20131018 consumer directed care social inclusion & wellbeing
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Consumer Directed Care It’s about Social Inclusion and Wellbeing…
© Précis:- The rules of economics apply to all industries providing us the opportunity to learn from others. Such an example is the rise and decline of Kodak. Kodak was the first to capture images by amateurs and its distribution. The medium for distribution was film. They focused on film but forgot they were in the image capture and distribution industry. They lost first mover advantage and dominance of an industry created by George Eastman Kodak founder in 1889. This process of image capture through film and distribution did no fundamentally change until challenged by digital photography competitors in the 1990’s leading to Kodak’s rapid decline in January 2012 when Kodak filed for chapter 11 bankruptcy1. They prospered for 100yrs and rapidly declined in their last twenty yrs. Organizations working in a fixed paradigm during a time of rapid technological and social change result in stagnation and rapid market decline2. The lessons learned from the Kodak experience was its disengagement between their theoretical constructs of where they thought the market was and where it actually was going. This was described by Janis Irvine (1982) in a term called Group-Think which occurs when decision-making is driven through the prism of the board or that of their close advisers as to what they perceive to be right which at times is at odds with the available evidence. In the case of Kodak this can be categorized as type 2, close mindedness which includes rationalizations in order to continue on their current path or policy direction”…The term "groupthink" draws directly from George Orwell's novel 1984, and is a play on Orwell's term doublethink (Sunstien, 2003)3. The convergence of the following has implications for established aged care providers; Social Expectations:- Affluence derived through economic systems that have leveraged off rapid social change and innovation has allowed people to live longer with an expectation of a lengthy and fulfilling retirement. Not unlike Dame Elizabeth Murdock when interviewed for her 100th birthday stated she did not see herself as old and did not think much of death…which she conceded was strange given she was turning 100yrs. The industry as seen through the prism of care and cure:- The aged care industry is built on a workforce derived from the care and cure industry predominantly made up of professional medical, nursing and allied health people. The key focus of these professionals is to care and cure based on technical expertise and innovation. Unfortunately many recipients of their care often referred to as patients and more of late as clients have an expectation they will receive the care they require… The risk of this model with Consumer Directed Care is that many people are like the late Dame Elizabeth Murdock and have an expectation of well being and access to a socially active lifestyle irrespective of age. The impact of commerce:- Aged care is an industry predominantly established by philanthropic organizations such as Churches. Over the years it has become increasingly the subject of government funding leading to entry by secular and corporatized organizations. In turn these Church organizations are attempting to compete by corporatizing themselves.
1 http://en.wikipedia.org/wiki/Eastman_Kodak
2 11-5-12 Walter de Ruyter, Adapting to Change (Briefing Note)
3 3-3-2004 http://www.anthonyhempell.com/papers/groupthink/
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Whilst focusing on the technical aspects of corporatizing a number of providers will be late in recognizing that it wasn’t in the aged care business. Rather it is in the business of social inclusion and wellbeing as an expectation of the client, whilst being technically competent in the delivery of care and cure services to these aged clients. ‘Baby-boomers’ have changed every market demographic and with the advent of consumer directed care these clients often do not see themselves as being old but just needing a hand to remain well and part of their community. It is our background and experience that creates a prism through which we translate government policy into practice as organizations reorganize their services to accommodate the changing needs of the community. Consumer Directed Care will challenge evolving service models in ways as yet to be fully appreciated as providers develop their relationship with clients. Challenges:-
1. Current processes associated with care have a focus on supporting the organisation (singular) in delivering a service to a client versus the process of care is to support the client across organisations (plural) in accessing their health and wellness needs. The latter is the expectation of client directed care.
2. Continuity of care when achieved through the alignment and sequencing of care needs through the collective umbrella of aligned organizations, result in a greater number of access points of care becoming a planned event. Examples of tools used to reflect this are agreed pathways of care between provider organisations and integrated student placement programs.
3. The process of guiding the flow of care information is not coherent, as the focus of care is often an isolated ‘puzzle-piece’ of care expressed in the jargon of the service. The puzzle-piece of care (often Health) has not been dovetailed in a culturally and socially inclusive way that is relevant to the client.
Summary:- The take home message from publications and health and wellness forums is future demand will exceed the current framework of health related services based upon the expectations of the consumer. A key strategy in addressing an escalation in demand is to move the number of health consumers accessing services in an unplanned fashion to processes that support planned access to services. The latter has greater efficacy regarding resources and associated morbidity when utilising existing operational structures.