A Dash of Organisational Discipline and a Lot of Staff Involvement

The Whiddon Group - Kelso facility is located on the tablelands of central NSW. It has, in total 51 residential aged care places with 20 places in a specific dementia unit. It has been benchmarking as part of The Whiddon Group in NSW since 2001.

Those that have been benchmarking with QPS for a long time might recall an article (March 2005) written by the Kelso team that explained how management communicated the benchmarking results with staff via a large quality board. This article prompted many other facilities to adopt the same strategy to communicate with staff, residents, relatives and the community. Since that time Kelso has continued to develop and evolve its culture of continual quality improvement.

"we like to maximise the use of the comment boxes in the on line data entry system and this is an enormous help to us in respect of closing the quality cycle and maintaining a history of achievement"

The Director of Care is Nicole Mahara, and together with Michelle Sharwood, the Deputy Director of Care, they have adopted an approach that staff engagement, understanding and strong analysis of data are the keys to maximising the benefit of the benchmarking process and achieving strong outcomes. Nicole asserts that "it is important that analysis has been conducted on each and every part of the data prior to the data being submitted......we like to maximise the use of the comment boxes in the on line data entry system and this is an enormous help to us in respect of closing the quality cycle and maintaining a history of achievement".

A sample of the analysis typically associated with each and every indicator inserted at the time of data entry is shown below.

Kelso is disciplined in its approach and their philosophy is that all data must be discussed with staff and at the CQI meetings. Following receipt of the reports the results are analysed and placed on the notice boards and many issues are communicated to staff via memos. Once this discipline is achieved the writing of the analysis at the time of data entry is much easier as staff input is integrated into the continual quality improvement process.

"Our simple strategies have enabled us to maintain participation in surveys near 100% for the past few years"

"Over the past few years we have tried very hard to focus on communication with the staff. Improved communication not only improves employee satisfaction but it also leads to better client care" says Michelle Sharwood. It is important to keep things simple and manageable. For instance, getting high levels of staff participation in employee satisfaction surveys is not always easy. One system developed at Kelso was to develop a QPS Competency Folder. Staff members can go to this folder to retrieve their surveys. If the staff member does not retrieve the survey then management will get the survey and hand it to them. This simple system ensures that all staff receive the survey and know the importance that management places on getting the surveys back. The surveys have the name of the staff member printed on the front. They know that once they have completed the survey they can tear off their name and place it in the `raffle' box to win a prize. They can leave their name on the survey if they wish and simply put their name on a separate piece of paper into the box, it is their choice. These strategies, combined with an emphasis on feedback, have seen the participation rate maintained at near the 100% level over the past few years.

A similar thing is done for the competency tests but the prize for participation is linked to the topic. For example, you might win a fire blanket for your home for participating in the fire competency test or a selection of antiseptic creams or hand wash for the infection control test. "The prizes are a bit quirky but it seems to work" says Nicole.

Building a strong staff culture

There is a strong emphasis on employee communication about performance at Kelso. It might sound a little bureaucratic but on average there are between 150-200 memos issued to staff each year about various aspects of results and performance, many of them linked to our benchmarked outcomes with QPS. There is also an inbuilt culture for rewarding performance, and the facility maintains a strong discipline when it comes to the employee of the month awards and one employee is nominated to attend The Whiddon Group Board of Director's Gala Dinner in recognition of their achievements throughout the year. There is also the `Above and Beyond' award where staff, residents or relatives can nominate employees for efforts beyond and above their normal duties. In addition to these awards there is the Annual Christmas Party Awards of `Attended Most Education Sessions' and `Attended Most Aged Care Channel Viewings'. Whilst this may sound like a strategy that is somewhat separate to benchmarking it is considered that the engagement of staff on a range of levels is critical to the overall understanding and commitment to good outcomes and the search for best practice.

Staff meetings are an important venue to discuss benchmarking results and strategies for improvement. There are rewards for attendance such as draws for movie tickets. There are regular agenda items to provide continuity and consistency. One of the four Mission Values of The Whiddon Group is always read and discussed and this helps to maintain alignment with the core values of the organisation. Another important standing agenda item is to work through a section of the orientation workbook. It is acknowledged that long serving staff do not periodically go through the orientation program and this is one way to ensure there a no gaps in the consistent flow of information to all staff. "We try to increase relevancy by choosing topics that are on the minds of staff, for example we will review the infection control section of the workbook in a lead up to the QPS Infection Control Competency Test" says Nicole. When the results come in from the test it helps us to close the quality cycle around the whole process.

Other standing agenda items for the staff monthly meetings include mandatory reporting, annual business plan; benchmarking results; compliments and complaints; changes to regulatory compliance; `I have an idea'; OHS; Food Safety; new policy directives; and, any other issues that staff wish to raise.

Commitment to all of the processes outlined in this article enables the organisation to discuss freely and willingly the results of our benchmarking KPI's. This helps us to gather information about our strategies, what works and what does not. When it comes to inputting data at the end of each quarter we are well armed to explain our outcomes and the reasons for any variations. As both the Director and Deputy Director of Care explain; "our staff help us keep a finger on the pulse of the organisation and so when it comes to understanding the explaining our benchmarking outcomes such as falls with injury the information is at the forefront of our minds".

The following extract was taken from comments made at the time of data entry: