The following article were first published at LASA Fusion Magazine Autumn 2017 issue. Re-published with permission from the publisher.
Kerrie Tickner-Flynn is Executive Manager Community Care with Carrington Care.
When working in the aged care industry it can sometimes feel like the volume of administration work takes so much time away from our meaningful work of servicing our clients.
At Carrington Care we have recently undertaken a comprehensive review of our business process and introduced digital technology which has cut 60 per cent off the time it takes to assess our clients, create a care plan with them, and start their services.
As a not-for-profit provider covering residential care, independent living and community care, our aim is to remain responsive to the changing needs of older people, while keeping at the forefront of the aged care and retirement living sector in what is an increasingly contestable environment. Our Community Care service spans across the Wollondilly, Camden and Campbelltown Local Government Areas in New South Wales and we provide care and support to 500 clients.
Part of our strategic approach at Carrington is to leverage off new information technology platforms to drive business efficiency and growth.
A recent focus has been moving our 70 care workers, our client care coordinators and our Senior Case Manager into the digital age by supplying them with mobile phones and tablet devices with the appropriate software and digital systems to streamline their previously paper-based approach.
Our care workers typically provide our clients with a range of services including:
- Personal care which may include showering, grooming, shaving, medication monitoring, wound care, bowel and stoma care.
- Social support such as travel to medical appointments, library visits, weekly grocery shopping or bill payments, outings to movies or museums, or visits to classes or allied health therapists.
- Domestic assistance around the home.
- Respite including in-home or on site at our River Cottage.
Shifting the focus of our staff members to their new digital work environment hasn’t been something that could happen overnight and we have had to go through several iterations to get it right.
Prior to late 2014 staff members worked from and produced printed fortnightly rosters, time and travel sheets, progress note sheets and home folder sheets for client communication. Care plans for service episodes were also printed for inclusion in client home folders.
In November 2014 we took our first tentative steps towards reducing this paper-heavy process by implementing the base module of Procura software system. Our focus at the time was to implement client-directed care and individualised budgets; input all clients into the system and establish billing cycles.
However at the time of roll out our resources were limited and the IT platform was unable to sustain the level we required for further implementation. As such, we continued to rely on manual forms for assessment and intake of clients and for developing care plans and service agreements. This remained a lengthy process which included much paperwork and travel time through home visits to finalise details and quotes of services for clients on Home Care Packages or starting services through the Commonwealth Home Support Program.
Twelve months later when we conducted a review of the service, we determined that on-boarding a client was still taking up to 16 hours and identified a need to map all high level business processes and work flows to try and streamline our system. We also realised that our biggest challenge was becoming more familiar with Procura systems and knowing the correct questions to ask.
Our Chief Executive Raad Richards has been the project’s biggest champion and it was he who suggested we seek external guidance. In July 2016 he engaged Rohling International to help us work through all business process and all technical aspects that needed to be considered and negotiated with Procura.
As a result of this process we identified Procura Mobility and Point of Care as being the best ‘fit’ for our organisation. It is a system that is already being successfully deployed in other aged care organisations, such as OzCare in Queensland and Presbyterian Aged Care in Surry Hills. We contacted these organisations and they offered support and advice, including suggestions to stage the training on devices; not to rush staff in ‘giving up’ their paper-based time sheets; and ensuring all back office systems were working 100% efficiently before switching off manual time sheet processes.
The immediate challenge was to manage ‘business as usual’ while preparing the service and staff members for the new approach and the new requirements emanating from the aged care reforms.
Our first steps included mapping our business touch point with our clients, their carer and their families to determine where we were doing well and where there was room for improvement. We then reviewed the service, position descriptions, and functions against the phases of case management from the point of intake through to providing services and discharging a client. We focused on streamlining business processes according to person-centred care and the phases of case management support.
This process, along with a systems analysis, scoping service capacity, software licensing, comparative pricing of devices, and then implementing new hardware which included a new web server, surface pro tablets and Android phones, and new software including additional modules, workflow systems, developing electronic forms and writing new case management policies and procedures, took more than a year.
We switched over to Procura Mobility on 6 February 2017.
Under our new processes, we have reduced our forms by half and those that are available are available online in Procura. On-boarding a client using Procura Point of Care now takes an average of 3–6 hours depending on the complexity of the client’s needs.
With Procura Mobility we can now input all service episode activities against the client’s schedule service and these are pushed as a roster through to our care workers’ mobile phones, we are also able to match client-specific care needs against staff attributes and competencies more efficiently.
Care workers also have capability to complete a real-time series of observations that relate to client safety, health and wellbeing, falls, incidents/hazards as well as record home visit progress notes as part of their client’s care plan.
An important additional benefit has been that any changes recorded in the client’s wellbeing and needs sends an alert through to the back office where this is reviewed and responded to by the client’s care coordinators.
The system also allows care workers to note any workplace health and safety issues for them during their service time which in turn allows us to monitor incidents in real-time.
We also established a mobile phone help desk for support and use mobile phone management software to support staff remotely over the phone. This enables us to view any issues they are having and remote into their phone and talk them through a solution.
While the new systems and processes are still in a trial phase, staff acceptance of the mobile technology has been amazing. We continue to use some paper-based timesheets until confident that the interface between the Procura Mobility and our payroll system is 100%.
An important success factor in this major project is the amount of training and education that we have advanced to our staff. Without this high level of commitment from our staff and for them to fully embrace the change through their direct involvement from day one, the implementation of a change management of this magnitude would not have succeeded.
Our Executive Steering Committee and Working Group will continue to oversee the implementation of our digital strategy and a formal review and evaluation is planned six-months out.
This article were first published at LASA Fusion Magazine Autumn 2017 issue. Re-published with permission from the publisher.