Consumer directed care – a catalyst for organisational change

Consumer directed care – a catalyst for organisational change


Nous Principal Deanna Paulin shares her insights into how best to successfully achieve organisational change – such as that instigated by the movement to consumer directed care (CDC).

I was sitting in the boardroom with the executive of a service provider last year as we were about to begin a large consumer-driven transformation program. There was excitement and anticipation in the air, fuelled by the desire for real change. Then an executive turned to me and said “what if we do all this, and nothing actually changes?”

Business transformation is complex, challenging, and replete with inter-dependencies. It requires focus, attention and resources. When done well, it delivers substantial value to consumers and other stakeholders. But it is a real possibility that you can do significant work to adapt your business models, change your structure completely and overhaul systems and processes – and yet not change people’s behaviour at all.

Transformation in consumer directed care

CDC has been a catalyst for organisational change, and in some cases business transformation. It has triggered aged care service providers to think more commercially and strategically about how their services should be delivered – including how to become more responsive to consumer preferences. This presents many challenges:

  • How do we design our systems to support increased consumer choice and changing demands?
  • What does success look like in an open and competitive environment, where cost becomes more important?
  • Will clients choose different models to the current ones, or want more flexibility?
  • How are system and process changes coupled with increased administrative costs?
  • Will new recruitment methods have an effect?

Further, some distinctive aspects of the aged care environment make such changes even more challenging. These include a focus on care rather than commerce, subsistence-level funding and margins, high levels of regulation, a complex incident reporting environment, and a geographically and culturally diverse and casualised workforce.

Steps to successful transformation

There are four main steps that leaders should take to guide change and engagement activities. They are iterative and non-linear, but must be considered from the outset:

The four steps to consumer directed care: set direction, engage for action, build and mobilise, make it stick

Nous’ experience also highlights a number of common challenges service providers experience across these steps, and strategies for overcoming them.

The way leaders behave and respond to change is critical

Some leaders take on too much and fail to distribute decision-making or solution-finding. They then lack the time to actually deliver, divert their attention away from what they are good at and fail to utilise others who are best placed to deliver. Leaders must also actively communicate about the unknowns and translate the change into people’s context. In the absence of information people make assumptions, which can turn into beliefs and plans.

Change management and project management should also go hand in hand

This means focusing on culture, capability and leadership as much as on technical progress against project deliverables. The change plan should be part of the overall project plan. The project manager and change manager should work together to align engagement activities so that stakeholders receive a coherent story. And change and project measurement should be integrated with the broader benefits realisation approach.

Delivering and celebrating quick wins creates momentum

Demonstrating success through actions that are meaningful, directly related to change and achieved quickly – for example, implementing a pilot, identifying examples of changed behaviour, or dealing with the biggest frustration source – creates energy and enthusiasm for the change. Conversely, it is OK to call out errors or incorrect decisions – but in private.

Culture underpins the ability to navigate change and make it long-lasting

It is important, therefore to choose a change approach that fits your culture. This requires initially measuring and assessing your culture and defining its desired attributes. Amount of sick leave taken, number of complaints and the extent of work arounds can provide clues to culture, along with readily observable actions and words. But intangible values, mindsets and thinking should be explored as well via engagement surveys, focus groups and stakeholder interviews.

There will be unanswered questions

What are the associated costs? What are the service levels? Where are the peak demands? Not everything will have answers yet, and that is OK. Find out the information you must know, and then let the smaller things go.

Successful organisation transformation requires focus, attention and resources. Investing in good change management is paramount, as when done well, it will deliver substantial value, a competitive advantage, organisational growth and better outcomes for consumers.

This article is based on Deanna’s recent presentation at the Catholic Health Australia Consumer Directed Care forum.