title: Implementing large-scale workforce change: learning from 55 pilot sites of allied health workforce redesign in Queensland, Australia.
abstract: BACKGROUND
  Increasingly, health workforces are undergoing high-level 're-engineering' to help them better meet the needs of the population, workforce and service delivery. Queensland Health implemented a large scale 5-year workforce redesign program across more than 13 health-care disciplines. This study synthesized the findings from this program to identify and codify mechanisms associated with successful workforce redesign to help inform other large workforce projects.
  
  
  METHODS
  This study used Inductive Logic Reasoning (ILR), a process that uses logic models as the primary functional tool to develop theories of change, which are subsequently validated through proposition testing. Initial theories of change were developed from a systematic review of the literature and synthesized using a logic model. These theories of change were then developed into propositions and subsequently tested empirically against documentary, interview, and survey data from 55 projects in the workforce redesign program.
  
  
  RESULTS
  Three overarching principles were identified that optimized successful workforce redesign: (1) drivers for change need to be close to practice; (2) contexts need to be supportive both at the local levels and legislatively; and (3) mechanisms should include appropriate engagement, resources to facilitate change management, governance, and support structures. Attendance to these factors was uniformly associated with success of individual projects.
  
  
  CONCLUSIONS
  ILR is a transparent and reproducible method for developing and testing theories of workforce change. Despite the heterogeneity of projects, professions, and approaches used, a consistent set of overarching principles underpinned success of workforce change interventions. These concepts have been operationalized into a workforce change checklist.
authors: School of Health and Human Sciences, Southern Cross University, Military Road, East Lismore, NSW 2480, Australia. susan.nancarrow@scu.edu.au.
authors: Susan A
authors: SA
authors: Nancarrow
authors: Alison
authors: A
authors: Roots
authors: Sandra
authors: S
authors: Grace
authors: Anna M
authors: AM
authors: Moran
authors: Kerry
authors: K
authors: Vanniekerk-Lyons
mesh_terms: D000488:Allied Health Personnel / Q000458:organization & administration* / Q000600:supply & distribution; D003695:Delivery of Health Care; D018166:Health Care Reform / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D011793:Queensland; D000078329:Workforce