Background and aims
Glow Health Care Australia undertook this project through ARIIA Flagship Project 2 to strengthen how skin integrity data is collected, handled, interpreted, and used to improve quality of care. The project built on GHCA’s Phase 3 findings, which showed that although the organisation was already collecting wound and skin integrity information, the data was not always complete, consistent, or easy to interpret.
GHCA works with clients within their homes and spaces. Unlike residential aged care most of the information concerning a client can be retrieved via support worker visits, well being checks, and assessments. While this is good and can vary according to client’s needs and health care requirements, in many scenarios unlike residential aged care, with frequent and regular visits, this may bring a big gap in acquiring knowledge on skin integrity challenges.
This makes early identification and escalation of skin integrity more challenging, particularly where clients are supported by a mix of GHCA-employed staff and subcontracted workers. Although skin integrity is not currently governed by the same mandatory quality indicator framework in home care as it is in residential aged care, GHCA identified it as an important quality-of-care risk area. This project therefore reflects GHCA’s proactive commitment to embedding data-driven quality care into its governance, care coordination and continuous improvement approach.
GHCA identified a need to improve skin integrity reporting in Phase 3 when it became clear that information in this space was being recorded in a variety of ways including: progress notes, care notes, clinical meeting notes and monthly reports. While this was beneficial in terms of data availability, it didn’t always present an accurate reflection of a client’s skin integrity journey over a period. Information regarding location of the issue, description of the issue, photographs, escalation action, review by RN and follow-up by care partner was not always recorded and this made understanding trends regarding when issues were recognised, whether they were escalated appropriately, or whether a client’s care plan had been updated in response to the issue difficult. This issue was more pronounced for self-managed clients and those supported by our subcontracted workers as they may not utilise the same reporting methods or systems as GHCA workers, and there were some care partners and RNs who didn’t always have access to skin integrity information.
To address the problem, Phase 4 focused on embedding a strong data culture to improve the quality of skin integrity data being collected and improve the usefulness of data to staff, care partners and clinical staff so they recognised and could escalate concerns appropriately, ensure care plans are responsive to a client’s changing needs and reduce skin integrity incidents. This was done through development of a structured skin integrity reporting workflow, supported by staff data literacy assessments and staff data education, care partner awareness engagement, RN review input and workflow and dashboard testing with the first 11 clients, development of dashboard metrics and data.
To support improvements to skin integrity observation and data capture at the frontline, GHCA established a process to collect, escalate, and feedback skin integrity data. The initiative started by engaging with care partners, managers, the RN and clinical team, IT and data to learn more about existing documentation issues.
We developed QR tools for support workers, registered nurses and care partners to support observations, reviews and actions. These include the pathway for observations by support workers being followed by RNs and care partners, with actions documented as part of care planning. GHCA also completed a staff data literacy assessment, developed resources to upskill staff on data use and conducted a pilot test with 11 clients. Data collection went live in April 2026 and care partners followed up with workers after shifts and supported clients with fewer visits.
GHCA worked with the IT and data team to create the Skin Integrity Platform using role-based forms, case management, audit logs, data visibility via dashboards, and notifications.
Key data points for the dashboard were identified and discussed with staff, and feedback reviewed. GHCA and the project team also adjusted the workflow and developed resources for sustainability and to share with other service providers in the sector.
Consequently, the project created a more structured way to collect and access skin integrity information at GHCA, creating a clearer feedback mechanism between support workers, Registered Nurses, and care partners. It created a process to capture an incident, report on it, and follow through to ensure it was addressed by a RN and linked to care planning (which previously would have been recorded in progress notes and not followed through to clinical input). This has increased GHCA’s ability to identify potential issues and ensured accountability for the issue being followed up by a clinical support worker.
There was an increased level of data literacy amongst staff who participated in this project, increasing awareness of the role of accurate documentation and its relevance to high-quality client care. This led to a more active approach by the care partners to check-in with workers to ensure they had identified if there were issues with skin integrity, the forms were completed correctly, and if it was necessary to request further follow-up.
Additionally, there was a greater capacity of GHCA to utilise skin integrity data in line with current quality monitoring and quality reporting requirements, as well as future requirements (Support at Home) and to ensure its relevance to the wider organisation, via the development of QR-based forms, the Skin Integrity Platform, the dashboard metrics and the organisation data dictionary.
In summary, the project was designed to improve GHCA’s documentation process from being somewhat inconsistent and ad-hoc to being more standardised and informed using data, which will ultimately allow us to monitor our skin integrity information and support staff in providing better client care.
GHCA plans to sustain and expand the skin integrity data collection workflow beyond the initial pilot cohort by embedding it into routine care partner follow-up, staff onboarding, clinical review and quality reporting. Moving forward, GHCA will tailor the Skin Integrity Platform to feedback from staff and streamline the reporting process. This tool will be gradually introduced with additional clients and support staff, where it is applicable to support staff. In addition to the platform development, GHCA will progress dashboard reporting to monitor skin integrity concerns, RN follow-ups, care partner actioning, care plan updates, and escalation timeliness as part of usual quality governance. In the future, this experience can assist other projects, such as the implementation of Support at Home, enhance decisions regarding acute to home models and be explored in other aspects of care delivery quality including falls and medication concerns, deterioration risk, and client wellbeing.
This project highlights that the quality of care in aged care services hinges on collecting simple, useful, meaningful, and purposeful data from the front line. For aged care staff, this study affirms that data literacy is more than a skill to learn; it's part of their daily practice of care. This includes support staff needing to recognise and report changes, Registered Nurses needing accurate data to inform clinical review, and care partners needing easy-to-understand data to inform follow-up, care plan updates and client support. In terms of the wider sector, this study (and the broader skin integrity project) demonstrates to Support at Home providers the value of structured skin integrity data collection in raising earlier risk identification, supporting timely escalation, supporting evidence to justify equipment or home modifications, and moving the aged care workforce to a preventive and informed approach to care.
In terms of the wider sector, this project demonstrates to Support at Home providers that structured skin integrity data collection can support earlier risk identification, timely escalation, stronger care planning and better evidence for equipment or home modification needs. It shows that home care providers do not need to wait for skin integrity to become a mandatory quality indicator before acting. By embedding skin integrity monitoring into routine visits, care partner follow-up and clinical review, home care providers can move the workforce toward a more preventive, informed and quality-focused approach to care.
The team learned that improving aged care data collection goes beyond creating a digital form or tool; it demands a clear care process, an understanding of role boundaries and staff engagement at all levels. Skin integrity data was made useful only when there was an RN review, follow-up and care plan update from the care partner. The skin integrity project provided an opportunity to develop the team's understanding of data literacy, data quality, workflow design, co-design, clinical escalation and dashboard design. The project has also highlighted the important role of care partners in the data feedback loop as well as the essential need for RN input to provide a safe and clinically relevant interpretation of concerns raised by support workers.
In summary, the skin integrity project contributed to GHCA improving its capacity to utilise data within day-to-day care, not just for reporting, but also to recognise risk, improve communication, and promote improved outcomes for clients.
Sector Resources
Glow Health Care Australia and ARIIA are pleased to share the following resources with the aged care sector to assist other providers wanting to implement similar solutions.
Form 1 - Support Worker AC Progress Notes - Skin Integrity
Form 2 - Nurse Skin Integrity Clinical Assessment
Form 3 - Care Partner Review - Skin Integrity
