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

1.1 - EBPRAC program

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The Encouraging Best Practice in Residential Aged Care (EBPRAC) program commenced in late 2008 with the aim of achieving evidence-based improvements for people living in residential aged care facilities (henceforth referred to simply as ‘facilities’), the staff caring for them, the aged care system and the broader community, summarised in the seven program objectives:

Improvements for residents

• Improvements in clinical care

Improvements for staff

• Opportunities for aged care clinicians to develop and enhance their knowledge and skills
• Support staff to access and use the best available evidence in everyday practice

System improvements

• Clearer industry focus on improvements to clinical care
• Wide dissemination of proven best practice in clinical care
• Develop national clinical or educational resources and evidence summaries that support evidence-based practice in aged care and are able to guide the ongoing development of accreditation standards

Community impact

• Build consumer confidence in the aged care facilities involved in EBPRAC

The program consisted of two funding rounds, with a total of 13 projects (Table 1). Round 1 commenced in late 2007 and ran until December 2009. Round 2 commenced in late 2008 and ran until December 2010. The length of each project was 24 months, except for two projects which were 22 months in length. Each project required the support of management in participating facilities and focused on improving resident care by taking into account gaps in current care practices. The objectives were supported by four key priorities which give further insight into what the program was meant to achieve and the means to do this:

• Improving quality of clinical care for residents in Australian Government funded aged care homes taking into account resident preferences.
• Communication of the changes required as part of this project to the residents and their families.
• Implementation of change management processes across all levels of staff to ensure that clinical best practice is accepted and informs care delivery.
• Improving clinical capacity and staff skills through a multi-disciplinary approach.

Further details of each project are included in appendices 1-13 in this report. The funding information in Table 1 includes $600,000 in additional money for the South Australian Dental Service project to develop resources for the national Oral and Dental Health Care Plan. The abbreviations are used to identify projects throughout the report, particularly in tables.
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Table 1 EBPRAC projects

Abbreviation	Lead organisation	Clinical area	Funding (excl. GST)
Round 1
DATIS meds	Drugs and Therapeutic Information Service	PRN medications	$511,511
NARI falls	National Ageing Research Institute	Falls prevention	$1,072,980
NARI pain	National Ageing Research Institute	Pain management	$1,057,183
SA dental	South Australian Dental Service	Oral health	$1,793,184
UN nutrition	University of Newcastle	Nutrition & hydration	$821,338
Round 2
HC behav	Hammond Care	Behaviour management	$907,187
MU behav	Monash University (later Flinders University)	Behaviour management	$1,272,225
MGPN pall care	Murrumbidgee General Practice Network	Palliative care	$755,353
NEVDGP pall care	North East Valley Division of General Practice	Palliative care	$873,480
PW inf control	PivotWest	Infection control	$703,116
QUT wounds	Queensland University of Technology	Wound management	$885,425
UQ pall care	University of Queensland	Palliative care	$1,375,098
UTS behav	University of Technology, Sydney	Behaviour management	$890,158
		Total	$12,918,238

Details of participating facilities are summarised in Table 2. Less EBPRAC facilities are located in major cities (51%) compared to the country as a whole (61%), with more EBPRAC facilities located in inner regional and outer regional areas (total of 47%) compared to the country as a whole (37%). Two facilities are located in remote or very remote regions.

The main providers of residential aged care across the country are religious organisations (29%), private providers (28%), community-based providers (17%), charitable organisations (16%) and state governments (9%) (Australian Institute of Health and Welfare 2009). Amongst the EBPRAC facilities ownership reflected the pattern for the whole country except for a smaller percentage of private facilities (16%) and a greater percentage of state government facilities (19%).

Table 2 Facility ownership and location

Ownership		Location by state		Location by remoteness
Type of ownership	No.	State	No.	Remoteness category	No.
Charitable	14	New South Wales	22	Major cities	55
Community-based	18	Queensland	14	Inner regional	34
Private	17	South Australia	23	Outer regional	17
Religious	38	Tasmania	2	Remote	1
State government	21	Victoria	43	Very remote	1
		Western Australia	4
Total	108		108		108

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