Introduction
In many instances, when new standards or regulatory frameworks are introduced, requirements are listed that lack background, accompanying material, or guidance on implementation. These requirements are important but often leave providers without the necessary support to implement them. Action 2.9.5 is certainly one of those instances.
Standard 2: The Organisation, Outcome 2.9: Human Resource Management, Action 2.9.5 mandates that "providers regularly review and improve the effectiveness of their training systems".
This article explores the new requirement and provides a mental model to “regularly review the effectiveness” of a “training system.” By introducing performance metrics, we can define the effectiveness and efficiency of an LMS and leverage education and training for growth.
Governing Body Oversight
With the provider governance reforms in effect from December 2023, governing bodies have increased responsibilities for overseeing their workforce's skills, qualifications, and competencies. This new responsibility necessitates a governing body actively overseeing Action 2.9.5.
While the L&D team actively runs the system and will report directly to the People and Culture Leader, executive teams and governing bodies (Board) need to be across this system. To meet Action 2.9.5, providers require a framework to assess their performance at a high level. We need clear criteria to evaluate whether the Learning Management System (LMS) is effective and whether it performs as intended.
Effective Training - A Solution to Workforce Challenges?
Ongoing workforce challenges in aged and home care, specifically attracting and retaining skilled staff, continue to lead to corporate-led initiatives. These initiatives include rapid upskilling and effective onboarding, reducing inefficiencies and improving the educational and organisational outcomes of induction and mandatory training schedules. Implementing best-practice onboarding, induction, and mandatory training strategies can provide significant long-term benefits in workforce stability and quality of care.
This is because there is a strong body of evidence, primarily from nursing studies, that effective onboarding programs support the initial socialisation of staff into the workforce. Best-practice-designed onboarding programs are more successful in helping novice practitioners gain confidence, feel supported, and move through the novice-expert continuum at an appropriate pace, leading to better care and improved staff retention.
Evidence Supporting Effective Onboarding
- Effectiveness of formal onboarding for facilitating organizational socialisation: A systematic review
- Best Practices For Healthcare Organisations Onboarding New Nurses
- Improving Communication and Collaboration Skills in Graduate Nurses: An Evidence-based Approach
- The Essentials for an Effective Onboarding Program for New Nurses
Meeting Action 2.9.5 of the Strengthened Aged Care Standards is essential — not just for compliance but also as a critical step in addressing staff attraction and retention.
Action 2.9.4
Before delving into Action 2.9.5, let’s examine Action 2.9.4.
2.9.4 The provider maintains and implements a training system that:
- includes training strategies to ensure that workers have the necessary skills, qualifications and competencies to perform their roles effectively,
- draws on the experience of older people to inform training strategies,
- is responsive to feedback, complaints, incidents, identified risks and the outcomes of regular worker performance reviews.
Key Terms in Action 2.9.4 and 2.9.5
The Glossary within the Strengthened Standards does not include the key terms in 2.9.4 and 2.9.5. So, let’s start by defining them.
What is a “Training System”?
A training system could encompass the processes and policies an organisation has in place for planning, scheduling, assigning, evaluating, and reporting on education. It might include a Learning Management System (LMS) or a workforce capability platform. Given that Actions sit within the human resource section of Standard 2: The Organisation, let’s assume that the Commission is encouraging us to consider a training system from the provider or organisation’s personnel in this particular instance.
We cannot exclude the learner's experience from our evaluation or quest to improve effectiveness. Even the greatest LMS that functions perfectly well for HR or L&D may not be effective if it is not designed with the learner’s needs, environment or learning experience in mind. No training and education will be completed if it always has to be completed on a desktop or disengages because it does not meet the diverse workforce’s multilingual and multicultural learners' needs.
A training system enables an organisation to achieve its key objectives relating to training, education and workforce development and achieves the desired learning outcomes.
What are “Training Strategies"?
Training strategies refer to the diverse set of activities, initiatives, and programs an organisation develops and rolls out to improve staff capabilities. Training strategies are delivered through various methods and formats to engage and educate staff effectively, depending on the goal and learning outcomes of the strategy. For example:
Training Strategy | Goal | Typical Method of Delivery |
---|---|---|
Onboarding (Orientation) Programs | Integrate new staff into the organisation. | Comprehensive introductory sessions with teams and HR-led activities. |
Induction Training | Specific training to familiarise new hires with the organisation's compliance requirements during onboarding. | Online modules, in-person or hybrid. |
Mandatory Training | Annual compulsory training completed as a condition of employment. | Online modules with in-person competency assessment and verification (as required). |
Continuing Professional Development (CPD) | Meet specific learning needs of registered health professionals (e.g., ENs, RNs, and other allied health professionals). | Seminars, workshops, online courses, lectures, webinars, and articles, with documentation and reflection on learning required. |
Optional or Non-Mandatory Training | Close or narrow targeted gaps in knowledge, skill, or practice through clinical education. | Online modules, in-person Toolbox sessions, microlearning. |
Mentoring Programs | Pair less experienced, novice staff with experienced staff to build competence and confidence. | One-on-one mentoring, group mentoring sessions. |
Leadership Programs | Support the development of current and emerging leaders to develop leadership capability and facilitate succession planning. | Leadership workshops, online courses, executive coaching. |
Specific Upskill Programs | Address specific knowledge, skill, or practice gaps amongst cohorts with targeted education and training. | Targeted online courses, in-person practical sessions. |
What are "Skills"?
Skills refer to the specific abilities required to perform job tasks effectively. These can be technical (e.g., clinical care procedures such as taking vital signs, documenting assessments or showering a client) or professional skills (e.g., communication, teamwork, handling a complaint).
What are "Qualifications"?
Qualifications are formal certifications or degrees that validate a person's ability to perform their job roles. This includes credentials from educational institutions (e.g., a Bachelor of Nursing) and Vocational Education and Training (VET) courses, such as a Certificate III in Individual Support (Ageing).
What are "Competencies"?
Let’s start by considering what it means to be “competent”. According to Donna Wright, competency is demonstrated through showing, demonstrating, or verifying knowledge, skills, behaviours or abilities in real-world settings.
Competencies combine skills, knowledge, and behaviours that enable individuals to perform their roles effectively. A qualified assessor often formally assesses and signs off on competencies to ensure that staff members can perform them to the required standard in a real-world scenario. A competency verification process may involve practical demonstrations, observed performance, various assessments or uploading of evidence to demonstrate and verify that individuals meet the necessary criteria for competence.
We’ve defined the key terms, so let’s unpack the other elements in 2.9.4.
Training Draws on the Experience of Older People
Incorporating the experiences of older people when creating training strategies prioritises person-centred care. This approach acknowledges that the quality of care in aged care facilities is not solely determined by providers but also by the residents' overall quality of life and lived experiences.
Here are two practical, evidence-based approaches L&D teams can take to draw on the invaluable insights of older people:
- Co-designing education with residents themselves.
- Integrating outcome measures into needs assessments.
Andrea Waring, Quality and Risk Manager at CareXcell shared a simple yet meaningful example: new staff members must have tea with a resident during their induction process. This simple act allows for genuine conversation and connection, enabling new staff to understand the resident's perspective from the outset. Additionally, Andrea invited residents to present education sessions, integrating their experiences into onboarding new staff. Listen to the full episode here for more inspiring examples.
The National Aged Care Mandatory Quality Indicator Program (QI Program) requires residential aged care services to collect data on quality care areas, resident experiences, and satisfaction. L&D teams can use this data to validate training needs in tandem with direct resident feedback. Furthermore, the quality data acts as an evaluation metric and can be used to measure the effectiveness of educational interventions by comparing pre- and post-training data.
Responsive to Feedback and Performance Reviews
An effective training system must respond to feedback, complaints, incidents, and performance reviews. However, it's crucial to approach this with a nuanced understanding that more than education is needed for all organisational issues.
Organisational issues stemming from poor systems, processes, morale, or lack of resources require different interventions.
Conducting a thorough needs assessment in the planning phase will identify and validate with data a clear need for training, education, or other relevant initiatives to mitigate clinical risks, such as high-prevalence, high-impact events. The best practice is to use education and training to address specific feedback, complaints, incidents, and identified risks when there is a validated need.
- Focus on addressing root causes while using targeted training to fill specific gaps.
- Using training and education wisely, to address educational gaps only will save time and resources and contribute to a positive learning culture.
Unpacking Action 2.9.5
2.9.5 The provider regularly reviews and improves the effectiveness of the training system.
Who’s Responsibility is Action 2.9.5?
Who should regularly review and improve the effectiveness of the training system? It's not as simple as assigning this task to the L&D team. While the L&D team should be heavily involved, they need a direct reporting line to the governing body. This connection ensures that the governing body overseeing workforce skills, qualifications, and experience is fully informed. L&D cannot operate in isolation; their data and insights must be shared. This also helps L&D teams effectively communicate the link between education initiatives and their outcomes.
What Constitutes “Regularly”
The term "regularly" is defined as "occurring at recurring intervals" (Aged Care Quality and Safety Commission, page 55). However, the specific interval should be determined for each case. For practical purposes, let’s consider a minimum of at least annually.
What Does "Review” Mean?
A formal review process includes several steps. Here’s a breakdown:
![“What](https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/marketing/Toolbox/Thought+Leadership/(01.07.2024)-TL+Image+6237.png)
Are these steps relevant and practical for your situation? Probably not. Let’s keep working through the action in our quest to create a framework to meet this requirement.
How Should We “Improve Effectiveness?”
We could look to a validated evaluation model to evaluate training and education strategies to identify how to improve effectiveness. For example, the New World Kirkpatrick model evaluates training across four levels:
![“The](https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/marketing/Toolbox/Thought+Leadership/(1.7.2024)TL+Image+6235C.png)
Simplifying Action 2.9.5!
Defining the key terms will at least assist with how we think about Action 2.5 by now. But we’re still lacking something measurable. Can we draw on other industries? Every sector, every company, and every CEO undertakes a process to review and improve the effectiveness of a core aspect of the product and service, right?
What Does the Aviation Industry Do?
How do airlines review and assess the performance of their engines to ensure efficiency? Ultimately it comes down to a performance metric of “passenger miles per litre of fuel”. Therefore, any effort to impact this number will be deemed effective. For example, reducing the aircraft's weight, improving the aircraft routes to avoid unnecessary stopovers, or replacing engines as new, more efficient technologies emerge, etc.
What Does the Freight and Transportation Industry Do?
Freight companies obsess over “average freight cost per km” or “average freight cost per tonne.” Good performance metrics help employees identify ways to reduce costs and increase performance while also being wary of decisions that may increase costs. For example, a delivery driver who makes fewer stops and shorter trips will deliver more parcels in a shorter period of time, hence a lower average freight cost per tonne.
These examples show that a company can increase its profit margin by focusing on specific metrics. Read more about Profit per X in ‘Good to Great’ by Jim Collins.
Establishing Performance Metrics for Training Systems
I asked Ausmed’s CEO, Will Egan, how he thinks about performance. How does he know one of our key products, the Ausmed LMS, is effective? Does he have a mental model he uses to assess if what we are creating is effective? What metrics does he use to evaluate performance? Here’s what he said.
We think about the term effectiveness in two ways:
- Most importantly, does the education lead to the desired outcome or change in behaviour?
- Was the education administered in an effective way?
Regarding item two, we tend to take an engineering approach to this question. For us, an effective administration system enables organisations to:
- Deliver a high number of learning outcomes,
- With a high average completion or compliance rate,
- For the largest number of staff (workforce),
- At the lowest cost (which we measure as L&D FTE).
For example, if a provider were able to deliver 34 learning outcomes, with an average compliance rate of 80%, for 5,000 staff with a 0.2 FTE in L&D per 1000 staff managed, this would mean one L&D professional can manage 170,000 training requirements for 5,000 staff whilst maintaining an 80% compliance rate before any interventions are required.
Ultimately, to determine the effectiveness of any system, we simply need to ask how much of the “work” the system does before a human is required to intervene.
Applying the Mental Model Beyond Action 2.9.5
The strengthened aged care quality standards specifically require providers to regularly monitor and review not just their training system but also their quality system , digital clinical information system and risk management system. By applying these principles to all critical systems, providers can create a robust framework for continuous improvement, fostering a culture of excellence and accountability throughout the organisation.
Regular review and improvement of training systems are crucial for maintaining high standards of care in aged care. Governing bodies, particularly CEOs and Boards, will benefit from a simple mental model to understand the return on investment they are making in training and building workforce capability and if it is achieving the desired organisational goals.
References and resources
For more information, you can refer to the following resources:
- Aged Care Quality and Safety Commission - Strengthening Provider Governance
- The Strengthened Aged Care Quality Standards – Final Draft
Author
![Zoe Youl - Head of Community at Ausmed](https://ausmed-cdn.s3.ap-southeast-2.amazonaws.com/marketing/blog/2024/zoe-youl.jpg)
Zoe Youl
Zoe Youl is a Critical Care Registered Nurse with over ten years of experience at Ausmed, currently as Head of Community. With expertise in critical care nursing, clinical governance, education and nursing professional development, she has built an in-depth understanding of the educational and regulatory needs of the Australian healthcare sector.
As the Accredited Provider Program Director (AP-PD) of the Ausmed Education Learning Centre, she maintains and applies accreditation frameworks in software and education. In 2024, Zoe lead the Ausmed Education Learning Centre to achieve Accreditation with Distinction for the fourth consecutive cycle with the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation. The AELC is the only Australian provider of nursing continuing professional development to receive this prestigious recognition.
Zoe holds a Master's in Nursing Management and Leadership, and her professional interests focus on evaluating the translation of continuing professional development into practice to improve learner and healthcare consumer outcomes. From 2019-2022, Zoe provided an international perspective to the workgroup established to publish the fourth edition of Nursing Professional Development Scope & Standards of Practice. Zoe was invited to be a peer reviewer for the 6th edition of the Core Curriculum for Nursing Professional Development.