There was much confusion and frustration among staff in the aged care industry when the Aged Care Act 1997introduced compulsory continuous quality improvement, and audits became a major part of the aged care industry. At this time, there were many quality consultants advising the industry, some of whom had never worked in aged care. This posed considerable difficulty in their ability to understand what, when, how and where improvements could be made, let alone the difficulties inherent in the application methods of what they were proposing to implement. Many people did not understand that aged care was a service industry and had many intangible products that were difficult to improve, or that the improvements may be so subtle that they could not be measured. The audit tools used in the industry were neither clinically nor scientifically significant. Some of them were not user-friendly; nor did they gather data to improve. The audit processes were creating an enormous amount of unnecessary paperwork and statistical analysis could not be conducted with the data collected.
Having studied continuous quality improvement as a core subject for a Master of Business Administration degree and continuous improvement processes in healthcare at the certificate level, the researcher knew the weakness of the system. The researcher had been implementing the continuous improvement concept at her workplace to improve resident care and work practices long before it was introduced through legislation.
In 2001, a report of a two-year review of aged care reforms was published and it confirmed the inherent weakness of the accreditation system. The report made seven recommendations, the last of which was to introduce objective measures of continuous improvement to enable assessment of improvement over time.
Thus it was both personal and professional interest that inspired the researcher to undertake this study, in order to make a contribution to the aged care industry regarding continuous improvement.