Leadership and organisational culture were key factors in the GP Super Clinics, in particular in relation to perceptions of clinicians and patients. This aligns with international evidence in health and other organisations which emphasises leadership and organisational culture as strong drivers of performance and innovation.27 In a study focusing on change in primary care in the United Kingdom towards the establishment of Primary Care Medical Homes, leadership from both physicians and practice managers drove the change process.74 Similarly the results of this evaluation show the GP Super Clinic Directors or clinical leaders, in collaboration with the practice manager, driving the models of care.
Organisational culture, and in particular, relationships among all members of the health care team, have been demonstrated to be associated with health outcomes, particularly those associated with chronic disease management.31,75 Not surprisingly, clinicians and administrative staff clearly articulated the importance of the culture, driven by the leadership of GP Super Clinic Directors, and supported by clinicians, as a critical factor in the models of care. Indeed, a number of the GP Super Clinics had recruited specifically on the basis of attributes of teamwork and commitment to the model of care. Conversely, a number reported that where staff turnover had occurred it was commonly because of inability to work as a member of a multi-disciplinary team.
The importance of leadership in the GP Super Clinics’ model is also an inherent risk. In the absence of clear succession planning, problems could occur with service delivery under the agreed model if change in leadership occurs. This needs to be recognised within GP Super Clinics and succession planning supported within the Department of Health and Ageing.
27Bisognano M. Leadership’s Role in Execution Healthcare Executive. 2008.
31Wagner EH, Austin BT, Davis C, Hindmarsh M, Bonomi A. Improving chronic illness care: translating evidence into action. Health Affairs. 2001;20:64-78
74Wise CG, Alexander JA, Green LA, Cohen GR, Koster CR. Journey toward a Patient-Centered Medical Home: Readiness for Change in Primary Care Practices. Milbank Quarterly.89(3):399-424.
75Benzer JK, Young G, Stolzmann K, et al. The Relationship between Organizational Climate and Quality of Chronic Disease Management. Health Services Research.46(3):691-711.