The Commission has heard that Ambulance Victoria’s change-management approach has led to many reform activities taking place without ensuring consistent, future-focused, workplace safety and equality improvements.
Change management describes an approach to transitioning organisations from a current operational state to a desired future state. It involves applying a set of tools, processes and principles to manage the people side of change to achieve the desired outcome.
Throughout the Progress Evaluation Audit, Ambulance Victoria's workforce told the Commission that they felt reform initiatives often come across as 'tick the box' exercises and do not appear to be truly aimed at improving their working conditions and reducing harm. Unfortunately, this perception undermines workforce trust in the reforms and has led to frustration and disengagement. To drive real progress, Ambulance Victoria would benefit from a more purposeful approach informed by meaningful intent to improve workforce experiences.
Lack of employee participation in reforms, particularly involvement of frontline and middle managers, is a known contributor to organisational-change program failure.[1] When change models are overly systematic and procedural, without genuine engagement or input from key stakeholders like Ambulance Victoria’s broader workforce, they fail to address the nuanced needs and strengths of diverse employees.
The Commission considers that Ambulance Victoria may benefit from engaging with key stakeholders in the health sector, including the Department of Health and hospitals, to refine its change-management approach. In particular, the Commission draws attention to the Royal Melbourne Hospital’s innovative change-management approach to successfully reduce emergency wait times.
[1] Ali Mohammad Mosadeghrad and Maryam Ansarian, ‘Why do organisational change programmes fail?’ (2014) International Journal of Strategic Change Management 5(3) 189.
Ambulance Victoria’s current change-management approach is a barrier to implementing the intended outcomes of many of the Review priority recommendations, including:
Recommendation 1: Learning through reflective practice: The current change-management approach is a barrier to achieving the intent of this recommendation, which requires linking reform activities to understanding the drivers of workplace inequality.
Recommendation 6: Improving safety in isolated environments: The Commission heard that the initiatives following the safety audit are perceived as ‘tick the box’ exercises. This is a barrier to the intent of this recommendation, which speaks to protecting workers from harmful conduct in isolated environments.
Recommendation 7: Resetting and embedding organisational values: The current change-management process has been a barrier to the uptake of Ambulance Victoria’s new organisational values. The Commission heard the workforce felt that reform activities lack their input and buy-in, reducing the impact and further diminishing trust in the process.
Recommendation 9: Contact officers and local champions network: The Commission heard that while the workforce was initially enthusiastic about the programs outlined in this recommendation, they have now become disillusioned because they are not yet seeing impactful changes to their day-to-day workplace experience.
Recommendation 13: A victim-centred and fair report and complaint system and Recommendation 20: Understanding how the report and complaint system is working: Delivering these recommendations is being impeded because the focus has been on achieving the activities, rather than the intended outcomes, of the recommendations.
Recommendation 31: Implementing and tailoring the Think Flex First Framework: The Commission heard there has been frequent pausing of programs and pilot programs such as those relating to flexibility as part of this recommendation. This hampers implementation and affects workforce trust that leadership understands the core issues with flexibility at Ambulance Victoria.
Recommendation 42: Organisational healing and cultural change through reflective practice: Ambulance Victoria’s compliance-focused change-management approach is holding back organisational healing and cultural change as it undermines workforce confidence in the achievement of the reforms.
Select the links above for further information on how this barrier is impacting recommendation implementation.
During the Progress Evaluation Audit, the Commission heard that many of Ambulance Victoria’s operational workforce members do feel they have been adequately engaged in reforms or had the opportunity to participate in shaping reforms.
ParticipantI would really like the program implementation team to understand what is the best timing for effective change to happen … and that includes effective change management (not just project management and stakeholder engagement) – along with appropriate resourcing, budget and support from all divisional leaders.
During the Progress Evaluation Audit, the Commission heard the workforce perceived that the workplace equality reforms being undertaken had not positively impacted them in practice.
ParticipantA lot of paramedics have not seen any change, or little change other than values being rolled out, and a lot of them wouldn't even know AV’s strategic plan, a lot of paramedics on road, so it's not something that's relevant to them.
During the Progress Evaluation Audit, the Commission noted that Ambulance Victoria has experienced difficulty in embedding the intended outcomes of some priority recommendations. The Commission considers that this is the likely result of Ambulance Victoria’s implementation approach focusing on delivering certain activities without considering their place in the long-term vision for the organisation and workforce reform.
ParticipantWe deliver a project, we roll it out, the project finishes and we move on to forget about it.
During the Progress Evaluation Audit, the Commission heard from the workforce that Ambulance Victoria’s progress towards implementing the Review recommendations lacked a comprehensive understanding and recognition of the intent behind the recommendations and was not truly aimed at improving their working conditions. This undermines trust in leadership.
ParticipantThis is what the recommendation said, as opposed to this is what the recommendation is – what does this mean for AV and what is the most effective way for AV to see a change, a genuine, tangible, authentic change as opposed to just tick the box.