Tackling barriers to continuous improvement in care and support organisations

Government and public expectations

Continuous improvement (CI) is recognised by academics and industry experts alike as an essential component of modern business, to the extent that it is a statutory requirement for services that provide care and support to older Australians and those living with a disability. The NDIS Practice Standards, for example, require disability support providers to implement a quality management system that ‘supports continuous improvement, using outcomes, risk related data, evidence-informed practice and feedback from participants and workers’. In aged care, legislation goes one step further, mandating that services also develop a documented plan for continuous improvement (PCI) that enables them to assess, monitor and improve the quality of the care and services they provide.

And yet…

Despite such clear obligations, evidence suggests that providers are experiencing challenges when trying to embed CI in their organisations. While the NDIS reports that it is ‘achieving positive outcomes for Australians’, no data is made publicly available on rates of provider compliance with CI requirements. Findings of high rates of reportable incidents and complaints in disability group homes suggest that there is room for improvement.

The ACQS sector performance report, however, consistently features standard 8.3c (which covers governance systems, including continuous improvement) in the top 10 most common reasons for findings of non-compliance. In the most recent quarter, 8.3c reached second position.

What’s holding CI back?

We recently surveyed providers from across the sector, and our findings suggest that they are keen to address this gap, with ‘Maintaining or improving regulatory compliance’ cited as the top reason that CI is important for their organisation. It is unclear, however, the extent to which this response might be driven by the pressure to continuously update systems and practices in the face of ongoing reforms in aged care regulations. From the continued evolution of restrictive practices regulation to planned updates of the ACQS themselves and the upcoming launch of 6 new mandatory reporting indicators under the NACMQIP, change continues apace. Government work on aligning standards across aged care and disability support also raises the spectre of more sweeping reforms.

Our respondents also shared their views on barriers and enablers to CI, with results showing general alignment with previous research in this area (examples can be viewed here and here). From sets of 15 options, ‘An open, blame-free culture that values learning from mistakes’ was nominated as the top facilitator of CI, with negative cultures being the primary impediment.

Unsurprisingly in the face of workforce crises in both aged care and disability support, inadequate staffing numbers and skills are currently also seen as key factors in continuous improvement. Our survey found ‘Adequate workforce skills/education’ to be rated as the second highest enabler, while ‘Inadequate numbers of staff’ and ‘Inadequate workforce skills/education level’ took second and third position as barriers.

Effective leadership also emerged as an important theme, with ‘Appropriate prioritisation of improvement initiatives’ receiving the third-highest number of nominations as an enabler, while inappropriate prioritisation narrowly missed the top 3 barriers list, coming in at fourth place.

Addressing barriers

Care and support services can increase the effectiveness of continuous improvement plans by developing an open, blame-free culture, including by providing an environment where staff and care and support recipients feel safe to raise concerns and provide feedback, and confident that their input will be valued and acted on.

Organisations may also consider implementing a comprehensive system of self-assessments and quality indicators, such as that provided by the MOA platform, which links through to a digital, collaborative plan for continuous improvement. MOA eases the burden of updating quality management systems to reflect the latest regulations – we do that for you. Furthermore, our integrated systems enable effective prioritisation of monitoring and improvement tasks, through user-friendly dashboards and benchmarked reports that enable insights and input at all levels, from executive managers to frontline staff. The streamlined MOA approach to compliance and improvement also helps to alleviate some of the pressures on overstretched staff, allowing them to action CI tasks while contributing to a better learning culture overall.

Contact us to find out how our programs can be tailored to suit your needs, enabling you to meet current CI requirements and be prepared and resilient for those still to come. 1300 760 209, or email [email protected].

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