Aged Care – No Guarantees in Change, Scale or History

Consumer directed and person centred aged careThe Australian Aged Care sector is undergoing significant change with variations in government policy, new market entrants and more informed consumers. The only guarantee is ongoing client choice with increased knowledge of increasing options.

Three lessons are clear as risk and opportunity become transparent in the competitive environment:

  1. Change doesn’t guarantee better outcomes.

Abundant research confirms change fails on more occasions than it succeeds. Poor strategy, poor management, poor execution and lack of clear outcomes account for lots of the failure. Flip this list and change can bring better quality services, increased client satisfaction and greater confidence in the future.

  1. Size doesn’t guarantee the benefits of economies of scale.

Bigger is not better.  If there is no clear advantage in being bigger, all being bigger does is compound problems.  Many economies of scale can be achieved in aged care: labour, purchasing, digitalisation, information technology, baselines and benchmarks to name a few.  Economies can free resources to shift to areas of higher yield, invest in business intelligence and quality improvement.

  1. Aged care is a business – No money, No Mission.

There is much to learn from history but the sustainability of a contemporary aged care service provider requires the application of sound business principles.  Old habits and the inability to forecast with predictive analysis to produce lead reporting simply won’t work in times of digital disruption.

Aged care clients deserve diverse quality service options as their frailty increases.  Introduction of ‘consumer directed care’ and ‘person centred care’ begs two questions:

  1. Why has aged care not always been consumer directed and person centred?
  2. When will aged care become consumer directed and person centred?

The listing of Regis, Japara and Estia Health on the Australian Stock Exchange sounds a warning to ‘not for profit’ providers.  

Poor performance or low client value undermines the benefit of ongoing requests for more Government funding.  When new market entrants make more effective use of scarce resources while increasing market share, client choice becomes their competitive advantage.

Aged Care Boards must have a clear definition of services quality defined in client outcomes. Not motherhood terms but in specific, measurable and timely outcomes. Flipping client complaints to positive outcomes is a good start.

Effective management will provide regular, timely and accurate reporting of performance against the definition based on a rigorous instrument evaluating quality. Addressing gaps must be a priority to the sake of client satisfaction, occupancy, utilisation, cashflow and sustainability.

Change Risk and Opportunity

Exploit opportunity by being clear on strategic objectives and being equally clear who is responsible and accountable for translating those objectives to outcomes. Define outcomes in Specific, Measurable and Timely terms.  

Keep your periscope up.  Be open to discussions with those who present options to exploit opportunity rather than rely on internal insight.

Manage risk.  The current case in the Supreme Court of Victoria where Trustee of the Scots’ Church Properties Trust and Trustees of the Assembly Hall of the Presbyterian Church of Victoria are being sued by Attorney-General of Victoria on the relation of The Presbyterian Church of Victoria Trusts Corporation is a sign of the times. Anyone who thinks ‘not for profit’ Board members don’t have the same obligations as other Boards should contemplate this case and the fact that the nominated Trustee in the proceedings is 83 years of age!

Aged Care Boards have traditionally displayed a Trustee role.  In a changing environment with increased client choice and increased competition, a strategic focus becomes more important in developing the Board’s strategic mindset.

It’s time.  Get good advice.  Test your competitiveness against your competitors. Consider broad options. Choose a preferred option to deliver quality client services, retain or grow market share and invest in sustainability.

Be clear on how you quality control the destiny of those in your care and by default your own destiny.  After all, isn’t that why you are an aged care provider – to meet the needs of your frail aged clients?

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