Establishing your service for change

There’s one key thing you should be asking as you ready your organisation for the changing sector, writes, Andrea Petriwskyj.

Service providers across Australia’s aged care sector are looking at new ways to do business, provide services and meet the needs of people as we age. Transformation projects, workforce strategies, service model redesigns, acquisitions and restructures are just some of the large projects on the agenda. New technology, software, and processes are continually being developed. Organisations are taking opportunities to rethink and reshape.

We have been talking with providers about the many changes they are exploring and implementing. Our first question is always: how are consumers and their families and carers involved in these new directions?

Engagement is about more than care delivery

The aged care staff we have been talking with are deeply and genuinely interested in involving consumers, hearing their voices, valuing their perspectives and shaping care around them. Because of this, there can be a perception that engagement is done well and there is no need to look at things differently.

The problem we often find is a disconnect between the organisation’s philosophy about care and how business tasks are seen. Engagement can too often seem the job of certain people in an organisation, something that relates to quality or complaints or care delivery. Aside from this, business units make decisions and implement solutions for business reasons.

That works, to a certain extent, until the effects of those decisions and solutions trickle down. The results can be frustrating at best, including invoices or communications that make efficiency at the expense of connection, or a disaster management plan that leaves consumers and families confused, or even angry. Strategies and frameworks may not be inclusive and may fail to have real impact, or shifts in service delivery models may be not well understood and hard to implement.

All of these are examples of why engaging, connecting and understanding consumers matters for the whole business. Sometimes decisions need to be made in a hurry or with limited resources, but it’s when they’re made by and for the business – without consumers at the centre – that they start coming unstuck.

There are a few key points we share with any provider facing this challenge.

Consumer-centred care is not the same as a consumer-centred organisation

It is easy to say that your organisation is consumer-centred because your care model is consumer-centred. But these are not one and the same thing. It’s time to think about care organisations – like we think about care – as being with and not just for people. Consumers’ roles extend well beyond decisions about their own needs, wishes and services. Their voices can and should be heard throughout the organisation.

“Creating a real shift is a long-term process.”

We often talk to service providers who are passionate about consumer voices driving care but find it more difficult to embed those voices in business and broader governance structures in a meaningful way. This requires another shift and brings in people and business units who may not have thought of themselves as having a role in engagement.

A consumer-centred organisation builds processes around people

Consumers at the centre of your organisation does not mean thinking about what is best for consumers, or what they might want, or having them in mind when making decisions. It means, in very practical terms, creating processes for decision-making around consumers so that they are actively involved. These processes need to ensure that people are not just consulted but know that they have been genuinely heard.

This may require a shift in how the organisation approaches decision-making, planning or projects. These processes, including planning and resourcing allocations, need to allow for genuine contributions by stakeholders; consumers in particular.

There is no one solution

There is a vast range of ways to involve people and to understand their needs and perspectives. Different approaches will be needed at various times for different people and different decisions. The ways that you are used to engaging with consumers, their families and support networks may no longer be enough. This is especially true for any organisation wanting to set itself apart.

One of the challenges we see is that providers sometimes identify ways to involve consumers that may meet a need in the organisation but are not built around what works for consumers and what fully facilitates their involvement. It can then be difficult to sustain involvement and ensure diverse perspectives are heard.

Inclusive processes consider a range of factors including what ways of engaging around different issues suit people best and what is needed to support people to engage fully.

We also often find people don’t realise how many avenues for engagement there are in their organisation. These may lack impact because they are not well understood or valued for what they provide. The challenge is identifying these and knowing how they can be used most effectively.

A coordinated strategic approach is needed

While big changes may be required, this doesn’t need to be overwhelming. It starts with a shared vision for consumers’ roles in the organisation. This must be more than an aspirational statement from the executive or board, or even just a directive or policy. It must be prioritised, enabled, and resourced throughout the organisation and given practical support so that it is actually possible. And it must be informed by a real understanding about what consumers want and need, not just what the organisation wants or needs from consumers.

“How are consumers and their families and carers involved in these new directions?“

There must be organisation-wide commitment and efforts to build the understanding of every member of the organisation about their own role. Each person must understand why the vision matters in the scheme of their own daily work and how it might look for them in practical terms.

Creating a real shift is a long-term process. A gradual, sustainable, and inclusive approach that makes the most of existing strengths and knowledge, values diverse perspectives, and fosters a culture of openness and curiosity. Working towards the vision might take a while and like any improvement process it should be a learning experience.

Current opportunities

With the ongoing changes in the sector, it is timely to explore how you engage and how to strengthen consumer engagement in your organisation. Regardless of what is on your agenda, make sure you ask this key question: how are consumers involved?

Andrea Petriwskyj is research and education coordinator at COTA Queensland. She works with aged care providers to enhance their engagement with consumers and other stakeholders.

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