The four new job roles were developed using existing junior care and supervisory roles as a foundation, including the Healthcare Assistant (HCA), Nursing Aide (NA), Centre Supervisor (CS), Centre Manager (CM) and Nurse Manager (NM).
The design was focused on the following principles:
Increasing productivity and efficiency
Improving senior experience
Enhancing value of jobs
Offering an attractive career path for non-Nursing staff
Providing clarity on roles and responsibilities
Developing ownership for the execution and reporting of progress against the Care Plan
Contributing to multi-disciplinary teamwork
New roles created
Within the roles of the HCA and NA, we identified manual, time-consuming, and suboptimal tasks that could be streamlined or eliminated through process redesign or technology integration. These solutions can be found in the Getting Started > Recommended Solutions section of this toolkit.
Additionally, we examined tasks performed by other related roles, namely the Therapy Aide (TA) and Enrolled Nurse (EN).
By first deconstructing the HCA and NA role, identifying tasks for redeployment and then reconstructing into a new job, we were able to create blended support care roles – the Community Care Associate and Senior Community Care Associate.
Junior Care Roles
(e.g. HCA, NA)
01
The Project Team conducted a review of the proportion of time spent on various tasks by Junior Care Roles.
02
The team then reviewed tasks that are manual, time-consuming and suboptimal that can be streamlined and/or eliminated through process redesign, technology enablement and/or regulation review.
Therapy Aide
Enrolled Nurse
03
Adjacent roles such as the TA and EN were also reviewed to identify tasks that could potentially be decanted and performed by the Junior Care Role, in the development of a redesigned support care role.
Quick Tip:
Given the foundation of the roles, Community Care Associate and Senior Community Care Associates typically work alongside the Therapy Aides and Enrolled Nurses, and are suitable for HCA and NA role holders who desire an enriched role with a greater impact to holistic care.
Details of the studied roles:
Tasks identified as pain pointsShoweringDiaper check / changeTransferring of clientInput / Output documentationSanitation / HousekeepingJunior care roles, such as the HCA and NA, attend to patients’ daily living needs and perform basic patient care procedures under the supervision of trained nurses.
Through our study of the HCA/NA role, we identified tasks that took up a large proportion of time. Examples of these tasks included:
- Manual and time-consuming showers, diaper checks and changes
- Manual and physically strenuous transfers
- Manual and double-documentation of vital sign taking and other documentation
- Housekeeping tasks
Time spent on these areas were reduced with the use of technology and through outsourcing to other roles. This allowed the new roles, the Community Care Associate (CCA) and Senior Community Care Associate (SCCA), to take on enhanced care tasks.
A work review was conducted that comprehensively examined the unit of work and people involved in the coordination and provision of care at the supervisory and managerial level. External market research and the aspirations of the sector were also taken into consideration.
Nurse Managers
Project Manager
Cluster Leads
Centre Managers
Centre Supervisors
Residential Care Manager
Residential Care Executive
01
Interviews, observations and job shadowing with core role holders were conducted to map out where Care tasks are being completed, how they are being completed, who is involved, as well as understand the current challenges and pain points when completing these tasks.
02
We also conducted a Time-Task Survey to confirm the split of responsibility and identify time-consuming processes, as well as a Sentiment Survey to understand tasks they enjoy, priorities for retention, and future ambitions.
Nurses
HQ Staff
CCO Leaders
03
Additional interviews with broader staff groups such as the Volunteer Management team and Programmes team were conducted to understand adjacent processes, interactions, pain points, and opportunities for the CCE and CCM roles.
Details of the studied roles:
Supervisory roles, such as the Centre Supervisor (CS), Centre Manager (CM) and Nurse Manager (NM), oversee the efficient and safe delivery of day-to-day operations of the centre or home. They evaluate and improve work processes and collaborate with multi-disciplinary teams to provide quality care to elders. They are also people managers for Junior Care staff, evaluating performance, providing feedback, and contributing to staff professional development.
Through our study of these roles, we uncovered four themes that informed our design of the new roles:
- Having Care staff in supervisory roles enables a greater focus on holistic care delivery.
- There are overlaps in roles and responsibilities across supervisory staff.
- In the Nursing Homes, the Nurse Managers are spending time on non-clinical operational, supervisory and process improvement tasks.
- There is a need to provide flexibility and variation in career progression, to cater for different aspirations.
The focus of the design of the CCE and CCM roles was to clearly define responsibilities and increase the ownership of tasks delegated to the Executive-level. This would allow the CCM to take on more strategic responsibilities, such as developing process improvement projects, establishing external partnerships and contribute to the psychosocial aspect of care for the elders. A review of tasks completed by the Nurse Managers was also conducted to identify opportunities for clinically-trained staff to operate towards the top of their license. This was achieved by freeing up time through the introduction of the CCE/M roles.
