Better health and ageing for all Australians

IT for Aged Care Providers: A Step by Step Guide

Planning for IT in the workplace

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Whether you are an IT novice and don't currently use IT, or are a proficient user of IT and are planning some upgrades or improvements to your set up, it is critical that you begin the process with a plan.

Organisations that treat technology as a serious management issue inevitably gain the most value from their IT investments.

Your organisation requires an IT plan because:

  • IT is a major item in your capital and recurrent expenditure budgets. This level of investment needs to be planned strategically, ensuring the best use of resources to meet business requirements;
  • IT continues to rapidly evolve. You should have a well directed plan to ensure best practice solutions with the optimum life span; and
  • IT is an asset like any other. It requires maintenance throughout its life and eventually becomes obsolete or requires replacement. The needs, wants, wishes and proposals for technology refresh are best analysed in the context of a longer term strategy.
It is definitely possible to use existing staff to develop an IT plan – although to do it effectively you'll need to allocate significant time. Alternatively, consultants can be engaged to work with your staff to develop an IT plan, also known as an IT strategy, tailored to your requirements. Your consultant should follow roughly the same steps as outlined here.

Developed in-house or by consultants – either way, an IT plan is a critical component of your overall business strategy.

Electronic Aged Care Client Record Project

The Department of Health and Ageing (DoHA) continues to collaborate with Medicare Australia, Aged Care Assessment Teams and Evaluation Units on the implementation of the electronic Aged Care Client Record (eACCR) project.

The eACCR provides ACATs with the ability to electronically sign and submit the ACCR with the Australian Government for processing within aged care payment systems.

Participating ACATs have the ability to electronically lodge and search client records online using Medicare Australia’s web site. In addition, existing aged care services that have registered for online claiming have the ability to access care recipients' information lodged online through the eACCR.

Benefits for aged care service providers include improvements in data quality, reducing the administrative burden, increased timeliness and accuracy of ACCR processing and improved access to the latest assessment data online.

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A good IT plan

A good IT plan provides a roadmap. It will include an overview of:
    • where you are now (regarding your IT);
    • where you want to be in the medium term (three to five years ahead);
    • where you want to be in the long term (ten years ahead); and
    • how you plan to get from here to there.
An important measure of a plan's quality is its clarity. The plan should be clear, easy to read and practical. Ideally it will become a document that is often used and referred to. Your IT plan must be a living document – subject to ongoing review and revision.

Staff involvement

Involve as many staff as possible in the process of developing your IT plan. The very process of developing a plan can act as an important means of internal communication. Consulting with staff enables everyone to have their say and you will very likely find that your team members:
    • are prepared to candidly discuss issues and concerns;
    • will enthusiastically offer ideas for improvements; and
    • are positive about their inclusion in the process of consultation.
Just talking about IT issues, as part of a constructive process, tends to raise morale and reduce frustration. Remember that an open and inclusive process will lead to a better plan and increased understanding by all.

Emerging issues

As you work through the early steps – clarifying just where you are now – you will find that the subsequent steps begin to emerge by themselves. Any significant problems will become clear and, as people discuss what they wish they had, so too will future directions. The results are sometimes surprising, so remain open minded about the issues that might emerge.

Where are you now?

Planning doesn't have to be a complex exercise and it doesn't require any sophisticated tools. As a first step, it's important to get a clear view of the problems and issues. Decide at the outset what you will include in your strategy. You may just want to concentrate on IT, or perhaps you'll use the opportunity to also look at your telephone systems.

Business goals

Begin by reviewing your overall business goals and objectives. If you have a mission or values statement, write down exactly how IT helps you to achieve those objectives. If there are any shortfalls, note them too. See text box at right for examples.

Existing IT

Collect a list of all your existing IT – hardware (PCs, laptops), software (including which version you use and how many licences you own), any existing contractual arrangements, and so forth. If a diagram would help to clarify what your existing IT set up looks like, create one. Some organisations keep such information in an IT asset register or database. However, if this list is difficult to compile, you may have just identified your first IT issue!
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Aligning IT With Existing Business Goals (some examples)

Business Objective: To ensure a positive work environment that delivers outcomes for clients

IT Response: Our staff and managers require tools that enable them to do their work efficiently. It is becoming clear, though, that technology problems and shortfalls are substantially impacting upon their work. Positive changes to the management and implementation of IT within our organisation will reduce frustration, improve morale and empower staff.

Business Objective: To be financially robust to achieve our goals

IT Response: We need to maximise the value we obtain from our IT investments in sensible and realistic ways. IT can (for example) enable more efficient handling of invoices, better tracking of service delivery targets, and integrated budgeting information.


Consultation

Talk to your team. Try to involve as many people as possible, using one-on-one interviews or group discussions. If you can't speak with everyone, at least try to ensure you include a representative sample of all your workers.

Make sure staff take the discussion seriously by making appointments to speak with them in a space offering privacy (at least an hour is usually necessary).

A suggested question guide is included at the end of this document but remember, it is only a guide. Begin by tailoring the list of questions to your own organisation. And during the discussion, be prepared to put the list to one side if the comments take an unplanned – but relevant – direction. You can always return to the list later in your discussion.

Where you can, prompt for more information – "What problems do you encounter?" "How could we do things better?"

You may believe you already know the answers to some questions, such as "What IT training is available to staff?" But the answers might surprise you. Staff may not know what's available to them, or may be obtaining training through channels you did not know about.

Describe the current IT situation

After the above steps, write up a clear summary outline of the current state of IT within your organisation.

Don't be tempted to be judgemental, just provide a statement that explains how it is. Include any issues or problems that you have discovered. Again, don't apportion blame, just describe the current situation and its implications.

Note that this is not the place to suggest specific solutions, or goals. That comes later.

A sample list of issues is provided in the text box.

Agree on the current IT situation

Before moving on to the next steps, obtain management agreement about the current IT situation. Meet with them to discuss the process so far, the issues raised and your proposed next steps for strategy development.
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A Sample List of IT Issues

  • The current speed and reliability of IT systems and infrastructure do not meet the expectations of internal or external IT consumers, resulting in much frustration.
  • Current IT does not enable managers to access the quality and comprehensiveness of information they require to manage their responsibilities.
  • Our organisation incurs significant inefficiencies and further staff frustration due to duplicated entry, duplicated records and manual local ‘work-arounds’.
  • We have no disaster recovery plan – if the server is destroyed, so are all our records.
  • Our organisation’s core systems (finance, payroll, and client information) each operate separately.
  • Our organisation lacks the level of Internet and intranet capability that is generally expected by staff and clients in this day and age. It is becoming clear, though, that technology problems and shortfalls are substantially impacting upon their work.

Where do you want to be?

Be clear about your goals and objectives – what do you wish to achieve and why? Aim to integrate the use of IT into the daily business of your organisation.

Analyse your current situation

Having developed a clear and agreed view of the existing IT in your organisation – what it is, how it is used, what staff think the problems are – look at IT in terms of the big picture. What are your IT strengths? Weaknesses? Have you identified any gaps that, if plugged, could make your organisation more effective?

If there are a number of issues to be addressed, try listing them in order of priority. Which problem needs to be tackled first?

What Are Others Doing?

Useful sources of information about other organisations in the sector include the Aged Care Association of Australia, your relevant state government agency and the Australian Department of Health and Ageing. These sources can refer you to useful contacts, and often have useful case studies available in publications such as this one or online.

Refer to the end of this guide for further information and contact details.

What are others doing?

Find out what other organisations in the aged care sector are doing in regard to IT. Talk to people within your professional network about what is (and is not) working for them. There are also a number of relevant conferences that you can attend and peak bodies that you can speak to.

Articulate your goals

At this stage it is not necessary to be specific about the IT that might help you to reach your goals. For example, after talking with management and staff, it may be clear that there are problems with the way client information is recorded, accessed and/or managed. As well, your staff might vary widely in their IT skill levels.

A poor way of articulating a goal relevant to these problems would be to assume you know how to resolve it:
    • "Our goal is to buy a YXZ software system in order to manage our client information"; or
    • "We will train all staff in the use of Excel spreadsheets".
At this stage it would be difficult to assume YXZ software is right for you. Or that Excel spreadsheets will continue to be right for you or that all staff should be trained to use them.

Other, as yet unexplored, options might provide better alternatives.

A good way of articulating a goal relevant to the problem might be to state that:
    • "Our goal is to better manage our clients' information"; and
    • "It is recommended that we develop, agree, articulate and implement a staff IT training strategy".
There are several ways of achieving the first goal, including: a brand new IT system; upgrades to an existing system; or using the existing system but implementing better business processes (including but not limited to IT). In the second, the need to take the time to develop a specific IT training strategy is emphasised. As you can see, achieving each stated goal becomes a separate project of its own. Thus the job of implementing your IT plan becomes broken down into manageable, prioritised chunks.
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Link to business goals

Be sure to link your IT goals back to the overall goals of your organisation. An example is provided below.
    • "Better management of our clients' information will lead to better service delivery outcomes through:
        • increased client safety (and a reduction in incidents);
        • better management information (including reporting, and trend analysis);
        • more efficient intake procedures; and
        • increased staff productivity".

Getting from here to there

The last part – the roadmap getting you from here to there – will likely take the form of a number of separate projects.

A number one priority, for example, may be establishing a client information system. Subsequent priorities may include, for example, installing an incident reporting system; upgrading existing PCs; and providing internet access to residents. Each can be tackled as a separate project, with the strategy ensuring that they are implemented as part of an overall, integrated plan.

You may find, however, that there are some things that simply cannot be accomplished. Go down your list and rule these out early. There is no point in wasting time on goals that can't be met, whatever the reason.

You should now be left with a set of achievable goals.

Be specific about each goal that you have identified.
    • Prioritise the identified goals/projects. These priorities may change as projects progress and cost estimates become clearer.
    • Be clear about dependencies – that is, where a goal can only be achieved once other activities have occurred. For example: in order to provide email access for all staff, the organisation must first establish an Internet connection.
    • Name who will be responsible for delivering each goal.
    • Where possible, outline some of the likely project tasks that will be necessary. Be sure to include Change Management as a priority on each project's task list.
    • Set dates for delivery. Deadlines should be ambitious without being impractical. Some projects may be reliant upon others being undertaken first.
    • Estimate the costs of each project. At this early stage it may be best to overestimate, and to clarify the costings as the project progresses (or if a formal business case is required). As a very general guide, software costs tend to be less than half of the overall costs of many IT projects.
    • Outline how you will know that goal has been achieved (for example success measures such as reductions in the time spent administering paperwork, or increased staff IT skills). A crucial question here is "Have we met our original business goals?"

Change Management

Change management is a set of management disciplines and best practices used to ensure a smooth transition and minimal disruption when system or process changes are introduced to an organisation.

The term applies to the activities necessary to introduce change of all types to an organisation.

The building blocks of effective change include:
  • Awareness – of why the change is needed.
  • Desire – to support and participate in the change.
  • Knowledge – of how to change.
  • Ability – to implement new skills and behaviours.
  • Reinforcement – to sustain the change.
Use a timeline to map each project – separately and as a group. This assists with the overall business planning process and will help you to allocate resources appropriately.

Business case development

If a significant investment in IT is required in order to meet one of the specified goals, you may need to develop a business case. Doing this will force you to look critically and in some detail at:
    • the benefits that you're expecting (for example time savings, increased safety, better management reporting); and
    • the anticipated costs (managing the process of purchasing and implementation, software and hardware costs, training, ongoing licensing and support).
An example of a typical business case template is provided at the end of this document.
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Fast fixes

From all the information you have gathered about the organisation, it is very likely that a number of solutions will begin to emerge. Some may need to be explored more fully, others will be simple fixes that may go a long way towards resolving issues and frustrations. Gather together a list of the simple fixes that can be implemented right away, at little or no cost.

Examples of Fast Fixes

Telephones

Assist staff to use the existing telephony system more effectively. Leave a laminated instruction page of common actions next to each phone. All staff members should learn how to:
  • transfer calls;
  • use speed dial and redial facilities; and
  • access voicemail messages.

Microsoft Office

Provide more information to staff about common features of the Microsoft Office suite. Again, a single laminated instruction page at each desk may be useful.

Workplace Change

Begin to establish a workplace culture that values IT skills, by:
  • regularly discussing IT at staff meetings. Discussions might cover staff skill levels, using IT tools effectively, or how IT can assist in service delivery; and
  • engage staff in the implementation of the IT Strategy. This will help to manage staff expectations while at the same time encouraging ownership of IT issues throughout the organisation.

Finalise your IT plan

The main deliverable of this process is an IT plan that provides a specific vision and goals for IT in your organisation. It is important that you present the plan to management and obtain their official approval. Without senior level support, it will be virtually impossible to implement your strategy.

Once management have signed off on the plan, it is also important to continue the communication process that began with the staff consultation. If your planning process has been open and broadly based, the completed plan should not be a surprise to anybody. However, it is still important to develop a communications plan to ensure that all stakeholders are fully aware of the plan's contents and implications. This communication process is the first step in effectively managing the recommended changes.

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