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A practice framework:
Beyond consumer directed care
Jacqueline Kelly Maria Mulheran
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Overview
Service Context
Customer Intimacy
Research
The Quintessential
Dilemma
Planned Approach
Framework
Pilot Program
Post Pilot
Implementation
Value Impact
Critical Success
Factors
Compelling Agendas
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The changing environment
Demographics
People’s perceptions, experiences
and expectations
Economics
Workforce
Reform
Competition
Service Context
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Commitment Continuum
Customer Intimacy Research
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The ideal service: empowering dynamics
Personalised, seamless, care gradient
Resists the process of loss of meaning
Predictive in the moment response
By which the person can engage with the world
And, have a role More than entertained Non trivial Independence within the group Active not passive Access to social media
Customer Intimacy Research
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The ideal service: empowering dynamics
A “functioning society” or family
Open and transparent
An aesthetic dimension The environment Individual engagement
Medical and health services
Communication depth
Real choice and control
Normalcy and informality
Fidelity
Flexible, adaptable, responsive
Customer Intimacy Research
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The ideal service: disempowering
dynamics
Overcare
We have to fit in and adapt
Possibility without opportunity
Weekend “black hole”
Felt levels of macro and micro control
Customer Intimacy Research
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The most enlightening insight
Perceptions of a vicious cycle – fast
track down the slippery slope of decline
Customer Intimacy Research
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Create a new paradigm of
service experience
Liberating and empowering
Respectful and equitable (shared
control)
Intentional and sophisticated
Holistic and inclusive
The Quintessential Dilemma
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The Quintessential Dilemma
A positive platform and lever for
change
Dominant industry paradigms
Cultural integrity and alignment
Systemic reliability
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Planned Approach
Meta plan
Adequate framework (encompassing,
inclusive, aligned)
Pilot Test
Review and evaluate
Implement and embed (Service)
Review and evaluate
Implement and embed (WOO)
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Framework
Customer value co-creation
Holistic
Client experience
Every encounter over time
Small details are important
End to endless
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Framework
Customer value co-creation
Customers participate and take on
roles
Value co-creating approach
Collaborative processes
Longitudinal
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Framework
CVC definition
“The benefit realised from integration
of resources through activities and
interactions with collaborators in the
customer’s service network”
McColl-Kennedy et al. 2012, p.375
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Pilot Program 2012, University of Queensland
Zion Nundah
100 bed residential aged care
30 years old
6kms from Brisbane City
3-level building
Clinical model
Some staff employed for over 20 years
Task-driven around staff routine
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Our approach
Field observations
Discovery workshops with clients and staff
Discussions with clients
Surveys with clients and staff
Value co-creation workshops with clients and staff
Development of a training manual
Additional workshops with staff
Pilot Program 2012, University of Queensland
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Implementation
Extending and embedding CVC
Employed new care manager
Interviewed each resident – role activities and interactions
Major roster changes – from task driven to client preference
Review lifestyle program
Recruited staff suited to a CVC approach
Orientation
Mandatory
Supported champions (10)
Senior staff all on board
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Implementation
Challenges
Many staff were task drive
Small amount of staff turnover
Others kept reverting back
Champions were resisted
Move from clinical to CDC
Cost plus extra staff (out weighed by
the benefits and value created for
clients and the organisation)
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Implementation
Success drivers
Move the focus from care needs to life plans
Drive change through lifestyle, arts and creative activities
Employ the right lifestyle manager and extend the lifestyle program
Physiotherapy – wellness program introduced
Empower staff – reward new initiatives, make resources available
Resident-initiated activities
Visibly and actively support the change champions
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Implementation
Success drivers
Little things can make a big difference
and they do matter
They add up Dog
Coffee Time of day for shower
Choice of meal times
Flexibility – how you have your meal and
when
Getting trays correct
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Value Impact
Customers
Post pilot Found workshops energising “meaningful” to them – not mindless games Found common interests didn’t know existed
before the workshops Shared interests (activities) and experiences Several people flourished Spawned new friendships Gave them more self confidence Started organising their own activities and social
occasions
Post implementation Everyone is treated like a favourite 10 residents on committees making decisions Residents always raising ideas and acting on them Happy residents initiating their own activities CV measurement tool confirms results
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Value Impact
Staff
Said workshops were unique in providing a forum for the open exchange of ideas and in cutting across functional staff barriers that other professional development workshops have reinforced in the past.
“Yes” culture is now the accepted norm
Staff are coming forward with innovative ideas and suggestions
Staff are engaging with residents in a variety of social context and settings
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Conclusions
Summary
Confident transition to a different
paradigm
A positive platform for culture change
Leadership team must be on board
(3 levels deep and wide)
Doesn’t need to cost a lot – it’s the
small and often simple things that
make the difference
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24 McDougall Street Milton Q 4064 PO Box 1535 Milton Q 4064 P 07 3858 3000 F 07 3858 3030 E [email protected] W www.lccqld.org.au Lutheran Church of Australia Queensland District ARBN 051 602 996 trading as Lutheran Community Care ABN 47 291 464 804 Incorporated in Queensland