Dr Nicky Baker, Research Fellow, ARIIA

Over the last decade there has been a 32% increase in people aged 65 years and older in Australia. With the increase in ageing population, there has been an associated 5.9% increase in residential aged care admissions nationally, so that, today more than 200,000 Australians live in residential aged care (RAC)¹. Of all the states and territories, Tasmania has the highest proportion (20%) of the population aged 65 years and older, and of these, 36.5% live in residential aged care². People aged 65 years and older are more likely than younger age groups to be hospitalised, experience a longer length of stay (LOS), and have higher rate of readmission. Longer stays in hospital for older people leads to increased likelihood of hospital acquired conditions, cognitive and physical deconditioning, and functional decline³. Further, the financial and system cost of managing unnecessary or avoidable presentations creates additional burden to an already overstretched health system⁴. Residents in RAC homes are often frail with multiple comorbidities. The priority for medical management of these comorbidities is a regular maintenance control rather than cure⁵. However, this group can also be frequent users of emergency ambulance and hospital services. The ambulance travel and hospital admissions are stressful for residents and families, and are costly to the health system, yet are often avoidable⁶. 

The Aged Care Reform Unit (ACRU) of the Tasmania Health Service (THS) was launched in January 2023. They deliver programs to improve access and flow between RACs and hospitals for better resident outcomes and health system benefits. ACRU also facilitates the Tasmanian Aged Care Collaborative (TACC) whose overarching purpose is to support delivery of person-centred care for residents in their movement between RAC and hospitals.

'To call or not to call' for residential aged care nursing staff is a proof-of-concept initiative that involves face-to-face workshops, provision of evidence-based resources, and follow up support via peer support and mentoring to address these issues.  The collaboration is supported by THS’ ACRU, the Aged Care Quality and Safety Commission (ACQSC), Ambulance Tasmania, Primary Health Tasmania and Aged care Research and Industry Innovation Australia (ARIIA).

The aims of the evidence-based practice workshops to be held across Tasmania in the week of the 24 March 2025 are: to increase capacity of residential aged care ENs and RNs with early identification and response to deterioration in the older person; to engage the right clinical support in place; to strengthen clinical reasoning, decision making and communication skills; and to make direct referrals to supporting Tasmanian Health Services (THS). 

Evidence-based resources include the Aged Care Learning Information Solution (Alis) learning platform, the after-hours tool-kit for aged care, information on shared transfer of care. These will be used by workshop facilitators to support experiential learning through case studies developed by ACQSC on scenarios depicting an older person who has fallen, an older person experiencing clinical deterioration and multiple hospital presentations, and an older person requiring end-of-life care.

Evaluation of this collaboration and the initiative aims to provide the evidence to support other regional areas to address these national issues in a context- and state-specific way; to support the aged care workforce to provide care in place wherever possible; and to meet the preferences and needs of older people living in residential aged care.

1. Source: (Australian Government 2025) Aged Care Research and Reporting

2. Source: (Australian Institute of Health and Welfare 2024) AIHW

3. Palmer (2018) The Acute Care for Elders Unit Model of Care. Geriatrics

4. Chen et al. (2024) Preventing functional decline in hospitalized older adults in medical ward: a best practice implementation project  JBI

5. Hillen et al. (2017) Disease burden, comorbidity and geriatric syndromes in the Australian aged care population Australasian J Ageing

6. Gullick & Islam (2023) Exploring avoidable presentations from residential aged care facilities to the emergency department of a large regional Australian hospital Australian J Rural Health

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.

​Paul Ross, Librarian & Information Specialist, ARIIA
Dr Stephanie Champion, Research Fellow, ARIIA

Understanding what drives success in aged care is essential for implementing evidence-based improvements. The process of gathering information, evaluating its reliability, and determining its relevance to your specific needs can be complex and overwhelming! Where do you start? It requires a solid understanding of evidence-based practice and an understanding about how to put that into action. An evidence-based approach integrates the best available evidence, professional expertise, and knowledge of your specific care setting—whether residential or home-based—while also considering consumer perspectives and preferences. Fortunately for the sector, this is what ARIIA have expertise in, and our mandate is to build up these capabilities in the aged care workforce to drive practice change together.

The definition of "best" evidence may vary depending on what you are looking for and the type or quality of the available studies. While ‘systematic’ and ‘umbrella’ reviews are often regarded by researchers as the best sources, they may not always address your specific needs, contexts, or provide you with the practical information you’re looking for. In such cases, it becomes necessary to explore a wider range of sources and to learn the tricks to be able to critically assess the strengths and limitations of each source, to ensure you’re using evidence, that is fit for purpose.

Overall, the variables of evidence-based practice in aged care include:

• Define the Problem: Clearly describe the issue you aim to address. Consider any contextual or organisational factors that may impact your approach, such as environmental constraints, budget limitations, timelines, and securing support from leadership.
• Plan Your Approach: Identify and assess the quality of appropriate information sources, develop a plan for what change you are going to implement, and include methods to test its safety and effectiveness in addressing the original problem.
• Implement and Evaluate: Follow your plan and implement the change and collect data on progress and process along the way so that you can tell if you are making a difference. Be prepared to revisit and update your plans periodically to ensure ongoing relevance and success.

To effectively use evidence and drive change, you will need specific skills, access to reliable and up-to-date evidence sources, and an overall research and implementation plan. To support this process, ARIIA offers various programs and services designed to guide you through the complexities of identifying evidence-based solutions for your practice needs, seeking to save you time and give you access to some of the most relevant sources related to aged care in Australia.

The Knowledge and Implementation Hub (KIH) provides a vast amount of free online information and resources to support the process of evidence-based practice, these include:

• Our aged care priority topics scoping reviews and a searchable collection of supporting online resources.
• The aged care search collection provides predefined one-click PubMed searches in a variety of formats (free to access, review quality and studies focused on Australian). Alongside these we have designed tailored Google searches on our priority topics and developed additional research sources which complement our organisations and programs and older people and families pages. 
• We also provide access to the highest quality reviews via our systematic review collection in aged care, which is updated monthly consisting of both open access and subscription-based reviews. 
• Implementation training supports such as a short implementation learning module on the basics of implementation and three themed supports on Reablement, Nutrition and Workforce Retention.

Finally, ARIIA provides the Innovation Capability Program offering the aged care workforce training, support and guidance needed to change the way things are done and build up their transferable skills. The program helps to develop solutions grounded in evidence, to ensure meaningful, impactful and sustainable results. The program supports you to define your problem, provides information and guidance into searching and using evidence, while enabling you to consider implementation barriers and plan for project success. Applications for a new round of training are now open for more information contact the ICP team.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.

Dr​ Meg Polacsek

Senior Research Fellow, ARIIA

Across Australia, volunteer numbers are in steady decline, with organisations facing significant short- and long-term challenges when it comes to recruiting and retaining formal volunteers (that is, people who willingly give their time for the common good and without financial gain). These include increased ‘red tape’, an uncertain financial climate and an apparent reluctance of volunteers to commit to regular, formal roles. In addition, the impact of COVID-19 on volunteering will be felt for years to come: while almost two thirds of volunteers were lost at the height of the pandemic, many of those who remained or returned are spending fewer hours in the role. 

With high workloads and limited resources, residential aged care providers often turn to volunteers to provide much-needed ‘non-critical’ social and emotional support to their residents. Compared to other healthcare settings, volunteers in residential aged care tend to form long and close relationships with residents. By offering important support functions that may otherwise not be delivered, aged care volunteers have a positive effect on residents’ quality of life and overall wellbeing. The resident/volunteer relationship is particularly important for older adults lacking the support of family or friends, and whose involvement in meaningful activities may depend on the support of volunteers.

It is for this reason then that aged care volunteers may have a specific motivation compared to, say, those in a hospital setting, where they often perform ‘meet and greet’ functions, help with hospitality services or serve as porters. 

So, how do we best go about recruiting and retaining volunteers? Free, easily accessible resources are available to inform volunteer recruitment and retention. However, few specifically address volunteering in aged care. 

Informed by our systematic review, we summarised a set of strategies to optimise volunteer recruitment and retention in residential aged care. Perhaps the most critical step is to identify their motivations. According to our review, volunteers were motivated most by the practical benefits and self-satisfaction of volunteering. They want to be matched to and trained in specific resident programs. And they are particularly interested in sharing of animals and animal-assisted therapy. 

When it comes to recruiting, aged care providers should present a broad concept of the volunteer role and function, to recruit diverse volunteers. Ideally (‘magic wand’ scenario), they should employ a volunteer coordinator to recruit, screen, train and support, supervise, and evaluate volunteers. Providers should also establish a management structure that accommodates the volunteer program within their overall care programs.

Tips for retaining volunteers include:

• Signing a contract and/or statement of commitment that describe the volunteer’s tasks and expectations for performance, while creating realistic expectations
• Matching volunteers to tasks that interest them and/or match their skills, and connecting them with other volunteers and residents
• Providing appropriate training on the role, organisational mission, knowledge of residents' physical and cognitive status (eg dementia), skills and techniques to manage challenging situations
• Using technology, such as email and social media networks, to communicate with volunteers.

Finally, aged care providers should ideally provide opportunities for volunteers to work in a range of roles, and a sense of 'ownership' by involving volunteers in role and task planning.

Optimising the vital volunteer resource takes money, time and effort, but not all of these strategies require significant costs. And with the right strategies in place, we should be able to achieve significant returns on our investment of time, effort and money, while improving residents’ quality of life.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.

Dr​ Amanda Adams

Research Fellow, ARIIA

In aged care settings, designing and developing a new technological solution - or repurposing an off-the-shelf one - is challenging. In the ever-evolving health and aged care digital ecosystem, providers are required to understand a new lexicon of terms and acronyms. Mastering the requirements of the Australian digital roadmap is one thing, but designing a useful and intuitive solution for an aged care service requires more than pitching the idea to the organisation to generate buy-in. 

Our latest evidence theme explores the processes, requirements and partnerships required to explore potential digital solutions to finite or wicked problems that impact effective and efficient care provision. Whilst a well-defined development process serves as the backbone for successful implementation and can ensure user acceptance, stakeholders' involvement can account for the complexity, context of use and the flow and collection of data. Taken from evidence and practical guidance, we describe the advantages of co-design with aged care staff, residents, clients and their families, offering insights into the daily challenges. Feedback from these key participants provides the opportunity to tailor robust products. Involving varied and diverse representatives in co-designing activities can ensure that products are easy to use and are integrated into workflows or routines, increasing the chance of successful implementation.

Factors influencing the successful deployment or rollout will also depend on the working structures and relationships between staff and the chosen technology vendor. Selecting a vendor just on price is risky. This choice should consider the developer's previous experience, their awareness of the requirements around interoperability, their capability to employ user-centred design thinking, and their ability to work around your staff, clients and workflows also matters. For many organisations, the need to assess the availability of human resources is equal to assigning a budget for development. In many instances, project managers are needed to facilitate and support the processes, to recruit and maintain working relationships with all the people involved. In many ways, the investment in external or 'nominated' or independent project managers can remove the burden typically felt by staff champions' who balance development and their regular duties.

For technological solutions to be accepted, adopted and sustained within care settings requires a development process and a multidisciplinary team that is user-centred in their approach. Developers and providers need to be open to feedback, good and bad, to continually shape prototypes to meet the needs of users and the business. Testing once is an absolute minimum. Testing across the development process is better, especially if people involved differ in their approach, background, capabilities, digital confidence and literacy levels. Constructive feedback allows for necessary changes before the product is rolled out at scale.

Developing within aged care can reward the organisation, older people and their families. However, there are risks and challenges to creating useful products that can be successfully implemented to influence change positively. For inexperienced aged care staff, maintaining control over the project's delivery and scope is difficult, especially when unsure of what to expect. Visit ARIIA's Developing new products evidence theme to learn more about what is needed, your role and responsibilities during development, choosing a vendor with the right team and process, what is involved in designing solutions, and which co-design and evaluation activities can be undertaken to allow everyone to be involved.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.