than 11,000 births, 280,000 ED presentations and 43,000 surgeries.

For the district, Transforming Your Experience is considered vital in ensuring staff are supported to deliver a healthcare service that is person-centred, equitable, consistently safe and responsive in what is one of the most rapidly growing and culturally diverse districts in NSW.

A five-year road map is guiding the project.

“Over the last several years, we have made significant improvements to the care we provide and in patient safety and quality. However, patients, consumers and staff have told us that there are opportunities for us to do even better,” the Transforming Your Experience 2017-2021 Strategy says.

The “significant and ambitious” program, which was developed in collaboration with patients, consumers, staff and the broader community, is shaping the organisation for the future. 

“To achieve this, it is vital that everyone involved in our organisation understands and is involved in this initiative,” the strategy says 

According to Sonia Marshall, Executive Director of Nursing and Midwifery at SWSLHD, the sweeping project is empowering staff.

“Transforming Your Experience provides us with an amazing opportunity to empower our staff with the capability and opportunity to deliver exceptional care,” Ms Marshall said.

“We will also provide our staff with the tools, knowledge and skills to improve their own health and wellbeing, which has a flow on effect to improve patient experience. 

“Our staff will also have the opportunity to develop leadership skills through various leadership programs that have been developed to support the TYE vision.”

But change doesn’t always come easy, which is why within its change management efforts SWSLHD has deployed “TYE coaches” 

“The challenges for staff are primarily around implementing a change. Change and disruption are hard for individuals and teams, and most people feel uncomfortable with change,” Ms Marshall said.

“Our TYE coaches have been recruited to focus on supporting our staff with the changes required to transform the experience of patients, consumers and staff.”

As a gauge to the complexities of the project, over 36 per cent of residents in the local health district were born overseas, and 49 per cent speak a language other than English at home. Meanwhile, more than 70 per cent of SWSLHD’s workforce is involved in direct patient care.

Transforming Your Experience was developed in collaboration with over 1200 patients, consumers and staff across the health district from Bankstown to Bowral. The consultation included surveys, interviews and focus groups. SWSLHD also liaised with key culturally and linguistically diverse groups and its Aboriginal communities.

Over 5000 incidents and complaints were reviewed to establish themes, and literature and best practice evidence was used to determine what makes an organisation safe and high quality, and the factors that support the delivery of exceptional patient and staff experiences.

Ms Marshall said the keys to leading large-scale organisational change include:

  • setting a clear vision
  • commitment from the leaders in the organisation
  • a communication plan that outlines the change including ‘why, how and what’s in it for me?’
  • a defined action plan that clearly outlines what the organisation will do and also allows some individualisation or localisation
  • a governance structure that includes key stakeholders including consumers
  • coaches to support managers and staff to implement and sustain the changes required
  • measurement and monitoring plans that allow you to monitor and track changes over time.

A district-wide implementation plan was developed for Transforming Your Experience, with activities to be rolled out over five years with a number of short, medium and longer term priorities. SWSLHD will review and update the strategy and the implementation plan along the way. 

Sonia Marshall, Executive Director of Nursing and Midwifery at South Western Sydney Local Health District, will be presenting the ‘Case Study: Transforming Your Experience: A Five-Year Road Map to Improve the Patient Experience’ within the Nursing stream at Australian Healthcare Week being held on 27-28 March 2019.