The Provider Loft

Supporting small and medium NDIS and health providers in Australia

David Kinnane

ALOFT 2: The fortnight’s most useful information for small and medium Health and NDIS Providers in Australia

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ALOFT: Advances. Legal Updates. Organisation. Frameworks. Tips.

Advances: ten health innovations to watch for, including “digital therapeutics”

As a Provider, it’s hard enough to stay up-to-date, much less to look ahead at what’s coming at us! But we need to watch for potential technological game-changers: things that might disrupt existing care models, or open up new opportunities (or both). The big brains at McKinsey have identified 10 major health innovations. The one that caught our eye was the potential of “digital therapeutics”: AI-powered applications using gamification and other behaviour hacks to engage clients and to help them achieve their goals. Read all about it (and the other 9 innovations – here).

Legal Update: 97% of NDIS appeals are settled before they get to the AAT.  Where’s the transparency?

The NDIS appeal process has always been a tad mysterious. Settlement details are confidential, which makes it hard for participants – and providers – to see what supports are being provided to people in similar circumstances. The Public Interest Advocacy Centre (PIAC) has joined more than 20 other major organisations in the disability community calling on the NDIA to make appeal decisions public. More transparency and accountability is a good idea, especially given the perception that participants who are better able to advocate and to appeal NDIA decisions are doing better than those who can’t. Read PIAC’s position and the open letter here.

Organisation: are vision, mission, and value statements a complete waste of time? How can we make them useful?

Almost every provider has a mission statement asserting their commitment to values like integrity, collaboration, client-centred care and respect, social responsibility, diversity and team work. But talk can be cheap. Do providers in general “walk the walk” when it comes to values? Researchers at MIT Sloan School of Management looked at the corporate sector in the USA and found no correlation between official values and corporate culture. This is a big problem. What can you do about it? It starts with better communication with your team. Read several easy-to-action tips here.

Frames of Mind: Work-life balance? What work-life balance!

As I write these words on a Sunday evening, I confess that this one cut close to the bone!

via: @lizandmollie

Tip: How to make planning less boring and more useful in uncertain times

Long-term strategic planning is out of fashion – especially given what’s going on right now. We need tools to cope with complex systems, and ways to build in flexibility. Agile planning is a snappy buzz phrase. But what does it mean? Alessandro Di Fiore  of the European Centre for Strategic Innovation explains all.

Find these snippets interesting?

If so, sign up for ALOFT and read information gathered by a real world Provider for Providers that is actually useful.

Child Safe Organisations: Why you need a Child Safety Code of Conduct and Policy

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If you work with children as an NDIS provider or a health provider, you need a Child Safety Code of Conduct and Policy that is consistent with the National Principles for Child Safe Organisations published by the Australian Human Rights Commission (the National Principles).

It is also important that your Child Safety Code of Conduct and Policy:

Why you need a Child Safety Code of Conduct and Policy

All NDIS providers and health providers who engage with children (face-to-face, online or both) should adopt the National Principles. Part of this process includes having a Child Safety Code of Conduct and Policy. By way of context:

  • following the 2013 Royal Commission into Institutional Responses to Child Sexual Abuse, the Australian Human Rights Commission recommended national action, including the development of National Principles for Child Safe Organisations; and
  • in 2018, the National Principles were endorsed by all Commonwealth, State and Territory Governments to provide a consistent approach to embedding child safe cultures within organisations that engage with children.

You can read the National Principles here.

Child Safety Code of Conduct and Policy Template

Our 16-page Child Safety Code of Conduct and Policy template is designed to help NDIS providers and health providers to respond to, and implement, the National Principles, as a step toward becoming a child safe organisation. The Child Safety Code of Conduct and Policy is drafted to:

Child safety is the most important obligation of NDIS and health providers who work with children. It’s also a key risk area that warrants attention at every level in the organisation. We wrote the template to help NDIS and health providers start the process of being Child Safe Organisations.

You can access lots of material, including the National Principles, free training modules, and other resources developed by the Australian Human Rights Commission here.

Go to the child safety code of conduct and policy

ALOFT: The fortnight’s most useful information for small and medium Health and NDIS Providers in Australia

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ALOFT: Advances. Legal Updates. Organisation. Frameworks. Tips.

Advances: sharing better information may make you more competitive than your competitors

Online review sites are not going anywhere. Compared to a decade ago, healthcare is much more transparent, and participants expect more from us, including better access to information. Good information can affect participant decisions about which provider to choose based on factors like reputation and costs. Traditionally, younger participants tended to seek lower cost options, and older participants went for higher quality (and cost) options. But recent research suggests that more transparency may cause nearly all participants and clients to prefer lower-cost, in-network options of average quality – value for money. There’s an opportunity for providers to lead the way in transparency and to build better relationships with participants and clients. Sharing better information with consumers may give some providers a competitive boost. Jenny Cordina of McKinsey makes the case for increased transparency as a way of improving the health system here.

Legal Update: Beware social media comments!

If you manage a public Facebook or other social media presence, you’re going to want to read about an important NSW Court of Appeal decision confirming that page administrators are “publishers of users’ comments” for the purposes of defamation laws. As with the decision of the lower court, this judgment increases providers’ risk of liability for defamation, and increases compliance costs for providers who manage public social media pages. Read this important update by the lawyers at Allens: Defamation in the digital age – beware of social media comments.  

Organisation science: supporting staff during the COVID-19 pandemic

The ongoing COVID-19 pandemic is making everyone nervous, including workers.  Professor Brooks Holtom of Georgetown University and colleagues provide five practical suggestions to help support workers during these interesting times, including: (1) communicate frequently; (2) provide safe channels for giving honest feedback; (3) support workers to work at home effectively; (4) address job security concerns directly; and (5) outline a plan for the future. Read more here.

Frames of Mind: The benefits of asking.

Who doesn’t like a good visual? In business, if you don’t ask, you don’t get; and persistence pays off eventually. Here’s a stark reminder:

via: @visualizevalue

Tip

Are all those inefficient Zoom calls driving you to despair? Here’s a tip to make your life better. All you have to do is check a box. Check our Wired’s guide to auto-muting yourself.

Find these snippets interesting?

If so, sign up for ALOFT and read information gathered by a real world Provider for Providers that is actually useful.

Better time management

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Providers: how to get it all done, even when you’re off your game or feeling burnt out

Working as an NDIS provider or health provider can wear you down and burn you out over time if you’re not careful. On Monday mornings, my average to-do list includes:

In my “downtime” – I have lots of other fun things to do like managing bookings and cancellations, sending out letters and other resources to potential referrers, responding to online and offline feedback and queries from the public, reading new research and writing blogs, participating in social media, getting the pesky accounts to balance to ensure I don’t go bust and attending to any legal, HR, professional development and ethical/professional requirements.

Pushing all those half-written assessment reports up the deadline hill can feel a bit Sisyphean, knowing that, come Monday, it will all start again.

How to wear yourself out

In my early years of practice, I found myself stuck at work for very long hours, working late into my evenings, and often on weekends, too. My workload was eating into quality time, as well as time to exercise and meditate regularly, to work on projects to help others (like this one) and to have a life! I’d also fallen into the trap of working too much “in” my business – attending like a busy worker ant to the day-to-day tasks – and not enough time “on” my business, such as improving the quality of my services for clients. It was starting to affect my relationships and health, my mood and creativity, and my motivation to keep doing the work professionally.

Something had to change. Quickly.

So how to do more in less time?

More recently, I’ve focused on getting more done at work in less time while maintaining ethical, and evidence-based standards and good client service. I tried out several leading “productivity systems”, and found many of them were too complex to use in practice. Then I found one that worked. I’ve used it ever since.

1. First, know your enemies: procrastination and Parkinson’s Law

For a couple of weeks, I wrote down everything I did at work, tracked my time, and then reviewed it. It was horrifying.

I found:

A. Heaps of wasted time, then guilt-laden attempts to make up for it:

  • staring at my computer, mulling big unanswerable questions;
  • getting side-tracked, starting lots of projects in parallel and not finishing any of them;
  • checking emails obsessively, a hangover from my law firm days;
  • reading breaking news on my phone;
  • engaged in pointless social media discussions; and
  • feeling guilty about not getting stuff done, so working on into the evening.

These are all examples of procrastination. They steal time from things that matter. They also deplete your attention, energy and capacity for critical thinking, which means all the “brain work” takes longer than it should to complete.

B. I was a hostage to Parkinson’s Law.

On the clinical-management side of my practice, I found myself enslaved to Parkinson’s Law. Even if you haven’t heard the name, you’ll be familiar with its effects.

Parkinson’s Law says that:

Work expands to fill the time available for its completion.

I found regular weekly tasks, like planning therapy sessions, or writing reports, seemed to take the same amount of time in total, regardless of the number of clients I was seeing, or the number of reports outstanding. For example, I found that four-client-days took me roughly the same amount of time in total to prepare for as eight-client-days. I had unconsciously determined that planning took X hours, and then gave myself X hours to plan the sessions.

2. Use The Pomodoro Technique

I first heard about this simple concept when listening to a podcast while out on a jog. At first, it seemed a bit gimmicky. But I decided to give it a go. And now I’m sold on it. A Pomodoro Evangelist, if you will.

The Pomodoro Technique is named after the tomato-shaped timer that was very popular in the 1980s. But you don’t need a tomato-shaped timer. I use my phone.

Here’s how to do it:

(a) Decide and stick to your “home time”. One way to stay focused is to force yourself to leave at a decent hour. (I like to have dinner with my kids, so I need to leave work in time to get home. It’s almost non-negotiable, although I still make the odd exception, e.g. if an adult client needs to see me urgently.)

(b) Jot down your “to-do” list the night before, with a “frog” at the top. This is the last task I complete before leaving work each day. I try to put the least thrilling important task at the top of the list – something Mark Twain called “eating a live frog first“. It means I can hit the ground running.

(c) Be ultra-specific in defining your goals for the day. Rather than set big, ambiguous goals (e.g. “Become a better speech pathologist”, or “Do marketing”), I set very specific goals, always starting with a specific verb/action e.g. “Plan [X] therapy sessions”, “Call [specific teacher] to discuss [specific client’s] progress”, “Read [specific article]”, “Score Assessment results for [client]”, “Write 1000 word blog on [reviewed article] for website”.

(d) As soon as I get in to work, I set my phone timer to 25 minutes. No time for checking the news or email, or reflecting on the success of my Sunday BBQ. Just straight down to “eating that frog”. During that 25 minutes, I focus on the single task. No distractions.

(e) Once the timer rings, I cross off one “pomodoro” and rest for a full five minutes. I stretch, drink some coffee or water, walk around the clinic and have a chat with my team members about the day’s workflow. I do not check emails, or social media. I know exactly what’s coming up because it’s on my “to-do” list. If something unexpected and urgent comes up, I amend my “to-do” list, but only when absolutely necessary.

(f) After the five minute break, I set the timer for 25 minutes, and get stuck into the next item on my list.

(g) After four “pomodori“, I take a 15-30 minute break.

That’s it! You can add bells and whistles as you go: I stepped up to using the Forest app to count my Pomodoro sessions for example.

3. How I use the technique in my clinic

I try to do at least 8 of these 25 minute pomodori a day – 200 minutes of solid work – outside therapy sessions. Where possible, I try to set each goal to something I can do well in 25 minutes. (I got better at this over time.) If I finish a task within 25 minutes, I spend the “leftover time” improving whatever I was working on, rather than jumping to the next task or *gasp* checking my email. For longer tasks, like writing an assessment report, I dedicate multiple pomodori to it over the course of the day (usually with other tasks scheduled between each to keep me focused).

Despite the temptations, I try to take the full five minute break after each pomodoro; and reward myself with a longer break after four, even if I feel I’m “on a roll”. If I have a “great idea” about something else in the middle of a pomodoro, I simply jot down the idea in my Evernote notebook dedicated to “random thoughts”, and get back to work. At the end of the pomodoro, I review the “great idea”. If it is in fact great (which is rare), I add it to my to-do list. If not, I delete it.

I never check emails during a pomodoro. I let calls go through to voicemail if I’m in the middle of a pomodoro and there’s no-one else to pick up the phone. If someone at work wants to speak with me, I ask if it’s an emergency. If not, I tell them I will speak to them at the end of the pomodoro. (My team members are used to this now!)

4. Why does it work?

Not entirely sure! Here’s what I think:

  • Chunking big tasks into smaller tasks makes them less intimidating – easier to start.
  • More control over my day. After doing it for over six months, I’ve now internalised the habit.
  • I find it easy to focus for 25 minutes. Any longer than that, and I get bored and distracted.
  • It combats Parkinson’s Law: e.g.:
    • each Monday, I assign three pomodori to plan all my sessions from existing management plans;
    • every work day, I assign one pomodoro to resource and set up each therapy session – no more, no less.
  • The timer jolts you out of procrastination or gazing blankly at the computer.
  • As you tick off each 25 minute pomodoro you build momentum and get more out of your day.
  • When I leave at my designated “home time”, I feel like I’ve accomplished a lot. I’ve also used up most of my mental energy and attention for the day on tasks that matter. I can relax and hang out with my family without guilt.

Whatever the reasons, implementing the Pomodoro Technique has led to big and sustained improvements in my productivity. If you’re struggling to get things done efficiently, give it a go!

Principal source: Cirillo, F. (2013). The Pomodoro Technique. 3rd Edition. Updated & Expanded by FC Garage GmbH (first published 2006).

Image: http://tinyurl.com/z7lmpxq

Better learning

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Providers: How to learn new skills rapidly.

By nature and necessity, NDIS providers and health providers are life-long learners. Not only do we have to stay on top of research to keep our skills up to date, we have to learn finance, marketing, technology, compliance, and other business skills, too.

Learning is essential to providing quality care to clients and for running our businesses. But there are so many things to learn, and so little time. So what can we do to learn new skills rapidly?

Skills and knowledge are related, but different. Both are necessary to do professional work well

Professional work combines practical skills with special knowledge. They are not the same thing:

  • In law, I graduated with good academic knowledge of the laws of evidence, but then found myself as a new grad unable to make a simple filing because I didn’t have the skill to know how to draft the filing in a form that would be acceptable by the Court. I needed my supervisor to show me how to do it, using a template and modelling.
  • In the first semester of my speech pathology degree, I memorised head and neck anatomy, but then struggled to complete my first cranial nerve exam on a real, breathing person. It took me a good 15 tries before I could smoothly coordinate the practical motor requirements of the tests with my theoretical knowledge of the cranial nerves.

As a nerd, I’ve always found it easier to start with knowledge, and then learn the practical skill. Some of my colleagues do it the other way around: throwing themselves into practical tasks and then building the necessary professional knowledge around what they do.

Both ways can work. But good providers learn quickly that, in clinical practice, you need both skills and knowledge to do a good job.

Learning a new skill isn’t the same thing as improving an existing skill

Seems obvious, right? But we sometimes forget that you need to walk before you run. Many providers I know (including me!) sometimes forget that acquiring the basic skill requires a different approach to training an existing skill. Learning to walk is hard. Going from walking to jogging is less hard; and accelerating your jog into a run is easier again.

How to learn a new skills quickly?

Josh Kaufman, in his excellent “The First 20 Hours: How to Learn Anything Fast”, recommends 10 key principles of rapid learning. Here they are, paraphrased and ‘translated’ for NDIS and health providers:

1. Choose a loveable project: Rapid skill acquisition is hard. It helps if you choose a skill that is important to you and your business – a skill that will make a difference, and ideally, that you will enjoy having. For example, early on, I decided to learn how to do evidence-based voice therapy for people with Parkinson’s Disease because I found the work very rewarding. I learned how to blog properly because I love sharing knowledge. I learned how to use video editing software (like Camtasia) to make training videos for my team because I was sick of spending my time saying the same thing over and over and wanted to save time. In each case, I had a compelling reason to do the work.

2. Work on one skill at a time: Focus! In our clinic skills improvement program, for example, we focused first on deepening our knowledge of language stimulation skills for children with Autism Spectrum Disorder before we kicked off a project to improve our diagnosis and treatment of childhood apraxia of speech. In business marketing, we decided first to learn the basics of Facebook, Twitter, LinkedIn, then Instagram because my target audience was interacting on those platforms. I don’t worry too much about TikTok at this stage. But, like Instagram, I might change my mind if it makes sense from a business perspective to do so.

3. Define your target performance level: To be good at my job, I don’t need to become a web or graphic designer, or produce award-winning documentaries. I need my work to be clear and useful. What does good enough look like to you?

For new business skills, our base-line is competence. We won’t offer a service until we’re sure we can do it competently. In business marketing and advocacy, our base line is based on the usefulness of the information we present. Will a particular blog post give participants enough evidence-based information to know what to do next or where to go for more information?

This means we always proofread our work for readability, and cite our sources. It doesn’t mean that we aim for perfection. Trying to be perfect is a fool’s game, and can lead to procrastination and paralysis. 

4. Deconstruct skills into sub-skills. Most important skills can be broken into sub-skills. For example, when learning to do Cycles Phonological Remediation Approach, we broke the program into sub-skills. We read a few of the leading peer-reviewed articles. We blogged about it (mainly to explain it in Plain English to ourselves). We broke the research down into chunks, like how to choose targets, how to do auditory bombardment, how to explain the program to parents, how to give clients feedback on attempts, how to use reinforcement and feedback, and how to ensure adequate dosage/repetitions in sessions. We then story-boarded a sample session and tried it out on each other in role-plays. We then developed resources (e.g. audio recordings and target word lists) to support efficient and consistent delivery across the practice. 

This approach works for business skills, too. For marketing with infographics, we first sat through a tutorial on how use the software properly (Canva), then worked out how to make a readable template, then practised summarising some of our more popular blog posts into single page bullet point lists, and finally mapped out how to get the work done on a schedule.

5. Obtain critical tools. It’s hard to practice a skill without the right equipment, and it’s easy to put things off because you don’t have the right tools. In business, having access to quality templates, procedures and management systems is essential when learning, for example, how to improve client satisfaction ratings and retention, or to reduce your failures to attend.

6. Eliminate barriers to practice. You need space, resources and time to practice new skills properly. Distractions (e.g. emails, phone calls, texts, Facebook) and emotional blocks (like fear, doubt, imposter syndrome, and embarrassment) can get in the way of learning new skills. In the clinic and in business, I block out times to work on new skills. I unplug my devices and force myself to persevere, despite my internal doubts.

7. Dedicate time to practice. You have 1,440 minutes a day to get things done. We all have work and family commitments. We all need leisure time, exercise, and sleep. But we all have time-wasting behaviours, too. I did a time audit and discovered mine were Netflix binges and reading the news on my phone. By reducing both, I found the time to learn new skills.

8. Get fast feedback. After learning about a new skill you think is important, don’t wait months to get your hands dirty. Try things out safely in the real world as soon as possible, and be prepared to make quick changes to improve your accuracy and skill level.

For skills like book-keeping and social media posts, you might get instant feedback from your system or followers (sometimes a little confronting!). For new client skills, try to gets lots of immediate feedback on how you are doing when you are first practising the skill; then move to delayed and less frequent feedback as you master the basics and start training the skill. Experienced mentors can be a big help here.

But, if you don’t have one to hand (and you should!), tools like biofeedback, or video and audio reviews of your performance can help you assess how you are doing – even if they are painful to sit through in the early days!

9. Practice in bursts, by the clock: When you’ve mastered a skill, time flies. But, during your first few attempts, time can drag. In the early stages, set a minimum block of time to work on the skill, e.g. 20 or 25 minutes. Once you start, keep going – even if it feels like you’ve been making mistake after mistake for hours. When I’m particularly hopeless at something (usually fine motor-related), I sometimes feel like the timer will never go off!

Hang tough, even if you feel terrible about your poor performance and ‘urgently’ need to know all about the local footy scores or have a sudden urge to Marie Kondo your garage. Aim to distribute practice throughout the day when learning a tricky motor skill. Kaufman recommends practising new motor skills just before bedtime so that your brain can consolidate your learning during sleep. 

10. Go for massed practice and fast repetitions: you need sufficient quantity of practice and speed of trials. Once you’ve achieved acceptable ‘basic form’ in whatever skill you are learning, practice as much as you can, and as often. The faster and more often you practice, the more rapidly you will pick up the skill. For motor skill acquisition (e.g. like touch typing or learning to use a new resource requiring manual dexterity), many of these principles will sound familiar to those of us trained in principles of motor learning.  

What about rapid learning of knowledge?

Aha! Good pick up and great question. Regular readers will note that some of Kaufman’s principles are consistent with evidence-based studying techniques, such as spaced practice, forced retrieval, and doing practice tests with the same structure as the real test.

This is one of my favourite subjects and an excellent topic for another day, don’t you think?

Bottom line

For NDIS providers and health providers, learning new skills is hard, but essential. When next preparing to learn a new skill, use the 10 principles above to practice it in the most efficient and effective way possible.

Principal source: Kaufman, J. (2013). The First 20 Hours: How to Learn Anything Fast. London, England, Penguin Books.

Image: https://tinyurl.com/y2pnmxx9

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