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Title: | Fit-for-purpose-The bottom-up redesign of the nursing home system: The Australian Aged Care System | Authors: | Sturmberg, Joachim P;Gainsford, Len;Pond, Dimity;Goodwin, Nicholas | Affliation: | Central Coast Local Health District Gosford Hospital The University of Newcastle |
Issue Date: | Apr-2024 | Source: | 30(3):511-520 | Journal title: | Journal of Evaluation in Clinical Practice | Department: | Central Coast Research Institute for Integrated Care | Abstract: | Nursing homes struggle to meet the needs of their residents as they become older and frailer, live with more complex co-morbidity, and are impacted by memory impairment and dementia. Moreover, the nursing home system is overwhelmed with significantly constraining organisational and regulatory demands that stand in the way of achieving resident-focused outcomes. These issues are compounded by the perceptions of poor working environments, poor remuneration, and poor satisfaction amongst staff. The system is beyond the state of 'reform' and requires a fundamental redesign based on first organisational systems understandings: a clearly defined purpose and goal, shared values, and system-wide agreed "simple (or operating) rules". A 'fit-for-purpose' future requires a complex adaptive nursing home system characterised by seamless 'bottom-up and top-down' information flows to ensure that the necessary 'work that needs to be done' is done, and a governance structure that focuses on quality improvement and holds the system accountable for the quality of care that is provided. | URI: | https://hdl.handle.net/1/2579 | DOI: | 10.1111/jep.13987 | Pubmed: | https://pubmed.ncbi.nlm.nih.gov/38606518 | Publicaton type: | Journal Article | Keywords: | Integrated Care |
Appears in Collections: | Integrated Care |
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