The Aged Care Standards and Accreditation Agency Ltd Continuous Improvement in Residential Aged...

The Aged CareStandards and Accreditation Agency Ltd

Continuous Improvement

in Residential Aged Care


Overview

Section One:

An introduction to continuous improvement

What is continuous improvement? Legislative background Links between self-assessment, continuous improvement

and strategic planning Benefits


What is continuous improvement?

Continuous improvement:

Involves lifting performance in each of the four Accreditation Standards and the 44 expected outcomes

Is part of an overall quality system, focusing on systematic and integrated improvements with clearly defined objectives

Is evidence-based Is a results-focused activity which can be demonstrated

through outputs and outcomes Ranges in scale from smaller programs to significant

strategic initiatives


The Accreditation Standards

Standard 1: Management systems,

staffing and organisational development

Standard 2: Health and personal care

Standard 3: Resident lifestyle

Standard 4: Physical environment and

safe systems

9 expected outcomes

17 expected outcomes

10 expected outcomes

8 expected outcomes


Legal responsibilities of approved providers

The Accreditation Grant Principles 1999 specify:

- that the residential care service complies with the Accreditation Standards and its other responsibilities under the Aged Care Act 1997

- that a process of continuous improvement is undertaken, measured against the Accreditation Standards


Legal responsibilities of approved providers

That a “plan for continuous improvement” for the home must be submitted to the Agency

That the plan should include how the home will address any matters identified for improvement by the assessment team during site audit

That the plan be in a form approved by the Agency


The link between continuous improvement and strategic

planning

Aims to raise the quality of service the home provides to residents

Strategic approach to the organisation’s vision, mission, values and objectives

A management plan including setting strategic goals, operational management and conduct of care and services


The link between continuous improvement, self-assessment and

the accreditation process

The accreditation process is designed to assess homes’ performance against the Accreditation Standards

The accreditation process requires self-assessment against the 44 expected outcomes that make up the four Accreditation Standards

Homes must provide a “plan for continuous improvement” to the Agency

Informs the home’s management of the results achieved through improvement projects previously implemented


Self-assessment results

The self-assessment process against the 44 expected outcomes will lead to a range of possible improvements being identified by a home

These improvements may be:

- to ensure compliance with an expected outcome

or

- to improve performance in an expected outcome where the home is already compliant


The link between self-assessment and continuous improvement

Self Assessment

Plan for Continuous

Improvement

Continuous Improvement Activities


Self-assessment results

A simple four-step model for self-assessment is described in the Agency’s updated education package Self-

assessment for Residential Aged Care Services – available at www.accreditation.org.au


Benefits to be gained from continuous improvement

Residents’ needs better identified and met Improvements in outcomes for residents and other

stakeholders More effective services A cooperative approach to improvement which brings

groups of stakeholders together Greater efficiency in resource allocation


Overview

Section Two:

The principles of continuous improvement

Overview of the principles Customer focus in detail Case study


Principles of continuous improvement

Strategic planning and implementation Clearly defined objectives and outcomes Resident focused Involvement of key stakeholders Encouragement of innovation Utilisation of a range of approaches and techniques Regular monitoring and evaluation


Customer focus in detail

This section looks at customers in greater detail, with a focus on residents in aged care homes


Resident input

Input should:

Be structured so that the most information can be gathered in the best form

Be thought through carefully during development, including talking to residents about obtaining their input

Allow for documentation and collation of the results Be reviewed regularly to assess whether it is actually

providing useful information to enable improvements to be made, and

Include feedback to the people who provided input


Obtaining customer (resident) feedback

Surveys, questionnaires Interviews Focus groups Suggestion schemes Complaints monitoring Resident meetings One-on-one discussions Care planning meetings


Customer (resident) feedback

Record it!

Use it!


XYZ nursing homecase study

Resident focus

Group exercise:

- Read the case study supplied in the education package

- Discuss the case study approaches to resident focus

-As a team, look at and complete the exercise


Overview

Section Three:

Continuous improvement in detail

A cycle of continuous improvement A simple model for continuous improvement activities Identifying continuous improvement opportunities Case studies Evaluating the approach to continuous improvement


A cycle of continuousimprovement

The home’s approach to continuous improvement should:

Focus on improvement as opposed to maintenance of existing performance levels

Achieve demonstrable improvement in care and services Be planned and systematic at all levels of the

organisation, and Involve measurement of results against the Accreditation

Standards


A simple model for continuous improvement activities

The Agency uses a simple four-step model to manage continuous improvement activities.This is one model that could be used, there are many other models and systems to help homes improve

This model can be used at any level of the home:- Service wide level- Clinical care level- Support service level- Staff team level- Individual staff member level



Step 1Plan the improvement

Step 2Implement the improvement

Step 3Check how well the

improvement has worked

Step 4Decide next steps


Step 1: Plan the improvement





Step 1Plan the

improvement



This level of planning is more detailed than the “plan for continuous improvement”

It involves planning for individual activities This occurs at specific team or staff levels, as opposed to

involvement of the entire service



Identify the expected outcome that the improvement relates to

The results expected to be achieved The overall objective The timeframe in which the result is to be achieved The actual steps involved Outputs/milestones to be achieved Staff members involved in each step Measurement of results/improvements


Step 2: Implement theimprovement








Now is the time to put the improvement in place!



As the staff go about making the changes indicated in their

plan, thought can be given to:

Ensuring the involvement of the appropriate staff Ensuring residents and staff are informed as appropriate Ensuring that the steps are documented Seeking feedback along the way

As the improvements are implemented, you will start measuring those improvements. The results of the improvements will then help you to know if they have worked well or not.






Step 3

Check how well theimprovement has

worked


STEP 3: Check how well the improvement has worked

This step is to evaluate how effective the

improvement effort has been. This step

can often be overlooked in the enthusiasm

to improve and make a difference!







Step 4

Decide next steps


STEP 4: Decide the next steps

Possible situations at this stage:

The improvement activity has been successful – well done!

The improvement activity has been partially successful and staff need to make further improvements

The improvement activity has been unsuccessful and staff need to make further improvements


Identifying continuousimprovement opportunities

It is quite likely that a home could develop more improvement ideas than it can undertake all at once

This means that you should prioritise and plan the continuous improvement activities you will be doing

The identified improvements can be grouped in an order that is logical to your home –

According to Accreditation Standard According to clinical or support care processes According to responsibilities


Planning for continuous improvement

As you prioritise improvement activities, you may be able to see links that can assist you. Several issues or expected outcomes could be addressed through one improvement activity.

The “Results and processes in relation to the expected outcomes of the Accreditation Standards” handbook lists links between expected outcomes


Planning for continuous improvement

Identify desired/possible improvements

- from self assessment

- Agency required improvements

Prioritise and plan the improvements, considering:

- resources

- timeframes

- responsibilities


Consider the following when prioritising improvements

Which are required to ensure compliance with the Accreditation Standards?

Which bring most benefit to residents? Will some improvements have a positive impact on a

number of expected outcomes? Which are required from the Agency’s audit results? What does your feedback tell you what residents, staff and

managers are most supportive of? Which are most likely to succeed? Are there some ‘quick wins’?


Individual continuousimprovement activities

Once you have identified, prioritised and planned your improvements on your “plan for continuous improvement”, you will be ready to manage the individual improvement

activities


XYZ nursing home case studies

Group exercise:

- Read the case studies supplied in the education package

- Discuss the case study approaches to continuous improvement activities

-As a team, look at the exercise for continuous improvement looking at Standards Three and Four for

your nursing home


Evaluating and improving the approach to continuous

improvement

How an organisation goes about planning and managing continuous improvement activities can also benefit from

evaluation and improvement

What was your home’s plan regarding continuous improvement?

What actually happened? Did the activities go as planned? What were the results? Were they as planned? What was

the benefit for residents? What benefits were gained by your home?

What can be done to further improve the home’s approach to continuous improvement?

Date post:	31-Mar-2015
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