Pebbles Programme - Pinnacle Practices
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Professional Development Unit
Pebbles
Clinical Leadership Development
Programme
For Registered Health Professionals
Programmes commencing
March, April, June, August 2021
“Just as ripples spread out when a single pebble is dropped into
water, the actions of individuals can have far reaching effects’
Dalai LamaPebbles
Clinical Leadership Development Programme
The Pebbles programme is a Waikato DHB professional development programme for clinically-based
registered health professionals. It introduces development strategies for health professionals to extend
clinical leadership skills and/or prepare for senior roles. The programme recognises and builds on the
contribution health professionals make in the provision of safe, effective, quality, person- centred
healthcare.
Aim
The programme utilises a Practice Development approach to:
• Develop the capacity to improve health outcomes for consumers and contribute to meeting the
health needs of the Waikato population through addressing equity strengthening, promoting and
enhancing the participants leadership competencies and abilities
• Develop registered health professional capability to lead quality processes and manage change in
clinical practice
• Support succession planning.
The programme provides a supportive, inter professional, peer learning environment and is seen as a
means of contributing to the development of health professionals working within clinical environments. It
is designed to promote clinical leadership for those wishing to remain in the clinical environment as well as
those aspiring to move into formal leadership and management positions.
Expected outcomes for participants
• Understand how knowledge regarding political, global, population and organisational influences on
healthcare practice can be utilised in own clinical and cultural practice
• Demonstrate increased knowledge and skills to facilitate the gathering and dissemination of
knowledge; teaching and communicating; and responding to and leading change processes
• Be able to articulate patient safety and quality priorities of the organisation and demonstrate how
these can be implemented in practice
• Identify areas for improvement in their own area, using data available from various sources e.g.
quality indicators, audit, CCDM, datix data, patient complaints/suggestions.
• Be able to articulate how increased knowledge and understanding of leadership theory will be
applied in own practice
• Further develop individual and collective leadership competencies such as communication and
decision making, advocacy, empowerment, and partnership.
Prospective Pebbles candidates are required to:
• Be nominated by their Manager/Team Leader
• Be a registered health professional with at least three years clinical experience and not currently in
an appointed senior position. Ideally practitioners will have been in clinical practice for less than 10
years, but consideration will be given for those outside of that time frame.
• Be employed by the Waikato DHB or employed in an area providing health care as part of the
continuum within Waikato DHBs area e.g., .NGO, PHO, ARC, Corrections
• Demonstrate a commitment in own practice to developing leadership skills – e.g. regarded for
clinical expertise, engages in peer education, has completed preceptor training,
leads/initiates/engages in quality projects.
• Demonstrate the following attributes required for nomination to this programme:
• Professionally committed and dedicated
• Demonstrates active commitment and participation in the ward/unit
• Role models commitment to provide quality care
• Adapts to new circumstances with flexibility and creativity
2Manager/Team Leader/Educator commitment
• Identify areas for improvement project based on demonstrable data
• Identify suitable candidate(s) to develop a project to address the issue. This could be split into
sections to culminate in a larger group effort over the course of the year.
• Release each nominee for four full days over a four month period.
• Provide coaching and support for their nominees throughout the Pebbles programme and beyond
to ensure continuity and progression.
Rationale for changes to the programme in 2020
The Pebbles programme content was originally based on an article by Huston (2008) who defined the
competences required for nurse leaders in 2020. These are further identified in the Global Advisory centres
information and in other articles referenced in this document.
The Waikato District Health Board’s (DHB) Health System Plan (April 2019), envisions becoming a learning
system that:
• thinks outside the square,
• improves the process of implementing and evaluating initiatives
• improves approaches that enable rapid turnaround of development and improvement
• Encourages the spread of successful innovation
• Improves the visibility of the good work that is already occurring in the Waikato
The Waikato DHB resource report (June19) identified that some initiatives and projects occur without
actually understanding why the proposal should occur, and what would happen if it didn’t eventuate. This
leads to many projects that add little or no benefit to the organisation and an increase in “change fatigue”
within the organisation.
Pebbles facilitators and senior nurses have observed significant repetition of projects previously
undertaken by a variety of areas demonstrating that while useful change may have occurred in some areas,
the opportunities to share and learn from these has not followed through to other areas. There has been
no follow up or “closing the loop” to ensure projects are completed or shared, as there is no infrastructure
to facilitate this.
From 2020 it was proposed that Pebbles participants be nominated to undertake specific, data driven
projects for their areas. Where possible strategic priorities should be driving the projects e.g. quality
indicators, poor audit outcomes or contributing to improved access, efficiency and patient satisfaction.
Projects will be encouraged to use the Releasing Time to Care models and/or co-design to ensure
consistent approaches to change management. There will be an expectation that in addition to presenting
their projects to their peers, participants will provide a literature review and executive summary that can
be collated and shared with the WDHB Executive. Participants will be encouraged to present their projects
to a wider audience via, for example, Nursing Round Table, conference presentations etc.
Applications from allied health are welcomed and their contribution to better inter professional
communication and care remains highly valued.
Applications are also welcome from NGO, PHO, Aged Residential Care and Corrections.
3Programme overview
The programme introduces participants to a wide range of information including leadership theories and
methods, practice development methodology, change management, evidence-based practice and
professional responsibilities required for clinical leadership.
They will also be provided with readings and support to enable them to complete a change project within
their clinical area. Participants will give a 15 minute PowerPoint presentation of their project on the last
course day.
The overall structure of the Pebbles programme aims to provide participants with an opportunity to reflect
on their own practice and also to share and discuss common concerns and situations as well as the
information contained in the course content. Participants will be supported to consider leadership from
different world views and how this may resonate with their own practice.
The programme aligns with the Waikato DHB strategy and priorities which includes health equity for high
needs populations, person centred care, and productive partnerships.
Nomination process
Nominations are called for through the Manager or Team Leader network. These are now open and we
invite managers/ team leaders to nominate staff for the 2021 intakes. Registered health professionals who
wish to be considered for nomination will need to discuss this with their manager/team leader. There are
limited places available. A selection process will consider applicants suitability and motivation to undertake
the programme. Applications for other cohorts may also be submitted at this time.
Please complete the attached nomination forms and email or send to Lyn MacLeod. Nominations for the
March cohorts close on 9th December 2020. Selection process and notification will be completed by 17th
December 2020. Please indicate if there are preferences regarding group because of annual leave/other
study commitments.
Programme dates (see programme information below for further details)
Venue
Sessions are held at Waikato Hospital campus unless notified otherwise.
Additional information
Further information is available from Lyn MacLeod or any member of the Professional Development Unit.
Contact Details and key people
Lyn MacLeod Nurse Coordinator Kate Yeo – Deputy Chief Nurse
Professional Development Unit Waikato District Health Board
Phone 021 759508 Phone 021 220 6344
Lyn.macleod@waikatodhb.health.nz Katherine.yeo@waikatodhb.health.nz
Suzie Gardner - Nurse Coordinator
Professional Development Unit
Phone 021549635
Suzie.Gardner@waikatodhb.health.nz
4SAMPLE PROGRAMME SCHEDULE (NB: Programme may change due to availability of speakers etc.)
SESSION TIME TOPICS
Session 1 0830-1630 Introduction and Overview
Health and the ‘big picture’
Change management
Quality and Patient Safety – co-design and consumer engagement
Preparing for change project
Session 2 0830-1630 Collaboration and team working
Leadership theories and methods
Decision making skills and utilization of evidence-based practice
Change project narrative
Session 3 0830-1630 Participant self-directed change project preparation
One to one support available
Session 4 0830-1630 Clinical leadership in practice participant presentations
Reflection on process and individual learning
Dissemination of outcomes/plans for the future
Pebbles dates 2021
Group 1 Rooms
23March Day 1 Library Meeting Room 2
20 April Day2 Library Meeting Room 2
18 May Day3 Library Meeting Room 2
22 June Day4 Library Meeting Room 2+ Library Meeting Room 3
Group 2
13April Day 1 Library Meeting Room 2
11 May Day2 Library Meeting Room 2
15 June Day3 Library Meeting Room 3
13 July Day4 Library Meeting Room 2+ Library Meeting Room 3
Group 3
3 August Day 1 Library Meeting Room 2
7 September Day2 Library Meeting Room 2
5 October Day3 Library Meeting Room 2
9 November Day4 Library Meeting Room 2+ Library Meeting Room 3
5Group 4
17 August Day 1 Library Meeting Room 2
21 September Day2 Library Meeting Room 2
19 October Day3 Library Meeting Room 2
23 November Day4 Library Meeting Room 2+ Library Meeting Room 3
Bibliography and recommended reading
Bradd P, Travaglia J, Hayen A (2017) Practice Development and allied health – a review of the literature.
International Practice Development Journal. 7 (2).
Casey M, McNamara M, Fealy G, Geraghty R (2011) Nurses’ and midwives’ clinical leadership development
needs: a mixed methods study. Journal of Advanced nursing. P 1502
Dilworth K, Lankshear S et al (2011). The top 30 Rising Stars Program: an inter organisational approach to
leadership succession planning. Healthcare management forum. Summer 2011. 24:68-71
Global Advisory Centre (2016) Tools and Templates. Nurse Executives’ competencies.
Huston C. (2008) Preparing Nurse Leaders for 2020. Journal of Nursing Management 16, 915-911
International College of Nurses, (2019). Strategic Priorities. https://www.icn.ch/who-we-are/icn-mission-
vision-and-strategic-plan
Manley K, McCormack B (2003). Practice development: purpose, methodology, facilitation and evaluation.
Nursing in Critical Care, 8 (1): 22-9
Manley, K., Buscher, A., Jackson, C., O’Connor, S. & Stehling, H. (2017). Overcoming synecdoche: Why
practice development and quality improvement approaches should be better integrated. International
Practice Development Journal, 7,(1).12. doi.org/10.19043/ipdj.71.012
McCormack, B. & McCance, T. (2017). Person-centered practice in nursing and health care theory and
practice. UK,Wiley Blackwell
McKillop, A., Atherfold, C. & Lees. G. (2014) The Power of Synergy: An academic / clinical partnership for
transformational change. Advances in Nursing. http://dx.doi.org/10.1155/2014/605835
Mills, C., Reid, P. & Vaithianathan, R. (2012). The cost of child health inequalities in Aotearoa New Zealand:
a preliminary scoping study. http://www.biomedcentral.com/1471-2458/12/384
Ministry of Health. (2014). ‘Ala Mo’ui. Pathways to pacific health and wellbeing 2014-2018.
https://www.health.govt.nz/system/files/documents/publications/ala-moui-pathways-to-pacific-health-
and-wellbeing-2014-2018-jun14-v2.pdf
Ministry of Health. (2014). He Korowai Oranga Māori Health Strategy.
https://www.health.govt.nz/system/files/documents/publications/mhs-english.pdf
Ministry of Health. (2018). Achieving equity in health outcomes.
https://www.health.govt.nz/publication/achieviequity-health-outcomes-highlights-selected-papers
6Ministry of Health. (2016). New Zealand Health Strategy. https://www.health.govt.nz/publication/new-
zealand-health-strategy-2016 New Zealand Health Quality Safety Commission. (2018).
https://www.hqsc.govt.nz/
Riley, C. & Crawford, R. (2010). Reducing health disparities for low decile children and families: a nurse-led
response. Journal of Primary Health Care, 2(3) , 243-248
Shirey M. (2009) Authentic Leadership, Organisational Culture, and Healthy work environments. Crit Care
Nursing Vol 32. pp189-198
Thompson J, Moyo N, Fullerton J, (2016) Midwifery Leaders Programme: Building capacity for the future.
International Journal of Childbirth Vol 6, issue 2.
Waikato DHB. (2019). Health Systems Plan. New Zealand.
https://waikatodhb.cwp.govt.nz/assets/Docs/About-Us/Key-Publications/Plans/7bf3d1e7ca/Waikato-
Health-System-Plan-Te-Korowai-Waiora.pdf
Waikato DHB. (2016). Healthy people excellent care: Waikato District Health Board Strategy. Hamilton, New
Zealand. https://www.waikatodhb.health.nz/assets/Docs/About-Us/Key-
Publications/Strategies/4750ac5a11/Waikato-DHB-Strategy-2016.pdf
Wong, C.A. (2015) Connecting nursing leadership and patient outcomes: State of the science. Journal of
Nursing Management, 23(3), 275-278
.
7Professional Development Unit
Pebbles Clinical Leadership Development Programme
For Registered Health Professionals
Nomination form
To be completed by Manager/Team Leader/Educator
(Please note: there are two forms, one for the manager and one for the nominee)
People seeking to participate in this programme need the nomination and support of their
Manager/team leader/educator.
Please consider the following attributes when nominating a person for Pebbles:
• Professionally committed and dedicated
• Demonstrates active commitment and participation in the ward/unit
• Role models commitment to provide quality care
• Adapts to new circumstances with flexibility and creativity
Applicant name Place of work
Manager / Team Leader/ Educator written recommendation
Leader Name Date and Sign
Email address: Phone:Professional Development Unit
Pebbles Clinical Leadership Development Programme
For Registered Health Professionals
Nominee information and personal statement
(Nominee to complete)
Please provide the information requested below and also a summary of approx. 150 words outlining why
you believe the programme will be of value to you in your practice. Include likely outcomes for
consumers and the clinical team in your area of practice. (You will need to take into account the
information provided about the Pebbles programme)
Name: Other certifications / qualifications
Age:
Area of work: Are you currently enrolled in academic study?
Employee number: If so what?
Work email address
Mobile phone number Number of years in current role?
Nursing / Midwifery/ HPC council registration Attained PDRP/QLP Level (nurses/midwives only)
number:
Applicant reason for participation in the Pebbles programme
Please use over the page if necessary
Signature and Date:
Please scan or email completed forms to Lyn MacLeod
Lyn.macleod@waikatodhb.health.nz
Nominations for the March cohorts close on 9th December 2020. Selection process and notification will
be completed by 17th December 2020. Please indicate if there are preferences regarding group because of
annual leave/other study commitments.
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