Does a minimum set of standards really equal high-quality care and a positive consumer experience?

With the recent announcement and official release of the new combined “Aged Care Quality Standards” which are set to take effect from the 1st July 2019, it is timely to reflect on how these new changes will impact current business processes and actual service provision.

Whilst the move by the Government to collapse the previously existing Accreditation, Home Care, Transitional Care and National Aboriginal and Torres Strait Islander Flexible Aged Care Quality Standards into a single format compromised of 66 standards & sub-standards, the move has been away from scrutinizing the robustness of aged care provider internal processes and will now have the consumers experience and providing a great level of transparency and clarity on expectations of services and care.

But does this change to a more “consumer focused” continuous improvement framework really equate to better or improved care at the cold face? Furthermore, it raises the question about the modern relationship between productivity, service quality and whether having a minimum set of standards is the tangible factor that can bring about the much needed change in customer experience and improve the level of care within the sector.

My first impression after reading the new standards are, that whilst they certainly seek to have the consumer in a more consulted role and place a greater emphasis on providers actively moving to meet consumer’s needs through more open engagement, for me the new standards seem to not capture, nor encourage care providers to address the critical key aspect of high quality service provision, being “workplace culture and support”. In an interesting article written by Davim & Clark at KPMG, the notion of whether the old adage of;

Productivity and Efficiency = Effort v’s Output

seems no longer in the modern era to rein true. It is simply no longer the case that the harder you work, or your staff work the great the effort or “standard of care” produced.

Instead they raise the very critical elements that now make up the equation being “PEOPLE, DIVISITY, TECHNOLOGY & INNOVATION”. They go on to advise that, without a strong and relevant company culture that supports these elements, that the chances of remaining competitive and breaking new ground to improve service delivery are slim.

I think many of us that work at the cold face, providing direct care to our clients, are acutely aware of the visible signs of stress, burnout, dissatisfaction, negativity perceptions and the severe lack of team morale, cohesion and positive culture that exists within many workplaces within the sector and my concerns are that this essential element, “company culture and support” has been perhaps overlooked in both the old and new quality standards. Whilst the premise of these changes have good intentions, I am left to wonder whether they will place an even greater amount of pressure on an already unskilled, bare labor market, that is not well financially resourced sector and with no additional funding on offer, how this remarkable transformation in service quality will be achieved.

In my company, we have recently experienced our own challenges around recruitment, retention and really establishing the culture that we desire, as a direct result of many of the same factors that affect our aged care provider partners, bare and transient workforce, a professional cohort that have limited exposure as a profession to specialist training in gerontology, a reduced perceived value in working within the sector and severe limitations on clinician service provisions imposed by strict ACFI business rules. So how do innovative and forward-thinking companies achieve the “Holy Grail” of quality healthcare provision if it’s not a regulated or legislated standard across the sector? We have chosen the path perhaps less travelled and have looked for inspiration in high performing teams such as the Richmond Football club, The Chicago Bulls, The Ford Motor Company, Apple and Google, all of whom have embraced the concept that performance outcome is defined by the sum of the teams cohesion and affinity for each other and the company and as such have sort the services of well renounced ‘Leadership & Cultural Change’ specialist Stuart Hayes to help our company strive to reach new heights.

For those of us that love football perhaps can relate to the Richmond Football clubs recent premiership success off the back a 30 plus year draught, a string of troubled players and negative media exposure for the club and mass scrutiny of Damien Hardwick’s ability to coach and lead an elite team, somehow this bottom dwelling team miraculously pulls off the biggest upset of the season and look to back it up again in 2018. Clearly not a one trick pony. So, what was it that was able to create such an enormous change and have this change sustained? The answer, was development of a team culture and set of values that were defined and created by the playing group and senior coaching staff that become so meaningful and ingrained that each individual lived the these authentically daily and when game days rolled around then the proof of their true value in achieving the ultimate success become evident.

A positive, effective organisational culture is not a given, but must be a core focus of leadership and middle management and filter through to every employee. Clark & Davim postulate that,

“You can have a clearly defined strategy and predetermined quality standards, but if culture is not aligned and employees do not have buy in to the company values and constitution, then there are mixed messages and people behave accordingly and the company can never achieve its goal”.

As such it brings us back to the initial question of whether, despite having this systems based quality framework and assessment, does this really translate to your care staff, nursing staff, domestic staff or even allied health staff providing a greater level of service?

If the leaders are not walking the walk, then the values, the mission the goals of the company will not be actioned at a service level. Clark further adds that the benefits of a strong culture extends to contractors, associated organizations or people undertaking consulting/ freelance projects within the company. Food for thought!

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