AAA May-June 2019 Cover Story

MAY-JUN 19

australianageingagenda.com.au

A better way to roster How Mirus Australia is transforming workforce management

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FEATURE

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Flexible rostering Mirus Australia is helping aged care providers streamline their workforce management processes to allow more time to focus on delivering high-quality care to residents.

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urse- and staff-to-resident ratios in residential aged care are again in the spotlight. The Royal Commission into Aged Care Quality and Safety has heard evidence from aged care nurses and care workers, nursing advocacy groups and unions, who are all adamant that mandating a minimum number of nurses and other care staff is the solution to the sector’s workforce woes.

Staff ratios alone are not enough to fix the issues the aged care sector is dealing with, says James Price, managing director of Mirus Australia.

“One of the biggest challenges we see our clients facing is inadequate systems and processes to manage its workforce, including the costs, skills and availability of staff, and making sure the workforce reflects the care needs of residents,” Price tells Australian Ageing Agenda. “Fixed staff ratios in isolation may not always be appropriate, simply because you need to have the right people at the right time.”

Residential aged care staffing is complex, more than what is frequently discussed, says 26 | MAY – JUNE 2019

James Price

Sara Golding, business lead of workforce solutions at Mirus Australia.

“As an example, when reviewing the May 2019 Mirus Industry Analysis this month, we saw a 22 per cent increase over six months in agency hours across the 60,000-plus beds we monitor. Anecdotally our clients have reported a spike in turnover and increase in sick leave due to the influenza season.

“Over the past six months there has also been a decline in enrolled nurse hours and an increase in both registered nurse and assistant in nursing hours per bed across the industry,” Golding tells AAA. “There is so much to consider when thinking about the staff required to care for residents within a facility, such as resident care needs, consumer directed care models, floor layout, staff engagement, health and safety, changing occupancy, skill mix and staff availability. All of which make it difficult to determine staffing levels through a ratio system,” she says.

“Mandating staffing ratios may seem like an easy-fix but the cost implications alone

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Mirus Works!

Key features of the rostering solution include: • Easy-to-use dashboard • Demand-driven rosters • Tracking of employee attendance • Absence management • Streamlined leave processes • Real-time reporting • Automated award interpretation and integration • Staff skills, training and qualifications at a glance • Workforce cost overview • Medicare data insights

could hamper an industry already struggling to make ends meet. The complex and often unpredictable care needs of our elderly within residential care should mean that the right staff are rostered to care for them. Advocating for the minimum number of staff will not necessarily provide quality care outcomes.”

The sector needs a better way to manage its workforce and one which better responds to the needs of residents and staff to get staffing levels right, says Price. “If we consider both the staff ratio and an investment in improving our tools to support, a mix of the two is a better answer.”

To address some of these aged care workforce management challenges, Mirus Australia has developed the workforce solution, Mirus Works!. The tool aims to help aged care providers optimise workforce processes and provide the right care to residents within the organisation’s budget.

“Our solution covers all of the staff in an aged care facility from a skills and compliance perspective. It gives real-time visibility of their skills, which is extremely important for the new aged care quality standards that come into effect from 1 July,” Price says.

Mirus Australia’s workforce solution, which launched 18 months ago, offers a full workforce management system. It allows providers to optimise staff coverage for every shift based on care requirements, staff availability and award interpretation.

The workforce solution also enables providers to have an overview of workforce cost for any period and reconcile Medicare funding data by resident. It features real-time data monitoring, enabling teams to see which staff members have clocked on for their shift and which haven’t. It can be integrated with payroll solutions to reduce the time spent on data administration and payroll errors.

Transforming the sector’s workforce needs to focus on how people and technology are integrated and move away from older business processes and reporting to improve the delivery of care, Price says.

“A challenge we see is that rostering technology hasn’t kept pace with the evolving aged care environment. Many of our clients have used the same roster for many months simply because it can be difficult to update a roster.

People don’t have the time to review these rosters,” he says.

The Mirus Works! skills module allows you to monitor skills, training, compliance and qualifications at a glance.

With real-time visibility, you can easily identify when skills have expired, helping you to follow-up, plan training and prepare for audits.

Sara Golding

Lanna Ramsay

“We found with a 14-day roster, providers often don’t have any management reporting for at least a few days after the period. The best we’ve heard is day 17 and the worst we’ve heard is at the end of the month. That means if they over-roster staff on day one, they don’t know about that until 17 days later at best or maybe at the end of the month at worst,” Price says.

With Mirus Works! providers can identify the right skills mix within its organisation and ensure the team rostered is equipped to provide high-quality care, says Golding.

“Organisations have their skills mix information on paper, in people’s heads and in the payroll system. But it’s hard to know at a glance where employee skills data supports the organisation and if it’s compliant,” Golding says.

Providers can make better decisions with their rostering through the real-time data visualisation, such as knowing when staff have started work on time on or whether someone is running late, says Price.

“Often that takes a long time to understand because I’m collecting a time sheet or a signin sheet, or I have to run a report from my fingerprint scanner or my kiosk. But if I know that my staff are running late, and I can see that in real-time, I might ask someone on the shift before them to stay in a bit later until that person comes in. I can make a better decision around my staffing rather than just call an agency and fill that position,” Price says.

Queensland-based residential and home aged care provider Ozcare worked with Mirus Australia on the development of Mirus Works! and is among organisations already using the workforce solution.

Lanna Ramsay, head of aged care at Ozcare, says they collaborated with Mirus Australia to support the organisation’s goal of implementing demand and care-based rostering with clear and real-time data to enable fast and accurate decision-making.

“We engaged Mirus Australia to review our workforce management process across our entire organisation, which includes 12 residential aged care services, specifically to review current staff shift patterns including when they were last reviewed, leave liability and the request process, rostering practices and skills management processes,” Ramsay tells AAA. australianageingagenda.com.au

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‘Making our life easier’ The Mirus Works! skills module was recently put to test during an unannounced accreditation visit. The facility manager tells us: “It was easy for me to navigate and show them [the accreditors] what they needed and to pull reports if necessary. They loved the fact we had immunisation and police certificate data in it also. My administrator and I have been using it the most here and we find it very easy to use and a great addition to our Mirus Works! rostering system. It’s making our life easier.”

Mirus Australia client, 2018

“We provide our services 24 hours a day, 365 days a year and we understood the complexities ahead in the execution on our workforce management vision. This included the responsibilities of solution design, continuous evaluation and validation, change management and stakeholder management to support our strategy.”

Ramsay says the executive team made the significant decision to partner with Mirus Australia because it has the skills, experience and technology Ozcare needed to achieve its goals.

“To attract and retain the best workforce, we must ensure we have invested adequately in the infrastructure, processes and systems to support our people,” she says.

Addressing demand and compliance

Attracting and retaining the right staff to join the aged care workforce is another of the key challenges the industry is facing. To help address these challenges, the sector needs greater flexibility to be able to provide staff with more choices and shifts that suit their individual

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The Mirus Works! dashboard provides visibility of staff coverage based on care requirements for every shift, every day. Take the complexity out of managing and interpreting conditions & rules associated with your Awards or EBA. Integrate with your payroll solution to reduce time spent keying data and reduce payroll errors.

“If we know how far away a ridesharing service is, shouldn’t we know who is working in our facility looking after our older Australians in real-time?”

lifestyles, says Golding. “There is now an expectation among staff in terms of choice and flexibility.”

The increasing demand for choice among staff is compounded by the residential sector moving towards an increasingly consumer-centric care model, where residents also want to choose when they receive specific care services, such as showers and meals.

“In the old world, residents were showered at seven o’clock, had breakfast at eight o’clock and had lunch at midday. But we’re moving to where a resident might say ‘I like my shower in the afternoon and breakfast at 10 o’clock, not eight o’clock,’ which adds to the complexity of how you manage your staff,” Golding says.

“For residents to be able to say, ‘I don’t like that, and this is what I want’, means you require the flexibility to manage your staff and their skills over a day.”

Mirus Works! helps providers respond to the needs and wishes of staff and residents.

Similarly, the rostering solution can keep track of the expiry dates of staff skills and certificates, which reduces the risk of non-compliance, says Price.

“As an organisation, if you know that 10 per cent of your staff have a skill expiring next month, you can plan for that ahead of time.

You can reduce the risk of anyone who is noncompliant being rostered. They won’t find their way onto the roster because you know that their skill is out of date,” he says.

The Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry has also brought accountability and responsibility of board members into the spotlight.

“We are moving into a world where the board will be held more accountable for what’s happening in the facility, so they need to be able to see that information,” says Golding.

The visibility of any non-compliance will give board members and executives peace of mind because they will know rostered staff are skilled to provide the level of care that residents require, she says.

“Investing in technology that supports that will be critical in the industry’s ability to move with agility through the changes ahead and provide quality care to residents.”

Many technology platforms being used by the

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Mirus industry analysis (MIA) May 2019 April

May

Change

Not-for-profits

92.46%

92.0%

-0.46%



For-profits

89.33%

89.17%

-0.16%



Industry

91.48%

91.11%

-0.37%



Occupancy

Percentage of claims not assessed > 12 months Not-for-profits

39.62%

39.46%

-0.15%



For-profits

27.91%

28.56%

0.64%



Industry

36.22%

36.31%

0.09%



Average value difference between new and departing claims Not-for-profits

($28.19)

($28.43)

$0.24



For-profits

($23.51)

($23.97)

$0.46



Industry

($26.83)

($27.13)

$0.30



(Mirus Australia recommended KPI $20 VARIANCE) Percentage of claims containing ACFI CHC 4b Not-for-profits

45.50%

46.05%

0.55%



For-profits

50.22%

50.71%

0.49%



Industry

46.95%

47.48%

0.53%



Based on the data of 110 aged care providers representing 750 facilities and 63,329 beds

“Over the past six months there has also been a decline in enrolled nurse hours and an increase in both registered nurse and assistant in nursing hours per bed across the industry.”

aged care sector have been developed for other industries and repurposed for aged care. Mirus Australia’s Mirus Works! was designed with aged care for aged care, says Price.

The adoption and advancement of technology plays an important part in the everyday lives of the communities where we live and work and the sector needs to consider this within their approaches to delivering the high-quality care being demanded, he says.

“With modern technology, we know how far an Uber is from our house by looking at the location on our smart phone. So, if we know how far away a ride-sharing service is, shouldn’t we know who is working in our facility looking after our older Australians in real-time?” Price says.

“Creating the future aged care workforce, requires a new way of thinking.” n

About Mirus Australia • Founded 1 October 2010 by James Price and Robert Covino • Provides services to 110 aged care providers representing 750 facilities and 63,329 beds • Manages over $4 billion dollars in revenue funding on behalf of its clients • Employs 46 staff

Contact Mirus Australia T: 1300 738 145 E: info@mirusaustralia.com W: mirusaustralia.com

australianageingagenda.com.au

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