Introduction: The Australian Government recently announced major reforms to the health system - A National Health and Hospitals Network for Australia's Future. The national health reform plan involves substantial structural change which the Government expects will deliver 'better health and hospitals' for future generations. Approach: A review is undertaken of the proposed set of reforms to determine whether its frame of reference can contribute to the effective achievement of the desired health and hospitals outcomes. Findings: The national health reform plan was found to have two striking weaknesses. Firstly, it fails to account for the political, cultural, behavioural and professional aspects of change. Secondly, it fails to position leadership and health management as central to the implementation of reform. Conclusion: The complexity of major structural change is such that major health reform strategies need to incorporate proper assessment of organisational behaviour aspects within a system which values the central roles of leadership and health management. A new leadership model for introducing health reform is presented.

Purpose - Positive organizational scholarship in healthcare (POSH) suggests that, to promote widespread improvement within health services, focusing on the good, the excellent, and the brilliant is as important as conventional approaches that focus on the negative, the problems and the failures. POSH offers different opportunities to learn from and build resilient cultures of safety, innovation, and change. It is not separate from tried and tested approaches to health service improvement - but rather, it approaches this improvement differently. The paper aims to discuss these issues. Design/methodology/approach - POSH, appreciative inquiry (AI) and reflective practice were used to inform an exploratory investigation of what is good, excellent, or brilliant health service management. Findings - The researchers identified new characteristics of good healthcare and what it might take to have brilliant health service management, elucidated and refined POSH, and identified research opportunities that hold potential value for consumers, practitioners, and policymakers. Research limitations/implications - The secondary data used in this study offered limited contextual information. Practical implications - This approach is a platform from which to: identify, investigate, and learn about brilliant health service management; and inform theory and practice. Social implications - POSH can help to reveal what consumers and practitioners value about health services and how they prefer to engage with these services. Originality/value - Using POSH, this paper examines what consumers and practitioners value about health services; it also illustrates how brilliance can be theorized into health service management research and practice.

At both the Commonwealth and state level, the agenda for healthcare reform is moving rapidly. The National Health and Hospitals Reform Commission (NHHRC) is currently reviewing the health system to make recommendations for sustainable Improvements to the performance of service delivery. Several states have also undertaken inquiries over the past two years in response to major issues identified in the delivery of patient care within the public health system. The need for improvement is evident. Rising health costs, the growing impact of chronic disease, an ageing population and the inefficiencies derived through a disjointed funding and policy mechanism, are Just a few of the many challenges ahead. Despite current national health expenditure being in excess of $94 billion, significant issues exist in terms of access and equity, safety and quality, poor health outcomes for Indigenous people and others with special needs, workforce shortages and a lack of focus on the promotion of health and wellbeing.

The Australian Labor Government recently announced a significant change to the structure of the Australian health care system - 'A National Health and Hospitals Network for Australia's Future'. The proposed reforms involve major structural change to the current health and economic systems so as to allow the required financing and governance foundations. It is widely recognised as the most significant health reform since Medicare was set up. Despite evidence from the United Kingdom, Europe, United States and Canada that health reform strategies rarely realise planned efficiencies and improvements, the Australian Government has created high expectations that it will deliver better outcomes and sustainable improvements in hospitals and health care. One likely impediment to success is that it is widely recognised that the Commonwealth and States generally lack the capacity and capability to lead such a major implementation process for reform. Unfortunately, this lack of skill and capacity is not just confined centrally, but exists at the local health service level among the health care professionals who are expected to provide leadership, management and support for the new arrangements in governance. Recent research in Australia indicates that appropriately qualified and experienced health managers are of central importance to the successful implementation of reform. However, the proposed reform package fails to account for this. This article aims to review the proposed national health reforms and to determine whether these new arrangements can contribute to or preclude the desired achievement of better health and improved hospital care for us all.

After studying this chapter, the reader should be able to: • Identify the context and environment that influences managing people in the health care industry. • Describe and analyse a framework of theories strategies and skills which can guide managers in thinking about developing their own systems and practices. • Demonstrate understanding of policies, procedures and practices in managing people in health care services. • Demonstrate understanding of how organisational goals are achieved through working with people. • Identify some of the common situations that managers face that call for interpersonal skills.

Since the emergence of digital imaging, there have been questions about the necessity of continuing reject analysis programs in imaging departments to evaluate performance and quality. As a marketing strategy, most suppliers of digital technology focus on the supremacy of the technology and its ability to reduce the number of repeats, resulting in less radiation doses given to patients and increased productivity in the department. On the other hand, quality assurance radiographers and radiologists believe that repeats are mainly related to positioning skills, and repeat analysis is the main tool to plan training needs to up-skill radiographers. A comparative study between conventional and digital imaging was undertaken to compare outcomes and evaluate the need for reject analysis. However, digital technology still being at its early development stages, setting a credible reject analysis program became the major task of the study. It took the department, with the help of the suppliers of the computed radiography reader and the picture archiving and communication system, over 2 years of software enhancement to build a reliable digital repeat analysis system. The results were supportive of both philosophies; the number of repeats as a result of exposure factors was reduced dramatically; however, the percentage of repeats as a result of positioning skills was slightly on the increase for the simple reason that some rejects in the conventional system qualifying for both exposure and positioning errors were classified as exposure error. The ability of digitally adjusting dark or light images reclassified some of those images as positioning errors.

After studying this chapter, the reader should be able to: • Define theories and concepts underpinning organisational performance improvement practices in health care. • Analyse international and local frameworks for improving organisational performance. • Demonstrate understanding of the steps required to implement a process for improving organisational performance. • Describe the advantages and limitations of standardised measures used to assess organisational performance. • Evaluate challenges and Opportunities for improving organisational performance.