In aged care, timing can mean the difference between relief and distress. For residents awaiting pain relief, the faint clatter of a medication trolley often signals a frustrating wait, prolonging discomfort.
Across Australia, aged care providers are starting to rethink this outdated model, turning to technology to deliver medications with greater precision and care. By adopting automation, some facilities are improving efficiency, accuracy, and resident autonomy while allowing staff to focus on meaningful, personalised care.
This shift marks a significant evolution in a sector long reliant on manual processes, where innovation is now taking hold to meet the needs of an ageing population.
For decades, aged care depended on paper-based systems: handwritten medication charts, manual logs, and labour-intensive routines that were time-consuming and prone to errors. Nurses spent hours cross-checking doses, while residents waited as trolleys moved slowly through sprawling facilities.
A misplaced chart or illegible note could disrupt care, and the rigid schedules of trolley rounds often left residents waiting for medications needed at specific times. Moving to digital record-keeping was a slow process, held back by tight budgets, staff reluctance, and an industry under constant pressure. Many providers stuck to familiar methods, wary of the costs and training needed to overhaul entrenched systems.
However, a transformation has begun. Driven by regulatory demands, growing expectations from families, and the clear benefits of technology, aged care providers are showing a greater willingness to innovate.
Electronic health records, telehealth consultations, and automated dispensing systems are gaining ground, promising to streamline operations and improve resident wellbeing. These advancements go beyond efficiency. They reflect a commitment to person-centred care, where residents’ needs and preferences take priority over rigid routines.
Among those implementing these changes is TLC Healthcare, who made the bold decision to explore new approaches to medication management through automation.
Jenny Foley, TLC’s Chief Quality and Risk Officer, recalls the organisation’s initial steps nearly a decade ago with an electronic medication management system.
“We got rid of paper charts and moved to tablets for staff,” she says. This allowed real-time prescribing, enabling doctors to order medications remotely and pharmacies to supply urgent drugs via an imprest system, such as antibiotics, so residents were able to have this medication at the time of prescribing.
The system reduced errors and improved coordination, although Foley soon encountered a case that exposed its limitations. A resident with terminal cancer, reliant on as-needed (PRN) pain relief, faced waits of up to 20 minutes as nurses navigated secure drug safes, known as DD cupboards, to retrieve controlled medications.
“It was no one’s fault, just the system,” Foley notes, pointing to the logistical hurdles that could delay critical care.
Determined to find a solution, Foley worked with TLC’s clinical pharmacist, who introduced the SASHA machine from Hark Medical, a biometric-enabled device that acts as a personalised medication dispenser.
“They put their fingerprint on, the medication comes out, and they take it when they need it,” Foley explains. Programmed with doctor-prescribed timings and safety lockouts to prevent overuse, the SASHA allowed this resident to manage pain promptly and independently. The result was profound, leading to what Foley calls “a beautiful, pain-free death”.
The resident’s family, involved throughout, appreciated the control and dignity the system restored, a stark contrast to the delays of traditional methods.
Buoyed by this success, TLC expanded SASHA machines to residents capable of self-medicating, supporting their independence and sense of agency. Installed in individual rooms, these devices are designed for accessibility, offering multilingual prompts for diverse residents.
“The machine might say in Italian, ‘It’s time to take your medication,’” Foley shares, ensuring ease of use for non-English-speaking individuals. Nurses can check compliance through the device’s digital records, maintaining oversight without undermining autonomy.
This balance is especially valuable for residents adjusting to aged care, where retaining control over daily routines, maintaining their dignity and independence can ease the transition.
TLC’s efforts extend beyond self-medicating residents. In its three newest facilities, medication cupboards in residents’ rooms have replaced trolleys. Staff access these cupboards with keys, guided by tablet-based orders, ensuring medications are given at the right time.
“Historically, the nurse might start at room one, so room 30 could wait until 10 a.m.,” Foley says. Now, residents receive medications without delay, and the absence of noisy trolley wheels preserves their peace. This approach also spares residents the disruption of early-morning rounds, allowing them to rest undisturbed, a subtle but meaningful improvement in their quality of life.
For older facilities not built with in-room cupboards, TLC is introducing SASHA machines and upgrading drug safes with biometric access. These changes have significantly reduced medication incidents, from up to 15 per month per home to just one, due to precise tracking.
“We know exactly who accessed what, when,” Foley says, highlighting the accountability these systems offer. Biometric safes also simplify access to controlled drugs like morphine, eliminating the inefficiencies of key-based systems, where nurses might lose time tracking down the keyholder.
This added layer of risk management ensures medications are secure and traceable, addressing concerns about misuse or loss that have affected some aged care settings.
The time savings are considerable. In homes using SASHA machines, the morning medication round, once spanning 7:30am to 11am for 30 – 40 residents, is cut by at least 90 minutes.
This extra time transforms staff routines, allowing them to focus on meaningful tasks: assisting with wound care, engaging in conversations with families, or supporting residents in activities that enrich their days.
“It shifts the focus from tasks to the person,” Foley emphasises, aligning with the sector’s growing emphasis on individualised care.
For residents, timely access to medications fosters a sense of normalcy and trust, particularly when delivered by familiar carers rather than an unfamiliar “medication nurse”.
The shift to automation has not been seamless. Some staff, accustomed to trolley-based routines, initially reverted to old habits, requiring patience and training to adapt. Foley views this as part of the process. “It’s about prioritising the person over the process,” she says.
Families have responded positively, valuing the dignity and autonomy these innovations provide. The ability to self-medicate or receive medications promptly helps residents feel more at home, a critical factor in maintaining their wellbeing.
TLC’s approach mirrors a broader trend in Australian aged care, where technology is being used to respect residents’ needs and time. Other providers are exploring similar solutions, from automated dispensers to digital auditing tools, as the sector responds to the demands of an ageing population.
Yet challenges persist: high upfront costs, staff training requirements, and the need for reliable infrastructure, such as power backups or SIM-enabled devices, can slow progress.
Smaller or regional providers, in particular, may struggle to invest in such systems, risking a gap between larger, tech-savvy facilities and those still reliant on manual processes.
Despite these hurdles, the benefits of automation are undeniable. Beyond efficiency, these systems empower residents, giving them greater control over their care. For staff, the time saved translates into opportunities to build stronger relationships with residents and their families, fostering a more compassionate environment.
As aged care evolves, the focus on timing, delivering care when it’s needed rather than when a trolley arrives, will only intensify. For residents, staff, and families, these changes point to a future where technology and empathy work together, proving that in aged care, timing is indeed everything.
