How to implement change on a tight budget in aged care

The aged care industry is in the midst of a dramatic transformation, and organisations are having to implement sweeping changes, often at great expense.

But at the Akolade 4th Future of Aged Care Summit this week, attendees heard that small “incremental innovations” can lead to improvement just as meaningful to operations as large “disruptive innovations”.

Smaller changes driven by the staff themselves can be particularly effective, said Lynn Bailey, executive general manager, Fresh Hope Care.

“It doesn’t have to be disruptive change to be successful,” she said.

Staff often the source of great ideas

HelloCare sat down with Ms Bailey after her presentation, and discussed the valuable contributions staff can make in driving change and finding solutions.

“Some of the innovation we need at an industry level is about policy and the funding model, that needs to occur and individual workers in aged care can’t influence that,” Ms Bailey said. “But they can influence the experience that every client or every resident has.”

Historically, the aged care industry has not been good at involving staff in planning and implementing change, but that is changing.

“If you ask residents, consumers and staff how you could improve, they’ll be very happy to tell you, and they rarely get it wrong. 

“But you must do something with that information,” Ms Bailey said.

Tools for change: post-it notes and sharpies

One of the best ways to innovate when you’re on a tight budget is to get staff to write down their ideas on post-it notes with a sharpie, collate the information, and use the feedback to generate fresh ideas. Taking photos of the notes, which of course we can do for free on our smartphones, is a good way to record the discussion.

The process is “cheap and easy to do, you just need the right mindset,” Ms Bailey said.

Part of the key to this technique’s success is buying good quality post-it notes, Ms Bailey said, and she also made the useful direction to peel them from the side, not the bottom, so they stick better. (In addition, I can recommend avoiding imitation Sharpies, particularly those from your local discount store. They leak.)

Talk to the staff

Ms Bailey gave examples of some of the innovations she has been involved in that have been inspired by ideas from staff.

In one session, Ms Bailey said 30 staff wrote down they didn’t like the colour of the pants in their new uniform. Easy – the colour was changed and the staff were happy.

In another example, she set out to find out why laundry costs had gone through the roof. When Ms Bailey went to the staff, they told her there was a drainage problem in the showers, so every time they gave a resident a shower they were putting towels around the outside of the shower. They were using six or seven towels for every shower! Problem solved.

In another situation, staff came up with a new way of packaging home care services. “One of the problems with home care packages is the amount of unspent funds the consumer has”, Ms Bailey said. What the team worked out, when they worked together, was they could package the services together. Rather than offering the customer separate OT, physio and yoga services, they offered these options together as a ‘wellness package’ – and the customers loved it!

In the time Ms Bailey has been with Fresh Hope Care, only 12 months, she has worked with residents and their families, making sure the services they are offering are in line with what the residents actually desire.

“We’re very busy, and we often spend time doing things the residents don’t value, so one has to question ‘why do we do that?’” she said.

Staff must feel free to speak up

Ms Bailey said for staff to be engaged in implementing change, they have to feel free to speak out and not fearful of retribution. They have to feel they are in a safe space to make mistakes.

“I generally work with staff groups without their managers present so they can say whatever they like. I don’t put their names down, I don’t connect their names against the information they share. I’m just after what the group shares, and they have the most amazing ideas and they know how to fix something,” she said.

Playing nice

Ms Bailey said staff must also be prepared to “play nicely”.

Her rules for getting along together are:

• No eye rolling. “Watch for it in meetings because it can shut down an introvert,” Ms Bailey cautioned.
• No shotgun conversations – when someone is not really listening, they’re just waiting for their turn to speak so they can shoot the speaker down.
• No buts, because that’s dismissing someone’s position.

Have fun

Ms Bailey said innovation starts with asking the question, “How might we…?” and then the first step has already been taken.

“There’s no time like the present to start your innovation journey,” she encouraged. 

In a management course at Disney, Ms Bailey learnt a key lesson she is bringing to her work in aged care – the importance of fun.

“Let’s have fun,” she said. “We need more fun in aged care.”