Australian Public Service Research Articles

COVID-19 and employee productivity in the public sector

ABSTRACT COVID-19 has affected the public sector significantly. However, since it is a recent event, its impact on employee productivity, especially the individual and organisational outcomes, is not well-studied. Using the 2020 data from the Australian Public Service Commission (APSC, n = 96,690), this study analyzes how the Australian Public Service (APS)’s changed working methods during COVID-19, especially the effect of five practices, has affected employee productivity. Findings suggest that team adaption, team effort, and organisational adaptation are positively associated with employee productivity, whereas managerial support and proactiveness are negatively associated with employee productivity. Interestingly, while the team effort has significantly enhanced the perceived productivity of employees, the proactiveness of the organisation to maintain new working methods led to a negative impact on productivity. This is surprising and indicative of the positive and negative impacts of the pandemic on employee productivity. A crucial implication of these findings is that intra-organisational responses to COVID-19, including at the team level and managerial level, have affected employee productivity in the public sector.

The current management of scaphoid fractures in the emergency department across an Australian metropolitan public health service: A retrospective cohort study.

Scaphoid fractures are commonly present to emergency departments (EDs), challenging medical practitioners to achieve accurate diagnosis and management. This is because of the prevalence of radiographically occult scaphoid fractures and complications associated with missed diagnoses. Clinical Guidelines are limited for treatment of suspected scaphoid fractures, and heterogeneity in the literature further complicates management. This study aimed to explore the differences in management between practitioners in the ED and determine if immobilizing clinically suspected scaphoid fractures is supported by current evidence. This study also aimed to establish if there are predictors to assist in the diagnosis of a scaphoid fracture in the ED. A retrospective cohort study analyzed clinical data from patient's charts who attended the ED for a scaphoid fracture in 2019. Using retrospective patient chart audits and a Data Extraction Form, the clinical data regarding the assessment, treatment, diagnosis, and follow-up outcomes were collected. Descriptive analysis and multivariable logistic regression were performed to assess current management and find out predictors of a scaphoid fracture. There was significance between practitioners performing physical assessments and providing treatment (P < .001). Physiotherapists performed assessment and education combined treatment more frequently than nurse practitioners and doctors. Thirty-four cases (11.7%) were negative for fracture in ED and positive in follow-up at the orthopedic clinic. There was an estimated loss of income of $327,433.60 (Australian dollar) for 221 patients who missed work due to overtreatment with immobilization. The strongest predictors for a confirmed scaphoid fracture were of male gender (odds ratio, 3.2; 95% confidence interval, 2.1-5.0; P < .001) and a positive x-ray in ED (odds ratio, 36.6; 95% confidence interval, 17.4-77.0; P < .001). Management of scaphoid fractures across the Gold Coast Hospital Health Service ED followed commonly accepted practices involving x-ray and immobilization; however, this conservative approach to management is associated with increased health costs and low rates of conversion to a confirmed scaphoid fracture. Male gender was the only significant predictor associated with a scaphoid fracture.

"Trying to develop a better workforce": Stakeholders' perspectives of a practice-integrated Australian hospital pharmacist foundation residency program.

BackgroundPractice-integrated education and professional development programs (also known as residencies), have been available to pharmacists in America and the United Kingdom for many years. In 2016, the Society of Hospital Pharmacists of Australia launched Australia’s novel Foundation Residency Program to support the development of early-career pharmacists, and has been implemented across many hospitals nationally. This model was adopted by the South Australian (SA) public hospital pharmacy statewide service and was granted full accreditation. The study aimed to explore key stakeholders’ expectations and early perceptions of the structure, role and impact of the SA program and in that process, to identify key influencing factors and strategies informing future program planning and design.MethodsPurposeful sampling was adopted to recruit participants who oversee preceptors and residents, across all employment levels and pharmacy service sites. Stakeholders participated in individual semi-structured interviews. Each interview was audio-recorded and transcribed verbatim. The transcribed dataset was managed using NVivo softwareTM (version 10) and analysed using reflexive thematic analysis through the lens of the PRECEDE-PROCEED logic model framework.ResultsThirty-three staff consented to participate. Participants were de-identified with a randomly assigned code number. Three key themes were identified using reflexive thematic analysis; alignment of program goals and visions, culture shift to prioritising workforce development as core business, program structure supports focused workforce development.ConclusionsParticipants view the residency as beneficial for development of the residents, preceptors, and the hospital pharmacy workforce. The multisite structure was a strength of the program. Whilst it was acknowledged that the rotations, cross-site rotations, and research project presented challenges, they were deemed worth the investment. Overall, it was felt that incremental increases in program capacity will occur over time, as culture changes, and as investing in workforce development becomes core business. The findings have led to several key recommendations to guide program expansion.

Insights for Indigenous employment into a case study of unconscious bias in the Australian Public Service

AbstractDrawing on a case study of unconscious bias levels in the Australian Public Service (APS), findings suggest gender equality remains a concern for career prospects for women, particularly for Indigenous women when two‐thirds of Indigenous employees in the APS are women. Additionally, age and length of service provide further insights into the implications for a workplace free of discrimination and prejudice. For example, male respondents across each successive age category show higher preference levels for Caucasian Australians than do female respondents. In this paper, I compare findings with results found in an Australian study reported by Shirodkar, (2019). Journal of Australian Indigenous Issues, 22, 3. The basis of both studies was the Australian Aboriginal Implicit Association Test (IAT) administered by Project Implicit. Arguably most importantly for the APS will be the need to convince senior managers to accept and act on the discriminatory effects of unconscious bias in Indigenous employment. Any policy response will need an enhanced understanding of unconscious bias, including a broader knowledge of Indigenous culture and gender equity in the APS. The framework presented at the end of this paper offers an opportunity to revisit the effectiveness of unconscious bias training for the APS.

Organizational Change in Complex Systems: Organizational and Leadership Factors in the Introduction of Open Dialogue to Mental Health Care Services

Conventional mental health services are frequently criticized for failing to support people and communities in their care. Open Dialogue is a non-conventional humanistic approach to mental health care, which has been implemented in many different settings globally. At two Australian public health care services, implementation of the approach led to positive client outcomes and sustained organizational and clinical change. The aim of the study was to identify and explore the organizational, management, leadership and cultural factors that contributed to sustained implementation in these complex systems. We conducted nine individual semi-structured interviews of health care leaders and managers from the two sites. Transcriptions of the interviews were analyzed thematically. Leaders facilitated a gradual development of clinical and organizational legitimacy for the non-standardized Open Dialogue approach by holding the anxiety and frustration of practitioners and parts of the administration, cultivating cultural change and adaptation and by continually removing organizational obstacles.

Blurred Lines: Exploring the Impact of Change Complexity on Role Clarity in the Public Sector

Over the past few decades, social, economic, and political developments have forced public organizations to continuously adapt to changing circumstances, casting them in ongoing cycles of organizational change. The continuous introduction of various types of change in an employee’s work environment may generate substantial levels of role ambiguity, which in turn could hamper performance and satisfaction. Given the increasing degree of change complexity in the public sector, it is surprising that no research has investigated whether more complex change is associated with greater reductions in role clarity. To gain a better understanding of how change complexity impacts organizations and their employees, we analyze survey data from the Australian Public Service Employee Census using propensity score matching. Results indicate that increasing levels of change complexity results in greater reductions of role clarity, suggesting that change trajectories sometimes exceed employees’ capability to adapt.

Burden of the Beast

Burden of the Beast

Reform Stress in the Public Sector? Linking Change Diversity to Turnover Intentions and Presenteeism Among Civil Servants Using a Matching Approach

This paper aims to examine the effect of having experienced diverse changes over a short period of time on the turnover intent and presenteeism behavior of public sector employees. Identifying such effect has been difficult since extant research often defined and studied organizational changes as single, isolated events. Consequently, they may have failed to capture how different changes interact with one another, and what cumulative impact diverse changes have on employees. We introduce nonparametric matching, using data from the Australian Public Service, allowing us to overcome the challenge of distinguishing between the effect of change diversity and that of preexisting problems. Results show both turnover intent and presenteeism increase in organizations with high change diversity. This suggests that employees perform emotion-focused (turnover intent) and problem-focused (presenteeism) coping when faced with high change diversity, and points at the need for sufficient recovery time in between changes.

Reinforcing managerial prerogative in the Australian Public Service during the COVID-19 pandemic

Over several decades Liberal-National Governments have encouraged Australian Public Service (APS) employers to uphold managerial prerogative by offering individual employment arrangements to employees. During the period of the COVID-19 pandemic, the Morrison Liberal-National Government’s Workplace Bargaining Policy reinforced this agenda. In place of collective bargaining, APS agency heads were encouraged to determine pay rises and new employment conditions for employees using Section 24 of the Public Service Act (PS Act) 1999. Workplace determinations did not need to be negotiated with public sector unions and some 85,500 employees across 57 APS agencies, or approximately 63% of the APS workforce, had accepted pay increases via workplace determinations by 31 December 2020. The widespread adoption of workplace determinations in the APS poses significant challenges for public sector unions and for the future of APS collective bargaining.JEL CodesJ21, J45, J53, K31.

Pandemic effects on public service employment in Australia

AbstractThe COVID-19 pandemic is sending shockwaves through communities and economies, and public servants have risen to the novel policy challenges in uncharted waters. This crisis comes on top of considerable turmoil for public services in recent decades, with public management reforms followed by the global financial crisis (GFC) leading to considerable change to public sector employment relations and a deprivileging of public servants. The research adopts the lens of the ‘public service bargain’ to examine the effects of the pandemic across Australian public services. How did Australian public service jurisdictions approach public employment in 2020, across senior and other cohorts of employees? How did this pandemic response compare to each jurisdictions’ response to the GFC a decade earlier? The research also reflects more broadly of the impact on public sector employment relations and to what extent pandemic responses have altered concepts of the diminished public service bargain or the notion of governments as model employers?

Identifying Australian Policy Makers’ Perceptions of EHealth Interventions for Smoking Cessation: Cross Sectional Study

Background: The increasing volume of research on electronic health (eHealth) smoking cessation interventions presents a challenge for policymakers and service providers when they try to decide which strategies to select for health promotion programs. This study aimed to explore the perceptions of Australian policymakers and service providers regarding the effectiveness and quality of eHealth and mHealth interventions for smoking cessation against the evidence in a recent systematic review. Methods: This cross-sectional study invited 38 Australian public health policymakers and service providers in smoking cessation to participate in an online survey assessing their knowledge of the current available evidence-base. Descriptive statistics were used to determine the results of the survey against the published review. Results: Eighteen participants completed the survey. Comparison identified that the majority of participants failed to correctly identify the effects and the quality of the evidence of popular smoking cessation interventions. They lacked knowledge of the usefulness and quality of some eHealth and mHealth interventions for smoking cessation. Conclusions: The finding of this study indicates that the prior perceptions and beliefs held by Australian policymakers and service providers about the effects of eHealth and mHealth interventions for smoking cessation are significantly detached enough from the evidence-base to affect the provision of effective interventions to smokers who want to quit. This has potentially widespread implications for improving health promotion and communication between policymakers, service providers, and the current smoking population.

Developing a tailored implementation action plan for a suicide prevention clinical intervention in an Australian mental health service: A qualitative study using the EPIS framework.

Background: Tailoring implementation strategies to local contexts is a promising approach to supporting implementation and sustainment of evidence-based practices in health settings. While there is increasing research on tailored implementation of mental health interventions, implementation research on suicide prevention interventions is limited. This study aimed to evaluate implementation and subsequently develop a tailored action plan to support sustainment of an evidence-based suicide prevention intervention; Collaborative Assessment and Management of Suicidality (CAMS) in an Australian public mental health service. Methods: Approximately 150 mental health staff working within a regional and remote Local Health District in Australia were trained in CAMS. Semi-structured interviews and focus groups with frontline staff and clinical leaders were conducted to examine barriers and facilitators to using CAMS. Data were analysed using a reflexive thematic analysis approach and mapped to the Exploration, Preparation, Implementation and Sustainment (EPIS) framework and followed by stakeholder engagement to design a tailored implementation action plan based on a 'tailored blueprint' methodology. Results: A total of 22 barriers to implementing CAMS were identified. Based on the perceived impact on implementation fidelity and the feasibility of addressing identified barriers, six barriers were prioritised for addressing through an implementation action plan. These barriers were mapped to evidence-based implementation strategies and, in collaboration with local health district staff, goals and actionable steps for each strategy were generated. This information was combined into a tailored implementation plan to support the sustainable use of CAMS as part of routine care within this mental health service. Conclusions: This study provides an example of a collaborative approach to tailoring strategies for implementation on a large scale. Novel insights were obtained into the challenges of evaluating the implementation process and barriers to implementing an evidence-based suicide prevention treatment approach within a geographically large and varied mental health service in Australia. Plain language abstract: This study outlines the process of using a collaborative stakeholder engagement approach to develop tailored implementation plans. Using the Exploration Preparation Implementation Sustainment Framework, findings identify the barriers to and strategies for implementing a clinical suicide prevention intervention in an Australian community mental health setting. This is the first known study to use an implementation science framework to investigate the implementation of the clinical suicide prevention intervention (Collaborative Assessment and Management of Suicidality) within a community mental health setting. This work highlights the challenges of conducting implementation research in a dynamic public health service.

Worsening general health and psychosocial wellbeing of Australian hospital allied health practitioners during the COVID-19 pandemic.

Objective To describe self-reported general and psychological health for allied health practitioners at an Australian acute public health service over three time points within the coronavirus disease 2019 (COVID-19) pandemic. Methods This study collected data from cross-sectional online surveys at three time points: May-June 2020 (T 1 ), October-November 2020 (T 2 ) and November-December 2021 (T 3 ). The self-report questionnaire consisted of demographic questions, a general health question and the 21-item version of the Depression Anxiety Stress Scales (DASS-21). Results A total of 308 responses were received (T 1 n = 135, T 2 n = 78, T 3 n = 95) from representatives of eight allied health professions. The proportion of allied health practitioners reporting poor general health significantly increased over time, as did mean scores on all DASS-21 sub-scales. General health status was also significantly associated with DASS-21 subscale scores. Anxiety scores increased significantly between T 1 and T 2 , while depression scores increased significantly between T 2 and T 3 . Significant increases in stress scores were recorded across all time intervals. Between T 1 and T 3 , the proportion of allied health practitioners reporting moderate, severe, or extremely severe symptoms increased for depression (10.3-30.9%), anxiety (5.2-18.2%) and stress (13.3-36.3%). Conclusion The general and psychological health of allied health practitioners appears to be worsening as the COVID-19 pandemic continues. Organisational strategies to support the health of the allied health workforce in acute care settings must address the cumulative effects of prolonged pressure on their general and psychosocial health. Support strategies need to be responsive to changes in psychological wellbeing at different phases of the pandemic.

A qualitative study of hospital clinical staff perceptions of their interactions with healthcare middle managers

PurposeThe authors explored clinical staff perceptions of their interactions with middle management and their experiences of the uncongeniality of their working environment.Design/methodology/approachSemi-structured interviews of clinical staff from an Australian public health service's Emergency, Surgery and Psychiatry departments. Volunteer interview transcripts were inductively coded using a reflexive thematic content analysis.FindingsOf 73 interviews, 66 participants discussed their interactions with management. Most clinicians considered their interactions with middle management to be negative based on a violation of their expectations of support in the workplace. Collectively, these interactions formed the basis of clinical staff perceptions of management's lack of capacity and fit for the needs of staff to perform their roles.Practical implicationsStrategies to improve management's fit with clinicians' needs may be beneficial for reducing uncongenial workplaces for healthcare staff and enhanced patient care.Originality/valueThis article is among the few papers that discuss interactions with management from the perspective of clinical staff in healthcare. How these perspectives inform the perception of workplace uncongeniality for clinicians contributes greater understanding of the factors contributing to adversarial relationships between clinicians and managers.

Achieving career satisfaction through fostering innovation: lessons from the engineering profession in the Australian public sector

AbstractThis paper proposes a novel approach that integrates the capability of empirical validation of structural equation modelling (SEM) and the prediction ability of Bayesian networks (BN). The Hybrid SEM–BN approach was used as a decision support framework to examine the interplay between salient organisational constructs and their ability to influence engineers’ career satisfaction in the Australian Public Service (APS). The results emphasise that the ambidextrous culture for innovation was the most important factor that needed to be implemented in their organisation. Managerial implications are recommended for senior managers on how they can implement innovation culture to increase workplace innovation, which could, in turn, help reduce the turnover rate of engineers employed in the APS.

Suresh Narayanan Comment on Wage Differentials in Malaysia: Public Employment, Gender, and Ethnicity

Suresh Narayanan Comment on Wage Differentials in Malaysia: Public Employment, Gender, and Ethnicity

Fear of missing out? Linking workplace changes and presenteeism

AbstractWhy do employees continue to work during illness? So‐called presenteeism behaviour is a topic of great managerial and societal importance as it is connected to a series of negative individual and organisational outcomes. A growing body of research points to the importance of workplace factors in shaping employee stress and uncertainty and, ultimately, presenteeism behaviour. Curiously though, the impact of workplace changes on presenteeism behaviour has not been examined, even though the potential stress‐inducing effects of such change are well‐recognised. Building on a data set from the Australian Public Service, we examine how workplace changes are related to presenteeism behaviour. Our findings show that workplace changes generally provoke presenteeism behaviour. Specifically, cutback‐related changes appear to cause presenteeism. This finding is relevant in times when many organisations are confronted with major budget cuts.Brief summaryThis article explores the link between working during illness, or presenteeism behaviour, and workplace changes. Presenteeism behaviour is a topic of great managerial and societal importance as it is connected to a series of negative individual and organisational outcomes. A growing body of research points to the importance of workplace factors in shaping employee stress and uncertainty and, ultimately, presenteeism behaviour. Curiously though, the impact of workplace changes on presenteeism behaviour has not been examined, even though the potential stress‐inducing effects of such change are well‐recognised. Building on a data set from the Australian Public Service, we examine how workplace changes are related to presenteeism behaviour. Our findings show that workplace changes generally provoke presenteeism behaviour. Specifically, cutback‐related changes appear to cause presenteeism. This finding is relevant in times when many organisations are confronted with major budget cuts. Employees who experience workplace changes are more likely to go to work sick. Decreased staffing (cutback‐related change) is the main driver of presenteeism behaviour. Presenteeism is higher among employees working harder and longer hours – that is performing overtime, likely for the purpose of meeting high job demands. Fairness of pay reduces the likelihood of presenteeism. The findings suggest that although change itself is unavoidable and even necessary for organisations adapting to external demands, the potentially negative effects of change may be mitigated by appropriate change management and structures.

'Waiting with Bated Breath'

'Waiting with Bated Breath'

A stakeholder perspective on public sector innovation: Linking the target groups of innovations to the inclusion of stakeholder ideas

Public sector innovation scholarship has not yet systematically explored how the target context (or output phase) of innovations impacts the early phases of innovation processes. This study theorizes and tests whether innovating organizations are more sensitive to ideas from particular stakeholder groups depending on the target group of said innovation. Using a large-scale dataset from the Australian Public Service, the results show that innovations with external target groups are more likely to be built on ideas from external stakeholders (compared with internal stakeholders) and—within the group of internal stakeholders—on ideas from managers (compared with non-managerial employees). Practical and scholarly implications are discussed.Points for practitioners: Innovations benefit from the inclusion of internal and external stakeholder ideas, both substantively (appropriate knowledge leads to better end products) and symbolically (innovations need to be deemed legitimate, and receive support from the actors that will be primarily impacted by the innovation). Innovating organizations need to be aware of the perceptions of the stakeholders affected by the innovation, and properly sense, capture and translate the ideas of those stakeholders in the innovation process.

Barriers and Motivations to Integrating Environmental Performance in the BSC: a case study in health care

PurposeThis study aims to explore the barriers and motivations to integrating environmental performance into balanced scorecards (BSCs).Design/methodology/approachThis research adopted a qualitative case study approach with semi-structured interviews within an Australian public health service organisation. Secondary document analysis was performed using annual reports, strategic plans and website data.FindingsThe internal barriers creating resistance to incorporating environmental performance dimensions into the BSC include the existing role of environmental disclosure, insufficient sustainability BSC knowledge, lack of BSC champion support, organisational culture and limited environmental commitment practices. Solutions revealed to support decisions to integrate environmental performance in the BSC include recruiting sustainability expertise, articulating financial motivations and recognising external pressures.Practical implicationsThe findings provide suggested actions for other organisations facing similar challenges regarding integrating environmental performance into a BSC.Social implicationsIn the current business environment, organisations face growing pressure to consider environmental performance in their BSCs. This study provides insights into the potential problems that prevent or delay the integration of environmental issues into BSCs.Originality/valueThis study provides evidence on how institutional and external factors influence barriers and motivations to embed environmental performance measures into a BSC. This study demonstrates how health-care organisations can effectively overcome barriers by modifying specific institutional artefacts. This is an important contribution to the body of knowledge because there is limited empirical research regarding integrating environmental issues into a public sector BSC that projects key organisational commitment indicators.