Chee, S. 2007, “Gerontological implications for the built environment”, pp. 1-10.

Abstract

Title: Gerontological implications for the built environment
Keywords: aged care, residential care, built environment for the elderly
Category of paper: Research paper
Purpose: To highlight the role of the built environment in maintaining the independence of the elderly and disabled
Methodology: Case study
Findings: This paper shows that architects and designers are as important as health and social care professionals in meeting the needs of our fast ageing population.
Implications for practice: The paper underlines the importance for policymakers and planners to create accessible built environment design to benefit all citizens, not just the able-bodied
Implications for theory: This paper also highlights the need to identify specific areas of gerontology studies and research methodologies that could contribute towards creating good built environment design for all citizens
Number of pages: 10
Number of tables/figures: 1
Section headings: Introduction, Adult care options, Successful adjustment to ageing, Challenges to the physical environment, Personal case study, Conclusion, References

McCabe, M.P., Davison, T., Visser, S., Hudgson, C., Buchanan, G. & George, K. 2007, “ Effectiveness of staff training programs to manage behavioural problems with dementia”, pp. 11-23.

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Abstract

Title: Effectiveness of staff training programs to manage behavioural problems of dementia
Keywords: behavioral problems, dementia, quality of life, staff training
Category of paper: Research paper
Purpose : Behavioural problems among older people with dementia are a major concern in nursing homes. This study was designed to evaluate the effectiveness of staff training programs on both staff and residents.
Methodology : Two programs (standard dementia care, individualised behaviour therapy) were compared to a control condition. A total of 90 staff and 113 aged care residents participated in the study.
Findings: The results demonstrated an improvement in the self-efficacy of staff who received either training program at post-intervention, and at three- and six-month follow-up. Facility managers also rated an improvement in the performance of staff who received behaviour therapy at post-intervention and at follow-up. There were no changes in behaviours or quality of life for residents in any group.
Implications: Staff education programs may not assist in the management of behavioural symptoms of dementia, but can improve staff attitudes. Other explanations and suggestions for future research are discussed.
Number of pages: 13
Section headings: Introduction, Method, Results, Discussion, References

Ranasinghe, D. 2007, “ Risk management in aged care: where should it begin?”, pp. 24-35.

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Abstract

Title: Risk management in aged care: where should it begin?
Keywords: Continuous Quality Improvement, Risk Management, Aged Care Facilities, Resident Classification Scale
Category of paper: Project report
Purpose of the project: In order to integrate risk management into the system and processes of residents care, in 2004, the author initiated an ‘Incident Management' project in aged care. Numerous incident reports as well as resident care assessment forms were reviewed for the project and it was found that risk management components were not included in either incident reporting or assessment processes. Most of the resident assessments were not even focusing on resident care outcomes but on Resident Classification Scale funding tools. After chart and document reviews, the author decided to, first, develop a better incident report format which included risk identification and a monitoring system and, second, introduce risk assessments into the resident care assessment process.
Methodology: After a literature search and documentation audits, the author decided to use a combination of case study and action research methodology in this project. The literature search did not find any articles on risk management in care delivery in aged care. Risk management in aged care mainly focused on occupational health and safety and resident falls. The case study indicated that a user-friendly incident report format was needed for staff to document the required information. The first step in this project was investigating incident reporting and management systems. This paper explains the sequence of steps that were taken to develop an incident report form to include risk monitoring mechanisms and introduce risk identification in resident assessment processes. The author has integrated the risk management concept into the continuous quality improvement process in aged care rather than looking at risk management as a separate issue. The paper highlights the different perspective of risk management, especially in aged care. The author describes a simple and practical way of managing clinical risks by implementing a risk assessment system which will monitor, measure and evaluate compliance requirements of the aged care outcomes.
Findings: Firstly, staff in aged care facilities report incidents such as resident falls, skin impairments, challenging behaviours, medication discrepancies. However, it was found that 85% of the completed incident reports did not have adequate information of what actually happened, and there was no documented evidence to indicate that an investigation had been conducted to identify the cause of the incidents. With the introduction of the new user-friendly ‘Incident Report Form', staff completed the relevant information accurately. In addition, investigations were conducted (most of the time) because the new format included an investigation component. Secondly, very little emphasis had been placed on assessing risk in care delivery. Most assessment forms are based on Resident Classification Scale funding questions rather than finding out what the risks of care were for the individual. Residents were assessed and risks identified in certain components of care delivery using new resident assessment forms, developed from the National Framework Assessment forms (Department of Health & Ageing 2005). As a result of this project, staff at participating organisations developed an overall awareness of risk management culture in care delivery.
Implications: Risk management needs to be integrated into aged care continuous quality improvement processes sooner rather than later. The majority of residents living in residential care facilities have severe or, more often, profound disabilities due to a range of medical conditions, such as physical and cognitive impairments. Therefore, the care of elderly persons is complex and often high-risk. The author strongly believes that aged care needs to adapt risk management into continuous quality improvement.
Value of the paper: This report will be valuable to practitioners in the aged care industry.
Number of pages: 12
Number of tables/figures: 1
Section headings: Introduction; Risk management; Risk management in aged care; Project background; Project steps; Conclusion; References

Sheffield , J. & Lau, E. 2007, “ Surfacing philosophical assumptions in health knowledge management”, pp. 36-51.

Abstract

Title: Surfacing philosophical assumptions in health knowledge management
Keywords: Health knowledge management, knowledge interests, inquiry
Category of paper: Research paper
Purpose of the research: The paper reduces ambiguity in diverse approaches to health knowledge management by developing foundational theory.
Methodology : Foundational theory is developed by organising diverse approaches to health knowledge management research into conceptual domains, and relating these domains to knowledge management perspectives and philosophical assumptions.
Findings: The conceptual domains in health knowledge management are: personal learning (knowledge creation); communities of practice (knowledge normalisation); and the exercise of technical expertise and technology (knowledge application). These three conceptual domains are related to knowledge management perspectives and anchored in philosophical assumptions about the interests served by knowledge and the nature of inquiry.
Value of the paper: The development of these conceptual linkages is of value to practitioners and researchers who address knowledge phenomena in which facts, norms and values intertwine. More generally, the paper contributes to the literature that seeks to understand systemic complexity in health knowledge management via awareness of one's own epistemic commitments and those of others.
Number of pages: 14
Number of tables/figures: 7
Section headings: Introduction, Conceptual domains in health knowledge management, Knowledge management perspectives, Philosophical assumptions, Results and discussion, Conclusion

Cheek, J., Ballantyne, A., Gillham, D., Kroemer, D. & Quan, J. 2006, "Interagency collaboration and sustainability: making it work", pp. 1-11.

Abstract

Title: Interagency collaboration and sustainability: making it work
Keywords: older people, service provision, collaboration
Category of paper: Case study
Purpose of the case study: The issue of caring for an ageing population is one facing many countries. In particular, the expected decrease in informal care provided by families and the like is expected to put increased pressure on the formal health and community care service systems. The increasing demand placed on aged care services often means that service providers have to work together to ensure the best outcomes for their clients. Increasingly, interagency collaboration is seen as a necessary part of effective service provision. In addition, service providers are aware of the need for collaborative efforts to be sustainable. However, what makes a collaborative effort successful and sustainable is less clear to service providers. Therefore, the impetus of this paper was the need to address issues of collaboration between service providers and the sustainability of these types of programs in the provision of services to older people and their families.
Implications for practice: These principles may provide useful guidance for future collaborative projects addressing the challenges of service provision to an ageing population.
Value of the case study: The paper will be of interest to academics, aged care service providers and policy makers.
Number of pages: 11

Curran, J., Brushe, V. & Leonard, G., 2006, "A survey of staffing supply levels in aged care in the Coffs Harbour Local Government Area and Mid North Coast to Ballina region of New South Wales", PP. 12-25.

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Abstract

Title: A survey of staffing supply levels in aged care in the Coffs Harbour Local Government Area and Mid North Coast to Ballina region of New South Wales
Keywords: aged care, nursing workforce, caring skills, nurse training
Category of paper: Research paper
Methodology: A survey was carried out between August and October 2003 of all aged care facilities and services in the Coffs Harbour Local Government Area and of a sample of aged care facilities in all major coastal population centres between Ballina and Forster, in New South Wales . The survey was conducted by face-to-face interviews with the relevant manager or Director of Nursing of each facility.
Findings: Analysis of data obtained from the survey indicates that, within the next five years, there are likely to be major shortfalls at all levels of the aged care workforce.
Implications for practice: The shortfall predictions obtained from this survey demonstrate the need to increase the region's number of nursing student positions, both at the Technical and Further Education (TAFE) level and at the university level. These data were used to justify a School of Nursing at the Coffs Harbour Campus of Southern Cross University. One hundred nurses a year are now enrolled in a three-year course, and the first batch will graduate in March 2007, just in time to match a crisis in staffing at the Coffs Harbour Base Hospital and the pressing needs of local Aged Care Facilities.
Value of the paper: This paper shows that:

• Current staffing supply levels are inadequate for existing demand, although the potential for increased staffing levels is inhibited by financial constraints;
• A large proportion of the existing aged care staff is greater than 45 years old, with up to 25% of managerial and clinical staff due to take retirement or long-service leave within the next five years;
• High turnover rates occur, with managers experiencing high stress levels, and nursing staff dissatisfied with wages and working conditions.

Number of pages: 14
Number of tables/figures: 2
Section headings: Introduction, aims, methodology, results, discussion, summary, acknowledgments, references

Ranasinghe, D. & Miller, P., 2006, "Continuous quality improvement in Australian aged care facilities", 26-46

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Abstract

Title: Continuous quality improvement in Australian aged care facilities.
Keywords: aged care, action research, continuous quality improvement (CQI), statistical process control (SPC) tools, indicators.
Category of paper: Research paper
Purpose of the research/paper: This study examines the continuous quality improvement process in Australian aged care organisations. In particular, it seeks to identify what measurement and monitoring instrument is best suited to monitor and measure the impact of changes in the Australian Aged Care Standards.
Methodology: Action research
Findings: The study finds that an indicator system can monitor and measure the impact of continuous improvement processes of the Australian aged care outcomes. The general level of knowledge and understanding of the use of CQI in aged care improved following workplace education and training. In particular, knowledge of data collection techniques improved among the aged care workers who participated in this project. The study finds that action research projects can increase workplace knowledge and improve work practices.
Implications for theory: The study demonstrates that action research methodology can be used to develop a scientific and clinically significant indicator data collection system.
Implications for practice: The paper demonstrates that changes in work practices require education, not just changes in policies and processes.
Value of the paper: The findings of this research will be valuable to academics, practitioners, managers, consultants, and policy makers in the aged care industry.
Number of pages: 21
Number of tables/figures: 2
Section headings: Introduction and background to the research , literature review, methodology, discussion and conclusion.

Sankaran, S., Shepphard, A., Cartwright, C. & Kelly, J., 2006, "How can we develop a leadership capability framework for non-profit Australian health and community care organisations?", pp. 47-60.

Abstract

Title: How can we develop a leadership capability framework for non-profit Australian health and community care organisations?
Keywords: leadership, capability, non-profit organisation, community care
Category of paper: Research paper
Purpose of the paper: To review the literature on leadership development in the for-proft sector and the Australian Public Sector in order to better understand how a leadership capability framework can be developed for the Australian non-profit sector.
Methodology: Literature review
Findings: There is a lack of research in leadership capability development in the health and community care sectors among NPOs in Australia.
Implications for theory: An investigation into leadership capability development in the non-profit sector focusing on organisations involved in health and community care would be a contribution to knowledge that would be beneficial to all NPOs that are providing services to the public in an environment where both the private and public sectors also play a role in the Australian society.
Value of the paper: This study is an important first step in creating a leadership capability framework for non-profit organisations who, along with for-profit and government organisations operating in the same sector, are key contributors to the social capital of Australia.
Number of pages: 14
Number of tables/figures: 3
Section headings: Introduction , leadership, managers and leaders, competency and capability, from competency to capability, leadership capability in the Australian Public Sector, emergence of non-profit organisations, developing leaders in the non-profit sector, conclusion, references