There has been a lot happening in the disability and aged care sectors, but of course one of the biggest things impacting organisations has been the development and release of the new NDIS Practice Standards (replacing all state-based quality standards like the Human Services Standards and Human Services Quality Standards) and the Aged Care Quality Standards (which brought together the Aged Care Accreditation Standards and the Home Care Standards).
These two new standards are not vastly different from what we had before. But they do require some effort to implement in your organisation, so that you can be truly ready for the next time an external auditor comes to visit. Here are three things that you can do:
A consultant like myself can help you with steps 1 and 2 above, but step 3 will always be up to you, and it is a crucial step. Remember to keep records of your transition – include what you’re doing in your Improvement Plan, ensure you have a system for keeping records of any new process (e.g. signing new Codes of Conduct, adding new training to your Training Register).
If you do need help with steps 1 and 2, give me a call! I can work across all states and territories and can currently offer a quick turnaround for your project.
Thanks for reading,
It's been a huge year for me at The Quality Nerd, as I followed my dreams and made the business my full-time job. I'm infinitely grateful for my clients that made the leap possible, and I'm very much looking forward to continuing to work with you in 2018.
For 2018, I hope for the following:
1. To support new businesses with their first external audits - if you registered as an NDIS or Home Care Provider in 2017, you will probably have your first audit in 2018. An audit can be scary if you haven't been through one before, but a great way to calm your nerves is to be prepared by having an internal audit. I have over 10 years experience in internal auditing, and I can help you with a desktop audit, or come to your site / office to thoroughly review your records.
2. Continue writing - I love to write, especially policies, procedures, tender applications, and self-assessments! I'm certainly not called a nerd for nothing. In 2018 I would like to support businesses by helping them write documents for their processes that are meaningful, useful, and compliant to requirements.
3. Travel with purpose - this links in with goal #2, in that I'd like to do more pro-bono work in 2018. That's right, if you're a small human services or animal welfare organisation, and you need some support with quality, processes, or management, I offer 1-2 days onsite of my time to help you with your business issues. All I ask is for permission to write a de-identified case study about you.
If you'd like to start 2018 with a business bang, please contact me any time: firstname.lastname@example.org
Thanks for reading,
Good morning and happy Friday!
Just wanted to share a great post from Process Excellence Network, and contributor Debashis Sarkar, 10 Reasons Why Employees Don't Follow Organisational Processes.
I think all of these are spot on, but for human services specifically, I think number 1 (not believing in process), is the reason why we struggle with process compliance in so many human services organisations.
Let me know which of these you think is our biggest issue in human services in Australia, I'd love to hear from you!
Thanks for reading,
I'm sure this has happened to all of us. It's usually when someone new joins your organisation / team, most likely in a management role. Brimming with energy, they see problems and they want to fix it. Or they want things to work as they did their last job. So they charge through a process change, implement it without any real consultation, breathe a sigh of relief, and then sit back and wait to be praised.
Have you experienced what happens next? That staff don't fully embrace the change because they don't really understand it, or why the process has been changed at all. Or that there's re-work because the change to the process wasn't really thought out and had unintended consequences.
I feel stunned every time I see this happen, because it demonstrates what I consider to be really poor management and leadership skills. I understand that, as managers, we often feel that our experience knows best, we know what works and what doesn't, and that if only things worked our way, then the business would be better. But to change a process without actually ever having done the process is fraught with danger.
Doing the process doesn't necessarily mean you're the one doing every task. But at the very least, you should see how the process works from start to end, several times, before you start making any changes to it. Why? Because not all businesses are the same, and not all humans work the same. You also need to know that if you change anything, that it will actually work - so you need to know how long something really takes to be done, how many resources are needed, etc - and you cannot know this unless you've done the process.
Sometimes process change has to be quick - but taking at least some time to do the process is vital so that you know that when you make those changes, that they'll actually work. It's certainly better than the embarrassment of having to go back and re-do the change, or, worse still, have the process fail completely.
As always, if you have any blog topics that you'd like me to write about, please let me know.
Thanks for reading,
I hope everyone has had a happy Easter / public holiday break. Personally, I've been taking it a little easy and trying to catch up on some sleep!
However, I still always have time for Quality. Last week I came across this great infographic that I had to share. Created by Rick Torben and from from his website, this is a handy list of the Top 40+ questions to ask before embarking on any change. If you are about to start a project or even just have an idea for improvement, I'd be printing this off and using it as a guide to kickstart your process.
I don't think you need to ask every question for every change—after all, sometimes we are only tweaking a process, other times we are conducting major systems change. For smaller changes, or if you're just starting out in quality management or change processes, just going through #2 of the list would be a great start. But always, always must we ask this question from #1: "What will tell us that we've been successful?" and all of #6 - review!! Without doing this, you'll never know if the change you made is actually an improvement. And if you don't know that you might as well have done nothing at all.
I've realised after I've embedded this that it doesn't quite fit onto my page. My apologies, I've tried several ways to do this but no luck. So please view this as a taste and click to view the full infographic in Rick Torben's website.
Thanks for reading,
At some point in the life of your quality management system you will need to document how something is done (I say 'document' but these principles will apply to whatever format you use—written, video, voice or picture). Developing a procedure requires a delicate balancing act—too little information and you may not be controlling risk effectively, or your procedure may be plain wrong. Too much information, though, and staff will just tune it out. Here are a few tips on how to write one that works:
1. Start with a scope, criteria and objective, or, the who, what and why—who does the procedure relate to? What does it connect with (link with standards, legislation, guidelines)? And why does it exist? For example:
Procedure: Client Review and Re-assessment
Scope: Services providing Home Care Packages.
Criteria: Home Care Guidelines (August 2013).
Objective: To ensure that all clients are reviewed / re-assessed in a timely and cost-effective manner according to their need.
2. I've talked before about using flowcharts to document procedures—specifically, I think swim lane flowcharts are good because they show who is responsible for particular tasks (Visio is best for creating these types of flowcharts). If you're not into flowcharts, however, lists can also work well if you need your procedure to be in written form.
One thing to remember when creating a procedure is to ensure that you have carefully considered everything that goes in, and will come out, of the process you are documenting. This is not a new formula by any means, but one that I find simple and helpful:
Inputs - Actions - Outputs - (Outcomes - optional).
Inputs are transformed by actions into outputs. So for a referral procedure, you might have an intake form (the input), which, after it's been completed, becomes the output (a completed intake form filed in the new client's file, for example. Specifying inputs and outputs is useful as it ensures that your staff are clear on what they need to use, and what should be the result of their actions.
3. Ensure that you make connections to other relevant procedures and forms, the purpose being that if you make a change to one you will know what other documents need changing. If you have the time or inclination, documenting these in a documents register or similar makes for quick referencing when documents are changed.
4. I cannot stress this enough—document control! Put a version number and date on everything. Remember, you are controlling risk by documenting your processes. You are also ensuring that your processes meet legislation, standards, guidelines, etc. You need to be sure that your staff are using the right documents and doing the right thing.
Helping organisations set up or review their processes and documents is part of the service that The Quality Nerd provides, so if you do need help, please contact me—I know it can feel overwhelming. But you can achieve much by keeping it simple.
Thanks for reading,
Overheard earlier this year while on holidays:
“TQM, ISO, KPIs, I tried all that. They’re all shit.”
After I had a little chuckle to myself for the coincidence that I would overhear something like this while on holidays after just starting my own business, I really wanted to go over and speak to this person and find out how I could help. Unfortunately, I didn’t, but here is what I would have like to have said.
Firstly, all of those are totally different things. TQM (Total Quality Management) I consider a ‘style’, if you like, for quality management. I believe by saying ‘ISO’ this person was referring to the 9001:2008 standards. And KPIs are indicators, of course, used for measuring how well we’re doing something.
I see this an awful lot—businesses jumping from quality management hot topic to another, usually so rapidly that they never really embed anything and therefore don’t allow any system to be successful. If you do this, I’m not surprised you would think they’re all shit! It would feel like a lot of time and effort spent on nothing but the same results you were getting before. So, is there any way we can make quality management less crap? Here are my top three tips! But, before that, a little secret:
There is no magic formula for quality management, and no catch-phrase system that will make your organisation immediately and suddenly perform better. Quality management is really simple—identify your processes, assess their risk, measure them, control them, evaluate them. This does take time, but if you start small and begin with the end in mind, it is achievable without exhausting your resources.
1. Take the time to design your system well—this includes all elements, but especially if you are using software or the intranet. Begin with the end in mind is a phrase I cannot use often enough! Mind mapping is great for this exercise, start off with your idea of the perfect system and work your way back to how you can achieve it. This is still possible if you already have a system in place but you want to improve it. Your system isn’t stone—it might take a bit longer to change, but you can still do it.
2. Don’t overload your system with documents—by this I mean if you have one line policies or four-point procedures, you really need to ask yourself if this is useful or merely in place because you want to say you have one. Ask yourself if you really need separate policies and procedures or could you combine them into one document? Remember—if you don’t use it, lose it. And a smaller number of documents makes reviewing them much quicker.
3. Prioritise—take the top three things you want to improve. Through whatever exercise you choose, identify what you’ll do to improve them. Now, this is the really important bit, what will they look like after you make these changes? Will you go from being able to do client reviews in three hours to 30
minutes? Will your wait list times reduce? Give the change some breathing space, then go and see what happened. Okay, if it worked, great, you can move onto something else. If it didn’t, that’s cool too—now you know, and you can try something else.
Sometimes issues are complex and require complex thinking, longer timeframes, and more work to solve. But I believe every issue can be handled by sticking to a ‘simple is bliss’ philosophy.
Are you finding something in your Quality Management System really challenging? Please feel free to comment or drop me an email.
Thanks for reading,
Quality management, for me, exists to help organisations consistently deliver their product / service, and to provide a framework for improvement. And the best way it works is through the process approach. For service organisations, we need to know that we are meeting our clients’ needs. We also need to be sure that we are meeting those needs in a time-efficient and organisationally effective way (that is, right number of
staff, resources and support).
In human services, as we move towards client-directed service models (such as the NDIS and Consumer Directed Care for Home Care Packages), knowing that we are delivering a high-quality service is vital. So what do you do if you notice that things aren’t going so well? Maybe an increase in complaints, a budget going in the wrong direction, or, worst of all, your clients start leaving. You need to be able to clearly identify where things have gone wrong, and improve on it—and quality management can help you with that.
So, if you have already set up your system, hopefully you will have done so using a process approach. It should be fairly simple to identify where things are going wrong—take a look at your complaints / incident data, budget, and staff and client improvement suggestions. Once you’ve got your process:
1. Map or flowchart it. Use a whiteboard, post-its, Visio…it doesn't matter what you use, just take the time to get it down thoroughly. Always get the help of a team who actually ‘do’ the process.
2. From your process map, and from asking staff, can you see where the pressure points are? What parts are messy, duplicated, onerous? Highlight these.
3. Look for linkages with other processes—are there other factors influencing how well the process is working?
4. Suggest improvements! Now that you can see the process in front of you, and those pressure points, what can you do about it?
And now here’s the most important step:
5. Make sure that you articulate what change you want / expect to see, develop a way to
measure it, and come back to the process later to evaluate whether or not your change worked.
Now that bit above in bold is probably the step that doesn’t happen the most, yet it’s the most important. Do not change for change sake. If you don’t know what improvement you want to see, and then you don’t go back and check that you’ve actually improved, you are missing a huge part of the puzzle. Check if it works! That’s the bottom line.
If you have any questions about process mapping or improvement, please don’t hesitate to ask! Suggest a blog topic or send me an email with your question.
Thanks for reading,
The Quality Nerd loves all things Quality Management and Internal Audit...too much is never enough!