Home' Australian Ageing Agenda : AAA Spt-Oct 2014 Contents the organisation's current practices.
The institute is led by Dr Susan Koch,
who, prior to the change in Federal
Government, was chair of the minister's
advisory committee on dementia.
"We just see it as an absolutely
essential investment in ensuring we
provide contemporary best practice,"
Muggleton says. "Our staff is delivering
more than two-and-a-half-million visits a
year; we need to ensure it is informed by
Muggleton says RDNS has tried to
identify the conditions of ageing its staff
encounter in their everyday work and use
that to define the structure of research
within the institute.
"So within the institute there's a
centre for dementia care, a lot of work
on medications management, which
has a strong link to some telehealth
innovations, and of course wound care
which in turn relates to diabetes and
chronic disease management."
Muggleton describes as "the essential
piece" the degree to which that research
then translates into practice. To address
that, next to the research institute is
RDNS's education and training centre.
It delivers specialist short term courses,
informed by latest research, both to its staff
and to the sector more broadly, he says.
With such a focus on research, it is
unsurprising that, despite the changes
and challenges he described at the outset,
Muggleton is optimistic about the future.
"We see it as a really exciting opportunity
to innovate and reposition for a more
contestable environment. That could be
horrifying for some but exciting for others.
We see it as a great opportunity to redesign
services around empowered workforces."
Muggleton, whose early career was in
hospital administration, including executive
roles in both the NT health service and
NSW Health, believes that community care
providers have potential to expand into
healthy ageing, chronic disease and the gap
between acute and sub-acute.
"A lot of the expertise that sits
within community care organisations,
and residential care, could just as easily
support chronic disease," he says. "It's
that horizontal integration into that space,
working closer with primary health and
then sub-acute care in hospitals. It's a
space we could all work on together." n
"We're not only informing the design
and operational management but the
intent is to help adapt and apply some
of the Australian standards around
quality care and operational management
framework into a Chinese environment."
Asked how the move into China came
about, Muggleton credits the RDNS
board for their leadership, and says the
organisation is lucky to have a constitution
that enables it to expand both nationally
He says RDNS has also benefitted
from the Victorian Government's heavy
investment in health exports -- Muggleton
himself was part of the government's
"We looked at the different markets
around the world and China was just
facing an enormous challenge. Their
ageing population currently is 200 million,
set to grow to 400 million. The whole
problem is compounded by the one child
policy, so they have fewer tax payers
supporting an ageing population."
Muggleton, who has been appointed to
one of the Chinese central government's
planning committees on ageing, says while
China is facing this huge challenge, it does
not have the same layer of regulatory
restrictions as Australia.
"In some ways that's a concern
because they don't have the standards
as refined and mature as we have
in Australia, but at the same time it
enables you to sit down with provincial
government officials and work through
better whole of system solutions that
involve more community engagement and
completely different responses."
As you would expect, Muggleton
says the scale in China in enormous. "It
means you can have full integration, so
you can work at informing throughput
from rehab hospitals back into
residential aged care. But you can
also have large scale retirement living
communities that are in fact part of a
wider community that involves child care
centres, shops and full communities."
RESEARCH A CORE FOCUS
Closer to home, Muggleton says RDNS
has worked hard in recent years to ensure
that research is embedded organically
across the organisation.
The RDNS Institute is charged with
undertaking research to improve care
and client outcomes, but also to evaluate
AGED CARE REFORMS
"I'm encouraged by the signals
that over the medium term
we're going to be moving to
implementing a lot of the themes
that were embedded in the PC
review, which are focused on
responding to client needs and
a degree of deregulation that
introduces more competition and
with that more innovation into the
sector. Any shift towards finally
adapting the recommendations of
the PC would be welcome."
"It gives us potential to have
immediate responses to client
needs rather than having to
scramble a nurse out in a car.
We were lucky to some extent
the organisation had invested
in a call centre several years
ago, which has100 seats with
a lot of specialist nurses ...
We received $3 million from
the government to run the
medication management trial
that is supporting more than
200 clients. In another trail,
involving more than 200 people,
we're hoping to demonstrate the
ability of telehealth to enhance
coordinated care and reduce
hospitalisations for people with
chronic diseases. That's early
days, but it's showing very
encouraging results so far."
MAKING THE LINKS
"We're doing an exciting home
peritoneal dialysis program
with Austin Health where our
community nurses are delivering
dialysis in the home. It's an
example of links that don't
depend on formal relationships
between governments or different
departments...Similarly, in the
last two years we conducted
50,000 worker health checks.
Our staff uncovered a lot of
underlying chronic disease and
identifying them early was a
really effective way of improving
health, of course, but reducing
the subsequent down steam
impact on the health system.
We're quite proud of that." n
"Ultimately it's redesigning the
organisation around agile teams of staff
cells that are fully empowered with
decision rights and can respond to
those client needs."
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