04-Oct-2011 With big money being spent on installing IT in aged care, researchers and providers are examining what's required to ensure success. Beverley Head reports.
Computer literacy is expected to become a requirement for aged care staff as electronic records and medication management systems become ubiquitous. But, for many aged care providers, taking their current staff on the journey to the electronic age can be a challenge.
Dr Ping Yu, a senior lecturer at the University of Wollongong, is coming to the end of a three year research project which is intended to shed some light on the factors that lead to a successful introduction of computer systems in aged care facilities. Yu's earlier research involved examining the IT literacy of aged care workers and their attitude toward computer systems, and how that impacted on the success of automation projects.
She said that although general literacy and computer literacy among aged care workers was low, "this cohort is quite keen to learn computer skills." However, she warned that "for 50 or 60 year old ladies it can take them a few years to become fluent with the keyboard".
Her warning echoes a June report from the Council of Ageing (WA) report in association with the Australian Communications Action Network, which found that few senior women were going online in general, in part due to a lack of skills.
Yu said that the training challenge was compounded by the high churn rate among aged care workers. It was important, she said, to provide regular training courses so that new staff could be taught the IT ropes, and current personnel have their IT skills refreshed.
"The problem is that people come and go all the time. Most aged care facilities have a good training culture - the initial training is good. But later on there can be a lack of support", she noted.
That, of course, translates to a significant ongoing education burden for aged care providers. It's not news to Jenny Zirkler, the executive general manager for Nambucca Valley Care, which is completing a computer system roll out in its four centres.
Zirkler has struggled to ensure that her workforce is equipped with the skills to use the new computer system. In the future, however, she expects some degree of computer literacy will be a prerequisite for aged care workers. "What I'd envisage is that every staff member would be up to speed on Skype, computers, email," she said, adding that this would make a transition to online care management much simpler.
A greater degree of comfort with technology would also allow aged care providers to provide more online, rather that classroom, education programs for staff, she said.
Yu said that better IT literacy and improved keyboard skills should also help improve the quality of data available to aged care facilities. She said that low computer literacy could lead to problems in terms of accurate data collection, and while computerised records management often made it easier to spot errors, there was still the opportunity for mistakes to creep in.
According to Zirkler, the key to effective technology roll outs is to work closely with staff throughout the change period, providing fine grained support at every stage of the computer system rollout.
Nambucca Valley Care operates four residential aged care facilities with 192 high and low care beds. The organisation has a total staff of around 200.
Formerly director of nursing at the Macksville Health Campus, Zirkler joined Nambucca Valley in 2010 and found that an iCare records management system which had been installed in two of the Nambucca Valley facilities had essentially stalled due to a lack of executive support. Over the last year she has been reigniting that program and is in the final stages of rolling out the electronic records system to the other two facilities.
She also hopes to get support this financial year to roll out an electronic medication management system to support staff with their day-to-day tasks, and reduce errors.
Having worked in the public health sector, she is keenly aware of the dearth of technical support generally available for aged care providers. But she remains convinced that computerised systems will lead to efficiencies, reduced error rates and improved care.
She said that vision had been brought home to her in the hospital system, as before computerised records were introduced at the Macksville emergency department, nurses or doctors would have to write a patient's name 19 times before they got up to a ward. In aged care, although the care required is not so acute, there is a requirement for comprehensive records management, not least for accreditation purposes.
"I get eight [unannounced visits] a year so we have to be prepared," said Zirkler during a recent presentation to an e-health conference organised by Cebit in Sydney.
To make sure the electronic system is effective though, it has to be embraced and used properly by staff. And that demands executive support for the system, without which it was too easy for carers to fall back into old practices.
"You have to engage stakeholders. You have to get to the 'what's in it for me?' That might be not having to go outside in the middle of the night to get information from the files," said Zirkler.
She said it was also useful to identify champions within the workforce who could work with carers and encourage them to use the system. "We tried two strategies - we got some who were keen and those not so keen and put them together and that did work.
You have to get champions at different levels of staff. One of the managers of her facilities, for example, has been very keen and championed the introduction of IT. She is also exploring beyond the boundaries of what is currently possible - for example, taking photos of residents' wounds and emailing them to GPs for feedback on how best to manage issues.
But she warned that "if the executive at the top thinks its hogwash, then it won't work."
Jason Falinski, Managing Director of CareWell Health added: "that simply put there is not enough people in aged care to cope with the current resources needed much less the 82 per cent increase happening between now and 2020. The only way to deal with it is with increase in productivity and these sorts of technologies are critical."
*****
Getting IT savvy staff: keys to success
* Seek and heed staff feedback around changing to their work practices
* Offer basic literacy and computer literacy courses
* Offer refresher courses to existing staff
* Have senior managers prepared to work side by side with carers while they get used to the new system
* Generate practical tip sheets showing staff how to use the system and have them available at all the computers
* Develop contingency plans that can swing into action at 2am in the morning when the computer crashes - have workflow sheets ready for staff
Computer literacy is expected to become a requirement for aged care staff as electronic records and medication management systems become ubiquitous. But, for many aged care providers, taking their current staff on the journey to the electronic age can be a challenge.
Dr Ping Yu, a senior lecturer at the University of Wollongong, is coming to the end of a three year research project which is intended to shed some light on the factors that lead to a successful introduction of computer systems in aged care facilities. Yu's earlier research involved examining the IT literacy of aged care workers and their attitude toward computer systems, and how that impacted on the success of automation projects.
She said that although general literacy and computer literacy among aged care workers was low, "this cohort is quite keen to learn computer skills." However, she warned that "for 50 or 60 year old ladies it can take them a few years to become fluent with the keyboard".
Her warning echoes a June report from the Council of Ageing (WA) report in association with the Australian Communications Action Network, which found that few senior women were going online in general, in part due to a lack of skills.
Yu said that the training challenge was compounded by the high churn rate among aged care workers. It was important, she said, to provide regular training courses so that new staff could be taught the IT ropes, and current personnel have their IT skills refreshed.
"The problem is that people come and go all the time. Most aged care facilities have a good training culture - the initial training is good. But later on there can be a lack of support", she noted.
That, of course, translates to a significant ongoing education burden for aged care providers. It's not news to Jenny Zirkler, the executive general manager for Nambucca Valley Care, which is completing a computer system roll out in its four centres.
Zirkler has struggled to ensure that her workforce is equipped with the skills to use the new computer system. In the future, however, she expects some degree of computer literacy will be a prerequisite for aged care workers. "What I'd envisage is that every staff member would be up to speed on Skype, computers, email," she said, adding that this would make a transition to online care management much simpler.
A greater degree of comfort with technology would also allow aged care providers to provide more online, rather that classroom, education programs for staff, she said.
Yu said that better IT literacy and improved keyboard skills should also help improve the quality of data available to aged care facilities. She said that low computer literacy could lead to problems in terms of accurate data collection, and while computerised records management often made it easier to spot errors, there was still the opportunity for mistakes to creep in.
According to Zirkler, the key to effective technology roll outs is to work closely with staff throughout the change period, providing fine grained support at every stage of the computer system rollout.
Nambucca Valley Care operates four residential aged care facilities with 192 high and low care beds. The organisation has a total staff of around 200.
Formerly director of nursing at the Macksville Health Campus, Zirkler joined Nambucca Valley in 2010 and found that an iCare records management system which had been installed in two of the Nambucca Valley facilities had essentially stalled due to a lack of executive support. Over the last year she has been reigniting that program and is in the final stages of rolling out the electronic records system to the other two facilities.
She also hopes to get support this financial year to roll out an electronic medication management system to support staff with their day-to-day tasks, and reduce errors.
Having worked in the public health sector, she is keenly aware of the dearth of technical support generally available for aged care providers. But she remains convinced that computerised systems will lead to efficiencies, reduced error rates and improved care.
She said that vision had been brought home to her in the hospital system, as before computerised records were introduced at the Macksville emergency department, nurses or doctors would have to write a patient's name 19 times before they got up to a ward. In aged care, although the care required is not so acute, there is a requirement for comprehensive records management, not least for accreditation purposes.
"I get eight [unannounced visits] a year so we have to be prepared," said Zirkler during a recent presentation to an e-health conference organised by Cebit in Sydney.
To make sure the electronic system is effective though, it has to be embraced and used properly by staff. And that demands executive support for the system, without which it was too easy for carers to fall back into old practices.
"You have to engage stakeholders. You have to get to the 'what's in it for me?' That might be not having to go outside in the middle of the night to get information from the files," said Zirkler.
She said it was also useful to identify champions within the workforce who could work with carers and encourage them to use the system. "We tried two strategies - we got some who were keen and those not so keen and put them together and that did work.
You have to get champions at different levels of staff. One of the managers of her facilities, for example, has been very keen and championed the introduction of IT. She is also exploring beyond the boundaries of what is currently possible - for example, taking photos of residents' wounds and emailing them to GPs for feedback on how best to manage issues.
But she warned that "if the executive at the top thinks its hogwash, then it won't work."
Jason Falinski, Managing Director of CareWell Health added: "that simply put there is not enough people in aged care to cope with the current resources needed much less the 82 per cent increase happening between now and 2020. The only way to deal with it is with increase in productivity and these sorts of technologies are critical."
*****
Getting IT savvy staff: keys to success
* Seek and heed staff feedback around changing to their work practices
* Offer basic literacy and computer literacy courses
* Offer refresher courses to existing staff
* Have senior managers prepared to work side by side with carers while they get used to the new system
* Generate practical tip sheets showing staff how to use the system and have them available at all the computers
* Develop contingency plans that can swing into action at 2am in the morning when the computer crashes - have workflow sheets ready for staff
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