Encouraging Best Practice in Residential Aged Care Program: Final Evaluation Report

9.1 - Alignment of EBPRAC with Government priorities

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The EBPRAC program is among a range of initiatives developed in recent years in response to changing demographics, client preferences and the increasingly complex care requirements facing the aged care and health sectors. New programs have been introduced and existing programs enhanced to address the attendant pressures within acute hospitals, expansion of community care service options and the impacts of disease-specific and end-of-life care issues which are increasingly part of aged care services (e.g. dementia-specific services, palliative care programs). Within this context, service providers have been required to change their practices and provide opportunities to ensure staff have the skills and resources to provide quality care.

At the same time, evidence-based guidelines specifically for residential aged care have been developed to address concerns such as palliative care, pain management and falls prevention. The development and dissemination of these resources have sometimes been supported by education and training initiatives funded by governments, at others times not. Increasingly, these efforts have been enhanced through the development of partnerships between academic institutions and aged care providers in a bid to ensure research, education and training are appropriate to the needs of the sector. Similarly, the federal government has invested in a range of initiatives to strengthen the capacity of the aged care sector, particularly to ‘provide additional training opportunities for existing staff and to create better career paths for all care workers’ (Department of Health and Ageing 2010, p 69). This includes a combination of financial, workforce and systemic approaches:

• The introduction of the Aged Care Funding Instrument in March 2008 which, through the use of validated assessment tools, provides funding based on the assessed need of residents, rather than the care provided.
• The Practice Incentives Program General Practitioner Aged Care Access Incentive which provides a financial incentive of up to $5000 per year for general practitioners to provide increased and continuing services in residential aged care facilities, in recognition of the difficulties faced in providing care in these facilities.
• The Aged Care Nursing Scholarship Scheme and Joanna Briggs Aged Care Clinical Fellowships which provide opportunities to undertake further education.
• The Dementia Care Essentials Program which provides accredited training in dementia care, including care planning, communication, and managing challenging behaviour.
• The Aged Care Education and Training Incentive Program announced in the 2010/2011 Budget which will provide payments to nurses and personal care workers to undertake further studies to enhance their career.
• The Teaching Nursing Homes program which will provide funding of $4 million over four years to strengthen the links between the aged care sector, research and training institutions by supporting the establishment of Teaching Nursing Homes across Australia.

The EBPRAC program fits well within this overall strategic context of addressing the changing needs of residential aged care. It has provided an opportunity to not only extend the reach of evidence-based practice guidelines but also to embed the guidelines in daily practice. The focus of the program has been on implementing existing evidence, although there has been some degree of developing new evidence as the program has progressed, in keeping with the dynamic nature of how evidence is generated.

The EBPRAC program has built on and enhanced existing initiatives. However, there is also an element of duplication. This is particularly the case with the projects targeting dementia, pain and palliative care, which parallel the significant investments by other parts of DoHA. Examples include the Care Planning Sub-Program of the Local Palliative Care Grants Program, which funded 33 projects nationally, over half of which focused on end of life care planning, predominantly in aged care settings; and the Dementia Behaviour Management Advisory Services funded under the Dementia National Priority Initiative, whose role is to ‘build staff capacity in aged care services so that they gain increased knowledge and confidence in understanding the needs of people with dementia and in managing care recipients presenting with Behavioural and Psychological Symptoms of Dementia’ (Department of Health and Ageing 2011, p 4).
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