One of New Zealand's longest-running aged care organisations, CHT Healthcare Trust, is funding a project set to transform care through a highly tailored, needs-based model.
Selected to receive an inaugural grant from the new CHT Aged Care Fund, Professor John Parsons, of the University of Auckland, is piloting a casemix project over six months at CHT's rest home, hospital and dementia unit in Te Awamutu.
Casemix involves a mix of patients treated, as described by a system which aggregates information about patients and treatments into groups based on the health condition or type of procedure.
"As the population continues to change, residents are now older, more frail and have more significant needs requiring skilled nursing care," says Professor Parsons. "Currently, an assessment system is in place to establish funding and care. However, it is both outdated and only looks at diagnosis and bed type (rest home, hospital or dementia) rather than the actual needs of each person."
Professor Parsons' casemix model uses 15 distinct categories across rehabilitation, clinical complexity, cognitive or behavioural issues, physical function and daily activity levels of an individual to form a full picture of that person, and more accurately determine their needs.
Max Robins, chief executive at CHT Healthcare Trust, says this project is now putting into practice the categories and assessing the casemix model in action, involving a small group of residents who are either stabilising after a hospital stay then returning home, staying for respite care, or for end-of-life care.
"Nationally, short-stay residents in aged care represent a significant proportion of all residents and use the most resources for providers," says Robins. "So looking into how their care and funding can be improved is critical for the long-term future of the aged- are sector."
"These residents will receive care using the casemix categories tailored according to their needs – and can be reclassified if their needs change during their stay, allowing our team to deliver a more responsive level of care."
During the course of the demonstration, residents will also receive important services like dentistry, OT, speech therapy, dietetics, and specialist mental health which are not currently offered (or vary markedly according to provider), to explore what impact those services might have as part of a casemix model.
CHT's dedication to continuous quality improvement and innovation, and its desire to support delivery of high-quality care across the entire aged care sector, inspired it to establish the CHT Aged Care Fund last year. The core ambition of the fund is to enhance the wellbeing of older people, through grants each year across research, access to care and workforce development initiatives.
Parsons and his team have a passion for developing services for older people, helping them maintain their independence and receive the right level of care for their needs. They have extensive experience with developing and experimenting with casemix in home care, ACC and district nursing settings, and a casemix model in home care was successfully implemented.
A specialist team from the Waikato DHB will also be seconded into CHT Te Awamutu for the duration of the demonstration, with results continually assessed by Parsons.
Robins says the CHT Aged Care Fund is an initiative that is unique in the aged care sector and has been established with a long-term view to instigating positive change.
"The charitable trust status of CHT is important because it means that all our surplus funds go back into improving our existing 16 facilities in Auckland, Bay of Plenty and Waikato, as well as the CHT Aged Care Fund," he says. "They don't go into the pockets of shareholders like many other major aged care and retirement organisations."
• Applications are now open for the 2020 CHT Aged Care Fund grant - simply apply online at www.cht.co.nz.