A practice framework:

Beyond consumer directed care

Jacqueline Kelly Maria Mulheran

Overview

Service Context

Customer Intimacy

Research

The Quintessential

Dilemma

Planned Approach

Framework

Pilot Program

Post Pilot

Implementation

Value Impact

Critical Success

Factors

Compelling Agendas

The changing environment

Demographics

People’s perceptions, experiences

and expectations

Economics

Workforce

Reform

Competition

Service Context

Commitment Continuum

Customer Intimacy Research

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

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

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

The most enlightening insight

Perceptions of a vicious cycle – fast

track down the slippery slope of decline

Customer Intimacy Research

Create a new paradigm of

service experience

Liberating and empowering

Respectful and equitable (shared

control)

Intentional and sophisticated

Holistic and inclusive

The Quintessential Dilemma

The Quintessential Dilemma

A positive platform and lever for

change

Dominant industry paradigms

Cultural integrity and alignment

Systemic reliability

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)

Framework

Customer value co-creation

Holistic

Client experience

Every encounter over time

Small details are important

End to endless

Framework

Customer value co-creation

Customers participate and take on

roles

Value co-creating approach

Collaborative processes

Longitudinal

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

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

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

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

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)

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

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

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

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

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

24 McDougall Street Milton Q 4064 PO Box 1535 Milton Q 4064 P 07 3858 3000 F 07 3858 3030 E lcc.admin@lccqld.org.au 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