Remote Governance during the age of COVID-19

4 years ago
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If given the choice, I doubt you could think of a more inopportune time to inflict a pandemic that disproportionately impacts elderly Australians than right now. With the aged care industry in the middle of a Royal Commission, and the sector wrestling with existential reform challenges, COVID-19 seems like a cruel joke.

The societal changes that are continuing to happen at a rapid pace have put even further strain on the aged care industry, their staff, residents and family. Restricted access to facilities and changes to the provision of home care have rightly been implemented to protect our most vulnerable from the COVID-19 virus.

The outpouring of empathy from the community along with the unwavering compassion of the aged care workers has been a bright light in these dark times. So, with all that is going on, shouldn’t we look to relax the compliance expectations on aged care providers?

Increased empathy doesn’t mean decreased scrutiny
An ABC 7.30 Report segment and follow up news article intimated that the Age Care Quality and Safety Commission (ACQSC) had stopped all inspections for aged care facilities. They were forced to amend their story after stern responses from ACQSC and LASA. The responses highlighted the importance of governance during a pandemic, but acknowledge that a change in audit approach didn’t equate to a reduction in oversight.

Whilst there is an acknowledgement that processes surrounding the administration of audits needs to change due to COVID-19 restrictions for age care services, ACQSC is steadfast in continuing to apply the Aged Care Quality Standards that came into effect in July 2019.

Often the Aged Care Quality Standards are portrayed as a bureaucratic burden on aged care providers, however this is a misnomer. The Quality Standards are focused on improving the outcomes for the elderly and ensuring they are treated with dignity and respect.

In these trying times, the Quality Standards are even more important, and their application is crucial to ensuring the safe provision of services to end customers.
Although the intention of the Quality Standards is appropriate, that does not mean that the processes that sit behind them cannnot be improved upon, especially in the current or post-pandemic world.

New world, finding new opportunities from old systems
The old adage of “never waste a crisis” should be applied to the governance and reporting of the Aged Care Quality Standards. The Standards themselves are well articled and supported by a significant education campaign by the ACQSC. However, these efforts have been let down by an immature and heavily manual reporting process.

Aged care providers are given reporting options for the Quality Standards which are:

  • a 47 page Word template
  • a 13 tab Excel template
  • or the option to create their own

These options require a significant amount of effort from providers, and offer an inconsistent data set to the Government. The Government should have taken a modern approach by establishing an Aged Care Quality Standards data model and providing an online portal. This would have enabled consistent reporting and data aggregation capabilities, whilst also reducing the reporting burden on the providers.

There was also a missed opportunity to promote arguably the most important component of the Aged Care Quality Standards: the Plan for Continuous Improvement.

Again the Government offered providers a static Excel template to report back on the continuous improvement initiatives. Obviously an online portal with an expanded data model and regular reporting schedule would have delivered a more detailed view of providers’ efforts to improve the services to their residents.

It’s not as if the Government isn’t leveraging a similar approach. The National Aged Care Mandatory Quality Indicator Program (QI Program) requires quarterly reporting from providers that is uploaded via the My Aged Care service provider portal. Thankfully the private sector has developed online platforms to help aged care providers manage the Quality Standards, however there is no mechanism to upload the data to the Government, nor a consistent data model to provide more quantitative information for analysis.

Remote control: Governance from afar
Providers are now beginning to ease into new ways of working under the new constraints across the country. Frontline workers continue to provide care, albeit with a heightened state of risk, back office staff are coming to terms with a different set of challenges. For many providers, this will be their first experience with remote working. The first challenge is opening lines of communication across the organisation which has seen an explosion in video conferences across the country.

The next obstacle is dealing with collaboration for complex business functions, none more challenging than governance. In aged care, governance, particularly around the Aged Care Quality Standards, is essential. There are 3 key success factors to managing governance remotely:

  • Accountability – ensure those accountable for compliance tasks, activities and reporting are aware of their responsibilities and meet their commitments.
  • Accessibility – ensure all that stakeholders have access to a remotely accessible, consistent and easy to use system to manage compliance activities.
  • Visibility – ensure Board members, executives and key stakeholders have visibility of what the current state of the compliance is and what initiatives are being undertaken to enhance them.

In these challenging times, our focus needs to be on providing quality support to our residents, but setting aside our obligations for continuous improvement and compliance does them a disservice. Now, more than ever, we need to enhance our governance and compliance activities; even more lives depend on it.

Vinnie D’Alessandro is Chief Product Officer at Umbrella Solutions.