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The voice of all aged services Winter 2014 | www.lasa.asn.au

Communications Feature: Branding, Marketing, Social Media and Crisis Communications CDC:

how to stand out

Legal Issues:

Risk management in Will preparation

Lynden Aged Care: Paperless and wireless

Pressure injury prevention and management

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Partnering with


The voice of all aged services Winter 2014 | www.lasa.asn.au

CONTENTS

IT

5 CEO Report

17 ITAC 2014

7 Chair Report

18 Wireless & paperless

8 SA Report

23 Leecare Platinum 5 Suite

10 NSW-ACT Report

60 CSIRO Staying at home

12 VIC Report 13 QLD Report

Communications

14 WA Report

12 Twitter

17 ITAC 2014: A must attend event

25 LinkedIn

18 Lynden Aged Care: Wireless and paperless

28 How to stand out

23 The Leecare Solutions’ Platinum 5 Suite

30 Crisis communications

25 LinkedIn

33 A brand new dawn

26 CDC ‘Gold’ 28 How to stand out in a sea of competitors

Customer Focus

30 Crisis Communications in Aged Care

26 CDC ‘Gold’

33 A Brand New Dawn

35 Customer Growth

35 What’s in a name? 37 Make your life worth living as your living is being made

37 Make your life worth living

38 Study puts spotlight on nutrition in aged care

44 With one voice

43 Decision Assist 44 With one voice

Industry Briefing

47 Aged Care won’t be affordable for everyone

47 Aged Care won’t be affordable for everyone

49 Legal Issues: Duty of Care beyond health

49 Legal Issues

53 A crystal clear answer for Pressure Injury Prevention and Management

80 Book Review

59 New national online resource to promote advance care planning

Clinical

60 Staying Home

43 Decision Assist

80 Book Review

53 Pressure injury prevention

81 Calendar of Events

59 Start to Talk

82 Product news

EDITOR

38 Spotlight on nutrition

Justine Caines National Government Relations and Communications Manager

LASA Federal Patrick Reid CEO Unit 4, 21 Torrens Street Braddon ACT 2612 E: patrickr@lasa.asn.au

LASA Victoria Gary Henry Interim CEO Level 11 600 St Kilda Rd Melbourne VIC 3004 E: garyh@vic.lasa.asn.au

LASA WA Beth Cameron CEO Suite 6, 11 Richardson Street, South Perth WA 6151 E: ceo@wa.lasa.asn.au

LASA NSW/ACT Charles Wurf CEO PO Box 7 Strawberry Hills NSW 2012 E: Charles.wurf@nswact.lasa.asn.au

LASA SA Paul Carberry CEO Unit 5, 259 Glen Osmond Road Frewville SA 5063 E: ceo@sa.lasa.asn.au

LASA QLD Barry Ashcroft CEO PO Box 995 Indooroopilly QLD 4068 E: barry.ashcroft@qld.lasa.asn.au

Adbourne

Adbourne Publishing PO Box 735 Belgrave, VIC 3160

Advertising Melbourne: Adelaide:

Neil Muir (03) 9758 1433 Robert Spowart 0488 390 039

Production Emily Wallis

(03) 9758 1436

PUBLISHING

Administration Robyn Fantin (03) 9758 1431

DISCLAIMER Fusion is the regular publication of Leading Age Services Australia (LASA). Unsolicited contributions are welcome but LASA reserves the right to edit, abridge, alter or reject

material. Opinions expressed in Fusion are not necessarily those of LASA and no responsibility is accepted by the Association for statements of fact or opinions expressed in signed contributions. Fusion may be copied in whole for distributed amongst an organisation’s staff. No part of Fusion may be reproduced in any other form without written permission from the article’s author.


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FUSION | 5

Report from the CEO Budget 2014: Fiscal Responsibility? Patrick Reid Chief Executive Officer | Leading Age Services Australia

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ur industry was dealt a onsiderable blow in the Federal Budget with the removal of the Aged Care Payroll Tax Supplement, comprising $653 Million over 4 years. This came with no consultation and will create a vastly uneven aged care industry, and industry that relies on competitive neutrality to ensure access for older Australians. The removal of this funding can only result in a concomitant rise in consumer pricing and the compromise of jobs, skills and care; these are cuts that LASA will not tolerate. LASA’s advocacy response was swift. I met with both Minister Andrews and Fifield in the first 24 hours after the Budget was delivered, with subsequent meetings with both the Treasurers and Prime Minister’s offices and shadow Minister and the Greens. This action was dovetailed with state CEO’s holding meetings with their relevant state Premiers and Treasurers delivering strong advocacy outlining the likely results from this direct attack on provider’s bottom line. LASA does not swallow the line that the removal of this direct industry supplement is simply a product of the current government’s taxation pushback to the states. The Aged Care Payroll Tax Supplement has been in existence since 1968, long before the institution of the GST and as a direct result of the special circumstances surrounding the provision of residential aged care. In taking up the National Commission of Audit recommendation to remove the Payroll Tax supplement, the government goes against its own justification for the payment “that in the interests of competitive neutrality, the Commonwealth currently refunds for-profit providers for the payroll tax that they pay”; yet the budget has perversely destroyed competition by removing the supplement, a supplement that contributes to their own assertion that there is a ‘strong rationale for government involvement in aged care on equity grounds’. LASA has also stated that while it supports fiscal responsibility in this case a perceived budget saving could ultimately cost the government considerably more; consequently one must question the rationale in which it was made. This is certainly the case with residential aged care, where a lack of funding will propel potentially thousands of older Australians into the public hospital

system. When the cost of providing a hospital bed is more than six times that of the highest residential care funding; any destabilising of our industry could not be considered ‘responsible’. Both the previous and current government have acknowledged the need for a $25 Billion investment in the age services industry to meet demand. How is this possible when options for capital investment will now prove non-existent, let alone viability for a cohort of providers? LASA was naturally pleased to see the return of the workforce supplement funding in the order of $1.5 billion over four years. Whilst this is significant it only brings the industry back in line with the funding that was removed from care budgets in 2012. When one adds the loss of the pay roll supplement removal it is a somewhat hollow victory. July 1 is now upon us as is the raft of changes that come into effect. LASA has consistently expressed the need for an active risk management approach in regard to accommodation funding choices. The government has not proven to us that they have the ability to respond quickly and as such LASA has been working with ACFA to enable closer monitoring of accommodation payments and the degree to which consumer sentiment to payment changes. A shift away from Refundable Accommodation Deposits (RAD) to Daily Accommodation Payments (DAP) coupled with the current loss of the payroll supplement has the ability to add even greater strain to some providers. With the final tranche of subordinate legislation only released shortly before the time of printing we are finally in a position to develop full information on the impacts of July 1 implementation. We will provide, through LASA state offices, our members with a go-to reference on how the legislation impacts their own operational context On the back of the success of LASA’s inaugural policy forum we plan to hold an industry wide workforce and training forum in August with Minister for Industry, Ian Macfarlane in attendance. LASA will gather leaders to represent the breadth of both service delivery, organisational type and special needs. An event that will be geared towards positive and practical outcomes to support the critical issue of workforce development and skills promotion. ■


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FUSION | 7

Message from the Chair Achieving industry success through innovation and collaboration Marcus Riley Deputy Chair, LASA

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s we arrive at the middle part of our year a number of annual activities take precedence. Firstly, the refinement of program for LASA’s annual conference, which is this year being held in Adelaide during October. The 2013 national conference was a smashing success due to the quality of speakers, themes of innovation, positivity and creativity which pulsated through the event and the coming together of people from across every spectrum of the age services industry. The 2014 national conference promises to even surpass what we saw last year. The conference planning committee has spent the past several months putting much energy and intellect into the preparation for the event and we are set for a wonderful program to challenge our thinking, provoke debate and assist in our consideration for the short and long term futures of our respective organisations. I encourage you to plan your attendance – and your colleagues – at this year’s national conference and derive the benefits as the delegates from 2013 did to such a great extent. Of course the key mid-year (or in the months leading up) activity is our preparation of budgets for the coming financial year. We do need to ensure however, the number-crunching is balanced with adequate reflection on our strategy, service (and business) models and practices. Through this process we need to be challenging ourselves as to – are we being innovative in what we do and how we’re doing it? Are we testing our previous thinking and previous methods? I am pleased to confirm LASA has been asking these questions of itself. The National Board and CEO are advancing these considerations through our strategic planning process and examining how we best (continue) to lead the industry and how we best represent and serve our membership. An important part of this strategic work is engagement with all state LASA Boards and staff and the wider membership across all parts of the industry. There will be various opportunities for members to make input as

the process continues and I encourage you to participate wherever possible. This is particularly important as LASA is an inclusive association and our direction and priorities are member-driven. As per one of the key themes from the aforementioned 2013 national conference, let’s not have our thinking constrained by inter alia the Government’s own budgetary framework – as significant an issue as it is – rather lets aspire to create ‘disruptive’ models, to be innovative, to lead. Collaboration is a key ingredient to enable this type of new-thinking to occur. Again when contemplating collaboration numerous questions come to mind – are we learning from each other? Are we open to hearing how others have had success? Are we open to share with others how we may have achieved success? Are we willing to look outside our industry? Once again the national conference and other such forums present a wonderful opportunity to initiate this collaboration. Budgeting is a crucial time of year but should be about more than just ‘bean counting.’ Of course many organisations will have other scheduled periods for deeper strategic planning but there is value in having these issues considered when the dollars are being examined too. Are we, as key personnel, leading our organisation or team’s thinking and creating opportunities for others to think and be innovative. It has been pleasing to see the national CEO and his team – with direction and support from the Board – actively seeking for better and more innovative ways to support members and enhance LASA’s contribution to our age services industry. We are completely cognisant that Governments will play their role and the constraints they place on us must continue to be challenged however we determine the success of our businesses. We as leaders of our organisations and industry will mark out the new ground we break. The asking of challenging and idea-provoking questions of ourselves and our teams is the starting point for reaching the new destinations that beckon us. Opportunity awaits. ■


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South Australia Report The Federal Budget meets aged care reforms Paul Carberry Chief Executive Officer | LASA SA

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ess dependence on welfare, a further shift towards greater user contributions for government-funded services, and reduced support to the states for the programs they run. These are some of the broader themes of the 2014 Federal Budget which will impact on the aged care sector, either directly or indirectly. The measures which directly affect aged care are in keeping with these themes. These include the reduction in the rate of real growth of the Home Support Program, which will inevitably transfer more cost to consumers needing care and support in their homes, something which the government, in other areas of policy, claims to encourage and support. The cessation of the aged care Payroll Tax Subsidy abandons a long-standing principle of ameliorating cost inequalities between different parts of the sector, a really good principle, given that the whole sector operates under the same rules with respect to subsidies, fees and outcomes. Lost on the folks in the Commission of Audit, who came up with the idea, is that whilst, in the overall context of the Federal Budget the saving is modest, the cost impact on the 35% of services most affected is very significant. Clearly, the Government has not thought through the possible consequences, including the effect this may have on the appetite for new sector investment, and the flow-on effect any reduction in investment will have on the supply of needed services and the growth in jobs. The 2.4% boost to subsidies is welcome although, there are two points to note. Firstly, although appreciated, it simply returns funds which were cut by the freezing of subsidies in 2012 and changes to the funding instrument rules. Secondly, for the providers affected, loss of the Payroll Tax Supplement will considerably outweigh the 2.4% subsidy gain. Other budget measures will have an indirect effect on the sector through changing the incomes and the necessary expenditures of senior Australians. Indexing age pensions to the CPI will reduce the rate of pension growth, which will flow to lower aged care basic payments linked to the pension.

The $7 GP visit co-payment and increased PBS co-payments will affect the disposable income of pensioners The Budget is also terminating the agreement with the states which contributes to the payment of state-government concessions for pensioners and seniors, for example, free public transport. The states will either have to find this money somewhere else, or pensioners will need to pay more. Removal of the Seniors Supplement may remove benefits from some better-off seniors who, arguably, didn’t need them; however, it will also increase the cost of utilities for pensioners for whom the benefit provided important assistance. These Budget measures, both direct and indirect, are taking place at a time of significant change in aged care, as the sector embarks on the biggest reform agenda since the arrival of the Aged Care Act. Care recipients entering the system after 1st July will contribute more towards their care and accommodation, in some cases, a lot more. Whilst, in the context of an ageing population and shrinking workforce, this trend is arguably both equitable and inevitable, questions remain over the design of the means-testing and payments system which is about to be introduced. For some in residential care, the cost of fees and accommodation will exceed their income. They can solve this problem by spending down their assets or by having their payments deducted from their accommodation deposits. Fair enough perhaps, but the $45,000 of assets which they must be left with is hardly “preserved” if they can immediately start using it to pay for aged care costs, and the accommodation deposit is hardly “fully refundable” if they have no choice but to have aged care costs deducted from it. Meanwhile, people further up the income and assets ladder may choose to pay RAD/DAP combinations, and may choose to have payments deducted from their RAD, but they will not be forced to, as their less well-off counterparts will. The current government inherited the design of these reforms and is implementing them predominantly unchanged. When the dust settles after 1st July, they may need to take a closer look at what they inherited. ■


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NSW-ACT Report Confronted by change, continue to adapt Charles Wurf Chief Executive Officer | LASA NSW-ACT

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hroughout the lead-up to 1 July I have been drawn back to one standout notion: this industry has been consistently confronted by change in the past, but has always adapted and continued to provide quality care. Commentary from members regarding the current round of changes from 1 July 2014 is mixed, each provider seems to have its own unique set of challenges, and some require greater internal adjustment than others. Anecdotal feedback suggests the Department does understand that change is taking place at different timeframes for different providers. But by what nature the Department’s

response will be to those who have struggled to meet timelines, ranging from additional assistance to the punitive, only time will tell. It will certainly be an interesting comparison to draw with the inability of DSS and DHS to fully meet their own timetables and organisational commitments since 1 July 2013. The Department does have an obligation to provide appropriate information and communication to providers who are preparing to adapt in advance of the 1 July 2014 changes. Yet information continues to be released later than what can reasonably expected to make decisions or provide feedback. The most recent example (at time of writing) was the release of the Exposure Drafts – Fees and Payments Principles and Subsidy Principles. This much anticipated release took place on 26 May, with comment requested by 2 June. This is another example of a difficult timeline to be endured, which has been a constant throughout the implementation of Living Longer, Living Better. Indeed, many of the issues which are challenging providers to be ready for 1 July could have been overcome or avoided had the Department provided greater detail sooner. While we always welcome the opportunity to assist members, clearly our Association has needed to step-in to address Department shortcomings through communication, education, and advice. LASA has adapted and had to step-in and fill the information void far more than would have been expected of reforms of this scale. As indicated earlier, I am regularly being drawn back to the notion that our industry has been challenged by reform in the past, yet has endured. I am encouraged through feedback that members are adapting, that back-of-house systems are being updated, and that organisational processes (sometimes ingrained over many years) are being re-worked. The Department must understand that there are many eyes currently watching it, with interest, and noting how the Department goes about its own timetables for implementation as well as the need for information and communication of the changes with providers. Other perhaps greater issues, with potentially more serious considerations, will be the level of communication and information that Government will provide to older Australians to inform them of the reforms. â–


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victoria Report Twitter: What it can do for your organisation, and for age services Ingrid Williams President | LASA VIC

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ince its launch in 2006, Twitter has grown to be one of the largest and most effective communications platforms in the world. In March 2014, there were 2.5 million registered Twitter users in Australia, posting over 1.5 million tweets per day1. Twitter allows users to post short, 140 character long messages (tweets), links and images and is both a social networking and microblogging service2. Twitter is not, however, only a broadcast medium. As with all social media, its potential lies in its use as a forum for discussion, listening, monitoring and engaging your audience in your story3. If the platform is used in this way, it is a powerful tool that will allow age services’ organisations to engage with their audiences in new and exciting ways. This will, in turn, result in expanding their reach, adding value and achieving communications goals.

Twitter and the age services industry The power of Twitter to enable age services organisations to communicate with their stakeholders, as well as drive industry advocacy, policy change and to ‘create’ news is immense. In addition, using platforms such as Twitter to engage with stakeholders can ultimately offer your organisation a competitive edge over others; which in the increasingly competitive environment of age services makes it a service that cannot be ignored. Age services providers can use Twitter to create a social network between the older people they care for, their families and loved ones. Twitter can be used to broadcast nonurgent messages, insights, news and achievements to those stakeholders, which in turn assists with the development of relationships and the building of an open and inclusive community. iCareHealth, an organisation offering software solutions for age services, suggests that engaging with the families of older people in your care via social media is a key enabler in developing trust and understanding. They also encourage age services organisations to view tools such as Twitter as presenting a valuable marketing opportunity to connect with families who are exploring care options for their loved ones4. Twitter can also be a powerful tool for advocacy, to drive policy change and to influence the creation of news. Age services peak bodies, organisations, consumers and wider stakeholders can connect directly with politicians, community leaders and the media; providing an opportunity to not just ‘join the conversation’ but to drive the agenda of change and improvement when it comes to our industry and the critical issues we face.

How to get started Twitter is free, easy to set up and easy to use and presents many opportunities and benefits for all organisations. It allows for proactive content sharing and stakeholder engagement, will allow your audiences a medium in which to connect, engage and feel involved with your organisation. However, before you get started, it is important to have a clear idea of what you want to achieve by using it, who your audience is and to have a plan for its use and maintenance. Get your team together and ask the following questions: What are our goals? To ensure your organisation gains the most out of its Twitter use and presence, ensure you fully understand what you want to accomplish. Who are our audience? In order to use Twitter effectively, you need to know from the outset who it is you want to be speaking to and engaging with. Understanding your audience will enable you to craft your Twitter presence accordingly, to best meet their information needs. What is our plan? As with all social media platforms; Twitter is a tool powered by people. It is important to implement an operational plan around your organisation’s use of Twitter such as; responsibility for tweeting, monitoring the account, approval processes and response policy. Twitter is a platform where the value you gain from it is proportional to what you put in. It is therefore of most importance to assess if your organisation has the time and resources to ensure you are engaging with your audience effectively, and creating value from your Twitter efforts3.

LASA Victoria on Twitter At LASA Victoria we joined the world of Twitter in February 2013 and have since steadily increased our use of the medium to connect and engage with members, key stakeholders and the wider age services industry. We find it to be a rich source of information, ensuring our team can stay on top of key industry news, trends and ‘trending’ topics and a useful medium to enable us to achieve our communications goals. Follow us: @lasavictoria ■

References 1. http://www.socialmedianews.com.au/social-media-statistics-australia-march-2014/ 2. http://en.wikipedia.org/wiki/Twitter 3. http://www.echoditto.com/insights/best-practices-non-profits-twitter 4. http://www.icarehealth.com.au/blog/connect-collaborate-communicate-socialmedia-aged-care/


FUSION | 13

Queensland Report Age Services – Not a contest Barry Ashcroft Chief Executive Officer | LASA QLD

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udget 2014/15 brought with it very little in the way of surprises…with some announcements welcome news… and others not so, for an age services industry still ‘adjusting’ to the reform edicts of government’s past. As was highlighted in our many Association responses to the budget (summaries, media, and advocacy) one of the announcements of most immediate concern for our members was the removal of the payroll tax supplement. With close to $700M stripped from the age services sector, the ongoing viability and vitality of the age services industry, and the quality and availability of services delivered to vulnerable ageing Australians, are not the only things under threat. What of the industry cohesion, unity and harmony we’ve worked tirelessly to establish by recognising the strength of diversity amongst age services providers – balanced by the need for equity irrespective of profit or mission status, organisational structure or geographic location? With the payroll tax announcement, the government has taken the diversity of age service delivery and driven a wedge between providers’ based solely on tax exemptions, with potentially dire consequences for industry and consumers alike. Almost certainly these consequences will see age services jobs and new developments placed at risk, and at a time when the demand for age services is increasing exponentially to meet a growing, ageing population. But it also has the potential to create unnecessary division within the sector, in the face of fiscal inequity. In what can only be seen as ‘washing their hands’ of the implications this announcement poses, the government has glibly and unthinkingly proffered as a solution that individual State and Territory Governments are ‘free’ to exempt providers from the tax.. if so inclined. Judging by the outspoken post budget retaliation by State Premiers, this option is clearly invalid. So the ‘hospital pass’ of the century now sees our industry as a ‘political football’ in the contest of duelling federal and state budgets, fundamentally resulting in increased costs of 5 to 6 percent being forced upon that portion of the industry (previously) known for actively building age care beds and exploring innovations in age service delivery. Of course none of this is a fait accompli, with budget bills set to proceed through parliament with some difficulty, and the potential for an early election to be called should their passage not favour the government. In the interim, and utilising our combined resources, expertise, knowledge and access, the national and state offices are actively

engaged in the advocacy of key officials at both the federal and state government levels. And as we have seen in successes such as the recent redirection of the Workforce Supplement, our Association is well placed across the country to pursue fairness for all age services providers, so that they might continue to provide and grow their enterprises in the delivery of vital care and support to older Australians everywhere. With One Industry and One Voice. ■


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WESTERN Australia Report In the trenches Beth Cameron Chief Executive Officer | LASA WA

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e stand at the dawn of a new, post-1 July, era. The amount of legislative and process change every one of us has faced in the last twelve months has been

phenomenal – I hope everyone has a decent holiday lined up, you’ve certainly earned it. On top of all of this, was the Federal Budget of 2014, where Joe Hockey and his garrison took a bayonet to aged care with the $653 million slashing of the Aged Care Payroll Tax supplement. We were under siege, and what better time to meet with Victoria Cross winner and LASA-WA conference presenter Mark Donaldson. He and I met before the conference to talk tactics – we were going into battle. We can attack directly, we should also attack from the sides, we should attack randomly so that nobody knows where we will be next. We talk to the state government, we talk to the media, then we pull of a surprise attack via a local member, or Palmer United. We were in the trenches and this was war. Luckily, there were plenty of allies in the west. The West Australian newspaper and local radio stations were on our side. State opposition were kind and asked hard questions in parliament. Our Premier gave us his time, as did the WA Treasurer. Mark Donaldson spoke a lot about resilience and the need to keep on fighting. He gave examples of fellow soldiers who worked alone to improve tactics and training for years before key people claimed to ‘always be on side.’ I know we have similar battlehardened, combat experienced soldiers among us. At time of printing, we don’t know what our outcome will be, but with Mark’s advice – we soldier on. Interestingly, there has been a recent payroll tax issue playing out in WA courts with our local CCI. The case refers to the Charitable Uses Act 1601 of the Parliament of England. The Act lists activities that the government of the time believed were of general benefit to society and to which the government wanted to encourage private contributions. The first item listed is “The relief of aged, impotent or poor people”. How interesting that governments have been working with businesses for hundreds of years to support the care of the elderly, recognising that they could not deliver this care alone. I believe that everyone working in aged care deserves a service medal for battling through the last year and I consider each of you to be victorious. We at LASA-WA have your back on the Western Front – go ahead and enjoy your shore leave. ■


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FUSION | 17

ITAC 2014: A must attend event By Rod Young, Chair ITAC 2014 Organising Committee

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TAC 2014 will focus on the revolutionary aspects of modern technology. Speakers will explore whether these change, especially whether the deployment of assistive technologies, will be a disrupter or enhancer of service delivery and models of care. If you are interested in the future role and function of Information Technology and the impact it will have on how we deliver services in the future; then a visit to Hobart in July to learn about the current developments in the industry is crucial. An area of particular focus at ITAC 2014 will be the place of the home based consumer as a key player in the service delivery models of the future. There is a strong emphasis on homecare and the role of technology in sustaining home based independence. The change in role for the home based care recipient from a “care recipient to a care participant” will be a crucial component of the future of service delivery. The organising committee has developed a programme that covers the spectrum of service types, models of care and recognises the evolving place of the home based consumer as central in the future delivery of services. Professor Jenny Basran MD, Associate Professor of Medicine and Head of the Division of Geriatric Medicine, University of Saskatchewan, Canada, is bringing her knowledge of the Canadian experience to ITAC 2014. Canada has many similarities to Australia, including geographic size, population and some aspects of health and care systems. Prof Basran has had considerable experience in service innovation through technology. Her most unique award in Canada however was winning the first prize at the McGill University’s hackathon – Hacking Health – for developing a care giver application.

ITAC 2014 will include the annual Aged Care Industry IT awards. The awards are designed to recognise community and residential care providers and IT Vendors who can demonstrate innovative design, successful deployment of major systems, or a successful change and adoption of IT systems deployment. ITAC 2014 will have a full session devoted to reports on the NBN Telehealth Pilot Projects which have been running over the last year. A number of the project Leads will report on their respective projects. What has worked and what has not. There will be presentations which will demonstrate such innovations as: • GP2U a virtual network between GP and patient that overcomes many of the existing communication inefficiencies • The NRMA’s plans for a consumer portal supporting easy access to information about most aged care services. The portal will include a consumer rating service for aged care services which will be conducted by Gallop International • Telstra’s Community Health Leads looking at Telstra’s plans in the health and aged care space • Anna the Clever Avatar – using technology as a personal assistant for older people The Organising Committee extends a warm welcome to attend this year’s ITAC Conference and hope you will find the program of particular interest. ITAC 2014 will be held in Hobart July 22-23 2014. Further information can be found on the ITAC 2014 website www.ITAC 2014 or www.LASA.asn.au or contact Jane Murray mobile: 0413 626 021. Look forward to seeing you in Hobart. ■

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18 | FUSION

Lynden Aged Care: Wireless and paperless By Justine Caines

Lynden Aged Care is a stand-alone, community controlled aged care provider in Victoria. Like many providers they aware that investing in information and communications technology (ICT) develops both clinical and organisational benefits. In recent times Lynden has made considerable advancement in their ICT capacity and now find themselves adopting innovative systems.

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ynden Aged Care’s current licence provides for 30 low care beds, 30 high care beds and 20 extra service places. The facility is amidst a major redevelopment that will see it transform to include a new wing accommodating 22 more high care residents. Another project has recently been completed to include six two-bedroom independent living units. Lynden is now totally wireless across the facility. They have made significant investment in the iCareHealth clinical management system, iCareHealth’s medications management system, and the Vocera communications and nurse call platform.


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After Wireless

Before Wireless Lynden has also installed an electronic time and attendance system for staff that records their attendance through a simple fingerprint scan. This has made paper timesheets redundant. Staff are also able to log on remotely to apply for leave and provide availability for shifts. Ann Turnbull, Lynden’s CEO was the driving force behind the ICT transformation. Her initial interest was in the benefit she could see from the medications management system. “I saw that at a conference and it was clear to me how much time we would save and how it would almost eliminate medication errors,” Ms Turnbull says.

“Just to set that up was the expensive part because we had to go fully wireless. For that to work properly is where the investment came in, but once you are already wireless the add-on bits aren’t anywhere near so much.” Lynden’s investment was substantial with a total of half a million dollars spent. This includes the infrastructure, Vocera and medications management – but you assess the cost in line with the benefit, particularly the convenience for nurses of the Vocera devices and the time saved on medication rounds, the return on investment is clear, she says. “Nursing staff just carry one device with them in which they can make and receive phone calls, they can receive nurse calls on it, they can talk to the residents, and they can locate each other. There are no telephones and they don’t have to carry a pager or any of that sort of thing, just the Vocera”. “With the medications management system, the main benefit is that the nurses have saved at least an hour every medication round. It has almost eliminated medication errors – that wasn’t a major issue for us but it’s still something you don’t want to have”. “And because we set that up and the staff really found the benefit from the medication management and the Vocera, they have embraced every other system introduction because they’re not scared of it.” Ms Turnbull cites the support she has received from her board as critical to the investment. “One of the real benefits of a place like ours is that most of the board members have got now or have had a family member living here, so they know what’s good and they could see the benefits of the medication management system and the Vocera system,” she says.


20 | FUSION “Their view was that this is why we make money – it is to spend it on residents, not to go into people’s pockets – and they could see very clearly the benefits to the residents.” Available data suggests that around a half of all current aged care facilities don’t even have an electronic clinical or documentation management system. This demonstrates just how advanced a totally paperless system is. When asked why other aged care providers have not made the transformation, Ms Turnbull says it is generally a lack of money that prevents providers from advancing their ICT capability. “I would imagine that it is because if you tell them it’s half a million dollars, they would flip out! But the cost benefit is just enormous. We have quite a few staff here who work at other aged care facilities as well and without exception they come back and say this is such a great place to work because it is so easy. They see the benefit so they embrace the other changes that you are bringing in.” The ability for Lynden to participate in the PCEHR has not proved as straightforward. The organisation has long understood the benefits of sharing information with other clinicians and providers. Lynden participated in an early shared health record project established by the Inner East Melbourne Medicare Local and its predecessor; however linking into the national system has proved difficult. The central issue is that they system has been developed with doctors as the central reference, she says, and she is not aware of any of visiting GP who is actively using the PCEHR. As someone who is acutely aware of cost-benefit ratios, the benefits of the PCEHR don’t seem to be well understood or translated.

“By the time a person comes in to aged care, they’ve got their GP, they’ve got their relationship with the doctor and if he or she is into the PCEHR, then it will come along without any problems,” she says. “But it has to be done through the doctor. My own doctor doesn’t even have the software to work with the PCEHR so there is no use in me hassling him because it won’t happen. The doctors have got to be set up for it.” GPs who visit to Lynden Aged Care are given access to the iCareHealth system when they are on the premises to make notes or changes to medications. Most GP’s are happy to use the system. For anyone who isn’t, a nurse will enter the data for the doctor to sign. “We don’t have any paper so they have to come onto our system,” Ms Turnbull says. “There is no paper for them to write on.” iCareHealth is PCEHR-enabled, but not currently being used. Ms Turnbull says the creation of a transfer document in the PCEHR would be very useful, but at this stage there was no benefit for the organisation to utilise it. “It would be terrific to be able to upload a transfer document and then when they get to hospital for it to be downloaded again, but to have that you’ve really got to have the residents signed up for it and the doctors participating. “The GP who has most residents here is really into IT and she loves it. She’s into telehealth, but I’m not sure whether she is signed up to the PCEHR. There just is not the benefit at the minute for us to drive it.” ■

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The Leecare Solutions’ Platinum 5 Suite The Leecare Solutions’ Platinum 5 Suite of products is an aged care organisation’s single source for all functional needs. By Caroline Lee

K •

• •

• •

• • •

ey responsibilities for aged care managers includes: • k eeping resident’s (and their family or significant others/friends) satisfied with their living environment and provided care/clinical support knowing what is occurring at all times re residents, staff, OHS, complaints, continuous improvements, building matters, operational services and real time results of all risk criteria so you can act fast, avoid non-compliances and sanctions ensuring ACFI claims are optimal to support viability managing accurate resident invoicing, bonds determinations and admission profiles to ensure appropriate skill mixes are available and viability is guaranteed, whilst charging fairly for services provided ensuring Information Systems are congruent throughout the organisation to avoid incorrect decisions being made with bad data – enabling strategic decision making, measured forward planning gaining efficiencies wherever possible to optimise current resources ensuring staff are adequately resourced educationally and physically to provide optimum care, lifestyle support and clinical decisions The solution is to implement a complete system that will: include in one single Database/product all aged and community care system requirements to manage Care, Lifestyle, Clinical, Medication management, Operational needs and Finance management (invoicing, bonds, budgeting and more) address your Total Cost Of Ownership requirements by not requiring ‘other software’ licensing fees or specific devices – that allows you to utilise the technology YOU want, that your organisation can afford and may already have at hand – reducing technology costs significantly (web-browser technology that supports any device and most if not all browsers) support effective, efficient and guaranteed complete disaster recovery mechanisms provide all staff and managers Quick access to all key risk reports enables staff to enter data once to prevent mis-matched information, adverse events, and ensures resident needs and wishes are captured and included in care planning and implementation

• utilises the best available technology the world has to offer to support staff perform in a considered manner Platinum 5.0 is a software program which includes the required tools to aid the management of all the clinical, care, social support and management requirements of an aged and community care and retirement living organisation, whilst addressing all professional Gerontology concepts. It includes an organisational dashboard, buttons to instantly open Reports, and features that enable managers to be alerted to key issues arising such as new Incidents, Infections, Wounds or Weights and Vital signs out of reportable ranges. Managers can monitor documented care and quality indicators through automated graphs and system made Reports, but also build their own ‘key reports’ and forms that identify key organisation touch points. Staff messages and task management is all intertwined with care and lifestyle management. P5 Med enables staff to administer medications using real time information / instructions (not waiting for a ‘docking activity’) and use the same data that staff have already assessed and planned/implemented in P5, where access to all relevant key clinical information is one click away. P5Exec supports all your operational needs regarding: HR/staff profiles and credentialing, education recording and analysis; suppliers, assets and maintenance management; complaints, continuous improvement and meetings management; information/documents deployment; hazards, incidents and risk matrices. F5 Finance supports an organisation with their complete resident billing, Medicare reconciliation, bonds management and budgeting requirements through a considered and detailed finance package designed specifically for aged and community care using international accounting standards and requirements. Analysing information, maintaining information system consistency across the organisation to support an organisation’s needs is what the Leecare Solutions client base achieve every day – join the Leecare Platinum team to achieve the same. ■


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LinkedIn Why Aged Care organisations should love it and how they should use it By Angus Smallwood Creative Tactician Shabbadu – Advertising Thinking

L

inkedIn is a brilliant tool for individual career development. It has 250 million users worldwide and 6 million in Australia. It’s a great way to show who you are, what you’ve done and what other people think about you. Whether it’s for getting your next job or showing people who may do business with you how switched on you are, it is a remarkable way to show everyone why you’re awesome. But that’s individuals. What’s in it for organisations? Sure, LinkedIn has functionality for profiling businesses, but it’s pretty limited and it’s never going to be as good as your website. Plus, it’s another channel you’ve got to find the time and the budget to manage. If LinkedIn is primarily about individuals, why should organisations even bother? And the answer is, because LinkedIn is about individuals. With the right strategy and guidelines in place for your organisation, you can use LinkedIn to: • Reinforce your organisation’s brand as a provider of choice • Solve a significant part of your external and internal recruitment challenges • Improve your staff’s networking and personal development • Draw on crowd-sourced knowledge to help overcome complex, specialist-knowledge issues. Most importantly, if you invest a small amount of time in planning how you go about it, you can implement a project like this simply, quickly and cheaply. Here are six simple, inexpensive things your organisation can do to make more of LinkedIn.

1. Get your company page in order Your organisation probably already has a brand, a logo, a look & feel and a company description. It’s a simple matter to put these into your company page so that it truly looks and feels like an expression of your brand.

by giving them a style guide that includes a standard paragraph to describe the business. Take a profile photo of them that looks clean, professional and energetic. Make sure that their job description is linked back to the real company page rather than a false company page that somebody created years ago because they didn’t know what they were doing (there are a lot of these on LinkedIn).

4. Get your staff engaged with the platform The best way to get people onboard is to give them some basic homework exercises; simple tasks such as joining a group, posting on a discussion board or maybe linking a blog piece from their profile.

5. Make more of the knowledge contained in your organisation There’s a huge body of knowledge inside your workforce. Run workshops to help them turn that knowledge into content that can be shared; content that can speak to the depth of knowledge and depth of culture that your organisation embodies.

6. Make more of your spread Encourage your staff to share your organisation’s posts. Every one of your employees has their own network. The people they knew before they started with you, the people they’ve networked with in the sector, the people they work with now including outside suppliers. Those people are exactly who your organisation wants to talk with when you’re looking to recruit or to crowd source. Of course, this is a top line summary of how to better use LinkedIn. But by adding more detail to each of these steps you can simply and affordably take advantage of much more of the networking power of LinkedIn. ■

2. Manage your risk Social Media has inherent risks because your brand gets put in the hands of individuals in a public space. Create a set of guidelines that outline appropriate behaviour and spell out behaviour that is inappropriate.

3. Show a united front Every member of your organisation should have a profile that looks like they are members of your organisation. Help them do this

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CDC ‘Gold’ The secret recipe By Greg Adey, Director g88 consulting

While it’s clear that great progress is underway in strengthening home care services, and using Consumer Directed Care (CDC) is one of the principle drivers of this, the challenge now is to develop innovations which focus less on budget redistribution and more strongly on evidence-based healthy ageing. We can settle for CDC ‘Lite’ with its minimalist approach to choice and control, or reach for CDC ‘Gold’, a premium strategy which optimises empowerment, well-being and healthy ageing. A new perspective

A

s Bette Davis said, “growing old ain’t for sissies”. She understood that successful ageing requires constant commitment and hard work to avoid the passivity and learned helplessness that contributes to poor health and low motivation. Wellbeing has been described as an active, lifelong process of assuming personal responsibility that empowers the individual to take informed actions towards a fulfilling life. We devalue older people by having or accepting low expectations of their restorative and wellbeing capacity. To avoid this passive paternalism, we need to consider a bolder partnership of shared expectations and responsibilities. The indigenous leader Noel Pearson proposed that, properly understood, self-determination (that is, control and choice) is the power to take responsibility. Preventing avoidable functional decline starts with health promotion, which requires health literacy and informed choice. Older people can’t lead the CDC decision-making process without adequate information and understanding. Under the WHO Ottawa Charter (1986) we have an international obligation to redesign

health services around health promotion to optimise healthy ageing for older Australians. We are required to embed health promotion in every aspect of our aged services. CDC choices must be informed choices if we are to truly optimise health, independence and well-being.

DSS CDC guidelines Under the Department’s CDC approach, “consumers are encouraged to identify goals around health, independence, wellness and restoration which will form the basis of the Home Care Agreement and care plan. They should be empowered to continue to manage their own life by having control over the care and support they receive. This requires the provision of, and assistance to access, information about service options that enables consumers to build a package that supports them to live the life they want, and potentially reduce the need for ongoing and/ or higher levels of service delivery”. Sounds great, but how? Where are the evidence-based policies and practice guidelines which clearly articulate strategies and interventions which Providers should be using to optimise this empowerment, wellbeing and healthy ageing? How are we going to build a ‘gold’ standard CDC, not just the ‘lite’ version or something in between?

CDC evidence In designing CDC ‘Gold’ we need to firstly look at what the evidence tells us: • While older people naturally want to stay in their own homes as long as possible, this decision often comes at a severe cost to their health and chronic illness. • Home care services are helping people stay longer in their homes, but rarely address preventable functional decline. Researchers frequently criticise the biomedical and ADL task models of aged services, and their inattention to health enabling practices and interventions. • CDC programs demonstrate increased consumer satisfaction, but no significant improvement in wellbeing outcomes. • The current CDC model lacks a unified framework or targeted policies to drive evidence-based health promoting approaches and wellbeing goals. • CDC consumers largely rely on their Coordinator to make suggestions and provide options, and few take a substantial self-management role. • Most CDC models are usually dependency-based, and pay insufficient attention to an individual’s healthy ageing.


FUSION | 27 • People (ourselves included) don’t always know or choose what’s best for them (a heretical but unfortunate truth).

The healthy ageing framework This healthy ageing framework is built on a number of essential requirements: • a shared partnership of responsibilities and expectations • health promotion and health literacy to support informed choices • role models and coaching • preventative and restorative interventions using a strengthsbased model • simple and effective tools and resources (such as ‘appreciative inquiry’ goal-setting tools, ‘My Well-Being Plan’, ‘My Perfect Week’ and learning logs), and • continuous evaluation and refinement based on evidencebased learning. A crucial requirement is to invest in educating staff about healthy ageing and what they need to do differently, which has been made easier by teaching staff about their own wellbeing and health enablers.

The innovators Fortunately, innovators across Australia are already building world-class frameworks for healthy ageing and enhanced wellbeing which have been adapted for aged services. They’ve researched the international evidence to develop practical strategies, interventions and tools that work in the real world, and are constantly refining the models using action research and new learnings. Their approach includes: • health literacy education • raised expectations of what’s possible • shifting the emphasis from traditional ADL support to target deconditioning and functional decline • exercise and activity prescriptions which challenge our ageist concept of ‘gentle exercise’ • cognition strengthening programs • wellbeing programs based on the positive psychology PERMA evidence, and

• early intervention multidisciplinary programs to address increased frailty or acute episodes of ill-health. And the research unequivocally supports this approach. Restorative and re-ablement home care packages are associated with significant improvement in quality of life, significant improvement in performing ADLs (up to 71%) and a significant reduction in the use of services (up to 39%). Researchers also note that by focusing on the enablers of healthy ageing, older people achieve more choice, control, independence and wellness.

Key features of CDC ‘Gold’ A CDC ‘Gold’ approach: • delivers a bigger win for older people – optimum well-being, healthy ageing and empowered choices. It doesn’t just delay a transition to residential care, but uses restorative strategies to increase healthy life expectancy, and reduce dependency on services. • understands that a genuine person-centred approach involves a greater expectation of the older person to assume reasonable responsibility for health enabling actions and health promoting changes to their lives. It provides clear roles and responsibilities for the older person, family, friends, staff and other agencies. • is not about Providers relinquishing budget input, reducing the critical role of coordination, or ceasing interventions based on ADL assistance, treatment and social supports. The Provider partnership remains critical in building a premium home services program focused on aspirational outcomes for older people, even for those who are extremely frail, ill or palliative.

Summary: Our CDC programs must avoid the risk of becoming little more than a budget-sharing exercise with a tick-the-box approach to choice and control. By developing a clear healthy ageing policy framework and implementing evidence-based strategies, we can learn from our innovators who are leading the way in partnering with older people to optimise their health, independence and wellbeing. ■


28 | FUSION

How to stand out in a sea of competitors The impact of CDC on marketing By Melina Walton, Director, MW Communications

T

he transparency of aged care service offerings created by the recent industry reform initiatives has led to increased competition amongst care providers. No longer can providers rely on doctor referrals or wordof-mouth alone to attract new customers. Every provider must become an expert at marketing, effectively promoting themselves and building an attraction model that sets them apart from their competitors. The new consumer directed service model should not be feared. Rather, it offers new opportunities to connect with a broader, engaged audience on a long-term basis that should be embraced. In addition, if you get this right, your bottom line will thank you. The following points outline some ideas of where to start and what your organisation needs to consider.

READY Identify your ideal customer and where they are. You already know who this is based on your local knowledge and networks of your current residents, but narrowing your focus to your perfect target market will help to define this more clearly.

AIM Your role as a marketer is to create a desire and satisfy a need that attracts your target audience. So, who else is meeting the need that you want to satisfy? Who are your competitors and what are they doing well and not so well? With this in mind, what makes you different? What do people think about your brand? What sets you apart from your competitors and what can you focus on in your marketing to attract an audience that is both ideal to you and interested in having their desires met by you?

FIRE Once you have the foundations of your ideal customer and your brand niche in place, there are a variety of steps throughout the attraction and engagement phases of acquiring a new customer that present different opportunities for providers to engage with them, some of which are outlined below:

• A t the start of the process, traditional forms of marketing such as word-of-mouth from your strongest advocates – your residents, allied health providers, families and friends of residents and staff – are still core to your marketing approach. There is no stronger reflection of your brand than a testimonial from someone who is happy with your service. • According to the Australian Communications and Media Authority, while older people tend to remain more loyal to traditional media platforms such as TV, radio and print, their online usage is displacing this trend. The government’s My Aged Care website is therefore an essential marketing platform to promote your organisation. As understanding of this platform grows, and is referred to by more and more potential customers, it will become an essential tool for your organisation to utilise. • Organisations must have their own website that is structured to present your brand well, and encourages interaction and engagement with your audience in a simple and easy-to-use format. Don’t just consider what you want your customers to know, consider what they want to know and how they will interact with your website. • A variety of paid advertising methods are available, but for a more cost-effective solution, tap into your local media and implement follow up processes to re-engage with interested customers. Marketing is a sure-fire way to guarantee your brand will stand out in a sea of competitors. By focusing on what makes your brand different and targeting your ideal customers, your chances of being seen are much greater. The right marketing formula for your organisation will generate the leads that will fast become conversions and lead to exponential growth over the longer term. To learn more about how your organisation can understand and utilise your brand and marketing potential, register to attend LASA Victoria’s Branding and marketing your residential care facility workshops in August and September this year. ■ For more information, and to secure your position, visit vic.lasa.asn.au/training-and-consultancy/workshops


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Crisis Communications in Aged Care: Are you prepared? 

As someone who has worked with many providers do you find organisations are generally well prepared?

N

o. People have the attitude “It’ll never happen to me”. If that’d seen what I’ve seen in this industry they would never believe that. Medication errors, hostile family members running amok in media or social media, financial misappropriation, sexual assault claims...these are the things I deal with on a regular basis, usually for providers who consider themselves responsible and competent. It surprises me that organisations can have such a casual attitude to something so important. Organisations that would never dream of failing to maintain adequate insurance are quite willing to fail to insure their reputation, something which has never been more important in the current competitive environment.

Do you have any particular examples (good and bad)? The good: Recently a major faith-based organisation engaged Grounded Communications to manage the communications on a reparation package for victims of historical sexual assault. The small number of initial claims related to events in the 1960s and now defunct predecessor organisations. Despite this, the leadership of Jewish Care Victoria, a major welfare and human services provider, developed a comprehensive reparation response and elected to widely promote it through an integrated communications strategy. This included proactive media, advertising, stakeholder relations and internal (staff, volunteer and member) communications. As a result, additional people came forward and received counselling and other assistance. Media reporting was positive and stakeholders, including vocal victims’ advocacy organisations, welcomed the initiative. In contrast to other denominations and organisations, which have been heavily criticised for their handling of abuse claims, Jewish Care Victoria met victims’ needs and enhanced its organisational reputation by acting, and being seen to act, in an ethical way. The bad: Some years ago a colleague and I managed the communications for a nursing home in a regional city that was suddenly plunged into a political and media firestorm after failing 33/44 expected outcomes during an unannounced agency visit. The audit results, and sensational claims that residents were “starved” and some weighed only 25 kilos, were hugely damaging. The minister of the time was even quoted as saying she was calling in the police with a view to criminal charges.

By Ingrid Svendsen

The organisation was totally unprepared for public and media scrutiny on this scale and early “no comment” stories compounded negative perceptions. Media went looking for any angle, including that a director had “fled overseas” (he was on holiday) and that “five people in three days” had died at another facility (which in fact specialised in palliative care). The first 24-48 hours of crisis are vital, because that is when often unshakeable public perceptions are formed. We came in the following day and were able to develop messaging for use in media and internal communications (staff and residents/families). We liaised with media to influence the tone of coverage and avert some of the more hysterical stories. But the organisation would have fared much better initially and subsequently had it had a system for rapidly responding to communications crises.

Do you have a ‘Top 10 Do’s and Don’ts ’ for Crisis Communications? Don’t... Don’t delay. The first 24-48 hours are critical when dealing with crisis communications situations. Don’t think it will all blow over. A major communications crisis won’t just go away; unattended to it is likely to worsen. Don’t say no comment. If something has gone wrong, media and stakeholders have a right to press for answers. Don’t tie up your executive team or key managers with communications issues. Let the communications experts manage the communications while senior management protect the organisation by dealing with the issue that caused the crisis. Do... Do apologise if the circumstances warrant it. Saying sorry, expressing your regret, remorse and sympathy, is generally an essential first step in crisis communications; find a safe form of words and get your communications off on the right foot. Do develop a crisis communications protocol so that you can respond quickly. A document that sets out what sort of situations constitute a communications crisis, who is involved in decisionmaking, how decisions are made and critical stakeholders that need to be communicated with will help ensure that you can respond quickly, clearly and consistently. Do think about more than just media. Staff, volunteers, external stakeholders in government, local government and the community, all need to hear from you directly in a crisis. Do ensure that your spokespeople have had recent media training. Is your spokesperson trained to stay on message, field hostile


FUSION | 31 questions and deflect off-message questioning? Fronting media in a crisis situation requires preparation, at the time and well beforehand. Do cultivate positive relationships with stakeholders. If things go wrong you need them to know and trust you. I recall one incident where aged care facility had had an issue. We put in a call to the local MP to ensure he was aware that the organisation was taking appropriate steps. His response was along the lines of “Oh yes, aged care organisation x, I know them well. Great organisation. If anyone asks that‘s what I’ll be telling them.” Do understand issues management. A surprising number of crises are precipitated not by “an act of God” but your own actions. Take a proactive approach to issues management. At the earliest opportunity plan the communications on potentially contentious initiatives like major workplace changes or site divestments. Make issues management part of your culture – ensure that executive and frontline managers understand what could constitute a significant communications issue and put in place a system to document, track and act on emerging and ongoing issues.

Not only does the brand of an organisation potentially suffer so does the reputation of aged care. What are your thoughts on maintaining an organisations brand and improving the public perception of aged care? Crises and high profile incidents are just one of the issues involved in the often negative public perception of aged care. A

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big factor is that many people have no contact with the aged care system and form their views based on cases highlighted in media, that don’t represent the vast majority of the sector. I’d like to see all aged care providers throw open the doors and invite the community in, and get out into the community themselves. Whether that is through open days; partnerships with schools, childcare centres, parent groups, holiday programs, kindergartens or men’s sheds; attending community festivals; partnering on initiatives like community vegetable gardens, there are so many ways the seniors and aged care sector can build community support and understanding.

LASA Congress attracts leaders from across the industry, what will they learn from your presentation in October? The title of my talk is “It’ll Never Happen to Me, and Other Great Crisis Communications Myths”. What I hope leaders in residential care, community care and retirement villages take away is that it can happen to them. Aged care is an inherently risky sector. Failing to plan for a communications crisis is a bit like buying Tattslotto tickets to fund your retirement. It might work; but there are plenty of tried and true methods that would be much more prudent and effective. ■ Ingrid Svendsen is the director of aged care and health at Grounded Communications. She is presenting on crisis communications at the LASA National Congress on 21 October.

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FUSION | 33

A Brand New Dawn By Andrew Giles

P

olicy reform in the Aged Care sector signals a new era for us all. Among other challenges, there will inevitably be more pressure to ‘sell’ your product well in a highly competitive market. For many of you reading this article, it’s unlikely that understanding how to be a highly effective marketer was ever a core part of your training. As caring for older people becomes more and more competitive, new providers enter the market, and new products and services are developed, our customers (residents) will have a much greater choice of where they want to live, and what level of services, support and care they need (and are prepared to pay for). This, of course, is easier said than done. While there is no ‘magic’ solution, marketing is a systematic approach to connecting with your consumer. The trick, if there is one, is to ensure you understand exactly who that consumer is. This is where working with people who specialise in the market you operate in is so important. Regular, carefully planned market research adds to the understanding of the psychology and behaviours of your customers, which in turn helps us develop the most efficient and cost effective ways to get your message out. There are five key areas operators should consider as part of their broader approach to marketing:

1. Determine your brand essence Undertaking a brand audit is always a good place to begin. You need to understand how your brand is being delivered across the organisation, from your business cards right through to how your staff interact with clients and their families each and every day. What are you best known for? What do you have that your competitors don’t? Why would your clients choose you over someone else?

2. Understand your market In any business, understanding the market is fundamental. Yet we have seen many projects fail because the foundation research on the market opportunity just wasn’t done. Define your catchment, and try and forecast the demand. Will you be able to satisfy the demand? Talk to your customers. What are their motivations and drivers? Are you able to satisfy these?

3. Making sure the product is right Your product encompasses the physical environment (the building and facilities), the services you provide and the way you provide them. You actually have more control over all these elements than you think, which provides an outstanding opportunity to differentiate yourself from the competition.

4. Choosing the right channels On average, Australians over 65 years old spend more time online than watching television, reading newspapers and magazines, or listening to the radio. It is their number one media source. While there is still a need to use other media to develop an active local referral stream, the internet is your most potent weapon. But how that weapon is used is the key, and this is one area where our sector needs to invest and provide a more engaging experience.

5. Remembering the brand experience is everyone’s responsibility While your executives can spend a considerable amount of time and money developing the perfect brand, it is ultimately delivered by each and every person who works ‘on the ground’ in your homes. To ensure that everyone understands and is true to your brand, ongoing training sessions are essential. ■ Andrew Giles, former CEO of the RVA and now Managing Partner of specialist retirement living and aged care marketing agency, One Fell Swoop.


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FUSION | 35

What’s in a name? Consolidating customer growth in age services

By Jacqui Parrish IRT

E

verything, if you are part of the Customer Growth team at IRT Group, a not-for-profit aged care provider based in the Illawarra. We adopted the new name as part of a capacity building restructure last year, bringing together three teams – customer service, sales and strategic projects – under one umbrella. It is easy to dismiss such changes as window dressing but our name change had real intent: to unite the three teams through one identity and one purpose. We had been working for some years on getting everyone in the teams to become more customer-centric and the new name was a vital part of that process. Previously we had been much more of a “sales” team, or an “allocations” team, with a heavy focus on the team’s function and the processes involved. We recognised we needed to shift the thinking and put the customer at the core of everything we do. The name “Customer Growth” resonated strongly with that aim. We also wanted to overcome the silos that had existed in the various teams. Belonging to the Customer Growth portfolio has helped them identify with the broader team. The result is a consolidated team with a much greater focus on the customer. The team members understand that their core purpose is to assist the customer and help meet their needs. That purpose is reinforced in operational plans, performance plans and position descriptions, as well as day-to-day conversations with employees. The success of this change can be heard in the conversations team members have with clients and potential customers. They think about the customer a lot more and have empathy for them. As such, the Customer Growth portfolio now aligns much more strongly with IRT’s long-standing mission, to create communities where seniors achieve their optimum quality of life.

It also positions IRT Group to maximise growth opportunities. Aged care is a growth industry; however, all aged care operators need greater customer focus if they are to succeed in growing their customer base. Government reforms are giving older Australians greater choice in aged care, across lifestyle communities, care centres and in-home care. It is important we understand and respect these policy changes, so that we can best serve our customers. Also, the cohort of older Australians is changing rapidly, as baby boomers replace the “silent generation”, born during the Great Depression and WWII. Baby boomers are generally more educated and better informed than previous generations and also have higher expectations. If a baby boomer believes an aged care organisation does not respond to their needs appropriately, they will simply take their business elsewhere. At IRT, we are acutely conscious of these policy and environmental factors impacting on our organisation. However, we believe we are meeting the challenges by achieving a significant cultural shift in the Customer Growth team. We have broken down silos and we have put the customer firmly at the centre of our organisation. The team members understand they aren’t simply involved in a process; they are dealing with real people in real situations, many of whom don’t want to be in that situation, and so their job is to help them achieve the best possible outcome. But this is a journey, not a destination. We constantly need to revisit what we do and why. We continually need to change and adapt to meet the needs of our customers. We consistently need to embed the change in our organisation, as we strive to increase our customer base. And that is what’s in the name: Customer Growth. ■


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FUSION | 37

Make your life worth living as your living is being made 

A

s a member of Leading Aged Services Australia, it’s likely both your profession – and passion is – to help older Australians age well. Most of you are ‘caring’ individuals by nature. So take a moment to think of people, outside family and friends, who have contributed in some way, large or small, to make your life – and your career – more pleasant. It could have been an encouraging teacher, a boss who believed in you, an elderly aunt who expanded your horizons, or a colleague who willingly helped on a project outside their job description. It could have even been a complete stranger – a burly truck driver who, in spite of a tight schedule, stops to change a tire for a stranded motorist, or an insurance agent who calls a widow long after her husband’s death, just to say hello. It might be a mobile phone dealer who loans his own phone to a tradesman relying on communication; or a manager who arranges childcare for a single mother in need of an operation; or a chemist who delivers a prescription to a pensioner after hours. After all, none of us are really in the transport, insurance, retail or health care business. We’re all in the people business! And, people buy goods and services from those they like. In every one of those true examples mentioned, repeat business flowed to those who did that little bit extra. By helping others, we help ourselves, even if it’s just feeling better about ourselves. What can you to help your stakeholders – both those you care for and their families – in these uncertain economic times, even if it doesn’t result in immediate business? When we think of helping occupations, our minds traditionally turn to the caring professions of nursing, social work and emergency workers. Yes, that’s probably you! But, every career has the capacity to care; to combine the head and the heart; to feel we make a difference to both our own pocket books and fill pockets of need in others, through random acts of kindness. When I started speaking professionally, I believed I could make money and make a difference. However, like most small business owners, I was often plagued with doubt. One such occasion followed a five-hour flight when I arrived at the hotel with no voice. Scheduled to speak to 400 people the next morning, this was indeed a predicament! At check-in, the receptionist started her standard greeting, outlining the five star facilities but I cut her short, with little more than a whisper, to say that I wasn’t well and simply wanted to get to my room immediately. I promptly unpacked, showered and curled up in bed, feeling somewhat sorry for myself away from home, when I heard an unexpected knock at the door.

By Catherine DeVrye

“Room service” I croakily informed him that I hadn’t ordered room service. “Yes, Ms DeVrye, we know you haven’t ordered room service but we also know you’re not feeling well, so have brought some hot lemon and honey with our compliments.” Sure enough, on a silver tray, was exactly what I would have wanted if I’d been home. In addition, there was a hand written note from the chef offering to make chicken soup and another note from the concierge, with some vitamin C tablets and an offer to obtain any additional medication from the pharmacy in town. As someone who spends over 60 nights per year in 5 star hotels, I know that sort of service isn’t standard, nor in anyone’s job description. The receptionist put herself in my shoes and coordinated others to deliver outstanding service. I felt better already and naturally, any traveller would remember that experience long after they’d forgotten the marble in the foyer! And. By the way, I’ll be looking for that 5 star service in aged care down the track. My voice marginally restored the next day, I addressed the audience and used this real time example of going that extra mile to truly care about the customer. I’d arranged for the receptionist to attend the presentation and when I later checked out, she said she felt somewhat shocked by the spontaneous applause from the audience. ‘Just to know that you felt better, made me feel better’ By doing that little extra, she gained extra satisfaction for herself. I’m pleased to report that the organisation I was speaking to adopted ‘Hot Lemon & Honey’ service as their annual theme, achieving record profits that year. And, ‘Hot Lemon & Honey… Reflections For Success in Times of Change’ subsequently became the title for my book, which I’m honoured to have endorsed by the late Sir Edmund Hillary and Jack Canfield, author of ‘Chicken Soup for the Soul’. Remember this receptionist, and all the other folks mentioned in this article, when you get up and head off to work each day. Because, in spite of the frustration we all experience in our daily tasks, isn’t it reassuring to remember that everyone in aged care truly can make a difference. ‘Make our life worth living as our living is being made.’ ■ Catherine DeVrye is the author of the #1 best seller ‘Good Service is Good Business’ – Hot Lemon & Honey – and 6 other best-sellers translated into over a dozen languages. The past Australian Executive Woman of the Year & Keynote Speaker of the Year speaks internationally on customer service, managing change and turning obstacles to opportunities. Don’t miss her educational and entertaining session at LASA Congress.


Cherie Hugo (far left), Liz Isenring (left) and Maggie Beer (main) will be speaking together at the Congress

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FUSION | 39

Study puts spotlight on nutrition in aged care By Justine Caines

W

ith research revealing one in two aged care residents are undernourished, Bond University on the Gold Coast has announced its involvement in a study, known as The Lantern Project, which aims to improve the nutrition and health of older Australians. The Lantern Project is a three year research program that will be undertaken by dietician and columnist Cherie Hugo, who has just begun her PhD in Nutrition and Dietetics at Bond University’s Faculty of Health Sciences and Medicine. Ms Hugo’s aim is to shine a light on the issue of food in the aged care sector and how it can be improved. Three Gold Coast aged care facilities, along with a number of others across Queensland and New South Wales will be involved, with more being invited to participate. The study has already had its first celebrity endorsement, with renowned cook and author Maggie Beer backing the research as part of the new Maggie Beer Foundation, which was launched in South Australia this week. Bond University Nutrition and Dietetics program head, Professor Liz Isenring, is a project member on The Lantern Project and was also announced as one of eight professionals from around the country on the board of the Maggie Beer Foundation this week. Along with supporting The Lantern Project, The Maggie Beer Foundation is piloting its program in South Australia with education and aged care facilities, to enhance the delivery of food and wellbeing approaches in aged care. Professor Isenring said both projects were major steps forward in improving the health and quality of life of the elderly, which was a complex issue. “There has been extensive research conducted across the public and private sector in Australia that shows one in two aged care residents are undernourished due to a range of factors, such as lack of appetite, not enjoying the food they are provided with and complications from multiple medical conditions,” she said.

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LASA NATIONAL CONGRESS 20–22 OCTOBER

2014

Adelaide Convention Centre www.lasacongress.asn.au

Program and Registration

LIVE

Australia’s premier networking event in age services with an enhanced social program and additional education sessions

LASA National Congress Invited Keynote Speakers Jos de Blok

Tim Longhurst

‘Integrate’ Keynote Speaker Jos de Blok is the Founder and CEO of Buurtzorg Netherlands. Named the most influential health care Director in Holland in 2011, de Blok has transformed home-based health care in Holland by focusing on what nurses should do, not how nurses should do it. Jos has been a leader in the nursing and healthcare sector since the early 1980s. He was a nursing care provider for ten years in various fields, and then held several senior management positions for ten years in two leading HMOs in the Netherlands. Buurtzorg was established in 2007 with one team of four nurses. Seven years later Buurtzorg supports more than 8,000 nurses in 700 teams serving more than 60,000 patients a year. Buurtzorg’s care quality is very high and delivered for 30 – 40% less than competitors.

Dr Jason Fox

‘Innovate’ Keynote Speaker

‘Motivate’ Keynote Speaker

Tim Longhurst is one of the world’s leading authorities on innovation and corporate strategy, having worked with global giants including IBM, Ikea and Johnson & Johnson. He is passionate about building organisations’ capacity for foresight which often means challenging assumptions and presenting inspiring glimpses of the future relevant to our age services industry. Tim’s contagious energy sees him bring much needed levity to the major challenges we face. His Keynote presentation will combine the latest data with powerful, industry relevant, case studies to inspire leaders and decision makers navigating the challenging age services environment.

Dr Jason Fox is a motivation strategy and design expert who shows forward thinking leaders how to influence behaviour, shape culture and build for the future of work. His adventures include working with multinational organisations such as Optus and Toyota to keep things on track and well ahead of the game. Jason’s work is innovative, incredibly clever and yet practical. He is the author of The Game Changer, a new book that unpacks the science of motivation to drive change within organisations. Jason will track ideas and outcomes from Congress plenary speakers in a cartoon/comic format. His closing Keynote will recap, somewhat humorously, important ideas emerging from Congress in a unique and engaging format.

CONGRESS APP The LASA National Congress 2014 will feature a fully

Congress Sponsored by:

dimensional App compatible with both Apple and Android products. The App will provide delegates with real-time information on the Congress Program and Speakers, allowing for in-depth networking and engagement between exhibitors and delegates, and will give you the opportunity to join the conversation through live polls, surveys and social media feeds. Information on how to download will be available in the coming months.

Q&A PANEL – LASA: Developing the National Ageing Agenda Tuesday 21 October 2014 LASA presents the industry discussion of the year. Participate in shaping our national ageing agenda. The LASA Q and A will ignite the national discussion on how Australia meets its obligations to ensure older Australians live well; a conversation which is long overdue. Facilitator

Panellists

Tony Jones ABC’s Q and A

Richard Denniss Executive Director, The Australia Institute

Patrick Reid CEO, Leading Age Services Australia

Susan Ryan Age Discrimination Commissioner

Mike Woods Deputy Chairman, Productivity Commission


FUSION | 41 “This poor nutrition leads to associated issues such as pressure ulcers, falls and an increased risk of hospitalisation, but it is not an inevitable part of aging; by improving nutrition we can improve quality of life in many ways. “The focus of both projects is not on showing which aged care facilities aren’t doing well, but rather highlighting those who are doing fantastic things and encouraging others to make similar improvements.” Professor Isenring said the average aged care facility had just $6 a day to spend per person for all meals and snacks, and The Lantern Project would delve into the cost and benefit of increasing this amount. “We will be undertaking some sophisticated health economics to highlight the fact food should not be seen as a cost that can easily be cut back on, but as important to health as hygiene or medication,” she said. “We are hoping to come up with a dollar value on the savings that can be made in these areas by lifting the dollar value of what is spent on providing good quality food. “We believe even adding an extra dollar or two a day could make a dramatic difference and are hoping the findings will help influence policy decision makers in this regard. “At the same time, we want to get the message across that it doesn’t take a lot of money to produce good quality food if you use fresh produce and the right ingredients. “We will be working with aged care centres to show them how they can better achieve this.”

Professor Isenring said the study would also look beyond food to associated aspects of the dining experience. “We will be considering things like ambiance, music and introducing proper napkins. Basically, how to make dining a really enjoyable time,” she said. “In aged care facilities, a lot of things are taken away but food is something people have control and choice over. They can talk about it and look forward to it, so it can really make a difference in quality of life. “The current generation in aged care have a tendency not to complain, but the baby boomer generation are unlikely to be as accepting. They are used to a lot more choice and will be more demanding, so there has never been a more important time to take a good hard look at this issue.” Any aged care facilities interested in becoming involved with the study can contact Professor Isenring on lisenrin@bond.edu.au or Ms Hugo on cherie@mynutritionclinic.com ■ LASA is pleased to announce that we will be hosting Professor Liz Isenrin, Cherie Hugo and the well known cook and television personality, Maggie Beer at National Congress in Adelaide October 20-22. If we are to be successful in achieving sound nutritional outcomes industry needs to work closely with innovative programs such as The Lantern Project to insure clear communication and an understanding of the current challenges across aged care; particularly the shortfall between government funding and demonstrated care needs.


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“I never thought that some day we would use a computer ourselves”

BrainTrainerPlus is a revolutionary designed console and software unit for the Aged that has been shown to alleviate negative symptoms of dementia and boredom prevalent in Aged Care facilities. The BrainTrainerPlus console utilizes its user-friendly touch screen to ensure focus on the games, rather than the physical and often daunting demands of using a regular computer. The software consists of specific memory games and quizzes with content relevant to the clients’ geographical location, social and cultural origins. Most residents are able to use the console independently alleviating high demand interaction by staff and positively inspiring independent interactions between residents.

Aged Care facilities who use the BrainTrainerPlus are unanimously enthusiastic about the fun that the game contributes to the atmosphere in the facility and the influence it has on the welfare of residents, staff and volunteers. As an act of love to combat his mother’s onslaught of dementia and diminishing quality of life, Hendrik Jan van Katwijk created the BrainTrainerPlus in The Netherlands in 2008. It is currently being used in over 1,000 Aged Care facilities in The Netherlands with its audience being documented as 65,000 residents suffering from varied degrees of dementia. BrainTrainerPlus was launched in Australia in 2013.

For more information: T: 0497 856 296 • E: info@braintrainerplus.com.au • W: www.braintrainerplus.com.au


FUSION | 43

Decision Assist By Warwick Ragg, Project Officer

T

he Specialist Palliative Care and Advance Care Planning Advisory Service Project now has a name. Now called Decision Assist, the project will be known as the Decision Assist Program (DAP) and will become a recognisable name as it rolls out a range of services to the age care sector over the next few months. Many providers will already be familiar with the project via recent surveys conducted of the residential and home care sectors as part of the environmental scan to inform the outputs of the project. The process of developing a name for DAP also included developing a logo which can be seen below. This logo seeks to visually demonstrate the communication linkages that DAP will deliver in a variety of ways.

The DAP is a suite of complex projects which together will provide a range of options for residential and home (community) care providers to enhance the staff skill set, especially in respect of advance care planning. One interesting aspect of the DAP is the linkages project. While it broadly targets providers across residential and community care, linkages lists, amongst its objectives, that it will seek: to identify service models and elements that promote linkages between palliative care services and aged care providers in both residential and community sectors which meet the needs of people with a culturally or linguistically diverse background as well as those who identify as Aboriginal or Torres Strait Islander. The linkages project will provide modest grant funding for industry to assist in identifying and improving linkages between palliative care and aged care services. As a starting point the project management team has conducted a comprehensive literature review to inform the development of a framework of strategic focal points which will guide the target areas for funding, these are: • Formalised agreements; • Role descriptions; • Communication pathways; • Multidisciplinary care; • Designated linkage workers; • Shared continuing professional development; and • Continuous improvement.

It is anticipated that by implementing this guidance palliative care services will be provided in a more effective and efficient manner, and the quality of end of life care will be improved for older populations. Another important tranche of the DAP is the provision of a telephone advice line. This advice line will provide targeted specialist palliative care advice. The service will also provide 12 hour per day advance care planning support focussed on the aged care provider sector. Both of these advice lines will operate from a single 1300 number and be appropriately targeted to support services depending on the needs expressed through the phone interaction. Over the next 18 months (from July) DAP will also deliver a comprehensive and interactive training program comprising of palliative care and advance care planning e-learning modules and face to face workshops nationally. The delivery of the training program will take into consideration existing programs and industry initiatives and will work to complement these where they already exist. Aged care training will be accessible to staff from across residential and community aged care sectors, and will be delivered in regional and metropolitan locations. A final component of the DAP will be the development of a website as a substantive support tool for the various components of the project. The website will have the following purposes: • To provide an accessible online resource of appraised information and evidence for independent information seeking and learning by members of the community; • To be the core set of clinical and care guidance for clinicians providing advice through the phone advisory service; • To be a resource for use in developing training, education and linkage activities; and • To be a resource to which phone enquirers (to the advice line) and project participants can be directed for relevant information and resources. In addition, the project will develop a Smartphone app to provide even greater accessibility to project information and decision support tools. As can be seen the DAP is a complex interrelated project that will seek to provide greater support services to aged care sector providers. As it is rolled out during the next six months it will provide opportunities for: improved linkages across the palliative/aged care sectors, telephone advisory services, a comprehensive training program, and a substantial web based resource which will be complemented by Smartphone apps. A comprehensive project in a complex sector seeking to provide greater support in key areas of aged care service provision is what Decision Assist is all about. Better supported palliative care provision, better supported advance care panning and better end of life care outcomes will be key indicators of success. ■


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With one voice By Stephanie Russell, Benetas

A

n innovative community choir in Melbourne’s western suburbs is bringing people together through the power of song. With One Voice, based at residential aged care facility, Benetas St George’s in Altona Meadows, gives community members, staff, families and volunteers the opportunity to join residents at the aged care facility to sing together at the weekly group. Based on research identifying the physiological and social benefits of singing, the group aims to engage residents from Benetas St George’s and local communities, as well as provide an opportunity for intergenerational activity, and challenge perceptions about residential care. However, now three months into the program, the choir is achieving so much more. The result of a recent partnership developed between Benetas and Creativity Australia, a not-for-profit organisation which runs community choirs across Australia, the choir kicked off in February this year with the first rehearsal held in the communal area at Benetas St George’s. The first community choir of its kind to be hosted by an aged care facility, weekly rehearsals saw the group grow and grow and culminated in the group’s first concert in late April. Benetas St George’s Community Coordinator Eleanor Naldoza said the choir had had a significant impact on the residents of the facility, and their general wellbeing. “It isn’t uncommon to walk around the facility and hear residents singing the choir songs, even on the days rehearsal isn’t held,” said Mrs Naldoza. “We have noticed a huge improvement in the moods of many of our residents who participate in the choir, and they very much look forward to rehearsal days.” One such resident is Maria, a 85 year old with advanced dementia who was a regular in the local Altona Choir when she was younger. “Maria checks on what day it is with me regularly,” said Mrs Naldoza, “because she doesn’t want to miss choir practice.”

“During practice she will often whisper to me, ‘I know this song, my husband used to sing it to me’ or ‘This is a song my sister and I used to sing.’ It is very special to be a part of this experience with her, and witness how significant the activity is.” “It’s far more than just a choir.” In fact, the benefits of group or choral singing as a treatment for dementia are just starting to become better understood. In early 2013 Benetas explored this connection, producing the report “Forgotten notes: Pilot study of a choir for people living with dementia in a residential aged care setting.” This research focused on the impact of choir participation on twelve people with dementia at Benetas Gladswood Lodge in West Brunswick, extending previous studies which had looked at music therapy as a preferred psychosocial intervention. Forgotten Notes found that organised group singing, which incorporates scheduled practice and performance, delivered benefits for social interaction and engagement, self-esteem, and levels of depression and other behavioural and psychological symptoms of dementia.


FUSION | 45 Manager of Innovation, Policy and Research at Benetas Dr Amee Morgans said the results were significant, and could inform future practice. “What we saw in this research was that there were a number of residents who displayed major improvements in mood. They were less agitated after choir and in the days following they were more alert and more engaged with staff and visitors.” “One of the main recommendations to come out of the report was that therapeutic psychosocial interventions should be included as a core component of care, and that music therapy interventions should be considered to address a range of needs for all residents.” “The group choir in a residential setting has the capacity to meet some of the residents’ needs for meaningful activity and social interaction, and can provide enjoyment and stimulation,” said Dr Morgans. Indeed, With One Voice has provided an opportunity for many residents to connect particularly with families on an enjoyable, activity-based level. “We see many family members come and join in,” said Mrs Naldoza. “Sometimes the sons and daughters look like they are having more fun than the residents!” “It’s nice to be able to share quality time with a loved one outside of their room, beyond talking about the ‘usual’ things.” “We also have members of the community of various ages regularly join us; it really is a terrific opportunity to ‘open the doors’.”

Dr Morgans said that one of the most significant benefits of the choir was its role in breaking down stereotypes of older people and aged care facilities. “The With One Voice choir works to reduce social isolation and facilitate a connection between St George’s and the local community,” said Dr Morgans. “We believe this could lead to improved relationships in the Altona Meadows’ community and an improved understanding between the generations and people from diverse backgrounds.” “We really hope this challenges people’s perceptions of what aged care homes look and feel like.” Led by professional conductor Kym Dillon, the With One Voice choir specialises in classics to the hits of today, with group members able to request their favourites. Generally, the group averages 20 members. “We’re always on the look out for more members,” said Mrs Naldoza. “We’d love to get to 60!” Participation is free for Benetas residents and their families, and by tax deductible donation for the wider community. Light refreshments are provided at the end of each session. ■ For more information about With One Voice Altona Meadows, please visit www. benetas.com.au/withonevoice or call (03) 8679 6088. Rehearsals are held on Tuesdays 6-7pm and no experience is necessary. To download a copy of Forgotten notes: Pilot study of a choir for people living with dementia in a residential aged care setting please visit www.benetas.com.au/ research-opinion/aged-care-research-projects


46 | FUSION

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DREW POTTS

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CFP® Senior Financial Advisor

Insight Aged Care Services P/L gavin.whitlock@insight-acs.com.au www.insight-acs.com.au 28 Pandora Street Boondall QLD 4034 (07) 3265 4659

Western Pacific Financial Group drewpotts@westernpacific.com.au www.westernpacificpa.com.au Level 3, 97 Pirie Street, Adelaide SA 5000 (Also in Port Augusta SA) 1300 684 402

Adv Dip FP

Meritum Financial Group ashley@meritumfg.com.au www.meritumfg.com.au 24A Darlot Street Horsham VIC 3400 1800 009 533 MATTHEW WOOLFORD CFP®, B. Bus Acc.

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Advisersure Financial Consultants richard@advisersure.com.au Suite 3/333 Canterbury Road Canterbury VIC 3126 (03) 9836 8399 SUSAN COOPER AFP®, MBA, Adv.Dip.FS(FP)

susan@eponafg.com Epona Financial Guidance www.eponafg.com Suite 6 Level 1, 329 Mitcham Road Mitcham VIC 3132 (03) 9874 4311 Australian Capital Territory

Affinity Wealth Services P/L robert.craven@affinitywealth.com.au www.affinitywealth.com.au Level 9, 60 Carrington Street, Sydney NSW 2000 (02) 8078 0888 0432 124 834 Western Australia GEOFF WOTZKO FCPA FCTA Dip FP

Western Pacific Financial Group P/L geoff.wotzko@westernpacific.com.au www.westernpacific.com.au 355 Scarborough Beach Road Osborne Park, WA 6915 (08) 9340 9200 CRAIG BILLING CFP®

Western Pacific Financial Group P/L craig.billing@westernpacific.com.au www.westernpacific.com.au Suite 2, 165 Seventh Avenue Inglewood, WA 6052 (08) 9381 6622

JEREMY GILLMAN-WELLS CFP®

Bravien Financial jeremy@bravien.com www.bravien.com Level 1, 29 Bentham St Yarralumla ACT. 2600 (Also in Bardon QLD) 1300 272 843

South Australia

JULIE LOCKERIDGE CFP®, Dip FP

KATE PHILLIPS

Kimmorley Financial Management julie@kfm.net.au www.kfm.net.au Suite 1404, Level 4, 56 Scarborough St Southport QLD 4215 (07) 5591 1725

DFS, ADFS, B T. , B Ed.

SHAUN AKROYD Bravien Financial shaun@bravien.com www.bravien.com Suite 9 / 60 Macgregor Tce Bardon QLD 4065 1300 272 843

MICHAEL YOUNG Second Innings Pty Ltd michael@secondinnings.com.au 156 Commercial Street East Mount Gambier SA 5290 (08) 8723 0411

Tend Financial Planning kphillips@tendfp.com.au www.tendfp.com.au 48 Fullarton Rd Norwood SA 5067 (08) 83624555

GAVIN WILLIAMS Garden Financial Services gwilliams@gardenfs.com.au www.gardenfs.com.au 1/5 Oval Avenue Caloundra QLD 4551 (07) 5437 2744 BRAD MONK LifePath Financial Planning info@lifepathfp.com.au www.lifepathfp.com.au 643 Kessels Road Upper Mt Gravatt QLD 4122 (07) 3219 4670 0433 271 001

ALDIS PURINS CFP®

Western Pacific Financial Group P/L aldis.purins@westernpacific.com.au www.westernpacific.com.au 355 Scarborough Beach Road, Osborne Park, WA 6915 (08) 9340 9200

JASON GORDON Dip FP, B. Bus (Accounting) Brisbane Hillross

jason.gordon@hillross.com.au www.brisbanehillross.com.au Level 8, 141 Queen Street Brisbane QLD 4000 (07) 3012 8040

Want to know more about aged care? ...Ask the Gurus!

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FUSION | 47

Aged Care won’t be affordable for everyone

By Rachel Lane

T

he Aged Care Reforms due to commence on 1 July this year are designed to create more of a “user pays” system. While on the surface of it getting people to contribute towards the cost of their aged care based on their assets and income and having a market price system for accommodation payments sounds fair and reasonable, the reality is quite different. Firstly, let’s look at the group of people the government already classify as financially disadvantaged – Supported Residents. Under the current system, supported residents are assessed purely based on their assets. People with assets below $45,000 are fully supported and cannot be asked to pay an accommodation bond or charge. People with assets above $45,000 but less than $116,136 are partially supported and make a contribution towards the cost of their accommodation, with the government providing a “top up” through the accommodation supplement to the facility. For example, Shirley is 82 and a Full Pensioner, her assets consist of $90,000 in the bank and $5,000 in personal effects. Under the current system the maximum amount Shirley can contribute towards the cost of her accommodation is $50,000 as a bond in Low Care (plus a retention fee of $331 p.m) or $24.04 as a daily charge in High Care. Under the new system Shirley will be assessed based on her assets and her income according to the comprehensive means test of: 50c per dollar above $24,731 plus 17.5% of his assets $45,000 – $154,179 In Shirley’s case, the Accommodation Charge/Daily Accommodation Contribution (DAC) would be the same pre or post 1 July. The issue for Shirley, and many current high care residents, is that when they pay their accommodation charge plus the basic

daily care fee and an allowance is made for personal expenses the cost of living in aged care exceeds their income. Of course, under the new system, Shirley will have the choice of paying by a lump sum (RAC), daily charge (DAC) or a combination. Calculating the lump sum amount for Shirley is done by taking the daily charge and converting it using the Maximum Permissible Interest Rate, currently 6.63%. The equivalent Refundable Accommodation Contribution (RAC) for Shirley is $131,984. Shirley cannot pay $131,984 as she simply doesn’t have the means and the facility are still required to leave her with the minimum assets amount of $45,000. So, if Shirley wants to pay by lump sum the most she will be able to pay is $50,000 and the remaining amount ($81,984) will be paid by daily charge of $14.93p.d. If Shirley wishes she can have her Daily Accommodation Contribution deducted from her Refundable Accommodation Contribution. As the RAC is reduced the DAC will increase, reducing her assets over time. The government will provide an accommodation supplement to the facility of between $1.61 and $28.45p.d depending on the number of supported residents and whether or not the facility has met the significant refurbishment criteria. For supported residents with higher levels of assets or income the accommodation supplement the facility can receive will essentially act as a cap. For example, Fred is a Full pensioner with assets of $135,000. Based on the means test Fred can pay a DAC of $43.27p.d or a RAC of $237,561. However, the facility that Fred is moving to only receives an accommodation supplement of $34.20, so Fred’s DAC would be capped at $34.20 and his equivalent RAC would be capped at $187,765. On this basis we can work out the “market price” for supported resident beds as follows:

Accommodation Supplement

Maximum Daily Accommodation Contribution (DAC)

Max Refundable Accommodation Contribution (RAC)

$52.49 – significantly refurbished, over 40% supported ratio

$52.49

$288,180

$39.37 – significantly refurbished, below 40% supported ratio

$39.37

$216,149

$34.20 – not significantly refurbished, over 40%supported ratio

$34.20

$187,765

$25.65 – not significantly refurbished, below 40% supported ratio

$25.65

$140,823


48 | FUSION Using this table aged care operators may be able to more easily identify the beds that should be offered to supported residents and compare the market price with the equivalent amount they will receive for a supported resident in a particular bed. The new market price arrangements will not apply to supported residents and it is not always possible to determine if someone is a supported resident prior to entry. The table above may assist both residents and providers to understand the amount that will be paid under the market price – essentially whatever the price is – and the amount that will be received if the resident is supported. For example, XYZ Facility have a bed with a market price of $350,000 RAD or $63.57 DAP. The facility meets the criteria of significant refurbishment and has more than 40% of residents as supported. If they allow Dorothy to enter and she is not a supported resident they will receive the market price through RAD, DAP or combination. If it turns out that Dorothy is eligible to be supported they will receive a RAC or DAC or combination payment from Dorothy and the remainder through the accommodation supplement up to the equivalent of $52.49 or $288,180. Now let’s look at the other group of people who are going to find meeting the cost of care difficult, they are not eligible to be supported but don’t have the means to pay the market price, they are in “no man’s land” financially. These were probably the same people concerned by stories of $1m + accommodation bonds and believed that a market price was a means of reducing the amount aged care facilities can charge them. The fact is that the only people currently paying $1m bonds are those that have more than $1m in assets, and in many cases they are receiving a discount from the facility for doing so. There will be aged care facilities that have a market price of $1m post reform. Regardless, whether the market price is $350,000 or

$1m residents who are not eligible to be supported will need to pay it.

Let’s look at an example Jack and Jean are pensioners, Jack needs to move into care. Jean will remain living in the family home. They have $400,000 in investments, a car worth $30,000 and $20,000 in personal effects. The market price at the aged care facility close to their home, that can deliver the care Jack requires, is $400,000 by lump sum or $72.66 daily charge. Under the current rules Jack could be asked to pay a maximum accommodation bond of $180,000 or an accommodation charge of $34.20p.d. Under the current system the aged care facility can charge Jack $180,000 but still get an average of $400,000 by charging the person with higher assets $620,000. Under the new rules the person with higher assets can only pay $400,000, so Jack needs to pay $400,000 or the equivalent thereof. If Jack chooses to pay by lump sum his maximum RAD will still be $180,000 as the assets of a couple are assessed on a 50/50 basis and the facility must leave him with $45,000. The remainder of his accommodation payment ($220,000) will need to be paid by a daily accommodation payment of $39.96p.d. While this measure is designed to “protect” Jack, it actually puts Jack and Shirley in a situation where they are forced to pay interest at 6.63% when they can only earn interest from their investments at around 4%. The person that has really been “protected” is the person with higher assets, who would have paid the $620,000 bond, as they cannot be charged more than the market price. But because no-one can pay more, no-one can pay less so those who are less well-off will simply need to pay more. ■


FUSION | 49

Legal Issues: Duty of Care beyond health: A solution for care facilities to manage risk in Will instruction By Donal Griffin, Legacy Law

Executive summary

A

case in New South Wales from 20131 overturned a will by an elderly patient who was living in an aged care facility. It should be required reading for administrators of these facilities. The will was deemed “suspicious” because the Charity named as a beneficiary was involved in its drafting. The Court considered the role of the Solicitor whose client was the Charity (and who worked from its office). The case should give charities pause for thought about introducing lawyers with whom they have a connection to their patients. If you apply a legal diagnosis to a situation involving a frail person you may get a very different result to that arising from a health / carer perspective. It will be a legal test that the Courts will apply so it is suggested that facilities with an exposure to risk promptly apply a legal lens to the issue.

What should managers of facilities do? Applying the discipline of medical structure to a legal problem: Let’s start by observing the issue with a view to doing no harm. Where possible, you should enquire as to which patients have wills, Enduring Powers of Attorney, Enduring Guardianship and Advanced Healthcare Directives in place to identify risks to your organisation. An audit will quickly reveal which patients are higher risk. Then prescribe a course of treatment if necessary. Discussions regarding financial arrangements and accommodation can, as in this case, be perceived to put pressure on patients. You should have a policy that includes making available independent legal advice for patients (and perhaps require that a family member be present during bequest discussions). Where estate planning documents are being executed for patients, be aware that harsh light will be cast on the circumstances as there will be winners and losers and losers often fight thinking the estate will pay costs (not necessarily so). They often feel like they have nothing to lose by casting doubt about the circumstances of a will they do not like. Be aware that evidence in your own files may be contradictory due to changing condition of patients but also the opinions of the different examining nurses and medicos: words like “emotional” in a file may be correct but can be used by lawyers to question why further action was not taken and query the ability of a patient to

approve changes in their wealth going one to one beneficiary rather than another. If there is a risk re capacity, it is often best for a medico who has been treating the patient and is familiar with them to conduct a thorough examination, make a conclusion as to capacity and understanding and record their notes. Don’t be perfunctory – lawyers need to ask about previous wills and spend longer than 5 minutes (in Dickman) with the client! Admittedly can be hard if silent but process needs to be observed. Finally, monitor and review periodically.

This

industry

will

become

highly regulated over the coming years of

with

the

involvement

government,

increased

medical requirements, improved facilities, pricing sensitivity and greater competitiveness. (David Hegarty, PWC)

A legal case – Dickman A lady died in facility in Collaroy in 2005 at age 102. She lived there for 8 years. Less than 2 years after admission she made a will leaving everything to a man she considered to be her son (although they just became friends when she was 63 and he was 19). He later became a Manly councillor. A year later, she made a new will appointing the financial secretary of the Salvation Army (NSW) Property Trust as her executor and gave the whole of her estate to the Salvation Army Eastern Australian Territory. Salvos had to reimburse the money they received!


50 | FUSION In Dickman, the Court revoked a grant of probate four years after it was granted on the basis that the delay did not cause the Salvos prejudice. Facilities may want to conduct a review of wills under which they have benefitted in the last five years as more cases of this type are expected in the future. These cases are messy and often fought on multiple legal fronts: can be application for injunction, Guardianship applications for financial management orders and even Apprehended Violence Orders. Busy administrators will have more important things to do with their limited resources of time and budgets. In a recent case, the NSW Trustee and Guardian was appointed as a financial manager and was asked to do everyone’s bidding. As a result, the facility looked like Central Station with potential beneficiaries and their lawyers all suddenly demanding visits but insisting on not having to cross paths with other beneficiaries. This can put a great strain on a facilities resources. The legal answer may not be as intuitive as one might think. People are often horrified to hear that family members can easily challenge a will or, if there is no will, the division of assets on an intestacy. While modern families are often more complicated, the leading case on capacity to make a will was decided almost 150 years ago.2 There are clear directions to health professionals in this regard so ignorance of the law will not be a defence especially where the facilities hold themselves out as providing specialist aged care advice. The large volume of publicly available information will be used against facilities:

From the NSW Government’s website: “Do not assume that because a person has memory problems or a disability that they lack capacity to make decisions. Also, a person may have an eccentric lifestyle or make personal decisions that we do not agree with, but this doesn’t mean that they do not have capacity. When there is a question or disagreement about a person’s ability to make their own decisions, an assessment can provide evidence about the state of a person’s capacity. A capacity assessment could be made by a health professional, such as a psycho geriatrician or neuropsychologist. When assessing a person’s mental capacity it is important to remember that what is being assessed is their capacity to make a specific decision at that point in time.” A guardian or enduring guardian is not always the person responsible for making health decisions for a third party. It is important to check that the guardian has the medical and dental consent authority or function included in the guardianship appointment. If the guardian does not have this authority, the treating practitioner will need to refer back to the hierarchy within the Guardianship Act NSW (1987) to find the next eligible person responsible. This could be a spouse or a unpaid carer prior to their being admitted to the facility. The legal obligations of solicitors in executing wills are set out in Mason & Handler’s “Wills, Probate and Administration Service NSW“: “(ii) One or more persons should be present, selected by the solicitor having regard to their calibre as witnesses if required to testify whether the issue of capacity is raised. Where possible, one of the witnesses should be a medical practitioner, preferably the doctor who has been treating the testator and is familiar with him, who

should in making a thorough examination of the testator’s condition, question him in detail and advise the solicitor as to the capacity and understanding of the testator. The presence of other persons at this time would require the testator’s consent; (iii) A detailed written record should be made by the solicitor, the results of the examination recorded by the medical practitioner and notes made by those present.”

Suspicious minds If you benefit under a will and are involved in its preparation the circumstances can be said to be “suspicious”. In Wintle v Nye3, the circumstances were that the will gave a significant benefit to the solicitor who drew it, who was not an intimate friend and whose evidence of the testatrix’s instructions was uncorroborated. Viscount Simonds said: “It is not the law that in no circumstances can a solicitor or other person who has prepared a will for a testator take a benefit under it. But that fact creates a suspicion that must be removed by the person propounding the will. In all cases the court must be vigilant and jealous. The degree of suspicion will vary with the circumstances of the case. It may be slight and easily dispelled. It may, on the other hand, be so grave that it can hardly be removed.”

A rule of thumb is “the three R’s” … the need for the testator to have the capacity to remember, to reflect and to reason. Ward J noted in King v Hudson4 that a respected counsel, Mr Willmott, referred to the three “R’s” adumbrated by Myers J, those being the need for the testator to have the capacity to remember, to reflect and to reason: He must be able to remember, so that he can call to mind the property at his disposal and those who may have claims upon him, to reflect so that he can consult within himself on the relative weight of their claims, and to reason so that he can judge, having regard to his assets, how far, if at all, he should give effect to them.

Call to Action Those engaged in the important provision of aged care should be aware that their duty of care can extend beyond the health of their client. The allegations that inevitably are made in cases like the ones mentioned in this paper are damaging for a charity: not all publicity is good publicity. Legally it may not be a conflict of interest but a conflict of duties. With an ageing population5, one million people with dementia by 2050 and 85,000 more aged care places required in the next decade, this is going to become an even bigger issue. Operators of aged care facilities need to be aware that Enduring Power of


FUSION | 51 Attorney documents are going to be executed on their premises and will be very closely examined. The operators may be called upon to give evidence. If the operators or related charities are beneficiaries of bequests from these patients, disappointed beneficiaries may well apply considerable pressure and negative publicity on those facilities, which in worst case scenarios could lead to a scandal and cast a doubt over the capacity of those organisations to continue in the important business of looking after senior Australians. â–

Other resources

References

community%20final_index.pdf

1. Dickman v Holley; Estate of Simpson [2013] NSWSC 18 2. Banks v Goodfellow (1870) LR 5 QB 549 3. [1959] 1 WLR 284 4. [2009] NSWSC 1013 5. http://www.percapita.org.au/01_cms/details.asp?ID=658

http://www.humanrights.gov.au/publications/your-rights-retirement/13-your-right-planyour-will-and-other-end-life-decisions http://www.mndnsw.asn.au/index.php?option=com_content&view=article&id=200: advance-care-directives-for-clear-guidance-to-your-doctors-about-your-intentions-formedical-treatment-in-the-future&catid=101:planning-ahead&Itemid=203 http://www.nscchealth.nsw.gov.au/carersupport/cc/ACP%20Workbook%20

http://www.advancecaredirectives.org.au/AdvanceCareDirectives-publications.html

About legacy Law The Principal of Legacy Law, Donal Griffin, and his partner Cath, are very pleased to say that all four of their parents are alive. They are in their 70s and 80s and in good health generally. We all know that may change so their parents have clearly communicated and documented their wishes in the event that their health deteriorated.

Good examples: http://www.ipac.com.au/Stories-aged-care


52 | FUSION

2013 winners, left to right: Helen Williamson, Mary Fromberger representing Better Together Cottage Team, and Craig Mills representing RSL Care.

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FUSION | 53

A crystal clear answer for Pressure Injury Prevention and Management By Margo Asimus, Felicity Williams and Pui Ling (Iris) Li

The Pressure Injury Prevention Program in the Hunter New England Health Local Health District is a model highly recognised within the healthcare profession since its inception in 2008. The program’s clinical lead Margo Asimus, nurse manager Felicity Williams and project officer Pui Ling (Iris) Li explain the program’s aims and outcomes.

I

t is 2014 and pressure injuries continue to remain a major problem for patients, families, health care professionals and organisations1. This adverse event contributes to harm of patients which affects long term wellbeing, while increasing length of stays2 and placing additional demands on the health care budget. An organisation that is willing to address this predominately avoidable injury must firstly be prepared to measure the real extent of the problem. It is then that the necessary strategies and changes can be implemented. Pressure injury point prevalence studies have been performed in five states across Australia; Victoria, Queensland, Tasmania, Western Australia and ACT. In 2003, 2004 and 2006 the Victorian Quality Council (VQC) supported point prevalence studies which resulted in significant improvement in prevalence rates from 26 per cent in 20033 to 17.6 per cent by 20064 . The state of Western Australia commenced state wide auditing in 2007 which has continued through the WoundsWest program (WoundsWest)5. WA identified improvement strategies which also resulted in the reduction in the hospital acquired prevalence rates. In an effort to gain continual improvement in reducing hospital acquired pressure injury prevalence rates, Queensland has imposed financial penalties for both stage 3 ($30,000) and 4 pressure injuries ($50,000) which had been classified as an adverse event. Jackson et al (2011)6 reviewed the ICD10 coder data for hospital acquired conditions from 2006 to 2007 in public

hospitals in the states of Victoria and Queensland. Over 144 categories were determined with pressure injuries being in the top 10 of all adverse events, (5th place) with over 2,873 cases identified in the 12 month period. The cost of a hospital acquired pressure injury was calculated at on average $8,435 for each case. It also reported an estimated expenditure of $24,234,740 would be required in the health care budget to treat the complications of a pressure injury. The increasing pressure injury prevalence, patient harm and escalating health care costs prompted an urgent organisational change to improve the quality and safety of care within a large health service in NSW1. A systematic approach to pressure injury prevention and management was implemented with outstanding achievements in several key areas.

Crystal Model: A Crystal Clear Solution for Pressure Injuries The Crystal Model was developed by Hunter New England Local Health District (HNELHD) in NSW and has been implemented by the Pressure Injury Prevention Program (PIPP) at an executive level in HNELHD7. It has focused on the prevention and management of pressure injuries since 2008; the prevalence rate of hospital-acquired pressure injuries decreased by 13.5 per cent over the six years. This Model has been recognised as best practice by winning the Clinical Excellence Commission Award in the 2009 at the NSW Health Baxter Awards.


54 | FUSION

Figure 1: Crystal Model Diagram HNELHD Pressure Injury Prevention Program Crystal Model: A range of key aspects working together to stop pressure injuries

There are nine components in the Crystal Model, which are interconnected in prevention and management of pressure injuries– policy, surveillance, equipment, communication, documentation, wound management, education, paediatrics and community care. Each component has a leader, a clinician or manager who has substantive roles in the PIPP and promotes the development of resources and strategies.

Crystal Model Components Policy The Pressure Injury Prevention and Management Policy include an equipment algorithm and have been developed with the reference to the best practice guideline. The policy interconnects key focus areas, strategies and evidence. The policy is reviewed regularly following recommendations from recent pressure injury prevalence studies. Surveillance Annual point prevalence surveys should be conducted to identify pressure injury prevalence, the sources and severity of the pressure injuries, patients’ risk profile of pressure injury and current prevention and management strategies. Our project has demonstrated that annual surveillance provides evidence of the effectiveness of strategies implemented, informs the development of future strategies, and enables future benchmarking. Equipment Appropriate choice of pressure redistributing equipment is one of the important components in pressure injury prevention.

In HNELHD, an equipment algorithm has been developed and implemented alongside an agreed and validated risk assessment tool8. The algorithm guides clinicians to identify through risk assessment the most appropriate pressure redistributing device. Communication The pressure injury prevention program logo was established as a marketing strategy. The communication strategies include fact sheets, meetings, and a dedicated PIPP website to ensure that all information and resources about the Pressure Injury Prevalence Study were supplied promptly to managers, staff and patients. In addition, all study results together with recommendations are accessible on the PIPP website. Documentation Introduction and implementation of a validated pressure injury risk assessment tool, Waterlow Risk Assessment8 and Pressure Injury Notification Sticker enables Incident Information Management System (IIMS) and coder data to be compared. This information provides clinical units with direction to improve clinical care and documentation. Incidents of pressure injuries are expected to be reported to the IIMs of the health organisation for analysis of the root cause of the adverse event which then informs improvement strategies. Education An interactive online program has been developed, which is available to all clinicians and students across HNELHD. The purpose of the program is to provide accessible,


FUSION | 55 consistent training, develop knowledge and critical thinking about pressure injury prevention, assessment and management. Completion requires successfully undertaking of an on-line assessment that is automatically recorded on the staff member’s learning record. Evaluation of the validity of the knowledge acquisition and competence was undertaken during the initial pilot of the on-line education evaluated.

There are nine components in the Crystal Model, which are interconnected in prevention and management of pressure injuries – policy, surveillance,

equipment,

documentation,

wound

communication, management,

education, paediatrics and community care.

Wound management Evidence-based management of pressure injuries using wound management principles has been implemented and this information is provided within an e-learning program.

Paediatrics and Community PIPP community study has identified gaps in pressure injury prevention in clients living in the community9. Strategies have been introduced to prevent pressure injuries following patients’ discharge into the community settings. The paediatric population has specific care needs that now form part of

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specific care delivery to avoid pressure damage from device related pressure. Measuring the extent of the pressure injuries Prevalence studies and clinic audits should be conducted to measure the extent of the organisations pressure injury problem and the effectiveness of the PIPP implemented. Also, to demonstrate excellence in accreditation, the systems such as prevalence study, clinical coder audit and IIMS data management that can capture, analyse and report data outcomes should be demonstrated.


56 | FUSION

Prevalence studies and clinic audits should be conducted to measure the extent of the organisations pressure injury problem and the effectiveness of the PIPP implemented. Prevalence vs Incidence The proportion of patients with a pressure injury(s) within a particular population at a given time is known as pressure injury prevalence; and the number of patient with a new pressure injury(s) in a specified population during a period of time is known as incidence. The prevalence study reflects the magnitude of the problem, while the incidence study reveals the quality of care provided.10 Data content Apart from patients’ demographics, the sources: hospital acquired or pre-existing, severity and anatomical locations of the pressure injuries, the following data can also be collected to assess the awareness of pressure injury prevention: • Compliances in risk and skin assessment and reassessment • Preventative action taken • Appropriateness of the supporting surface and the length of time to access pressure redistributing equipment, especially for community clients • Compliances in IIMs reporting The extent of data this collected will also depend on the purpose of the study and resources available, such as the number of surveyors, number of eligible patients to be surveyed, settings (inpatient or community), and who will manage the data. The quality of analysis can also be affected by available resources. Planning and study methodology At HNELHD it has been necessary to obtain ethics approval before conducting the district wide annual study. The methodology of the study has been determined to collect accurate, valid and consistent data collection to enable trending, benchmarking and comparison with other studies The point prevalence study can be conducted, for example, by physical examination and medical record audit and extracting data from clinical record coding or IIMs. It also sets out explicitly the inclusion and exclusion criteria, such as age, ward, and medical specialty. The methodology of the study in acute settings varies from primary care settings. Validity of the study To ensure the quality of data collected, standardised education and training and inter-rater testing are required for surveyors prior to the prevalence study11. An external assessor or independent surveyor is allocated to each survey team to mitigate bias. HNELHD first point prevalence surveillance conducted in 2008 survey was facilitated by the district project team members leading surveillance teams. Local ownership of annual surveillance has transitioned as surveyors were trained and assessed. PIPP district team members were able to support

surveillance teams by providing education and validation regarding the methodology and process to facilitate that the survey is consistent and of appropriate. As the study with higher consent rate is more likely to reflect the true prevalence rate of pressure injuries, all facilities in HNELHD are required to achieve a minimum of 75% consent rate for eligible patients in prevalence studies. Leadership has been a crucial component of the program’s success12. Executive sponsorship by the District Director of Nursing and Midwifery was vital in recognising the role of nurses in identifying risk, preventing and managing pressure injuries. Executive sponsorship has engaged strategic and clinical leaders responsible for implementation of standardised prevention and management. The clinical governance unit are engaged and involved to enable pressure injury prevention to interface with other district wide programs. A range of forums have been used to convey a consistent message to staff at all levels of the organisation these focus on clinical quality and patient care and include Senior Nurse Management, executive leadership and Nurse Educators/Nurse Practitioner/Clinical Nurse Consultant forums. They provide opportunity for the Pressure Injury project team to report on key results and trends emerging from prevalence studies and engage with staff on strategies for improvement. The interdisciplinary district project team consists of members from clinical nursing, allied health and management with medical staff contributing to sub-committee activities as key stakeholders. Membership is based on geographical location, clinical expertise and ability to influence and lead1. The team is responsible for the development of processes, policies, procedures and engaging content matter experts around current evidence based practice to prevent and manage pressure injuries. To cascade a consistent message to 41 inpatient facilities and 44 community health centres, Pressure Injuries has been included as a KPI for clinical managers. This factor facilitates engagement and clarifies accountability for clinicians at all levels of the organisation in preventing adverse events. The Pressure Injury prevention and management e-Learning program interfaces with the district learning management system (LMS). All clinicians who prescribe pressure relieving/ redistributing equipment are required to undertake the learning program and managers have access to their staff completion details. The online PI learning course is required by all people who participate as a surveyor. Following the first district wide point prevalence study a mattress replacement scheme and equipment algorithm were rolled out. Hiring of powered mattress systems was reduced and this saved $500,000 in the first year. The reduction in


FUSION | 57 preventable pressure injury prevalence and severity has also reduced the cost of services by contributing to reducing use of consumables and reducing length of stay The annual point prevalence surveillance is the key evaluation process for implementation of pressure injury prevention and management strategies. Analysis of trends informs the priorities and direction that future strategies should take. To undertake the survey in all 44 inpatient facilities, the commitment of approximately 200 staff members is required. Survey teams of three people consist of all levels of nursing, from undergraduate students, local university academic staff to senior nursing leaders. Inter-disciplinary engagement has occurred with increasing numbers of allied health participating in these teams. The Pressure Injury project team analyses the data and prepares reports for the district, clusters, facilities and wards. Accompanying these are survey recommendations which are individualised according to the results. The reports are pivotal to the communication process and are published on the intranet site so all managers can compare results with other services. In recent years alignment with the clinical governance unit has been strengthened by the inclusion of Pressure Injuries in the National Safety and Quality Health Service (NSQHS) Standards as Standard 813. The district uses a range of change management strategies to cascade strategies, articulate accountabilities and imbed expected behaviours. The Crystal model developed in HNELHD is an example of a systematic approach which engages both executive leadership and clinicians in the prevention and management of pressure injuries. Implementing the best practice strategies has created a difference in the quality and safety for those patients in our care. Additional resources are now available to support organisations in developing programs to minimise the prevalence of pressure injuries. In 2012 the Pan Pacific Clinical Practice Guideline for the Prevention and Management of Pressure Injury8 were released and can be freely accessed on

the Australian Wound Management Association website (http://www.awma.com.au/publications/publications. php#pipm). These guidelines have been acknowledged across Australia as a best practice resource for organisations to refer to in preparation to meet National standards, improve outcomes and reduce the incidence of this avoidable wound. ■ Republished with permission from The Australian Hospital and Healthcare Bulletin Autumn 2014

Margo Asimus is a Nurse Practitioner – Wound Management and Clinical Lead (2008-2013) for the Pressure Injury Prevention Program in the Hunter New England Health Local Health District. She participated in the guideline development group for the Pan Pacific Clinical Practice Guideline for the Prevention and Management of Pressure Injury. Margo is Vice President of the Australian Wound Management Association (AWMA) and President of AWMA-NSW.

Felicty Williams is the Nurse Manager Professional Development for HNELHD. She has additional Midwifery and Management qualification and broad experience across Metropolitan, Rural and Remote Nursing. She has management responsibilities for the Pressure Injury Prevention Program at HNHELHD since 2008 and education component at a local and state level.

Pui Ling (Iris) Li currently works as a Project Officer. She has been involved in the Pressure Injury Prevention Program since 2009. Iris completed her nursing Gerontic Master degree in 2005.

References

6. Jackson, T., Nghiem, H.S., Rowell, D., Jorm, C. & J. Wakefield ‘Marginal costs of

1. Asimus M, Maclellan L, Li P. Pressure ulcer prevention in Australia: the role of the

and research,’ Journal of Health Services Research &Policy, 2011. 16(3): 141-146.

nurse practitioner in changing practice and saving lives. Int Wound J. 2011;8(5):508–

7. Rayner R, Asimus M, Li PL. Pressure Injury. In: Swanson T, Asimus M, McGuiness

13.

B editors. Wound Management for the Advanced Practitioner. 1st ed. London:

2. Graves N, Birrell F, Whitby M. Effect of pressure ulcer on length of hospital stay.

Academic Press; In Press May 2014.

Infect Control Hosp Epidemiol. 2005;26(3):293–7.

8. Australian Wound Management Association. Pan Pacific Clinical Practice Guideline

3. Victoria Quality Council VQC State-wide PUPPS Report-2003 [Internet]. Victoria;

for the Prevention and Management of Pressure Injury. Cambridge Media Osborne

Department of Human Services; 2004 [cited 21/1/2014]

Park, WA: 2012

Available from:

9. Asimus M, Li P. Pressure ulcers in home care settings: is it overlooked? Wound

http://www.health.vic.gov.au/qualitycouncil/downloads/pupps2/statepupps_report.pdf

Practice and Research. 2011: 19(2): 88-97.

4. Victorian Quality Council VQC State-wide PUPPS Report 2006. [Internet]. Victoria;

10. International guidelines. Pressure ulcer prevention: prevalence and incidence in

Department of Human Services; 2007 [cited 21/1/2014]

context. A consensus document. Australia: IP Communications, 2014.

Available from: http://www.health.vic.gov.au/pressureulcers/downloads/pupps3.pdf 5. Strachan V., Prentice J., Newall N., Elmes R., Carville K., Santamaria N. & Della P. WoundsWest Wound Prevalence Survey 2007 State-wide Report. Ambulatory Care Services, Department of Health 2007: Perth, Western Australia.

hospital acquired diagnoses: Information for priority setting for patient safety programs

11. Prentice JL, Stacey MC, Lewin G. An Australian model for conducting pressure ulcer prevalence surveys. Primary Intention. 2003;11(2):87–109. 12. Studer Group. The Nurse Leader Handbook, Florida: First Starter Publishing; 2010. 13. Australian Commission on Safety and Quality in Health Care. Safety and Quality Improvement Guide Standard 8: Preventing and Managing Pressure Injuries (October 2012). Sydney. ACSQHC, 2012.


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FUSION | 59

New national online resource to promote advance care planning By Chris Shanley

Advance care planning (ACP) is the process of a person thinking about and communicating to others their values and wishes about possible future care at a time when they still have capacity. ACP is relevant for everyone in the community, but especially for people with chronic health conditions or at risk of losing capacity from illnesses such as dementia.

C

onsumers report many barriers to undertaking ACP. It is not a routine part of healthcare practices and there is a reluctance to have open discussion about death and dying within the general community. The laws and regulations around ACP vary between States/Territories and are often inconsistent and confusing, even for legal and health professionals If ACP does occur, this is not always followed through in the way end-of-life decisions are made within the healthcare setting. In response to these barriers, the Dementia Consumer Research Network within Alzheimer’s Australia funded a project to develop a nationally-focused website and campaign to promote advance care planning and other aspects of planning ahead. The campaign and website is called Start2Talk. While there are a number of websites related to planning ahead available, there are aspects of this new Start2Talk website that add value to existing resources. • It uses a consumer-focused model that seeks to address the issues raised by consumers during extensive consultations. • It moves beyond providing information to include a number of worksheets that promote communication and help users take action related to planning ahead. • It includes the ability for users to register with the website and store their worksheets online if they want to.

• While not being restricted to persons with dementia, it has sections that are clearly focused on people with dementia and their families. • It has comprehensive information and links relevant for all States and Territories as well as a section for health and community care professionals. • The website is being widely promoted through collaborations with a number of consumer and professional organisations. This new website is a practical and comprehensive resource for members of the community across Australia who are interested in planning ahead as well as people with dementia and their families. It can be found at www.start2talk.org.au

Promotion through social media Alzheimer’s Australia will be promoting the website through two videos on YouTube as well as posts through Facebook and Twitter. Individuals and organisations are encouraged to pass these on through their own networks.

Promotion through link from your website Organisations are encouraged to make links to the Start2Talk site from their own website. Can you please let us know if you do this. ■ For all enquiries about promoting the Start2Talk website please contact Chris Shanley, Project Manager and Website Moderator on 0423 842 781 or info@start2tak.org.au


60 | FUSION

DIGITAL PRODUCTIVITY AND SERVICES NATIONAL RESEARCH FLAGSHIP WWW.CSIRO.AU

Staying home A new paradigm for digitally enabled aged care services December 2013

Executive summary

Executive summary By 2056 approximately 25 per cent of Australia’s population will be over 65, and this will drive significant changes in the provision of aged care services. As we get older, we all want to lead an independent lifestyle, maintaining choice and flexibility. Living in appropriate andof affordable housing will require supporting Byindependently 2056 approximately 25 per cent Australia’s population will be new over service 65, anddelivery this willmodels, drive significant wellbeing, safety, health, and quality of life as people age. While living alone can be satisfying and changes in the provision of aged care services. rewarding and independence something to prize, social isolation can also be a frightening or lonely New providing aged carelifestyle, services maintaining are requiredchoice to meet theflexibility. growing Living needs of our Asexperience. we get older, weparadigms all want tooflead an independent and aging population. independently in appropriate and affordable housing will require new service delivery models, supporting

wellbeing, safety, health, and quality of life as people age. While living alone can be satisfying and Over theand last independence two years, CSIRO and the to Australian Centre for Broadband Innovation (ACBI) support rewarding something prize, social isolation can also be a frightening orwith lonely from NSWNew Trade & Investment have invested $1.8m developing the Smarter Safer platform. experience. paradigms of providing aged care services are required to meet theHomes growing needs ofThis our platform integrates an unobtrusive in-house sensor network with smart algorithms to process the sensor aging population. data, video conferencing, and iPad applications for sharing information and communications. The platform hasthe thelast potential to enable paradigms for aged care services supporting older people in their Over two years, CSIROnew andservice the Australian Centre for Broadband Innovation (ACBI) with support own homes, their families and care givers. from NSW Trade & Investment have invested $1.8m developing the Smarter Safer Homes platform. This

platform integrates an unobtrusive in-house sensor network with smart algorithms to process the sensor Thevideo initialconferencing, research project established thefor technical of the concept underpinning the Smarter data, andhas iPad applications sharing viability information and communications. The platform Safer Homes technology platform. CSIRO is now seeking to create an industry consortium of aged care has the potential to enable new service paradigms for aged care services supporting older people in their providers, service providers; other industry enterprises from a broad range of own homes, government their familiesagencies, and care IT givers. market sectors; academic institutions; and members of other industry associations with related or similar interests, to develop and has trialestablished new sustainable service models the Smarter Safer Homes platform. The initial research project the technical viabilitybased of theon concept underpinning the Smarter TheHomes consortium will develop and CSIRO commercialise services build additional pipelineofofaged service Safer technology platform. is now seeking toand create anan industry consortium care concepts to be developed and implemented in the future. providers, government agencies, IT service providers; other industry enterprises from a broad range of

market sectors; academic institutions; and members of other industry associations with related or similar interests, to develop and trial sustainable service basedof onstakeholders the Smarter who Saferwill Homes Consortium participants willnew benefit from being part models of a coalition haveplatform. the The consortium will develop and commercialise services and build an additional pipeline of service opportunity to learn about the potential of digital technologies for aged care, to inform the development of concepts to be developed and implemented in the future. innovative products to ensure that they target market needs, as well as to be given opportunities for involvement in trials and deployment of new products in the aged care market. Consortium participants will benefit from being from part ofparties a coalition of stakeholders will have the CSIRO is now seeking expressions of interest interested in joining who the consortium to be a opportunity learn about the potential digital technologies for aged care, to inform the development part of theto development journey, fromofthe Smarter Safer Homes Platform technology into commercialof innovative services. products to ensure that they target market needs, as well as to be given opportunities for involvement in trials and deployment of new products in the aged care market. CSIRO is now seeking expressions of interest from parties interested in joining the consortium to be a


Introduction

FUSION | 61

Introduction Digitally enabled aged care services are the only way Australia will maintain a sustainable health and aged care sector in the future. 1 In 2011, 14 per cent of care the Australian population wasAustralia aged 65 years and over. By 2056 thishealth proportion will Digitally enabled aged services are the only way will maintain a sustainable and aged rise to between and 25 per cent and the median age will rise from 37 years to between 41 and 45. 2 This care sector in the23future. represents a significant ageing of the population in Australia, mirroring what is happening elsewhere in the world. In 2011, 14 per cent of the Australian population was aged 65 years and over.1 By 2056 this proportion will rise to between 23 and 25 per cent and the median age will rise from 37 years to between 41 and 45. 2 This The ageing apopulation Australia presents significant represents significantinageing of the population in Australia, mirroring what is happening elsewhere in the challenges and opportunities to industry, government and world. society, including our economy and living standards, health and welfare, andpopulation the wellbeing and quality of lifesignificant of all Australians, The ageing in Australia presents 3 regardless their age or statetoofindustry, health. government A major effect challenges of and opportunities andwill come from rising health expenditure, attributed to the society, including our economy and living standards, health and increasing costs deliver services, increasing of welfare, and theto wellbeing and quality of life ofprevalence all Australians, 3 chronic disease andage higher expectations the general regardless of their or state of health.from A major effect will population. come from rising health expenditure, attributed to the increasing costs to deliver services, increasing prevalence of Australia's health expenditure is currentlyfrom in excess of A$110 billion annually (over 9 per cent of Gross chronic disease and higher expectations the general 4 Domestic Product), . Expenditure on aged care services represents a further 3 per cent of total government population. expenditure on aged care, including residential aged care and community care. This is forecast to grow to a 5 To slow the increase in this expenditure, we(over need9toper find new total of 5.6health per cent by 2049-50. Australia's expenditure is currently in excess of A$110 billion annually cent ofways Grossto 4 provide cost-effective health services that meet the needs of patients, the health system and health Domestic Product), . Expenditure on aged care services represents a further 3 per cent of total government workers. expenditure on aged care, including residential aged care and community care. This is forecast to grow to a total of 5.6 per cent by 2049-50.5 To slow the increase in this expenditure, we need to find new ways to It is believed that therehealth are economic and social benefits possible, continuing livehealth provide cost-effective services that meet the needsto,ofwhere patients, the health systemtoand independently in appropriate and affordable housing as people age. However, this also increases the workers. demand for aged care services to be delivered in the community, with over 3.5 million Australians expected 6 to these services each by 2050. It isuse believed that there areyear economic and social benefits to, where possible, continuing to live independently in appropriate and affordable housing as people age. However, this also increases the The challenges and pressures come with an populationwith present serviceAustralians and product demand for aged care servicesthat to be delivered in ageing the community, over new 3.5 million expected 6 opportunities for all sectors of industry. to use these services each year by 2050.

Given the number breadththat of challenges opportunities ahead, CSIRO, asservice the nation’s leading The challenges andand pressures come with and an ageing population present new and product science and technology organisation, is seeking to create an industry consortium to address a key opportunities for all sectors of industry. opportunity presented by the ageing population. Together the consortium will conduct trials of potential new services whichand willbreadth enable older people living in the community to CSIRO, live longer in their homes, in a safe Given the number of challenges and opportunities ahead, as the nation’s leading environment. science and technology organisation, is seeking to create an industry consortium to address a key opportunity presented by the ageing population. Together the consortium will conduct trials of potential new services which will enable older people living in the community to live longer in their homes, in a safe environment.

1

ABS 2011b. Australian Demographic Statistics, June 2011. Cat. no. 3101.0. Canberra: Australian Bureau of Statistics. ABS 2008. Population Projections Australia 2006 to 2101. Cat. no. 3222.0. Canberra: Australian Bureau of Statistics. 3 Promoting health ageing in Australia, PMSEIC, http://www.innovation.gov.au/science/PMSEIC/Documents/PromotingHealthyAgeing.pdf 4 Health Expenditure, AIHW, 2009-10 5 1 Long-term Funding of Health and Ageing The Rising Pressure on Commonwealth and State Budgets , Business council of Australia, 2012 ABS 2011b. Australian Demographic Statistics, June 2011. Cat. no. 3101.0. Canberra: Australian Bureau of Statistics. 6 2 Australia Government, Department of Health and Ageing, Staying at home, July 2013 ABS 2008. Population Projections Australia 2006 to 2101. Cat. no. 3222.0. Canberra: Australian Bureau of Statistics. 3 http://www.livinglongerlivingbetter.gov.au/internet/living/publishing.nsf/Content/staying-at-home Promoting health ageing in Australia, PMSEIC, http://www.innovation.gov.au/science/PMSEIC/Documents/PromotingHealthyAgeing.pdf 2

4

Health Expenditure, AIHW, 2009-10 Long-term Funding of Health and Ageing The Rising Pressure on Commonwealth and State Budgets , Business council of Australia, 2012 6 Australia Government, Department of Health and Ageing, Staying at home, July 2013 http://www.livinglongerlivingbetter.gov.au/internet/living/publishing.nsf/Content/staying-at-home 5


LEADERSHIP

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For more information contact our team p: 02 8850 7124 or e: contact@realiseperformance.com.au

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• Wireless Viewing of Channels on Tablets • Compendium and Information Pages • Set Top Box Free - Smart TV’s • Digital Signage Screens


FUSION | 63

The Smarter Safer Homes Platform Using a network of simple sensors, smart algorithms and high speed broadband, the Smarter Safer Homes Platform presents information in way which allows the aged to care for themselves and share that information with family and care givers The Smarter Safer Homes Platform developed by CSIRO incorporates a non-invasive sensor-based in-home monitoring and support system for use in either individual homes or supported-living community settings. The data from the sensor network is converted into simple to understand quantitative data that is displayed in a easy to use iPad app. The data provides a continuous picture of the aged person’s health and wellbeing. The data can be used by the aged person to self-manage and to provide a picture of their ability to live alone to their family and care givers. The platform also designed to assist with social inclusion and psychological well-being through inbuilt video conferencing to enable older people to stay connected with their family and friends. CSIRO expects that the Smarter, Safer Homes platform will support a wide range of services to assist the older person in their home. The current iPad application is only one possible way of analysing and reporting on the data from the sensor network, with any number of potential ways of using the data to provide personalised services to the aged. CSIRO is looking for consortium partners to help imagine how these services can be offered and what new services could be built on the platform. Figure 0-1 : General overview of the Smarter Safer Homes Platform technology

At home

Data storage & analytics

Sensors

Web server

Clinicians/ allied healthcare providers User-interface tool/platform

Data store Base station

User interface

Data analytics Alert/event signal generator

Support network – friends and family/ Aged care providers User-interface tool/ platform

Data transmission (in and out of home)

1. At home data transmission – Zigbee, Bluetooth 2. Out –of-home –Broadband/Wi-Fi


64 | FUSION


How does it work? The platform includes a combination of low-cost, non invasive sensor technologies placed in the home to FUSION | 65 continuously monitor and record daily living activities of the resident and physiological monitoring devices such as scales and blood pressure cuffs for How it work? specificdoes health checks. The data that gets collected by these devices is sent to a The platform includes a combination of low-cost, non invasive sensor technologies placed in the home to central data store where it is analysed. continuously monitor and daily Unexpected variations canrecord be used to living activities of the resident and physiological monitoring devices such as scales and blood pressure cuffs trigger the decision support system to for specific checks. Thewhich data that gets provide health alerts and signals, can then collected these devices is sent to or a be sent toby relevant family members central data store where it is analysed. healthcare providers as well as the support Unexpected variations used to network nominated by can the be resident. trigger the decision support system to provide alerts and signals, which can then be sent to relevant family members or healthcare providers as well as the support network nominated by the resident.

In a broadband-connected smart home the sensors are currently able to: 

Sense the physical environment, such as heat in the kitchen and bathroom (i.e. that appliances can be left on and could cause burns or scalds)  Sense movement inside and outside the house, enabling any decline in movement patterns and wellbeing to be recognised and the to help identify slips and falls In a broadband-connected smart home sensors are currently able to:  Assist with social inclusion and psychological well-being by connecting with video-conferencing  Sense the physical environment, such as heat in the kitchen and bathroom (i.e. that appliances can systems enabling people to communicate and stay in touch with family and friends be left on and could cause burns or scalds) CSIRO usedmovement its in-house technical, social and scientific expertise well asinoutside experts when and  has Sense inside and outside the house, enabling anyasdecline movement patterns requiredwellbeing in building platform. During initial development stage CSIRO has ensured the platform tothe be recognised and tothe help identify slips and falls has features Assistthat with social inclusion and psychological well-being by connecting with video-conferencing systems enabling people to communicate and stay in touch with family friends  complement human interaction through virtual social engagement withand video conferencing functionality; CSIRO has used its in-house technical, social and scientific expertise as well as outside experts when  provide non-invasive monitoring personal control overstage information andensured sharing;the andplatform required in building the platform. During with the initial development CSIRO has gives that feedback and coaching for residents to promote personal care. has features The current participants in the trial, all aged over virtual 80, have been involved throughout development of complement human interaction through social engagement with videothe conferencing the platform and application. functionality;  provide non-invasive personal control over information and sharing; and The current system is simple, monitoring flexible andwith reliable.  gives feedback and coaching for residents to promote personal care.

Forthcoming conferences in 2014 ...

The current participants in the trial, all aged over 80, have been involved throughout the development of the platform and application. The current system is simple, flexible and reliable.

Melbourne, August 20 & 21

Melbourne, October 30 & 31

Facilities Management in Aged Care Conference Melbourne, October 30 & 31

Melbourne, October 30 & 31

Each conference has exceptional 2 for 1 Early Bird Registration Special All enquiries re exhibiting or attending, contact: Wayne Woff, Manager, Total Aged Services P: 03 9571 5606 / 0422 484 209 E: office@totalagedservices.com.au www.totalagedservices.com.au


66 | FUSION

Potential Services Delivered to End User (elderly in the home) The services which can be built using the SSH platform are only limited by our imagination. Working with industry partners we aim to identify and trial as many of these services as possible. CSIRO is researching approaches that rethink existing service delivery models for older people in their own home. The SSH platform technology is a potential enabler to deliver more value to the end user. Types of potential services are tiered as:

• Level 1

Wellbeing/Self-management

• Level 2

Family Connection & Support

• Level 3

Assistive Care/Maintaining Social Care

• Level 4

Chronic Care/Medical Conditions

• Level 5

Transition Care/Rehabilitation

Independent Living Support Family/Relatives

Self-Mgmt

Social Care/ Nursing Service

Doctor/Clinical

Emergency


Potential Benefits

FUSION | 67

CSIRO is currently exploring the potential use of the Smarter Safer Homes Platform as a way to deliver a Potential Benefits range of services to the direct end-users (those the platform at the home), CSIRO isusing currently exploring potential use of the Smarter Safer Homes Platform as a way to deliver a their clinicians allied health Family/Relatives rangefamily, of services to theand direct end-users (those using the platform at home), Figure 0-2: Connectivity of the Platform their family, clinicians and allied health Family/Relatives Figure 0-2: Connectivity of the Platform

Self-Mgmt

Nursing Service

Self-Mgmt

Nursing Service

Doctor/Clinical

Emergency

Doctor/Clinical

Emergency

care providers as well as to agencies delivering health and care services. care providers wellend-users as to agencies delivering Benefits to the as direct (older people living health and care services. in their own homes or in residential facilities)

include potential remain living Benefitsthe to the direct to end-users (older people living independently for longer, in an environment in their own homes or in residential facilities)that monitors their safety and quality of life. include the potential to remain living independently fortheir longer, in anfamily environment Benefits to families and social support networks include reassurance that elderly memberthat has a monitors their safety and quality of life. watchful eye for their ongoing safety, health and wellbeing, as well as the ability to connect and communicate with them via video-conference if distance is an issue. that their elderly family member has a Benefits to families and social support networks include reassurance watchfulto eye for theirand ongoing healthproviders and wellbeing, well as the ability to connect andthat can be Benefits clinicians aged safety, care service includeashaving quantitative data available communicate with them via video-conference if distance is an issue. used to support the aged person. Clinicians and service providers will be able to provide new business models services that the needs preferences of having their clients and patients. Services that suchcan as be Benefitsand to clinicians and meet aged care serviceand providers include quantitative data available community care the andaged telehealth video consultations can providers be delivered used to support person. Clinicians and service willat behome, able toenabling providegreater new business independence and flexibility in how these services are received. models and services that meet the needs and preferences of their clients and patients. Services such as community care and telehealth video consultations can be delivered at home, enabling greater independence and flexibility in how these services are received.

Awards The Smarter Safer Homes Platform, although still in its developmental stage, has received a number of key Awards national accolades and awards. The Smarter HomesState Platform, although 2013Safer Queensland iAwards Winnerstill in its developmental stage, has received a number of key national accolades and awards.  2013 National iAwards Merit Recipient   

2013 Roundtable Innovation Award 2013 Health Queensland State iAwards Winner 2013 National iAwards Merit Recipient 2013 Health Roundtable Innovation Award

Proposed Consortium Proposed Consortium

CSIRO is seeking partners to create an industry consortium to develop and trial new sustainable service models based on the Smarter Safer Homes platform. The consortium will also provide a vital perspective on current future challenges and business needs in relationtotodevelop our ageing CSIRO isand seeking partners to create an industry consortium and population. trial new sustainable service models based on the Smarter Safer Homes platform. The consortium will also provide a vital perspective on The objectives of the Smarter Safer Homes Platform Consortium include: current and future challenges and business needs in relation to our ageing population.  A respected coalition of industry stakeholders: comprising aged care providers, government The objectives of the Smarter Safer Homes agencies, IT service providers; otherPlatform industryConsortium enterprises include: from a broad range of market sectors; institutions; and members of other industry associations withproviders, related orgovernment similar interests  academic A respected coalition of industry stakeholders: comprising aged care


68 | FUSION

Program and Registration LIVE

Australia’s premier networking event in age services Speaker Announcements

Jos de Blok

Tony Jones

Susan Ryan

Mike Woods

Founder & CEO, Buurtzorg Holland

Breakthrough: Breakthrough: Motivate Motivate Innovate Innovate Integrate Integrate

LASA LASA NATIONAL NATIONAL CONGRESS CONGRESS

20–22 October 20–22 October

2014 2014

Adelaide Adelaide Convention Centre Convention Centre www.lasacongress.asn.au www.lasacongress.asn.au

Age Discrimination Commissioner

Industry Debate

Deputy Chairman, Productivity Commission

Enhanced Social Program Welcome Reception

Monday 20 Oct, 5.00pm – 7.00pm Explore the Exhibition Hall while networking with fellow delegates over fine food and wine

Taste of Adelaide

Monday 20 Oct, from 7.30pm Continue networking by booking a seat at one of Adelaide's premium restaurants and enjoy the culinary delights of South Australia. Bookings essential, fees apply.

Congress Dinner

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CSIRO is seeking partners to create an industry consortium to develop and trial new sustainable service models based on the Smarter Safer Homes platform. The consortium will also provide a vital perspective on current future challenges and business needs in relationtotodevelop our ageing CSIRO isand seeking partners to create an industry consortium and population. trial new sustainable service models based on the Smarter Safer Homes platform. The consortium will also provide a vital perspective on FUSION | 69 The objectives of the Smarter Safer Homes Platform Consortium include: current and future challenges and business needs in relation to our ageing population.  A respected coalition of industry stakeholders: comprising aged care providers, government The objectives of the Smarter Safer Homes Platform Consortium include: agencies, IT service providers; other industry enterprises from a broad range of market sectors; institutions; and members of other industry associations withproviders, related orgovernment similar interests  academic A respected coalition of industry stakeholders: comprising aged care IT service providers; other industry enterprises from a broad of market sectors;  agencies, Investment: provision of the necessary investment to develop robustrange and commercially viable academic institutions; andservices members of the other industry associations with related or similar interests platform product and the that platform enables  Investment: of the necessary develop a robust and commercially viable Developmentprovision of services from a uniqueinvestment platform: to being involved and providing input to shape platform services that the platform enables innovativeproduct servicesand to the match market needs and demands  Development of services fromopportunity a unique platform: being involved andto providing shape Commercialisation: providing to Consortium participants provide input to into innovative services match that market needs and demands business and servicetomodels is appropriate for the commercialisation of the platform product. will be the opportunity commercialise services and build an additional of service  There Commercialisation: providing to opportunity to Consortium participants to providepipeline input into concepts to be developed and implemented in the business and service models that is appropriate forfuture. the commercialisation of the platform product. There will be the opportunity to commercialise services and build an additional pipeline of service concepts to be developed and implemented in the future.

What is involved?

Participants who join the consortium will contribute to the development of services that utilise the Smarter What is involved? Safer Homes platform and contribute to its ongoing development. We expect that stakeholders across various sectors industry and government will provide an development appropriate level of investment to develop Participants whoofjoin the consortium will contribute to the of services that utilise the Smarter commercially viable services. Safer Homes platform and contribute to its ongoing development. We expect that stakeholders across various sectors of industry and government will provide an appropriate level of investment to develop The consortium participants will take part in a series of structured workshops over the duration of the commercially viable services. proposed research program. These workshops will be coordinated by CSIRO, and consortium partners can provide ideas and feedback on progress the program. Theseworkshops workshopsover will also involve discussion The consortium participants willthe take part inof a series of structured the duration of the about future issuesprogram. and anticipated trends and will will be be coordinated used to position the consortium as thought leaders proposed research These workshops by CSIRO, and consortium partners can in this area. provide ideas and feedback on the progress of the program. These workshops will also involve discussion about future issues and anticipated trends and will be used to position the consortium as thought leaders in this area.

Benefits to Participants The Smarter to Safer Homes Platform has the potential to enable new services that address a growing unmet Benefits Participants need in the ageing population market, both in Australia and beyond. Consortium members will benefit from being part of Homes a coalition of thought leaders whoto can potentially guide the development of an unmet The Smarter Safer Platform has the potential enable new services that address a growing innovative ensuring that it targets needs. They will also be given members the opportunity to take need in theproduct, ageing population market, bothmarket in Australia and beyond. Consortium will benefit the Safer Platform to market. fromSmarter, being part of Homes a coalition of thought leaders who can potentially guide the development of an innovative product, ensuring that it targets market needs. They will also be given the opportunity to take The facilitated workshops will also provide an avenue for stakeholders to explore implications of future the Smarter, Safer Homes Platform to market. issues and predicted trends in delivering services to elderly people in a new way, enabled by the Smarter Safer Homes platform. The facilitated workshops will also provide an avenue for stakeholders to explore implications of future issues and predicted trends in delivering services to elderly people in a new way, enabled by the Smarter Safer Homes platform. Consortium Participants Partners in the Staying Home consortium will need to be a sufficient and sustainable group that represents a balance of interests across the aged care services industry, and have the skills needed to take the project outcomes through trials and to market. CSIRO is seeking participants from industries including:        

telecommunications; telehealth and digital services providers; government health and aged care service agencies; residential aged care providers; community service providers; IT industry service providers (with server management and customer call centre response expertise); academic institutions with an interest in health and ageing issues in Australia; and other industry enterprises from a broad range of market sectors with experience of delivering services to aged care industry customers.


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FUSION | 71

Options for Participation Consortium participants will help fund the Staying Home research program by contributing financial and/or in-kind support. The collected investments will be used for:     

development and trial of service models using the smarter safer homes platform; further development of the smarter safer homes platform; workshop and meeting coordination and facilitation; communication activities; and program management/secretariat

It is proposed that the research program led with consortium participation commence in April 2014, and conclude 24 months after commencement, depending on the level of investment obtained through the consortium. What are the entitlements for each tier level?

Cost Suited to

Participation in workshops Access to project outcomes Industry documents and reports Contribution to reports and industry documents Influencing research agenda Reduced cost licensing posttrials Option to trial new service models with clients

Heading

Understanding

Observing

Trial site

$1m pa for 2 years Technology companies & large for profit service organisations

$250k pa 2 years Government & Large not for profit

$10k pa 2 years Only for aged care organisations to host trials.

Yes

Yes

$25k pa 2 years SMEs Small aged care not for profit International governments Yes

Yes

Yes

Yes

Yes

Yes

Yes

Limited

Yes

Yes

Yes

No

Yes

No

No

Yes

Limited

No

Yes


72 | FUSION

The Staying Home program The Staying Home program will trial the use of CSIRO’s current Smarter Safer Homes Platform to examine new service models within Australia and ensure a robust market-ready product is produced. The current platform has been developed including the required hardware and software interfaces with functionalities such as video conferencing. A small pilot study with 15-20 people in regional NSW will be completed in March 2014. The platform currently has the ability to collect and analyse data to produce relevant alerts and signals. The validity of this data and the data modelling has been evaluated through this trial. The proposed two-year program aims to enhance the robustness of the current platform by further validating the data collected via sensors as well as to develop further functionalities to produce a platform that is useful and relevant to the end-users. The diagram below outlines the general development pathway to achieve a commercially viable platform that is market ready by 2016.

Figure 0-1: General overview of Development Program

March 2014 Current state of Platform

• Platform technology is at developmental stage with key hardware and interface functionality developed (i.e. connectivity protocols, videoconference, sensors) • Small pilot study completed • Has ability to collect and measure raw data • Has ability to produce alerts and signals for health monitoring

2014 - 2016

2016 Market-ready Smarter Safer Home Platform

R&D program

• Further development needs to be articulated • Continuous review and consultation with Consortium • Pilot trials to be conducted • Larger scaled trials including a national phase trial • Further modifications and development • Development of business models for payment scheme, service and product offering options

• Technology is commercially viable • Service, product and business models are identified • Platform is productised and market ready • Commercialisation partner on board

Project outputs and outcomes under different scales The Staying Home program is dependent on the level of investment received. The figure below provides a general overview of the anticipated outputs, outcomes and impact of the program under different scales of investment.

Figure 0-2: Research program outputs and outcomes


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The Staying Home program is dependent on the level of investment received. The figure below provides a general overview of the anticipated outputs, outcomes and impact of the program under different scales of investment.

74 | FUSION

Figure 0-2: Research program outputs and outcomes Investment levels

$1.8m (CSIRO only)

$1m

$~1.5m

$~2m

Timeline of research program

Ends March 2014

12 month

18 month

24 month

Research program activities (overview)

Determine the type of sensor data from independent living.

1-2 regional scale trials across Australia.

3-4 regional scale trials with differentiated aged cohort groups.

National randomised control trials for further data validation.

Development of Clinical portal and community care services response option.

Development and integration of add-on functionalities such as home services.

Determine the degree and focused areas of interaction of SSH platform.

Platform enhancement

Outcomes/Output

Platform in early developmental stage.

Platform with basic features recording activities of daily living, and video conferencing facility.

Robust understanding of larger scale use of platform.

Clear commercial product roadmap with appropriate business model for roll out.

Impact to end-users

Familiarization with platform technology in their home.

Basic understand of how to track their activities of daily living/ ability to video call for social interaction.

More reliable platform to assist tracking of activities of daily living.

Ability for elderly to connect to health and other home service providers to enhance quality of life.

Appendix A: FAQs Appendix A: FAQs

What is the consortium membership value proposition? There is a strong value proposition for this consortium. CSIRO will be able to bring together diverse stakeholders interested in providing digital solutions to older people, specifically with the SSH platform technology. Joining a consortium is a cost way to be part of the opportunity. What is the consortium membership valueeffective proposition? There is a strong value proposition for this consortium. CSIRO will be able to bring together diverse Who will participate in the consortium? stakeholders interested in providing digital solutions to older people, specifically with the SSH platform The consortium is open, inclusive, and has a diverse and experienced membership base. Participants technology. Joining a consortium is a cost effective way to be part of the opportunity. include representatives from: aged care providers; IT industry service providers; other industry enterprises from broad range ofinmarket sectors; academic institutions; and members of other industry associations Who awill participate the consortium? with related or similar interests. Inand the has future, government organizations could participate to the level that The consortium is open, inclusive, a diverse and experienced membership base. Participants rules forrepresentatives industry consortia permit. is open and allservice interested companies, foreign orenterprises domestic, include from: aged Membership care providers; IT industry providers; other industry are to range join. of market sectors; academic institutions; and members of other industry associations frominvited a broad with related or similar interests. In the future, government organizations could participate to the level that Are there specific criteria for consortium membership? rules for industry consortia permit. Membership is open and all interested companies, foreign or domestic, Membership in the consortium, and therefore in its councils, working groups etc., is available to corporate are invited to join. entities and other organizations. It is the objective of the Consortium to ensure that the composition of each of thespecific councils, the affiliates, and membership recruitment represent the diversity of the membership Are there criteria for consortium membership? market segments large (e.g. aged technology service providers, IT infrastructure developers, Membership in theatconsortium, and care, therefore in its councils, working groups etc., is available to corporate manufacturers etc.) entities and other organizations. It is the objective of the Consortium to ensure that the composition of each of the councils, the affiliates, and membership recruitment represent the diversity of the membership Is the consortium open to international participation?


Membership in the consortium, and therefore in its councils, working groups etc., is available to corporate entities and other organizations. It is the objective of the Consortium to ensure that the composition of each of the councils, the affiliates, and membership recruitment represent the diversity of the membership market segments at large (e.g. aged care, technology service providers, IT infrastructure developers, FUSION | 75 manufacturers etc.) Is the consortium open to international participation? Yes. The opportunity is based upon research grade products and open standards, relating to proprietary technology. Although CSIRO is Australia’s national science agency, theoretically, there is no barrier to participation. Further, this is an effort of commercial concerns from a diverse business sector grouping with a shared vision to explore the commercial opportunities relating to the SSH platform technology. What is the level of investment required to participate in the consortium? Participants in the consortium will be able to invest financially or provide in-kind resources. We encourage interested potential participants to contact us directly to discuss potential investment options. The benefits and outcomes to the participants will vary dependent on the level and type of investment. We encourage interested potential participants to contact us directly to discuss potential investment options. Please contact Colin Kelly: Colin Kelly

Business Development

Digital Productivity and Services National Research Flagship Phone: +61 2 937 24525 | Mobile: 0477 371 391 colin.kelly@csiro.au

Appendix B About CSIRO Appendix B About CSIRO Today, CSIRO - the Commonwealth Scientific and Industrial Research Organisation – is one of the largest and most diverse scientific organisations in the world

Today, CSIROfor - the Commonwealth Scientific and Industrial Organisation – isits one of the research largest The Council Scientific and Industrial Research (CSIR) wasResearch established in 1926 with primary and most diverse scientific organisations in the world devoted towards agriculture. In the late 1930s this was extended to include industrial research. In 1949, the CSIR was reconstituted as CSIRO, and gradually expanded its activities so that its research was related to The Council Scientific and Industrial (CSIR) was established in 1926 with its primary research almost everyfor field of primary, secondaryResearch and tertiary industry in Australia. devoted towards agriculture. In the late 1930s this was extended to include industrial research. In 1949, the CSIR was reconstituted as CSIRO, and gradually expanded activitiesOrganisation so that its research related to Today, CSIRO - the Commonwealth Scientific and IndustrialitsResearch – is onewas of the largest almost every field of primary, secondary and tertiary industry in Australia. and most diverse scientific organisations in the world. It has over 6,400 staff located across 54 sites throughout Australia and one overseas. Our research delivers: Today, CSIRO - the Commonwealth Scientific and Industrial Research Organisation – is one of the largest and most scientific organisations in the world. has overchallenges 6,400 staff located across 54 sites  diverse integrated solutions to help address majorItnational throughout and to one overseas.orOur research delivers:for Australian industry  Australia technologies transform create new markets  innovative technologies to improve the competitiveness of existing industries  integrated solutions to help address major national challenges  advice, information and research to meet specific community needs  technologies to transform or create new markets for Australian industry  Knowledge-based services to governments and businesses.  innovative technologies to improve the competitiveness of existing industries  advice, information and research to meet specific community needs CSIRO’s research is structured across five broad research areas all of which are active in delivering impact in  national Knowledge-based services toinclude: governments and businesses. global and settings. These areas CSIRO’s research is structured across five broad research areas all of which are active in delivering impact in  Energy; global and national settings. These areas include:  Environment;        

Information and Communication; Energy; Manufacturing, Materials and Minerals; and Environment; Food, health and Life Sciences. Information and Communication; Manufacturing, Materials and Minerals; and Food, health and Life Sciences.


Appendix C About Digital Productivity and Services Flagship Appendix C About Digital Productivity and Services Flagship

76 | FUSION

By 2025 we aim to create A$4 billion per annum in added value for the Australian economy by developing and delivering more efficient and innovative services that improve people’s wellbeing and prosperity. By 2025 we aim to create A$4 billion per annum in added value for the Australian economy by developing and delivering more efficient and innovative services that improve people’s wellbeing and The Digital Productivity and Services Flagship is a $A40 million research initiative from CSIRO, focussed on prosperity. Australia’s productivity challenge. Established in July 2012, the Flagship targets productivity improvements and growth in the digital economy through services innovation. The Flagship will follow three broad approaches to help businesses, industry and Government change the way services are CSIRO, created, delivered The Digital Productivity and Services Flagship is a $A40 million research initiative from focussed on and consumed: Australia’s productivity challenge. Established in July 2012, the Flagship targets productivity improvements

growth in theand digital economy through services innovation. follow three broad and Effectiveness efficiency – doing more with the resourcesThe weFlagship currentlywill have approaches to help businesses, industry and Government change the way services are created, delivered  Doing old things in new ways – changing the way services are delivered and consumed:  Doing new things in ways we’ve never thought of before – changing what we do in the digital economy and changing and the way people– engage withwith technology  Effectiveness efficiency doing more the resources we currently have

Our Doing old things in new key research areas are: ways – changing the way services are delivered  Doing new things in ways we’ve never thought of before – changing what we do in the digital economy  Government and Commercial Services and changing the way people engage with technology  Health Services key research are: Our Smart Secure areas Infrastructure

 Government and Commercial Services  Health Servicesand Commercial Government  Smart Secure Infrastructure

services

We are working with the services sector to address big challenges to increase competitiveness, improve productivity; innovation efficiency to improve the ways services are delivered to benefit their Government andand Commercial services customers. We are working with services sector to theme addressisbig challenges The Government and the Commercial Services focused on: to increase competitiveness, improve productivity; innovation and efficiency to improve the ways services are delivered to benefit their  Evidence-based policy making and decision support customers.  Customer centric services The Government and Commercial Services theme is focused on:  Services innovation and transformation. Research Evidence-based making and decision support focus areaspolicy include:  Customer centric services  Harnessing big data to analyse complex interactions, understand long term trends, understand risk and  Services innovation and transformation. forecast demand Research focus areas and include:  Business process logistics monitoring and improvement  Harnessing Development of sophisticated decision tools for disaster big data to analyse models complexand interactions, understand longmanagement term trends, understand risk and  forecast Harnessing social media to enhance the power of decision support tools and customer engagement demand tools  Business process and logistics monitoring and improvement  Development Development of of sophisticated sophisticated models modelling for risk management. andtools decision tools for disaster management 

Harnessing social media to enhance the power of decision support tools and customer engagement tools Services Health  Development of sophisticated modelling tools for risk management. We are helping to improve people’s health, wellbeing and prosperity through innovative health services delivered our state health departments. Health through Services We are helping to improve people’s health, wellbeing and prosperity through innovative health services delivered through our state health departments.


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78 | FUSION

The Health Services theme is focused on:   

Access to services - through Australia’s national broadband infrastructure Productivity in health service delivery – creating a sustainable health system Quality of care – supporting national investment in eHealth architectures

The research focus areas include:    

Leveraging broadband and mobile platforms to improve access to online health services and connecting clinicians and patients especially those in rural and remote areas Unravelling complex, non-standardised data systems that hold health information and developing tools that apply analytics and decision support to improve productivity Smarter tools to improve hospital productivity by reducing waiting times and improving quality of care for patients through the management of hospital workflows and operations Tools to accelerate the uptake and add value to electronic health records by improving security whilst allowing the sharing of this vital information for medical research.

SMART SECURE INFRASTRUCTURE We are identifying the opportunities enabled by broadband communications, developing smart wireless technologies and ensuring the security and privacy of Australia’s physical and online infrastructure. The Smart Secure Infrastructure Theme is focussed on:    

Broadband networks Broadband services Security of Australia’s cyber-physical infrastructure Smart utility planning

The research focus areas include:      

New wireless technologies for delivering broadband services to rural and remote areas Innovative media content delivery and access via the Cloud Highly accurate positioning and mapping technologies for industry and business Mobile tele-presence, tele-education and training systems Cyber security technologies for government, industry and the public Smarter utility planning, management and delivery.

THE AUSTRALIAN CENTRE FOR BROADBAND INNOVATION The Australian Centre for Broadband Innovation (ACBI) is a key platform within the Digital Productivity and Services Flagship for facilitating new research projects across our three research areas. The goal of ACBI is to develop and test innovative broadband-enabled services, applications and technologies and their use in real world situations. It will also help evaluate their potential commercial and social value. ACBI is a collaborative national research initiative between CSIRO in partnership with National ICT Australia (NICTA), NSW Government, NBN Co and the Tasmanian Government. ACBI’s current projects include:     

Smarter homes and communities - using wireless sensors and monitoring platforms to assist the elderly SMART Farm – Together with the University of New England CSIRO is demonstrating sensing technologies and decision support tools on a farm in Armidale NSW Social TV – NICTA and CSIRO are developing technologies for TV content and distribution and social recommendation online Broadband Networks - design, delivery and support for the broadband testing and production networks Social and Business evaluation of broadband projects.


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FUSION | 79

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80 | FUSION

Book Review: Architecture for an Ageing Population Author: International Association of Homes and Services for the Ageing

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his compilation of more than 20 outstanding projects in the areas of assisted living, continuing care retirement communities and nursing homes represents the best current work designed by architects for the everincreasing population of the ageing and elderly. Produced by IMAGES Publishing in association with the IAHSA, Architecture for an Ageing Population complements the successful Design for Aging series. Each project is presented with photographs, detailed plans and statistics, illuminating the high level of research, planning and community involvement that goes into these advancements in living environments for seniors. This comprehensive review of architectural design trends in aged-care facilities will appeal to aged-care providers, developers, users, and advocates, as well as architects, interior designers, landscapers and other design professionals. A wide range of projects are covered, from a range of projects, from large-scale residential communities to semiindependent living, in the USA, UK, China and featuring 7 projects from Australia. For this reviewer a standout was the ‘conscious community’ concept, Silver Sage Senior Cohousing in Colorado. This project is an independent living project built with the capacity to incorporate care assistance without renovation. The Chinese example Essen Care Tianning in Changzhou is an eye opening intergenerational approach to ageing with a large complex of ‘active adults (still in the workforce) with elder care units with the ability to age in place. An interesting project combining the traditional eastern approach to ageing (where 90% of older Chinese live with family) with a more western approach. Closer to home Holy Spirit Boondall represents a world class facility providing independent living in the form of 1 through to 3 bedroom apartments; through to high care beds. Community Gardens and the ability for varied social interaction have been captured within the design.

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82 | FUSION

Product News

Is Your Facility Prepared for the Aged Care Reform? With more competition, aged care facilities will need to invest more in services in order to attract more residents The Living Longer Living Better aged care reform represents the start of significant changes in the aged care sector. The Accommodation Pricing Guideline, which states what consumers will need to pay for their own accommodation, will have a deep effect on the commercial and competitive environment in aged services. With a more competitive market, the demand for quality care will increase and as a consequence aged care facilities will need to invest more in their services. Having the right Nurse Call System in your facility can assist you in this transition by adding value to your services, help you reduce costs and increase resident satisfaction and safety. Austco’s flagship Solution, Tacera, is an IP-based system that enhances the care delivery process, with measurable improvements to quality of care and resident satisfaction by linking residents in real-time with caregivers, support systems and internal processes responsible for their care and safety.

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Diversey Care VeriCleanTM/MC Program Recent studies demonstrated that current cleaning practices results in high touch surfaces being adequately cleaned less than half the time1 Diversey Care’s VeriCleanTM/MC Program is an evidence-based approach to improve the cleaning and disinfection of high touch surfaces by integrating products, processes, training, and validation into an integrated approach to improve patient outcomes. VeriClean is a continuous improvement process designed to improve cleaning outcomes and reduce the risk of the environment in the transmission of Hospital Acquired Infections (HAIs). VeriCleanTM/MC accomplishes this by optimising patient room cleaning process, incorporating the right products and tools, implementing best practices through training and customised materials, and measuring cleaning outcomes through surface testing and web-based audit software Surface testing with the VeriCleanTM/MC fluorescent marking spray and UV torch, used in conjunction with IMap, Diversey Care’s webbased audit software, allows facilities to pinpoint areas that require improvement and help them to optimise their cleaning practices. The VeriCleanTM/MC Program, OxivirTb®, a TGA registered one step Hospital Grade Disinfectant Cleaner with Accelerated Hydrogen

peroxide technology; and Jonmaster microfibre cleaning system are three innovations from Diversey Care’s Infection Prevention Program to help Healthcare facilities deliver improved cleaning outcomes and reduce the risk of the environment in the transmission of HAIs.

Diversey Care is a division of Sealed Air, a global leader in cleaning and hygiene solutions. To learn more about VeriCleanTM/MC contact Diversey Care on 1800 647 779.

Centre for Cultural Diversity Representatives from a range of sectors across the country will converge in Melbourne for the biennial Cultural Diversity in Ageing 2014 Conference: Shaping Inclusive Services. The Conference will be held at the Melbourne Convention Centre on 12-13 June 2014, and will provide a forum for delegates to gain insight and inspiration in their pursuit of excellence in meeting the needs of a culturally diverse society. Hosted by the Centre for Cultural Diversity in Ageing, the Conference will showcase culturally inclusive measures and models designed to ensure quality outcomes for older Australians from culturally and linguistically diverse backgrounds.

Featured presentations will cover themes including workforce diversity, Indigenous ageing communities, Australian research, diversity within diversity and excellence in culturally inclusive initiatives. The Cultural Diversity in Ageing 2014 Conference will also see the presentation of the inaugural Centre for Cultural Diversity in Ageing Excellence Awards that recognise and celebrate best practice examples of culturally inclusive care and support by not-forprofit organisations, aged care services and individuals across the country. Nominations are now open for this unique award scheme. Registrations to attend the Conference are now open, and eligible delegates are able to receive RCNA and DTA professional development points.

For more information and to register, visit www.culturaldiversity.com.au or call 03 8823 7979.


84 | FUSION

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NOCOSPRAY NOCOSPRAY brought to you by Equipmed, is a complete disinfection technology without harmful chemicals. NOCOSPRAY combines a Hospital Grade disinfectant with a revolutionary HPV delivery system, destroying 99.9% of all harmful bacteria, viruses, funguses, moulds and yeasts. Based on Hydrogen Peroxide vaporisation, it leaves no residues and requires no additional labour. Protect the health of your patients and staff by containing organism outbreaks easily and efficiently. The HPV generated by the NOCOSPRAY technology will attract itself to bacteria and viruses in the air and on surfaces, causing a chemical reaction that will destroy them.

OUTBREAK CONTAINED SAFETY FOR EVERYONE! H2O2 vapour is biodegradable within minutes and breaks down into microscopic air and water particles, making it a much more environmentally friendly method of disinfection. Because NOCOSPRAY is having a chemical reaction with compounds on the cell membrane of viruses and bacteria, it is impossible for the organism to develop resistance, as the same chemical reaction will take place every time. More features and benefits of Nocospray: • Total air and hard surface disinfection for 99.9% of all Bacteria and Virus and Mould

• Non corrosive – CASA approved to be used in aircraft, so can be used in rooms containing the most delicate computer equipment and screens, including operating theatres and ambulance. • Eliminates human error • Eliminates the use of harmful and irritating chemicals • Takes the HARD WORK out of the disinfecting process • Inexpensive at a usage level of 1ml/ cubic metre • Disinfects air conditioning air-flow • 99% Biodegradable almost immediately Outcome: Total surface and air disinfection with little-to-no effort.

For more information call 1300 668 755 or visit http://equipmed.com.au/infection-control/ nocospray/disinfection-technology


FUSION | 85

Eden AlternativeTM in Oz & NZ receive International recognition

At the recent 7th Eden Alternative International Conference in Nashville Tennessee USA, our region was recognised for our ongoing commitment and development of the Eden AlternativeTM. Sally Hopkins, Business Development Manager (Eden in Oz & NZ) has been elected to the Eden Alternative USA board. The Nancy Fox Leadership Award was awarded to Jill Woodward, CEO, Elizabeth Knox Home and Hospital, Auckland NZ for outstanding leadership. Knox Home has also achieved recognition in all 10 Eden Principles and is the first home in New Zealand to reach this milestone.

Eden Alternative Seedling Award goes to Presbyterian Support South Canterbury, NZ for their innovation and engagement of their community through the Eden Alternative by enriching the lives of young and old alike and improving wellbeing for all. What is the Eden AlternativeTM? It is a philosophy of person directed care that focuses upon improved wellbeing for individuals by eliminating loneliness, helplessness and boredom. Ongoing Eden Alternative education provides your teams and community with the framework for culture change and an improved and positive approach to aging. To start your Eden Alternative journey, consider our in house Eden Alternative Associate training, Eden @ Home or Dementia Beyond Drugs workshops.

Contact: Eden in Oz & NZ T: +61 3 8819 4732 E: admin@edeninoznz.com.au www.edeninoznz.com.au

• Monitoring low level beds to detect a patient rolling out of bed. • Across doorways to detect wanderers and sleep walkers

INVISA-BEAM® – Helping to Prevent Falls and Harm from Falls The INVISA-BEAM® Chair Monitor is one of the most versatile products in its range of Falls Prevention devices. It is most useful for retirement homes and community services – home use. It is portable and battery operated. In its primary function, the Chair Monitor is placed beside the bed with its invisible pencillike beam covering the width of the chair. It does not interfere with other chairs. When a patient ’at-risk’ of a fall attempts to rise, the knee action triggers the alarm on a remote alarm or Invisalert® [pager]. The Chair Monitor has other uses including :-

• Testimonial ‘…In September 2008, we bought an Invisa-Beam for our sleepwalking son. The monitor has worked wonderfully well since we purchased it, and has helped us ensure that our son does not injure himself when he sleepwalks... as our bedrooms are on the second floor of our two storey house, it continues to provide us with peace of mind.’ JT, St Marys, NSW, 20 Jan 2014.

INVISA-BEAM International Pty Ltd is an Australian company.

Features • TGA listed Medical Device ARTG 173590

INVISA-BEAM products are manufactured in Sydney, NSW, Australia.

• Conforms to Standards – IEC 60601.1 AS/NZS 3200.1

Distributors are in all Australian states, territories and New Zealand; also UK and Ireland.

• Chair Monitor is free-standing and portable • INVISA-BEAM products give instant detection and continuous monitoring ‘catch them before they fall®’ is our motto.

For further information: T: +61 2 6251 1374 M: 0417 438 914 E: info@invisabeam.com W: www.invisabeam.com


86 | FUSION

Smart Aged Care facilities optimise Flexible Payroll, Rostering and HR solutions helping your organisation grow into the future.

business growth along with its robust compliance with SOC1 (Sarbanes-Oxley) and Australian Privacy legislation.

As life expectancies rise and birth rates drop, it has become increasingly more important for Aged Care facilities to find efficiencies in the way they operate. Streamlining and optimising Human Resources, rostering and payroll processes offers opportunities for both employee efficiencies and budgetary constraints. Think about it: are you happy with the way your HR processes are run today?

Many organisations also look at outsourcing their most complex HR processes as a way to reduce internal administrative tasks. Outsourcing HR tasks to a specialist provider helps drive down operational costs, avoid compliance issues and focus attention on improving on your core business: providing care and supporting your constituencies.

Having the right talent at the right place at the right time is what makes the HR function critical in an Aged Care facility. Smarter HR technology and services can help care and support teams in better planning, scheduling, rostering and rewarding caregiving staff. When core HR processes are optimised, more evolved options such as advanced payroll and rostering as well as talent management can be deployed to generate further efficiencies. Anglicare – one of Australia’s largest Christian care organisations – does exactly that. They utilise NGA’s smart, cloud-based HR solution Preceda to reduce central administration overheads required to support a large workforce. Employees are provided with easy to use online tools to manage and update personal records, check leave balances and apply for leave. Preceda’s workflow capability then automatically forwards applications to the employee’s manager who can then see at a glance what, if any, impact that leave may have. As a result, caregivers can spend more time on the job and less time on HR processes, and the burden on central administration is reduced significantly.

Globally NGA Human Resources has helped hundreds of Aged Care customers, and well over 600 organisations in Australia, optimise and streamline core HR, rostering and talent management. Preceda also supports advanced HR requirements with partners such as RosterLive and Successfactors. Give us a call today: you’ll be surprised of the efficiencies we can bring to your HR.

For further information contact: 1300 866 400 info.au@ngahr.com www.ngahr.com

Beyond the core functionality and features of Preceda’s HR and payroll solution, its scalability and flexibility is regarded as key to supporting

Dualpak As the name implies, DUALPAK® dual-ovenable paper board trays can be used in both microwaves & conventional ovens, withstanding temperatures between -40°C & 220°C. Manufactured from food grade board with a moisture resistant PET coating applied to the interior, DUALPAK® pressed paperboard trays are ideal for many food applications being an alternative to plastic take away containers. The range of Confoil’s DUALPAK® trays is extensive, ranging from a single serve pie right through to large catering trays. That, combined with environmentally friendly & recyclable qualities (containers free of food residue can be placed in some home kerbside recycling bins), make DUALPAK® a versatile option. Many hospitals and government institutions have reported dollar savings using the system, as it allows kitchens to prepare and freeze meals for later consumption. This means that costly weekend kitchen hours can be drastically cut. Lidding is available for the DUALPAK® range or it can be used in conjunction with the “Oliver” system which heat seals plastic film to both the DUALPAK® and pulp trays The easy peel lidding option creates an air-tight seal and is beneficial for customers who may normally have food accessibility issues. Another option of lidding is using an “Oliver” lidding machine, which creates an air-tight plastic seal over the tray (this lidding can also

be frozen). These machines are installed and serviced by Confoil and many businesses have found that being supplied the entire packaging solution from one source has led to increased packaging, warehousing & logistical savings. This has proven popular with many small operations which use the small manual sealers through to large factories & institutions which use high speed packing machines. The machines themselves are easy to use & clean & can seal from 4 to 34 packs per minute. Another feature of the “Oliver” System is the availability of compartmentalised trays, which can segregate different foods. Confoil also have the ability to supply DUALPAK® with customised print/logo’s as well as manufacture speciality shapes (MOQ’s apply). According to Steve Flaherty, Marketing Services Manager at Confoil, the printing capabilities at Confoil have increased dramatically recently, “allowing our customers the opportunity to enhance their product offering to their customers, by including high impact graphics”. This capability provides effective product differentiation & reduces the need for further outer packaging.

For more information call 1800 786 340 or visit www.confoil.com.au


Electrical Safety may not be your core business…. but it is ours.

We make electrical safety as easy as abc: Affordable Beneficial Compliant

Our focus is on reducing: Energy consumption Environmental impact Overall maintenance costs

Swift Electrical • Uses Licensed Electricians and testing is performed to Australian Standards • Provides detailed reports to meet legislative requirements • Cares about the residents’ health and respond quickly • Provides organisations with comfort and security Servicing: • Aged Care residences • Community Service organisations • Health service providers • Schools and pre-schools

Specialising in: • Electrical compliance services • Electrical safety gap analysis • Lighting recommendations and installations • General electrical works with rapid response • Falls prevention systems (Bedside Guardian)


Australia’s number one provider of integrated health solutions

Hills Health Solutions have brought together industry leaders Merlon Technologies, Questek Australia and HTR (Hospital Television Rentals) to become Australia’s number one provider of interactive patient care. We are Australia’s most trusted brand with more than 40 years industry experience providing integrated health solutions including IP and WiFi Wireless Nurse Call, WiFi, communications and entertainment systems to healthcare facilities. In over 350 hospitals and 600 aged care facilities nationwide, we are the one seamless integrated solution for your healthcare needs.

hills.com.au

LASA Fusion Winter 2014  

Aged Care magazine

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