PEOPLE: How Zara reacted after uncovering flaws across almost every aspect of the healthcare system

Zara Lord founded uPaged after experiencing first-hand and discovering from further research the depth and breadth of flaws in the Australian healthcare system, including over-working nurses and inefficient management of hospital budgets, leading to poorer patient experiences.

In this interview, she outlines how she is addressing these problems with technology and her goals for uPaged despite the disruptions of the pandemic.

  • What sparked the idea for uPaged? 

In 2016, I’d been working as an 8th year Registered Nurse (RN) in one of Sydney’s largest and busiest Intensive Care Units. I’d also just completed a Graduate Certificate in Critical Care Nursing, and was undecided as to what was next in my career. 

With a love of travel, and while living in one of Australia’s most expensive cities, I had been supplementing my income doing as many as three agency nursing shifts a week. I first started as an Assistant in Nursing (AIN) while I was an undergraduate. Even when I was full-time and in charge of the ward, I picked up the odd agency shift when work had no overtime. 

The agency nursing experience always left me with a feeling of unease about the disconnect. With experience on both sides of the fence – as the agency nurse and the nurse in charge – both roles highlighted several points of abrasion between agency nurse, agency, permanent hospital staff, hospital booking manager and patient.

This led to nine months of research into how I could make the agency nursing experience better for the nurse, hospital and patient.

What I uncovered through that research revealed flaws across nearly every aspect of the system.

Hospitals were paying for nurses whom they knew very little about, and had no choice over whom they were given – in effect, a recruiter was making the decision about what staff were sent to look after patients, so hospitals couldn’t effectively utilise the unique skills and experience of their agency nurses.

Nurses I spoke to repeatedly complained of frequent agency cancellations, a lack of respect for their skills, no trust from peers and allocations to patients they had no experience with.

I also discovered that the Australian healthcare system spent at least $1.2 billion dollars on contingency workforce fees in 2018 alone. In NSW Health, this figure is conservatively reported at $15 million, a figure that increased by more than a million dollars from the year before. That got me really fired up – here I was working two jobs to get by comfortably – and that money that was not going on nurses’ wages – it was just on recruitment agency fees.

The cost to Australian hospitals for agency nurses cripples hospital budgets. It’s a vicious cycle. When budgets dry up, hospital beds get closed, contingency workforce is slashed, more pressure is put onto permanent nursing staff who burn out, and patients lose out. I knew I had to do something, and so that’s how uPaged came about.

  • What are your key goals? How will you know if you’re making a difference? 

My goal is for uPaged to be available to every hospital in Australia, and for every nurse that works additional shifts in other healthcare facilities, to have a profile on the platform, so that clinicians can make the decisions about who cares for their patients. 

I  want the technology to deliver so much efficiency that hospitals find uPaged 10 times easier than their current incumbent manual processes. We’ve just saved one of our hospitals $85K in the past year, with quite conservative usage (2,475 hours). Furthermore, in a time when agency nurses are hard to come by, uPaged has had a reliable and consistent supply of nurses for their intensive care, wards, day surgery and outpatient clinics. I’d love to be able to do this for at least another dozen hospitals.  

For nurses, my key goal is for higher rates of pay across all uPaged shifts, while giving nurses more control and choice over where and when they work.

I also want to save the Australian healthcare system a billion dollars over the next decade, and that’s doable if more hospitals start using the platform.

My final goal is for better patient outcomes. And uPaged positively impacts shift fills rates so that they are well above industry standard, patient care – and outcomes – are improved. 

Oh, and investment – we’d love to get investment so we can supercharge our growth.

A key element of the uPaged platform is its 2-way ratings and feedback loop between hospital and nurse. It would be a dream to be able capture patient feedback one day, but in the meantime, I’ll settle for knowing that I’m making a difference by saving hospitals tens, if not hundreds of thousands of dollars every year, and by improving the career paths of nurses by putting control and choice back in their hands and by making sure they get better rates of pay. We can already track most of this in the platform and we know we’re getting some great results already.

  • What have been the biggest challenges to date? How have you overcome them?

Since day one, our biggest challenge has been identifying and getting in front of the decision makers in hospitals. There are so many stakeholders, and hospitals have tended to be slow to adopt change, but COVID has shown just how quickly they can move if they need to, so we want to capitalise on that. 

uPaged is disrupting an outdated, 30-year-old model that has worked in the past, but just isn’t appropriate any more, and its long term impact is only being realised now through the awareness that uPaged is creating. Change is difficult for large organisations, so we’re working hard to bring uPaged to every hospital nationwide but it requires stealth, grit, determination and feet on the ground to do that, so that’s what we’re doing. 

  • How has the pandemic impacted the way you run the business? 

We can’t ignore COVID’s impact on healthcare, small businesses and startups.

uPaged has undertaken immense diversification during the pandemic, and we acted at lightning speed to innovate and adapt to the challenges presented. This included pivoting our business model, as well as our user and customer base on both sides of our marketplace. 

We took an approach to ‘build the plane while flying it’, to do whatever it took to meet our clients’ changing requirements and make the experience as high touch and service-focused as possible. We also secured new revenue streams by tapping areas we’d previously not engaged with. 

When hospital operating theatres shut down, our workflow in the acute private sector dwindled and business development opportunities halted as hospitals averted their attention to their own pandemic response. The nurses who usually served these areas were left without work as local health districts redeployed their permanent staff, and then filled their gaps with staff from the hospitality and tourism sectors. 

Our swift response, our agility and openness to change meant that nurses gained and retained employment opportunities that they would have otherwise been unable to. 

It means we’ve created partnerships in sectors we once steered away from, and we’ve achieved breadth and depth serving clients that were not previously part of our business strategy. 

While already a very lean, bootstrapped operation, we implemented cost cutting measures immediately, so I’ve been working without pay for 7 months, and the Development Team of 3 worked on significantly reduced hours for 3 months.

  • How has this impacted your business plans for 2021?

We’ve been able to get really laser-focused about where we want to be for 2021. We’re opening up to serve healthcare organisations requiring term contracts, as well as facilitating permanent placements, in addition to serving healthcare providers and facilities nationwide.

In true marketplace style, we are also delivering our service as a technology solution so that hospitals and our nursing agencies can fully integrate our technology into their businesses so that their own staff can be better utilised within their own organisation, the talent pool can be improved, as well as across their multiple facilities, putting an end to under-employment of existing staff.

At this point in time, 2021 is looking very promising.

About the expert

The founder of uPaged, Zara Lord is an 8th year registered nurse, specialised in Intensive Care. Having experienced the current model of agency nursing from both the nurse and institutional side, she knew there had to be a better way. Having harnessed technology, her deep industry knowledge/experience and her network she has single handedly built a nursing digital marketplace which is the first of its kind in Australia.

Image description: Zara is smiling and wearing a blue shirt with ‘uPAGED’ print on the right. She has blonde hair, which is tied up. She is in front of a green and leafy hedge.