Chain reaction

The tireless work of in-home care provider Silverchain has made a difference to the lives of countless Australians over its 130-year history. From palliative and aged care to allied health monitoring programs, Silverchain has been there to meet the needs of those most in need.

The not-for-profit has gone above and beyond over the years, making the case for a better class of home care in Australia. It has done so by implementing complete, state-of-the-art health care into its range of services, along with core values of integrity, respect, trust and compassion.

Every day, the quality of life for many Australians requiring such care is lifted by the work of the Silverchain team. Headed up by Group Chief Executive Dale Fisher, Silverchain’s clinicians and care experts toil in service of the wellbeing of their clients.

If there were any doubts surrounding the impact Silverchain has had both for people in need and the industry in general, they were put to rest last year, when Fisher was appointed a Member of the Order of Australia.

“It’s still quite surreal,” Fisher tells The CEO Magazine. “I think people like myself who are dedicated to the mission and public service don’t do it because of the possibility of any reward, although I’ve certainly been honored and awarded previously along the way.”

“This is the first year there have been equal awards to men and women. I think that’s heading in the right direction.”

The reward, says the former nurse, is the intrinsic value of the work itself. “But because it’s the highest category of award available in Australia, it really is an honor to receive one; now, I find it affirming.”

The award triggered a whole wave of gratitude from colleagues and industry wellwishers.

“People in my current team were just so beautiful with their words,” she says. “I was particularly thrilled to hear from people I’d worked with in the past, thanking me for my support and mentorship. We’re so focused on solving problems that we don’t celebrate each other enough. It’s been all about respect, warmth and love.”

Now, it’s Fisher’s duty to nominate others for next year’s awards.

“It’s my responsibility to make sure others are acknowledged,” she says. “And I understand this is the first year there have been equal awards to men and women. I think that’s heading in the right direction.”

Change leadership

When Fisher joined Silverchain in 2018, the organization was looking for a change, in order to develop Silverchain nationally. They found it in Fisher, who’d developed her leadership style as Chief Executive of the Royal Women’s Hospital and the Peter MacCallum Cancer Centre in Victoria.

“I was mentored and taught a leadership model I’d call change leadership, or non-synoptic normalized incrementalism,” she says. “This innovative approach to change is now in vogue. Basically, you get great people in to help solve problems and progress the organization, and that has a great knock-on effect of positivity within. It pulls the whole organization together in pursuit of its ambitions.”

The next step in pursuit of Silverchain’s ambitions is to identify the informal leaders that emerge from that process and empower them.

“People will follow those that are actually working on content, that are positive, that care about people,” Fisher says. “My team has been working with this collective leadership model for two years now. We hold each other up. It’s a model for the future.”

“People will follow those that are actually working on content, that are positive, that care about people.”

But as successful as it has been, Fisher’s term at the top has been marked by the COVID-19 pandemic, which shone a spotlight on problems within the residential aged care system.

“The message in the media seemed to be that ‘aged care equals residential’, and there was a bit of a blind spot on home care,” she says.

“Due to the pandemic, people now recognize that high-level home care is possible, and that the community now demands it. We decided to focus on keeping our clients and staff safe, which we did particularly well, instead of all the hoopla.”

Too many organizations got caught up in the crisis of the day, while Silverchain deliberately kept an eye on the future, Fisher adds.

“Many leaders forget their role is to focus on the future state,” she says. “Something I always do is respect the past, understand the present but create the future, and one of the tactics in our strategic direction is Future Care, which is our research and innovation arm.”

A better way

Silverchain’s ambition is clear: to create a better home care system for all Australians.

“Not just for our current clients,” Fisher says. “We’re trying to solve many problems in health and aged care, and we’ve gotten some great traction in the last two years.”

Part of this approach has involved dropping the prefixes of ‘health’ and ‘aged’, instead concentrating on a broader care system.

“Our model is to first identify the current problems of care and then bring in the best clinicians and researchers to work on them. We’re now partnering with 14 universities across Australia to do just that.”

“Many leaders forget their role is to focus on the future state.”

One area in particular Fisher believes is a significant public health gap is the mental health of older Australians.

Silverchain has recently been awarded a Medical Research Future Fund grant to pursue research of anxiety and depression in aged care clients. “This is an exciting area of development for Silverchain to add to our strengths in palliative care and wound care.”

Team effort

The organization’s digital strategy has also picked up steam since the pandemic’s heyday.

“Digital-enabled care in the home is a huge opportunity,” Fisher says. “You’ve got three mega-trends across the world: home care, as well as our digital-enabled care in the home and workforce. Silverchain, fortunately, is in a sweet spot for all three, and we’ve been investing in our digital strategy as well as our partnerships.”

For the former, data has proven to be a gold mine. “We’re building up our capability as we need data to inform that direction. Fortunately we have a lot of it, so we’re organizing it for use in research innovation. That’s important.”

Silverchain is also in the process of building its own care record.

“We’re not a hospital or a community provider, we have created a new category,” she says. “A product to serve our clients doesn’t exist, so we’re building our own.”

The end result will help Silverchain leapfrog into providing more complex care in the home.

“We’re not a hospital or a community provider, we have created a new category.”

A further exciting development is the recent acquisition of fellow in-home care provider KinCare on 1 July this year. This addition to Silverchain’s portfolio has given the company the opportunity to expand its aged care operations on the east coast and the chance to continue to provide high quality care at home for KinCare’s clients.

“We believe that everyone deserves the right to choose where they receive their care, and that home care helps keep you connected to your community,” Fisher says.

“Silverchain has been revolutionizing the way health and aged care is provided over many years and transforming the way people can access care. KinCare coming under Silverchain’s umbrella is an extension of that.”

Fisher also acknowledges that many of Silverchain’s services are made possible through its strong partnerships with personal protective equipment suppliers, logistics companies, cleaners and fleet management.

“We view our partners as absolutely critical to our success,” she says. “We need medical consumables, we need warehousing. We can’t function without high-level cleaners. We don’t view it as a supply chain at all, and I see them as partners rather than suppliers.”

But it’s a two-way street, and Fisher says Silverchain is always learning how to be a better partner.

“I’d like to think we’re good partners, and one thing we’ve learned is how to exit when partners don’t share our value system. That’s a very important area for us,” she explains.

The future is now

Silverchain’s healthy balance sheet has allowed for a greater investment in the people and tools required to provide the best possible care.

“We’re not-for-profit, but we’re also not-for-loss,” Fisher says. “We can’t provide good care unless we’re looking after our people, and we’ll prosper if we’re providing good care.”

It has also made the future use of cutting-edge AI technology that much more viable.

“AI is not this sort of crazy future thing,” she says. “It’s a real area that can provide huge benefits for us and for health care in general.”

Fisher hopes generative AI and its patterns of learning can be used to develop human-like thinking that can then be put into practice for care planning. “We’re looking at all of that, partnering well with industry and academia to see what’s possible. It’s very exciting.”

Silverchain’s quest for greater research innovation has taken it beyond Australia’s borders.

“We’ve been working with the Sheba Medical Center in Israel in particular to bring the best people together on the development of home care,” she says. “At the same time, they’re interested in Silverchain’s wealth of know-how.”

“We can’t provide good care unless we’re looking after our people, and we’ll prosper if we’re providing good care.”

In the Northern Hemisphere, other countries are waking up to the realities of home care.

“In the United States, they pay just as much for home care as hospital care, as an incentive for providers to do more in the home,” she says. “That’s triggered a huge amount of investment in home care and technology solutions.”

The United States boom in home care investment is great news for Silverchain and the rest of the world.

“We’ll be able to use that development and translate solutions to our business rather than trialing at smaller scale and then trying to adapt, because the Australian market is quite small,” she says.

Lending a hand

Being in a positive financial position has also given Silverchain the room to flex its charitable muscles. Through an internal charity called Silver Hand, people in economic distress can apply for rent relief, food vouchers or help with paying for utilities.

“When I started as CEO five years ago, I’d get one application every four months,” Fisher says. “Now I’m getting four a week. The stories of what people are dealing with in the community, particularly in vulnerable communities, drives us to do even more strategically to improve equity and access to care.”

“The world is changing, and so is the nature of funding in aged care. We have to make sure we’re well prepared for that.”

While Silverchain has always looked after those most at risk in the community, Fisher says the current level of stress in the system is profound.

“The world is changing, and so is the nature of funding in aged care,” she says. “We have to make sure we’re well prepared for that.”

Clear and present challenges

Most of the world has moved on from the COVID-19 pandemic, but Fisher says we’re still living with the virus, albeit safely.

“People think it’s over. It isn’t. It’s probably the tail end of the pandemic, but every day, we know it’s still a real risk to our staff and our clients.”

With the fragility of the aged care and supply chain systems exposed by the pandemic, Fisher says preparing for the unexpected today will pay off tomorrow.

“There are going to be more and more surprise scenarios to come, and the worst thing we can do is act as though we have any control over it. We’ve probably never been in control, we only had the semblance of it,” she says.

“In order to be successful today, you have to understand the world in which we’re operating.”

“What I’ve been trying to do is help people understand that having certainty before making decisions, having a full picture, it’s not going to happen. And a lot of people are concerned about that.”

This is when Fisher’s leadership strategy again does much of the heavy lifting required to restore a sense of calm to a frenetic industry.

“Business productivity is down across all sectors, and health services in particular,” she says. “In order to be successful today, you have to understand the world in which we’re operating. Silverchain is very good at doing that, at being in tune with our operating environment. That way, we can develop strategies and plans and get people together to work on problems that are becoming more complex as time goes by.”

The people’s choice

While the shadow of the pandemic may be fading, Fisher says it’s left a lasting – and mixed – legacy on her industry.

“The community value of aged care has gone up significantly because people of all ages cared about what was happening to elderly Australians during the pandemic,” she says.

“Health care has always been held in high esteem in the community, which is why politics has been biased to health. There is a better balance with political attention now focused on aged care.”

“We’re a mission-based organization; it’s a huge natural advantage.”

In the aftermath, Silverchain is perfectly poised to bring in what Fisher believes will be the next era for aged care.

“We can finally shift to the home. It’s what people want,” she explains. “At Silverchain, we’re more in tune with community values, but within the industry, other organizations know they have to be in touch with what the community wants. Otherwise they’re out of business.

“We’re a mission-based organization; it’s a huge natural advantage. And we’re here for others to learn from and connect with.”

At the forefront of the industry, Fisher knows that aged care is changing. She believes that it’s important to understand that the world is in flux and adaption is inevitable, but her priority remains making sure people are at the heart of what Silverchain does.

“We believe the future of care, not only in Australia but across the world, is in the home,” she says. “Silverchain is about care and we will make sure our care is provided with humanity.”