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Evidence happened on the way to The Forum

VMIA brings BWA on board for better health outcomes

The Victorian Managed Insurance Authority (VMIA) has appointed BehaviourWorks Australia (BWA), in partnership with the specialist behaviour-change consultancy, The Shannon Company, to undertake three-year program of research designed to reduce the risk of harm to patients in Victoria.

The challenge

The VMIA provides risk and insurance services to Victorian government assets, including hospitals and health centres. This research and innovation program seeks to mitigate the effects of increasing costs of medical indemnity premiums for the Victorian public health sector, improve health management systems and patient outcomes, and enhance interventions for high risks.

But where do you start?

There is a science to working out priorities facing business and organisations. One of the (many) things this project does is to help VMIA create prioritisation tools for exactly these decisions. Is it just about saving money, or the biggest impact for a small group? Are they only focused on the best evidence, or are they after the one that gets the most media attention? Or should all of these be considered?

BWA are bringing tools and processes that allow VMIA and its stakeholders to consider a range of prioritisation criteria. In doing so, VMIA will build gain a better understanding of how they arrive at priority topics.

The Forum

Key to this process is The Forum method, pioneered in 2009 by world-leading knowledge translation expert Professor John Lavis from McMaster University in Canada.

The Forum – which is a systemised method summarising evidence and presenting it to the key stakeholders for deliberation for them to collectively decide what actions can be taken – was brought to Australia by BWA Senior Research Fellow, Associate Professor Peter Bragge. He will be supported on this project by BWA’s Dr Breanna Wright, who is currently working as Researcher in Residence at VMIA.

Peter has been involved in around 20 to date and seen how effective the process has been in inspiring people and encouraging the recommendations to be translated into policy and practice.

In the words of one participant, “It was an extraordinary gathering in many ways and fascinating to see how you took us through the process so professionally and diplomatically”.

You just might find you get what you need

In John’s words, The Forum “isn’t necessarily about reaching consensus”. His reasoning is that when you get people from different stakeholder groups together, they have (by definition) different and often conflicting reasons for being there.

It doesn’t mean consensus won’t happen but Lavis is a big believer in what he calls the ‘Goldilocks Rule’; that one of the three options canvassed will be “just right”.

For example, a Forum might be held to look at how funding for Victorian diabetes centres should be spent.

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Kathryn Rezeltsky West by DFAT via Flickr

Most diabetics would be based in the big cities, which could leave regional centres at a disadvantage. Three options might be:

– 1 an even spread of diabetes centres around Victoria2 a single centre of excellence, based in the capital city (Melbourne)3 a main centre of excellence based in Melbourne with satellite support in regional cities.

– 2 a single centre of excellence, based in the capital city (Melbourne)

– 3 a main centre of excellence based in Melbourne with satellite support in regional cities.

One of these options is just right – or just right enough – for agreement between the various stakeholders, all of whom have been supplied with the supporting evidence.

Forums yield action plans and outcomes.

Now, someone has to make these outcomes happen, which is where BWA and the Shannon Company come in. 

Six of the best 

With this project, BWA will apply its entire model of behaviour change six times over the three years. In fact, it’s the first opportunity for BWA to apply its full methodology end to end. This involves understanding and unpacking problems, ‘deep diving’ to discover the barriers to and drivers of behaviour, and utilising the behaviour change communication skills of the Shannon Company to trial interventions. 

The truth will out

The VMIA research program is therefore, not only a series of projects to reduce the risk of harm to patients in Victoria, it’s also a structured process of getting to those risk topics.

The first task is to decide what needs doing. The second is how best to do that. It’s an innovative approach that has not been applied on this scale in Australia. BWA will be there, from go to whoa.