Epfini / Insights

Managing Complexity for Aged Care – 10 Action Points

Complexity made simple

The Rubik’s Cube was launched across the world in 1980 as the most difficult puzzle ever, with more than a billion possible variations across its six sides. Yet it looked very simple. 

The Rubik’s Cube is a perfect analogy for Aged Care, especially now in the advent of the Royal Commission recommendations. Delivering quality care for the elderly is the simple outcome we all want. Yet the sheer number of moving parts, such as human psychology, processes, logistics, legislation, public perception and paperwork makes the number of possible ‘moves’ nearly as great as a Rubik’s Cube.

The perils of complexity

‘Business’ has tried to solve this by the introduction of compliance, technology and high-speed communication, but the complexity of running a company is ever increasing, with new technology, globalisation, bureaucracy and customer demand. Add to this, 148 recommendations across 2580 pages in a 5-volume report from the Royal Commission and for many, it may become overwhelming.

History is full of disaster stories where complexity takes what appears to be a robust system and turns it to dust in a heartbeat. The Air France Flight 447 disaster of 2014 is probably the best-known example of this. The pilots had to make the right call based on contradictory information and failed systems coupled with Air France’s approach to risk management.  A crash killing all 228 passengers and crew was the result. This means that making the right call is very difficult without hard, unbiased and non-contradictory data (even in life and death situations). Where systems are already flawed as has been seen in parts of the aged care industry, the route to disaster is even faster and more assured.

The Aged Care Challenge

In the light of the Royal Commission report, Aged Care faces sweeping changes to answer the issues that have made it such a challenging industry: problems such as poor governance, leadership misalignment, resistance to change leading to low morale, performance, high staff churn, poor safety and quality outcomes for both staff and residents. These are all signs that the system simply isn’t functioning. Many business leaders recognise that problems exist but just like the pilots of Flight 447 making the right call with poor, contradictory or misleading information is a huge risk. This is why so many businesses fail to implement change successfully and then actually fail.

Current business improvement solutions

Sometimes businesses turn to third-party consultants for help and advice. That is if they know where to look and have pockets deep enough to engage them.  These consultants spend considerable time, energy, and their client’s resources trying to gather enough information to provide some direction to fix business issues. However, this is also high risk. Consultants are only human with their individual motivations, inherent bias, desire to win business, eagerness for billable hours, not to mention a filtered view of the world. Moreover, the issues that arise will be symptoms of some other interconnected problems. 

For example, consider what happens when a business appears to have a culture issue. Poor culture doesn’t just happen. Culture is an outcome, it is a direct result of something else;  for example, stemming from dysfunctional leadership or perhaps poor process management or a combination of both. Bringing in an expert to fix symptoms is doomed to fail yet the one favoured by the majority of businesses. In addition, expecting (for example) a culture expert to be able to find, analyse and fix an inter-related problem such as process management isn’t realistic. Without the correct data and root cause, problems will soon re-emerge. In short, seeing “symptoms” as “causes” is a major issue.

So what can an Aged Care business do? The team at Epifini believes the 10 short action points below will help.

Facing the Royal Commission Recommendations in 10 actions points

  1. Embrace Change – This isn’t easy – humans tend to dislike change and run from it. But for the Aged Care industry this is not an option, so take it on the front foot, communicate to your people; the need for change, what’s going to change, how and whom it will affect and then go for it.
  2. Accept not all complexity is bad – Complex systems can create wonderful things and in these cases it’s the complexity that is key (the human nervous system for example). Don’t try to manage everything or you’ll fail, but understand everything is connected.
  3. Always seek simplicity where it can be found – Can each part of a complex system be made simpler?  So be curious and always ask if it’s as simple as it can be and if not, what can be changed without breaking something else.
  4. Measure, Analyse and Prioritise – Getting the right information is possible with the right technology in place – you manage what you measure so make sure your data is clean, accurate, relevant, timely and usable.
  5. Create a big picture – The end goal is the most important whether it’s a product or a service. There is a balance between focusing the attention on what’s most important and getting overburdened with small details that can stop the flow of the operation. Bureaucracy has a tendency to do just that.
  6. Plan your delivery (but have a plan B and a Plan C) – Be dynamic in planning. Assume it won’t be perfect the first time so backup is important. Having a good plan is more than just about execution as it allows a business to scenario plan as it goes and makes a business answer the “what if” questions.
  7. Create alignment and ownership of each part of your plan – No alignment means everyone will do their own thing. No ownership means no accountability and no decision-making and as a result, no delivery.
  8. Empower those at the operational level to make things work better – Business leaders can’t be everywhere. Use the expertise you have, especially operational expertise. They will see things differently from the leadership and see individual parts of the system that the leaders can’t. They may have solutions leadership have not thought of, nor are able to see.
  9. Get Feedback – Once the plan is in place get real-time feedback as you implement it. Don’t wait for the wheels to fall off following a series of missed KPI’s.
  10. Fail fast and fix – Make decisions, don’t expect perfection and don’t call it failure. Paralysis by analysis creates stagnation and missed opportunity. An Aged Care business will be successful if it adapts quickly and is flexible.  That means an idea or a process may work one month and then not work the next. Get your data, make a decision, learn from it and then move on.

Find out why leading businesses are choosing Epifini to help them change successfully. Feel free to contact us through the contact page.