Aims: Care for older adults over 65 years, is characterised by a system of multiple providers and funders that contribute towards a complex service offering. This project aimed to determine clinicians’ experiences of providing care for older adults in NSW and the factors contributing to value.
Methods: The 10-item Clinician Experience Measure (CEM) captures experiences across four domains: 1) Quality of Care, 2) Interprofessional Collaboration, 3) Psychology Safety and 4) Clinician Engagement, and was administered to clinicians across NSW. Online focus groups elaborated the CEM data.
Results: Responses were received from 282 clinicians, representing 15 health districts and networks. Of these, >80% of clinicians agreed they could provide high quality, person-centric care, collaborate effectively and harmoniously with colleagues, had strong psychological safety in their workplaces, and were engaged in organisational decision-making. Despite positive individual experiences of providing care, qualitative data from the focus groups with 21 clinicians demonstrated that system fragmented funding and service delivery models between aged, acute, and community care detrimentally impact experiences. Eight themes demonstrated lack of clarity for older adults as to the care available to them, timely and equitable access to care, poor system interoperability and problems in identifying and retaining staff. These factors impact staff well-being, timely care provision for older adults and ultimately expose older adults to preventable acute care admissions, longer length of stay in hospital and poor health outcomes.
Conclusions: Value is the care of older adults requires tackling issues of funding and system fragmentation, resourcing, and equity in access to information and services for older adults.