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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.
DOI: 10.1111/jep.13987
Publicaton type: Journal Article
Keywords: Integrated Care
Appears in Collections:Integrated Care

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