Background: Multipurpose Services (MPS) are unique facilities in small rural communities across Australia that provide a combination of health services in populations less than 3,000; including emergency, acute, community and residential aged care.
As acute and aged care services are provided simultaneously in the same facility, residents are sometimes cared for as patients in hospital rather than residents living in their home.
MPS are accredited against National Safety and Quality in Healthcare Standards (NSQHS) and although most care provided is Aged Care, there is no requirement to meet Aged Care Standards. In 2015, the Australian Commission on Safety and Quality in Healthcare identified gaps not being assessed as:
The role of the person in their own care
Hydration and Nutrition
Leisure activities and lifestyle
Methology: ‘Living Well in MPS Principles of Care’ were developed to support staff in providing care for residents of MPS - not as patients in hospital, but as people living in their home. A toolkit includes the principles of care, a self-assessment checklist, a resource guide of evidence based strategies and an evaluation package.
25 MPS teams have been part of a Collaborative to implement the principles of care. Over 2017, the teams participated in three learning sets and three twelve week action periods. They completed rapid Plan Do Study Act (PDSA) change cycles and shared the results with their peers at other sites to enable faster collective improvement state-wide. Sites were supported with weekly change management coaching and via an online portal to share ideas and network. Bi-monthly data was collected to track progress via resident and staff surveys to gauge satisfaction with:
Relationships between residents and staff
Usual level of physical wellbeing
Quality of everyday life
Amount of independence
Outcomes: To date, over 350 small scale improvements have been made. Outcomes were measured using a standardised quality of life tool (resident reported) and a process checklist. Qualitative resident feedback shows an improvement in quality of life and in choice and control over activities and lifestyle. Quantitative resident feedback will be available at the time of presentation. One of the biggest improvements has been harnessing community and volunteer networks in small country towns to increase connectivity with lifestyle factors and integrate community with residential living to maintain relationships and a sense of belonging and self-worth for residents.
Take Home Message: The Collaborative has been successful in creating and expediting large scale change across rural NSW. The short PDSA cycles have generated a wellness philosophy and solidarity not previously widespread and expansion of successful strategies to other MPS is panned to further maximise achievements in the eight Principle areas:
Respect for Rights as an Individual
Comprehensive assessment and care planning
Informed and Involved
Access to Recreation and Leisure activities
Positive dining experience
Expertise in aged care.
“The best part of the project is seeing the way residents are enjoying the change, The MPS collaborative project has been great. I love my job.” – NM, MPS Site