Building a culture of safety in Australian residential aged care facilities

Aged care in Australia is complex and expanding. The sector is the subject of intense scrutiny due to problems in the safety and quality of care provided to residents in residential aged care facilities (RACFs). Many failings have been attributed poor organisational culture, including toxic cultures, a focus on box-ticking instead of quality, and limited respect for residents. However, unlike hospitals, culture in RACFs has had little empirical research.

Methods to measure culture, particularly in relation to safety, have not been adapted for Australian RACFs. There has been a dearth of mixed-method, longitudinal research to understand how aspects of organisational culture influence safety and quality in RACFs. This is urgently required to diagnose problems in safety and quality in Australian RACFs and develop evidence-based interventions to improve culture.

The overarching aims of my research program are to examine how organisational culture and context influence safety and quality in RACFs and to evaluate the effectiveness and implementation of an evidence-based culture change intervention. This research is conducted in collaboration with a large national provider of residential aged care services and will involve mixed methods including surveys, ethnographic fieldwork, and interviews.

In Australia, the aged care sector has been challenged by issues of quality and safety, including toxic cultures neglect and poor respect for residents. This research program will identify how the culture of residential aged care facilities affects the safety and quality of care provided to residents and put into action strategies to improve culture and thereby residents’ outcomes.