New Thinking for Aged Care OperatorsA discussion and case studies of how other sectors and complex organisations have achieved transformational change
21 March 2019
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Existing and emerging factors continue to disrupt and shape the aged care landscape, placing providers under significant stress
• Deregulation of the HCP market has led to increased competition
• Higher expectations about quality of care
• Consumers are becoming more savvy with a greater array of choices
• Single Quality Framework, Royal Commission and previous reviews highlight a greater focus on quality and safety
• Demographic shifts changing the demand for and nature of services
• Technology developments are major drivers
• Resource insecurities are changing the nature of investment opportunities
• Rise in the middle-class has fostered consumer-centricity
• Decreasing viability of traditional models of care
• Increasing public scrutiny
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Historically, changes within the sector have largely been superficialcreating greater complexity
Despite reforms, consolidation and market trends, the industry has largely remained unchanged for the last 30 years in delivery of services
Government and providers have favoured additive, superficial changes over system transformation
Lack of wholesale transformation could be the greatest threat to the sector… However… in the next twenty
years, changes in
demographics, workforce
and consumer demands will,
without doubt, lead to a
vastly different sector.
…and to the survival of organisations
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Demographic changes are compounded by lack of preparation and workforce issues
Demographic trends will magnify the need for services and will change the make up of Australia
Compounding the lack of large scale transformation within the industry, is also a lack of preparation amongst consumers for their aged care needs
Workforce transformation, enabled by technology will be necessary, in order to keep up with growing service demand
To meet demand, it is anticipated that the aged care workforce will need to triple between now and 2050
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Consumer-centricity is no longer optional
• Globally, there has been an increase in the middle class, which has led to a rise of the individual and consumer-centricity.
• The sector is not innately structured to be consumer-driven, but shaped by providers and funders - this is supported by public opinion that the sector is “upside down”.
• Despite significant research and investment, organisations are failing to make consumer-centricity the backbone of their organisation.
• Reputation is at risk – growing social media outlets and findings of the Royal Commission pose the greatest threats.
6© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
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The rise of technology is undeniable, but is it our knight in shining armour?
• Technological developments continue to act as major drivers of social, economic and environmental change, creating new opportunities and disrupting business models.
• In fact, the opposite may be true. In the health sector, increasing technological adoption has been correlated with growing expenditure.
• The role of technology is indisputable, however it is in the hands of leaders to strike the right balance in terms of technological adoption and implementation.
• The extent to which organisations adopt technology will not be a determinant of success, rather, success will lie in innovatively implementing technology enabled solutions that add value and not just cost.
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You are not alone ……
Similar sectors in countries around the world agree on both the trends and the challenges associated with responding effectively to them. For example:
• Constantly and rapidly evolving sectors
• Various operational issues plaguing efficiency and sustainability
• Uncertainty grounded in tightening of funding and the regulatory environment
Poor responses can be linked to leaders not having a complete “toolkit” to respond to the changing landscape.
The KPMG Global Human and Social Services CEO Outlook Survey supports this hypothesis, with findings highlighting:
• The need for innovation is critical and was rated as the second highest strategic priority
• However, only 13 percent of human services organisations have a foundational approach to innovation and only13 percent of CEOs indicated they were effective innovators
13%
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Innovation needs to be supported by data and technology
• The KPMG Global Human and Social Services CEO Outlook Survey identified data use and technology as two key domains fostering organisational innovation.
• The link between effective data use and improving the quality of services is well understood. However, only 56 per cent of CEOs believed that they were effectively using data.
• Technological transformation continues to be a priority for organisations, with digitisation rated as the highest priority for 24 per cent of leaders.
• This begs the questions – how will data be used? And how can organisations use data to undergo digitisation in an already resource constrained environment?
Please click here to view the KPMG Human and Social Services Outlook
9© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
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Aged care leaders have invaluable experience and knowledge that will be instrumental to change within the sector.
The experience and knowledge of leaders will play a critical role in shaping innovation and change within the sector
Knowledge and experience, together with innovation can create sustainable and competitive organisations.
How do organisations then position themselves for success?
10© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
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The Quadruple Aim can be used as a framework to enhance and foster change in the sector • The Triple Aim, introduced in 2008 by the Institute for Healthcare Improvement, is a framework
used to optimise healthcare systems.
• Triple Aim Quadruple Aim, highlighting the importance of team experience.
• Through innovation aligned to the Quadruple Aim, aged care organisations can position
themselves for success in the future.
Triple Aim
Reduced Costs
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Quadruple Aim
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Quadruple Aim
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Cons
umer
Expe
rienc
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11© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
12© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
12© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Quadruple Aim
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Linking staff performance to consumer experience Overview John Hopkins Hospital tied executive, management and clinical performance to patient experience measures, including; Patient Reported Experience Measures (PREMs) and call bell response times.
Benefits
Increased accountability for creating a culture of consumer-centricity at all levels
Scalable and can be used across sectors
Improved consumer experience
13© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
13© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Quadruple Aim
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Empowering consumers to live independentlyOverview Atvisor.ai is a digital platform for assistive technology consultation. The platform connects people living with disabilities, the elderly and rehabilitation professionals to source and match assistive technologies, products and devices.
Benefits
Personalised and tailored assistive technology
Shared decision making between consumers and providers
Regular checking of consumer progress
Redu
ced C
ost
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Quadruple Aim
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14© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
15© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
15© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Quadruple Aim
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Buurtzorg, the neighbourhood care solution Overview Buurtzorg – translating to “neighbourhood care“ is an innovative district nursing and home care model used in the Netherlands. The model deploys a team of up to 12 nurses to support 40 to 60 consumers in a designated area.
Benefits
Estimated potential cost savings of up to 40%
Enables consumers to live at home for as long as possible
Minimal formal support for consumers
16© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
16© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Quadruple Aim
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Tackling diabetes through social impact investing Overview Social Finance Israel pioneered a Social Impact Bond, treating 2,250 high risk pre-diabetics. Diabetes prevention was approached through professional intervention, innovative solutions, data use and ongoing monitoring.
Benefits
Reduced financial pressure on providers and government, as they looked to investors
Facilitates socially responsible investment
Model can be tailored to specific contexts
Impr
oving
Con
sum
er
Outc
omes
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Quadruple Aim
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17© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
18© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
18© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Consumer-centred dementia careOverview The Butterfly Household Model specialises in meeting the needs of consumers living with dementia, through a consumer-centred approach, that moves away from traditional sterile environments, to nurturing, stimulating and engaging ones.
Benefits
Improved consumer wellbeing
Evidence of reported increases in quality of life indicators
Decrease in staff turnover and absenteeism
19© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
19© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Improving patient outcomes through data analytics Overview Ambulance Victoria together with KPMG worked to improve emergency health care by delivering the right response to the right patient in the right time. The response leveraged existing data and analytics capabilities to problem solve.
Benefits
Faster response time to emergency calls
Consumers taken to the most appropriate hospital based on their needs
Improved consumer outcomes
Please click here to view the KPMG data analytics hackathon for Ambulance Victoria
Team
Expe
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Quadruple Aim
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20© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
21© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
21© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Overview St John of God Hospitals implemented data driven ‘clinical command centres’, which involves a wall of screens and digital dashboards that track each consumer’s ‘surgical journey’.
Benefits
Data-driven decision making and informed workflows
Increased efficiency for surgeons and operating theatres
Increased worker satisfaction
Monitoring the pulse of hospital operations
Please click here to view the St John of God Clinical Command Centre
22© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
22© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
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Enabling care providers through technology OverviewDisability & Home care Solution by KPMG and Microsoft provides a single view of consumers, connecting front office and back of house enabling quality service delivery and reporting.
Benefits
Gives staff insights into support networks, goals, medical records and care preferences
Enables more time to focus on meaningful consumer interactions
Seamless consumer experience
23© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
What key lessons can leaders learn from these examples?
• These case studies highlight that even in traditional and resource stretched sectors, innovation
and change is possible.
• Technology alone will not transform organisations, but rather,
leaders need to understand:
• trends shaping the sector
• evolving consumer demands and sentiment
• the value technology will bring to their specific organisation
…… to enable critical steps to be taken to position themselves for
success.
24© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International. Liability limited by a scheme approved under Professional Standards Legislation.
Document Classification: KPMG Public
How can you shift the current paradigm?Insight Led
Intentional
Integrated
Extended
Digitally-Enabled
Innovative
Seamless Access Channels
Partnerships, Alliances & Vendor Management
Responsive Supply Chain & Operations
Experience Centricity
Advanced Data, Analytics & Insights
Organisation Alignment & People Capability
Service Delivery & Strategy
Technology Architecture & Enablement
Responsive
Empowered
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Document Classification: KPMG Public
© 2019 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. The KPMG name and logo are registered trademarks or trademarks of KPMG International.
Pick fewer priorities and stick to them: focus efforts to drive real change
Successfully sustaining change
Embed this at all levels: support middle managers to understand the change process
Align your organisation to deliver your ‘True North’: ensure transformation work reflects overall strategy and aligns with Board, executive, staff, consumers and community expectations
Engage and empower consumers: help them to help staff focus on improvement work
Digital technology can support: but get management systems and culture in order first
Remember that there are no quick fixes: allow time for your organisation to understand, adopt, and reflect
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Contact us
Nicki Doyle Partner T: +61 2 9335 7794 E: [email protected] is the co Lead Partner for Ageing and is highly respected within the sector, providing advice to a range of Government and non-government clients.
Evan RawstronPartner T: +61 2 9455 9586E: [email protected] is the Lead Partner for the NSW Health Economy and the Global Health Data & Analytic Lead. He is a trusted advisor to a wide range of organisations within Australia’s health system.