Employing BPMN and BPI to Realise Quality and Productivity

Improvements in Aged Care

David G Thompson and Chris Coughlan

October 2009

Table of Contents

• Global Aged Care Sector Overview• Global Aged Care Trends• Australian Aged Care Sector Trends and Drivers• The Challenges facing Industry Participants• CAC Business Model and Overview• Business Problems• How we Approached these Problems• The Findings• Business Process Improvement Case Studies• Outcomes and Expected Outcomes• Future Quick Win Initiatives• The Road Map Going Forward

Global Aged Care Sector OverviewAged Care is a very significant 21st Century challenge. Analysing and clustering the British Royal Geographical Society’s biggest 21st Century Challenges yields three major issue groupings, namely:

1. The Environment and Sustainability

2. The future of Capitalism and Trade

3. Aging, Retirement and Health

The following striking facts bring the enormity of this challenge into sharp focus:

• 60% of all people employed in Sweden’s capital city Stockholm, work in community care; and

• By 2020 the elderly population in China will reach 248 million and by 2050 the aging population will reach over 400 million.

Global Aged Care Trends

Patient

Cure

Hospitalisation

Institutions

Govt. Delivered

Paper based

Patient Plan driven

Was Future State

Centralised Care

All of these factors increase the importance

of improving Process

ManagementCapability in

order to deliver Quality and Productivity Outcomes

Recent National Aged Care Growth Trends

Residential Aged Care Sector Compound AnnualGrowth Rate (98-08) 2.2%

Community Based Aged Care Sector Compound AnnualGrowth Rate (98-08) 17.5%

National Aged Care Sector Policy Drivers

$ 1 $ 10 $ 100 $ 1,000 $ 10,000

Incr

easi

ng Q

ualit

y of

Life

Independent Living

CommunityClinic

Doctors Office

Chronic Disease

Management

Home Care

AssistedLivingNursing Facility

Residential Care

Clinics

Hospital

IntensiveCare Unit

Acute Care

A Key Economic Driver of Recent Policy

Daily Cost of Care

The Challenge facing Industry Participants

• Deliver optimum care outcomes in a sustainable fashion

= (Enhanced Quality Care Outcomes) / (Reduced Cost of Care Delivery)

Process Management & Improvement Capability lies at the heart of this Challenge

Baptcare’s Community Aged Care Business Overview

Baptcare’s Community Aged Care Business Model

Baptcare Community Aged Care

Government Agencies

ProgramManager

ProgramManager

ProgramManager

ProgramManager

ProgramManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

CareManager

Provide high quality case management services by:

Responsibilities of the Care Manager

• Undertaking a comprehensive assessment of each client

• Working with the client and their family to determine a number of health and well being maintenance and promotion strategies.

• Focusing on encouraging independence and assisting the client to maintain quality of life.

• Sourcing a range of care services, medical equipment and home help services such as gardening to achieve the above goals.

• Monitoring the client’s progress is monitored to ensure that optimal outcomes are achieved.

A Day in the Life of a Care Manager

Morning

• 9-11am Visit client in Mornington and provide assessment of care needs

• 11-11.30am Return to Office

• 11.30am-12 Write up Case Notes

• 12-12.30pm Check Invoices

Afternoon

• 1pm-2pm Update Weekly Schedules and Financial Tallies against the changed Care Plan

• 2pm-3.30pm Ring Service Providers to order Care and Medical Equipment Provider to order a Wheel Chair

• 3.30pm-4pm Ring a family member to discuss changing needs of the client

• 4pm-4.30pm Ring some Respite facilities to arrange respite services for the client

• 4.30pm-5pm Catch up on some general paperwork

Managing the Client Care Plan

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

AHCSShopping1030-1230

Helen

In home physio

program1430-1530

In home physio program1130-1230

physio program at the

hospital1400-1500

AHCSPersonal care

Meal prep1600-1730Samantha

AHCSPersonal care1630 - 1700Samantha

AHCSPersonal care

Meal prep1600-1730

Helen

AHCSPersonal care

1630-1700Helen

AHCSPersonal care

Meal prep1600-1730

Helen

A core function of Baptcare’s community aged care is the provision of these care services via third party providers

The Business Problems

• Increasing Service & Labour costs

• Increasing Compliance requirements

• Client complexity is increasing on account of longer life expectancy

• Inconsistent process implementation across Baptcare

• Rapid growth in the number of service providers also resulting in process inconsistency.

How we approached the Problems

Build on the Prince 2 Based PMF Framework Roll Out

Develop BPMN / BPI Capability

Tackle Business

Problem 1

Tackle Business

Problem 2

Tackle Business

Problem 3

BPMN and BPI is not an end in itself. It is a means to business problem solving outcomes

Findings - Process Hierarchy Diagram

Area of Initial Process Interest

Findings - Context Diagram

Findings – Context Diagram showing Processes of Interest

Business Improvement - Case Study One

Normal Equipment Ordering Process– High Level Current State

Geoff Urbach Slide

1

Cap Ex Equipment Ordering Process– Current State

Cap Ex Equipment Ordering Process– Target State

Cap Ex Equipment Ordering Process– High Level Target State

Changed Business

Rule

Business Improvement - Case Study Two

Results – Service Provider Authorisation Current State

Results – Service Provider Authorisation

Results – Service Provider Authorisation – Target State

Outcomes and Expected Outcomes

Universal, easy to understand way of defining, communicating and improving CAC processes

Improved process efficiency and quality

Improved internal audit transparency

Aids the selection and implementation of supporting IT systems

Aid for improving the Baptcare / third party relationships / process performance.

Future Quick Win Initiatives

Build on the Prince 2 Based PMF Framework Roll Out

Develop BPMN / BPI Capability

Improve Supplier

Management Processes

Implement IT systems to

support BPM

Improve CACBrokerageProcesses

The Road Map Going Forward

1.

2.

3.4. 5.

Questions?