- Title
- Fit-for-purpose-The bottom-up redesign of the nursing home system: The Australian Aged Care System
- Creator
- Sturmberg, Joachim P.; Gainsford, Len; Pond, Dimity; Goodwin, Nicholas
- Relation
- Journal of Evaluation in Clinical Practice Vol. 30, Issue 3, p. 511-520
- Publisher Link
- http://dx.doi.org/10.1111/jep.13987
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2024
- Description
- 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.
- Subject
- aged care; complexity thinking; health system redesign; nursing homes; regulation; systems thinking
- Identifier
- http://hdl.handle.net/1959.13/1503395
- Identifier
- uon:55324
- Identifier
- ISSN:1356-1294
- Language
- eng
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