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,
Those of us working in the aged care sector in Australia have recently watched, in horror, as details have emerged from South Australia and Newcastle of shocking incidents and practices in aged care facilities. This has become public news, rightly so, and the government’s response to public outrage is, usually, to launch an inquiry. Which has, of course, happened.
However, the Aged Care Accreditation Standards, and the way in which those standards are assessed, has been under review for some time already. Actually, many years. There was one crack at it a few years ago, which stalled, but when the Quality Agency took over Home Care the move to make a single aged care quality standard was inevitable.
A few weeks ago, the Department of Health released its final consultation on the draft single set of standards and the assessment / review framework. But yet now the Quality Agency faces another inquiry. What no one has answered, yet, is how these two reviews will meet, if in fact they will at all.
But more importantly than that, have we really addressed the issue of aged care quality in Australia? Do we really know what we want to achieve? Do we understand how facilities work, how the staff in those facilities work, and how to balance safety and a person-centred approach?
The Aged Care Accreditation Standards came about because nursing homes were not accountable for providing quality, safe care – it led to poor outcomes for residents, and a workforce that couldn’t sustain itself. The Standards were all about safety, to start with. There were a few nice things in there about meeting the individual’s needs, but essentially, it was about protecting safety, rights, and overall wellbeing. I strongly believe it still achieves this, overall.
The draft single standards want to go in a completely different direction, and focus more on person-centred care. PCC is a model that is very popular in Australia, because it has worked so well overseas. I feel, though, that no one has asked – are our facilities the same as they are overseas? Is our workforce the same?
I would love to say that Australia provides person-centred care. But we don’t. Not yet. We provide very good care; we have wonderful staff, and we have commitment at all levels, from what I’ve seen, to give residents the best quality of life that we can.
But – we are over-regulated, we are not funded adequately (I’ll concede that the government is reviewing the funding model also), and our workplaces are just not yet set up for true person-centred care.
The trouble with aged care quality in Australia is that the support system it needs isn’t there yet. We need to address that first. I believe that quality will remain the same – despite a new model, standards, or inquiries – until we can address the support system first.
I might be a bit late to the party, but today I received my usual update from Stephanie Evergreen - data visualisation expert - which mentioned her Evergreen Data Academy. It took me about 15 seconds after clicking on the link to the Academy site to decide to sign up. Now, why would a quality manager want to pay to learn about data visualisation? Let me explain..
1. It should be very clear by now that how we "do" human services in Australia is changing very, very rapidly. We are no longer just 'delivering' services, nor do we just have to 'comply' to continue our funding. We are very much moving towards outcomes and competitive models. We need to be able to demonstrate what we are achieving. Organisations that can do that well will have a market edge.
2. How Quality Managers operate within human services organisations must change along with how are organisations will be run. We can't sit on the sidelines issuing reports detailing what people are doing wrong.
We must be able to proactively gather data about how services are running, and be able to display that data in a way that engages the management team to take action. We must also be able to engage clients and potential clients with that data - therefore, it needs to be accessible and appropriate to our audience.
3. A Quality Management professional should never sit still. We need to be the leaders in our organisations; the people others look to for advice; the people that others consult and collaborate with. This requires us to maintain, update, and expand our skills. I have no doubt that data and how it is used and presented is a very important part of the future of Quality Management. I am, therefore, so excited to be part of the Evergreen Data Academy, and I can't wait to start learning!
Best of all, increasing my skills means I can help your organisation more. Contact me if you'd like to talk about your data at firstname.lastname@example.org.
Thanks for reading,
There was a bit of a change of pace in a couple of ways for Day 2 of the forum – firstly, there were tables today! Which I thought was excellent and much better than the lecture layout of day one, as it encourages more interaction with other delegates (most of us are there to network so anything that promotes this is a really good idea). Also the theme for today was focused on healthcare in the Asia Pacific.
One thing that I was immediately impressed with from other countries is the collaboration and sharing of health information across a number of services. Australia does not do this, and it is to our detriment. I fear that our regulatory framework and the diversity of existing systems would make information reform near impossible, but the benefits from other countries are demonstrable.
For me, the talk of the day came from Gustav Strandell, a Swede living in Japan, who spoke about global care models. While I have not had the depth of investigating global models as Mr Strandell has, I too believe that no matter where you are in the world, at one point all of our aged care systems looked the same. Some countries moved away from the old medical / institutional model a long time ago; others are still going through that change. But we can’t judge each other – we can only hope and strive to learn from one another.
I do think that as we are all now so connected, that we are all now moving to the same place – one with the client at the centre of care, one that allows dignity of risk, and that values quality of life. It makes me very proud to be part of such a dynamic sector.
We still have a way to go in Australia before we can achieve what other countries have achieved, and vice versa. Let’s look for the best in each other.
I, of course, am passionate about quality standards as a way of ensuring consistent services and promoting good practice. Please contact me for further information on how I can help your organisation develop and implement quality standards and/or management systems to improve your services.
Thanks for reading,
If you follow my Twitter (which I hope you do!), you’ll have seen my tweets yesterday from the conference. In summary, it’s a very, very long day, but the speakers were great and it was very interesting to hear about how aged care works in different countries.
But I’m a Quality Nerd! I’m here to listen, learn, and talk about quality management. Which was exactly the one thing missing from yesterday. Many of the speakers talked about quality – quality of life, quality of services. But no one talked about quality standards. This really surprised me. Towards the end of the day I had the opportunity to ask a question of Sean Rooney, CEO of Leading Age Services Australia (LASA), who was on a panel discussing the future of assisted living and skilled nursing care for Asia Pacific.
Two other members of the same panel spoke about aged care that very heavily aligns to my own values about human services – that is, that above all else, quality of life is what matters; and that our work must come from a place of love. So my question was: have the Australian aged care quality standards failed; have they stifled innovation; and have they stifled love?
Sean Rooney, as I expected, talked about where the standards came from – to implement safe practices – which lead to a bit of a discussion on risk and the dignity of risk. And I believe that has been the big achievement of the Australian framework – I believe that at the time they were implemented, and even today, they do promote safety and better services for aged care clients.
But that leads to the question – why hasn’t Asia (and other parts of the world) got standards? Have they just skipped past safety? How safe are their services in that case, and who decides that? Asia, it seems to me, has moved past standards to where Australia is only just now coming into – quality of life, and true person-centred care.
I could write another whole (several) blog posts about whether or not I think quality of life outcomes and person-centred care will work under the current funding model in Australia (short answer: no). But for now, I’d like to ponder the question – who is asking about safety and risk in aged care services in Asia, and who is deciding what that looks like?
I’d love to hear from you, especially if you are in aged care services in Asia.
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,
The not-for-profit (or for-purpose) sector and its stakeholders (especially government) have been flirting with outcomes measurement for a long time. Sometimes it’s felt like a game of cat and mouse, or ‘will they, won’t they’. The sector’s interest and commitment to outcomes measurement within its organisations has wavered in line with what it’s perceived as ‘likelihood of threat’. This, actually, is not a great way to live, or operate, or manage.
So, can we, the sector, say now is the time? Because now IS the time! It really is! Performance measurement, measuring social outcomes, social impact, social bonds – all this stuff – it’s been around now for a REALLY LONG TIME. And as a sector, we STILL haven’t fully embraced it? Sometimes I find that so hard to believe, because it really would not be too hard for each and every organisation to measure ONE THING.
If I seem overly passionate about this, I am! I truly believe we need to measure in order to know that our services are making the difference we want them to make. We are constantly saying that ‘the system is broken’, or we lack funding, or we need new ways of getting funding – so let’s measure. Let’s show the difference we’re making. Or if we’re not making the difference we want, measuring gives us the opportunity to improve. There is no downside.
So I just wanted to share three of articles / resources that might fire up your interest, if you’re new to outcomes or measuring.
From Social Ventures Australia:
Managing to Outcomes: What, Why and How?
Finding the golden thread: A new approach to articulating program logic
From the Centre for Social Impact:
The Compass: Your Guide to Social Impact Measurement
If you have any more, please let me know in the comments!
I have been a huge fan of Christopher Paris’s work essentially since I first started in Quality Management way back when. His Eyesore 9001: A Smartass’s Guide to ISO 9001:2000 (now in 2008 version) basically saved my bacon when I was a Quality newbie. It was useful and applicable, and it told me that I wasn’t going crazy and that no matter how ISO tried to dress up 9001 as a standard for both ‘products and services’, it really, really wasn’t written for services at all (or by anyone who understood service organisations?), especially human services.
For ISO’s 2015 version of 9001, Paris hasn’t released an Eyesore – instead he went down the rabbit-hole and has written and published an entire book. This book is the most comprehensive drill-down of the ISO 9001 that you will ever read. How Paris made it out of his analysis alive and sane could be considered a miracle (or did he? Someone let me know), as he has really left out no detail – it’s pretty much a word-by-word breakdown of what is, in my opinion, the worst written anything of everything.
I have, since the beginning of my Quality career, been a huge critic of the use of ISO 9001 in human service organisations. I absolutely believe that organisations should have management systems in place, and should be concerned about the quality of their services and how they achieve quality for their clients. But it scares me that governments have written into service agreements that human service organisations must be certified to ISO 9001, and that some organisations are voluntarily opting-in (because they think it helps prove that they’re doing the right thing) when the standard just isn’t written in our language and is still very much “we make products” focused.
(Also, governments, there are so many human services quality standards you can now pick from that you could ask organisations and services to demonstrate compliance to (without needing them to be certified if the standard is from another state). Why waste time with ISO 9001?)
Paris’s book is amazing, right from his documentation of the history of how the standard comes about (which should be appalling to all of us quality professionals), to his breakdown of the clauses, to how we can apply it in our organisations – but (and this is not Paris’s deficiency, but rather my conclusion), his book only further convinces me of the unsuitability of ISO 9001 for our industry. That being said, if you do work in human services and you do need help figuring out ISO 9001, this is the best book you could buy to help you.
PS – this blog post is not sponsored, and I don’t know Christopher Paris and I’ve never done any work with Oxebridge. I just really respect what he is trying to do and I have genuinely found his work to be very helpful to me as I’ve tried to navigate the ISO 9001.
I've been going to a store for almost a year and a half now. I've never been satisfied with their service: there's never enough people available, it's slow, I have overheard staff be rude about customers, and swear - things that when I was working in the same job were unacceptable! But I've never said anything - let's face it, making complaints in person can be uncomfortable. But today, after another bad service experience, I just felt like I had to.
As a Quality professional, I deal with complaints all the time. So when I make them, I stick to facts, why something is an issue, and I always strive to be professional (even though it's in my personal life) and polite. Which is why I was so surprised when my complaint was met with disdain and disagreement. I just had to write this blog post about it, and what we can all do to make the complaints experience a positive one.
1. Firstly know that your body language means more than the words you say - the supervisor I spoke to today about my complaint continually raised his eyebrows and frowned. That to me says "I don't believe what you're saying, and I'm annoyed that you're saying it". Even if his words had been nice, I would have thought he was lying just to get rid of me. It sounds strange, but it pays to practice in the mirror how you'd respond to a complaint so you can see what your face is doing - it should be relaxed, open and signal to the complainant that you care about what they're saying.
2. Number 1 being said, you still have to say the right things - today I was told by this supervisor that he thought they provided good customer service. No other comment. But, I'm the customer! And he forgot that. In the end, your customer is the person that tells you if your service or organisation is on track. It's not easy to hear that they aren't satisfied, but it's important. What the supervisor should have said is "I'm sorry to hear you haven't had good service experiences here. What could we do to improve on that?" Saying sorry isn't saying "you're right" - it's acknowledging what your customer is feeling. Asking them how to improve turns a complaint into an improvement action, and makes the customer feel like you do care.
3. Thank you, thank you, thank you - no one likes to get a complaint; it's disappointing, especially when you think you've been doing great. When receiving an initial complaint, it's natural to want to defend your business / service - but it's not always the right time. The supervisor today was defensive, so I kept raising issues (nicely). If he had said the sorry sentence as per number 2, and then said "thank you", my complaint would have been left at one or two issues - instead of blowing out to five. And in the end, we should always thank our customers for their complaints - in human services, especially, it can be a brave act.
I know it's been said over and over, but complaints really are a useful tool to help organisations improve. Your customer is the reason why you exist - if they're not happy, don't you want to know? By following my tips above, you can turn the complaints experience into a positive one with a positive outcome - which leads to happy customers!
The Chartered Quality Institute (CQI) is a UK-based chartered professional body for quality professionals. I’ve been referring to their website for years—they've got some great resources, including a newsletter and magazine that are usually well worth the read.
Recently, the CQI developed and released on their website a Competency Framework. The following is directly from their website:
The framework is designed to:
I was really happy to see that something like this was developed—quality management may be well-embedded into many industries, but here in Australia, and particularly in human services, it still feels like we’re a poor substitute to some other career. That is changing, and I think that a framework like this one
helps to position us as a professional body.
There are five sections to the framework: context, governance, leadership, assurance,
All aspects of the framework I think are important, but in the context of human services in Australia and where we are heading, for me, the leadership component really stands out. It says:
Uses leadership behaviours to maximise influence and develop a culture of evaluation and improvement.
The key words there are ‘leadership behaviours’. The CQI explains this in detail on their website, but for me it means:
· Are you objective and fair in your measurement of the organisation, not allowing your personal feelings or the feelings of others to influence your assessments?
· Do you approach each day with positivity, and rather than think it’s too hard you think ‘how is it possible?’
· Do you want to know ‘why’ rather than ‘who’?
· Do you have an enquiring mind; are you ready to learn and be open to other ways of doing things?
The links above will take you to the actual framework diagram and explanations of the above, so I won’t regurgitate them all here; rather, I encourage you to take a look and see how the framework might apply to you. This would be particularly useful if you are just setting up a quality department or role and are wondering what it is quality people actually do!
Thanks for reading,
The Quality Nerd loves all things Quality Management and Internal Audit...too much is never enough!