Australia: Surgical practice set for transformational cultural change

Earlier this year, an Expert Advisory Group (EAG) commissioned by the Royal Australasian College of Surgeons (RACS) released the results of its research into cultural issues in surgical practice, revealing widespread "discrimination, bullying and sexual harassment" (DBSH) as significant and persistent problems in medical work environments.

Notably, the EAG's background briefing indicated that past attempts to change workplace culture have focused on victims and perpetrators, but overlooked the influence and significance of the behaviour of observers or bystanders who contribute to maintaining a culture that accepts inappropriate behaviour. Indeed, there is now a commonly acknowledged leadership principle that "the culture of any organisation is shaped by the worst behaviour the leaders are prepared to tolerate" (undated quote, Gruenter & Whitaker).

Following the release of the EAG's final report in September, the RACS released its Action Plan last month, foreshadowing a number of changes and initiatives that will seek to achieve cultural and transformational change in the practice of surgery.

What is the RACS Action Plan?

The RACS has committed to focusing on "cultural leadership, surgical education and complaints management" in its Action Plan, which sets out the details of what will be a comprehensive and systematic approach to reducing the prevalence of DBSH across the industry.

Perhaps one of the most significant elements of the Action Plan is that surgeons will be required to undertake compulsory training as part of a Continuing Professional Development (CPD) program. The training will focus on:

• Promoting awareness and understanding about what constitutes DBSH
• Teaching skills of resilience in maintaining professional behaviour
• Encouraging those who see bad behaviour to "call it out", not simply walk past it
• Promoting organisational change to nurture respect and good behaviour.

Some of the other elements of the Action Plan are briefly summarised in the table below.

How can we help?

DibbsBarker has a team of experts who have extensive experience partnering with organisations in a number of industries to achieve not only baseline compliance, but also transformational cultural change. Our experts look beyond what might be technically required by any given CPD program, tailoring solutions to meet particular needs which might include:

• Reviewing Codes of Conduct, Anti-DBSH policies and complaints resolution procedures
• Training programs for all employees to:
• • Outline legal requirements (Anti-DBSH policies, complaints resolution procedures and consequences of breach)
  • Clarify the boundaries of 'reasonable management action' and bystander expectations
• Running leadership sessions focused on cultural change and leadership skill development including:
• • Courageous conversations and providing effective feedback
  • Developing healthy and engaged workplace teams.

This article is intended to provide commentary and general information. It should not be relied upon as legal advice. Formal legal advice should be sought in particular transactions or on matters of interest arising from this article. Authors listed may not be admitted in all states and territories