Shared on-call after hours service prototype

Shared on-call after hours service prototype
Organisation: The Australian Centre for Social Innovation Partner: Community Living Australia Partner: Lutheran Disability Services Partner: Lighthouse Disability Partner: Department of State Development (SA)
Contact: Kerry Jones

The intent of this project was to develop a more flexible and skilled workforce of support workers through designing and testing a shared service model for casual support workers and after hours on-call coordination.

"It is an exciting opportunity for us, not just in terms of the benefits the project brings to us, but the learnings we can get as organisations."
–Soula Dagas, Community Living Australia
"It’s mainly about building trust and mentoring the support workers. On call person needs to guide rather than make decisions."
–Steve Denholm, Lighthouse Disability Services
"Language is really important for Lighthouse. We have tried really hard to value our front line staff. It is about empowering them and paying respect about their knowledge about clients."
–Steve Denholm, Lighthouse Disability Services
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    Community Living Australia

    Lutheran Disability Services

    Lighthouse Disability

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The Context

In 2017, a disability roundtable was held in Adelaide as part of the Social Capital Residency. During that event, the partners in this project recognised the opportunity to work together to explore shared service models to increase back-office efficiency and strengthen service quality. This project allows the opportunity to implement and trial this way of working together.

The Problem

The implementation of the NDIS requires disability service providers to become more responsive to the needs of the people they support, and at the same time operate in more cost effective ways.

A challenge most disability service providers are familiar with is coordinating responses to out-of-hours calls from people accessing services and from support workers. These duties usually fall to team leaders who assume responsibility as part of a rotating roster. The project partners feel that there must be a way to streamline and simplify this work that can be brought about through a structured collaboration process.

The Solution

In this project TACSI led a co-design approach to tackling the problem. This involved collaborative, face-to-face workshops, as well as analysis of call logs from all services. The early outputs were a value proposition canvas and a service blueprint. These useful tools helped the project participants to negotiate their differences, to see what the guiding principles were, and to surface what was not open to negotiation.

This process was important when working across multiple organisations, as each individually needed to integrate the approach in with existing protocols, policies and procedures.

The resulting service design was developed using lean start-up and rapid prototyping methodologies.

Expected Impact

During the project, the design was trialled firstly using paper prototyping, then enacted prototyping and then two iterations of live testing. Each cycle built on the learning from the previous cycle and increased the number of people participating in the testing.

The evaluation focused on the experience of the live trials. It identified positive outcomes for the only service user who accessed the on-call service during this time. Workers accessing the service reported feeling supported during their interaction with the service. Further, call logs indicated early signs of workers taking initiative to organise shift changes and problem solve.  

The evaluation also found early signs that suggest the service model will make a significant contribution to organisational sustainability based on the potential for the services to alleviate manager and team leader stress. Since the beginning of the trials, all managers and team leaders expressed that they have begun to have a better work life balance and lower stress levels. This is expected to significantly reduce turnover in these roles. 

Perhaps the greater impact however will be the learnings by the organisations involved. They stand to learn how to follow the process and use the tools associated with co-designing the solution to a problem, and working with other services to achieve this.

Stage and Spread

Post IWF project completion, the design will continue to be refined with a further two live testing cycles. By this time, the service will be fully implemented. 

The key thing to learn from this project is the process taken, though insights can also be found by the solution they developed. The approach is relatively new to the service provider organisations in the project, though TACSI has a strong background in enabling these kind of projects in a breadth of sectors.

Analysis of this project will provide other disability service organisations with a solid case study about how design thinking and selected tools can be used as part of a co-design process to solve business problems.

For this project, the organisations have found a way to work together to share an efficient out-of-hours service. Arguably, it has really been the journey that they have learnt the most from.

Lessons and Insights

The complexity of working with multiple organisations at a time of rapid, externally-driven change cannot be understated. Given the increasing competitiveness of the sector as a result of marketisation, bringing organisations together required considerable time and conversation to develop an atmosphere of trust. Significant negotiations were needed to agree on the basic approach to be taken with the new service. This posed issues for the co-design process. Time was needed for these discussions to happen between CEOs before it was considered possible to meaningfully invite people with disability and frontline workers into the process. The live testing cycles afforded significant opportunity for contributions by these groups during the testing cycles. 

Another learning from the process came about through the analysis of the call logs. Services were able to identify patterns of calls and opportunities for the coaching and training of staff, as well as ways to strengthen service delivery.

Roadblocks and Risks

The most significant roadblock to this project was the time it took for the parties to work through their current ways of working, identify differences and find a way to move forward together. The project lead made the decision to allow the time required for negotiations so that everyone was satisfied with the activity that was being designed. Time restraints associated with project funding risk compromising the outcome of this kind of work.

As a result of the time lag, another risk to the integrity of the process arose. The activity was largely designed through negotiations between CEOs and client services executives. This meant that there was little opportunity for input by people with disability and frontline workers during the ‘divergent phase’ of the design process. The testing cycles however, provided additional opportunity for their input in refining the solution.