Agency staff linked to poorer quality of care, says research

The reliance of agency staff in aged care facilities leads to poorer quality care outcomes for residents, Australian research has found.

Noting evidence from overseas showed aged care homes with a dependence on relief workers had a detrimental effect on the quality of care for residents, researchers from University of Technology Sydney wanted to examine whether outcomes differed for residents in Australian aged care facilities, which also relied on agency care staff.

Dr Nelson Ma – author of the research paper The quality effects of agency staffing in residential aged care – told Australian Ageing Agenda the findings suggested not.

“Residents in facilities relying more on agency staff were more likely to be hospitalised for preventable reasons, were more likely to be reported as missing or assaulted and raised more workforce-related complaints. These facilities were also cited as failing to meet a greater number of quality standards based on regulatory inspections,” said Dr Ma.

The retrospective observational study published in the Australiasian Journal on Ageing was conducted using de-identified data obtained from the Royal Commission into Aged Care Quality and Safety. Regression analysis was then conducted from information gathered from 1,709 care homes across five years – 2015-2019.

The exact reasons for the poorer quality of care outcomes are difficult to pin down based on the UTS results alone, Dr Ma said. “However, studies elsewhere indicate because agency staff tend to work intermittently, they lack familiarity with individual residents and their unique needs. This can both undermine the continuity of their care and be disruptive and distressing for residents and their families.”

As for what can be done to address the poorer outcomes of quality care, Dr Ma told AAA: “Agency staff are typically used to address labour shortages, which have been a persistent issue in the Australian health care sector. Government policy can help address these shortages by increasing the labour pool in the sector through avenues including skilled migration and subsidised training programs.”

Dr Ma added: “However, given the current workforce challenges in aged care, providers are unlikely to be able to reduce their agency staffing in the near term.”

In such cases, providers may consider adopting organisational strategies for mitigating the detrimental effects, said Dr Ma. “For example, they could adapt their sourcing processes with agencies that ensure proper matching of workers to the needs of individual facilities or drawing on the same pool of agency staff to improve continuity of care for residents. They may also help agency staff more easily integrate within their organisations through more systematic onboarding and orientation programs.

“Finally, they could improve the communication and teamwork between agency and permanent staff by including agency staff within training programs, investing in more reliable client information systems and developing effective shift handover procedures.” 

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