Linda Justin has held a variety of senior management roles in health and human services, in the NGO, public and private sectors. Linda has worked to achieve operational excellence through collaboration and innovative thinking, placing client/customer quality practice and service at the centre of an organisation. She has worked with Boards, executives, and front-line staff for organizational transformation both culturally and operationally. Linda has worked with several national and international health organizations’ and policy committees. Linda is enrolled in a PhD programme at UTS. Her PhD Title is “Who do you say I am? Language, Culture and their intersection with Quality and Safety in Aged Care”. Linda is a casual lecturer at UTS, Board Member for Hammondcare a leading Australian dementia specific care provider and is also an external adviser to St Vincent’s Healthcare and a member of the We-Thrive collaboration with Prof. Kirsten Corazzini and Michael Lepore.
Who do you say I am? Enabling change, models and their intersection with practice, quality and safety.
Linda Justin, University of Technology Sydney, Australia
Joanne Travaglia and Deborah Debono, University of Technology Sydney, Australia
The health and social service sectors are operating in what is known as a volatile, uncertain, complex and ambiguous (VUCA) world. The aged care service delivery within Australia is currently experiencing a perfect storm on a multiplicity of levels: scrutiny, policy, demographics, fragility, Covid-19 and increasing customer expectations.
Against this VUCA backdrop the ageing sector is undergoing the most intense public scrutiny through Royal Commission into Aged Care Quality and Safety (ACRC), into the instances and prevalence of abuse and neglect. In addition to attempting to navigate these VUCA operating environments, the ACRC and Covid-19 has exposed an even larger question of what we as a society understand constitutes care, the aging process and what ultimately is a good and meaningful life are being laid bare detailing harrowing stories of abuse and neglect. Indeed, the opening statement of Commissioner Tracey to the ACRC stated that,
“The hallmark of a civilized society is how it treats its most vulnerable people, and our elderly are often amongst our most physically, emotionally and financially vulnerable,”
In reviewing Australian social services legislation, three themes emerge: person-centered approaches; choice and control, and presumption of capacity. There are models from the USA and UK that purport this enterprise approach to achieve these three themes. In the USA these include- Eden Alternative; Green House and Household and in the UK Butterfly model and My Home life. These change models have challenged the notion that nursing homes or residential care provides just ‘care’, in a traditional institutional or biomedical perspective. Instead, they offer an alternative for providers who wish to see their service offerings enhance the quality-of-life for people.
Aged care is at an inflection point, especially as the successful implementation of quality improvement programs require organisations to collectively see quality as a component of culture and as an organisational competency. This approach sets a new direction for the aged care sector, one which demands a more comprehensive understanding of what operationally excellent service delivery actually requires for successful implementation, beyond that of meeting basic compliance standards. This is further compounded, by language and a multiplicity of models and terms such as compassionate-care, relationship-based care, customer-centric care, which undergird various models which creates a conceptual pluralism with regards to approaches and consequently the agreed coherent organizational enablers.
In reviewing the results though, what became apparent was the multiplicity and interchangeability of the terms to and approaches for implementation depending on which ‘tribe’ or lens your professional qualification or executive role originated from. They are also at times disconnected from the business of operations and the financial and human resource requirements to deliver care. But are these not two-sides of the same coin?
This paper will review the models, links between person centred practice, implementation, and share considerations and insights from research Interviews with CEO’s and developers of some core models regarding successful implementation. Instead of lurching from compliance what are those transformational elements that support the inherent dignity of each person in receipt of services.