Joyce Cheng’s Paper Reveals the Full Story Behind NurseWatch

Joyce Cheng Paper

Prof. Simon Lam
11th May 2023

When talking about ageing and elderly care, often the stereotypical image that comes to mind is one of socially isolated older people sitting around and living out the rest of their days, in and out of hospitals. This is not what Kate Alexander had in mind when she founded NurseWatch, a premium, professional, and personalised aged-care-at-home service provider based in Australia.

Born in the 60s in Australia, Kate grew up during a period in which the ageing population was smaller and the reliance on the public healthcare system was not as heavy. Back then, the healthcare system was more community-based, with most General Practitioners (GP) taking care of the health of their patients like they are extended family members, providing tailored and personal services. This community-driven model slowly died down over the years due to the growing ageing population and then the more corporate and public hospital driven model took precedence. The primary model for the current healthcare system in Australia is one driven by cure instead of prevention; it aims to provide medical treatments to people who are already ill instead of focusing on improving the overall wellness of people to prevent illnesses.

As a Registered Nurse (RN) with over 40 years of experience in the nursing profession and graduated with an EMBA qualification, Kate has worked in different hospitals and aged care institutions and witnessed first-hand how many medical emergencies could have been prevented or achieved better outcomes if the patient had received proper holistic healthcare by nursing professionals when they were well. On top of being a seasoned nursing professional, Kate is also a strong advocate for equal rights and believes in inclusivity and diversity. To fully commit to and integrate this belief into her business, Kate took one step further to gain the Rainbow Tick Accreditation, reassuring the LGBTIQ customers and staff that NurseWatch is a safe and inclusive space that is aware, responsive, and understanding of their needs.

NurseWatch is also accredited with ISO 9001, a quality management standard ensuring that customers get consistent, good-quality services.

As the primary healthcare provider closest to the patients and making up the majority of the healthcare workforce, nurses are in the ideal position to spearhead the change that Kate is promoting in the healthcare system, especially in the aged care sector. With the appropriate tools, nurses could perform medical activities such as taking blood samples and measuring blood pressure, et cetera, in the client’s home. It could greatly help to facilitate the life of the elderly, especially those who are immobile. With medical services carried out at home, it also helps to ease the pressure on the public health system. Through one-on-one care, nurses can also provide more personalised support in the comfort of the patient’s own home, making it more humanistic and dignifying. It is her expertise, experience, and passion to bring quality aged care services to the older population and the belief of “prevention is better than cure” that drove Kate to set up NurseWatch. Through her business, she wishes to integrate more wellness into everyday life and bring back the community-based, nurse-driven model which is human-oriented, personal, and takes care of all aspects of life instead of just the patient’s physical health. Qualified nursing professionals will also be able to practise to the full extent of their training and expertise instead of merely assisting the doctors. To many elderly, a hospital is not a place where they feel comfortable and going to one can often be a stressful experience that puts them in more distress. Providing healthcare at home, NurseWatch helps patients to feel more relaxed and can lead to betterment in their physical and mental health.

Before Kate officially founded NurseWatch, she had multiple in-depth discussions with her brother Mike, a multi-entrepreneur with experience in banking, finance, and the F&B industry. Together, they worked out a business plan and model appropriate for Kate’s ambition and vision. Relying mostly on Kate’s own savings, NurseWatch was founded with a core team of only Kate and one external consultant. The two of them worked closely together to build the general framework and policies for the business. Many administration and operation functions are digitised at the early stage or outsourced to professionals as Kate wishes to focus her energy and resources to the core function of the business, which is to provide quality care services. When asked which part of the business was kept in-house since the beginning, Kate answered “training and education” without hesitation. With little to no brand recognition and minimal marketing resources, it is important for NurseWatch to consistantly deliver on its promise to the customers to establish a name and reputation. High quality, premium, and personal care services form the core to the NurseWatch brand identity and value. The only way to ensure quality of service is to provide mentorship to the nurses and wellness professions and guide them towards the right way. Many nurses, coming from a public healthcare background, are not accustomed to one-on-one tailored services. Therefore, Kate also has to help to reframe what “care” really means in NurseWatch and how they should interact and communicate with the elderly under their care. Through keeping the training and education in-house, Kate ensures that all staff working for NurseWatch are onboard with and understand the value of NurseWatch and to ensure quality of service is consistent with the brand and its promise. Through this direct mentorship arrangement, Kate also works closely with the frontline staff and guides them through any situations or difficulties they might face, giving them guidance and support to help erase any stress or pressure.

The key value proposition of NurseWatch is to provide premium, professional, timely, and all-rounded care services to their clients while offering the families a high level of flexibility and convenience that they could not receive in the traditional aged care institutes and hospitals.

To achieve this, NurseWatch adopts a unique tripartite service model of Wellness, Care, and Social. Under their Wellness sector, they place a heavy focus on the holistic well-being and vitality of their elderly customers. They provide nutrition and health consultation, health coaching, massages, and naturopathy to ensure that wellness is incorporated at an early stage so as to improve their customer’s quality of life. In alignment with Kate’s strong belief in inclusivity, they also provide LGBTIQ concierge services to better address the needs of and support the LGBTIQ community. This sets NurseWatch apart from the rest of the aged care market as there has been no other institution that has taken a specific effort to serve and support this community and to provide a safe space for them in their golden age. Under their Care sector, NurseWatch focuses on providing support for common health situations of elderly such as surgery, dementia, speech impairment, et cetera. Professional care includes post-surgery care, disability care, dementia care, speech and occupational therapy. Lastly, under their Social sector, NurseWatch regularly partners with external organisations and companies to host social activities to encourage their clients to have fun and flourish at home and in their community while receiving appropriate professional support. Examples of social activities include ballet classes, concerts, theatre visits, and life story drafting. The professional team at NurseWatch also assists elderly in their daily transport and helps with shopping and errands. A combination of all the three sectors above means NurseWatch is taking full attention to the physical, mental, social, and everyday needs of their clients; they provide professional on-demand, and quick-to-respond services to everyone under their care.

In this paragraph, we will cover the key partners, resources, and activities of the Business Model Canvas for NurseWatch. The key partners working with NursWatch include trained nurses, wellness professionals such as nutritionists, psychologists, counsellors, social service providers, and social activity partners. External parties include Human Resources and Accounting service providers, roster management company, and consultant for the business. The key resources include the nurses and professional healthcare providers, the digital systems for onboarding and storing customer’s information, and the medical devices and toolkits for at-home healthcare services. NurseWatch’s key activities cover at-home healthcare and daily home-care service, arranging social activities and providing mental healthcare services.

NurseWatch’s target customer segments are the Baby Boomers, who are likely to be taking care of children in their 20s and have parents in their 80s. Unlike many other healthcare service providers in Australia, NurseWatch does not target to serve pensioners but focuses on retirees who are financially well enough to pay for premium healthcare services using their superannuation funds. NurseWatch takes a personal approach towards building and maintaining customer relationships via building a caring and supportive community. On one hand, it aims to provide one-on-one care with designated nurses who also act as a warden and family to the clients; on the other hand, it maintains relationships with the client’s family much like one of an extended family member, to provide the support they need for their elder.

Unlike many other healthcare institutes in Australia, NurseWatch arranges a designated nurse to each client and the service hours often last for 8 hours a day. Compared to the more common 2-hour shift with multiple clients, NurseWatch essentially gets four times the income from one client. With this difference in shift arrangement and its positioning as a premium healthcare service provider, NurseWatch can become profit-generating and maintain a high level of service quality while targeting a niche audience group in the market. Therefore, NurseWatch has very minor online presence via website and social media; the primary source of leads come through word-of-mouth. In the future, Kate plans to enter the corporate market by working with companies to provide healthcare packages. A summary of NurseWatch’s Business Model Canvas has been attached as Appendix I.

NurseWatch sells its services primarily through word of mouth. Through careful management and timely response to clients’ needs, the team maintains a high level of service quality and lets it speak for itself and becomes the driving force of NurseWatch’s business growth. The ISO 9001 and Rainbow Tick accreditations also help NurseWatch establish a professional and socially aware brand image, showing and proving to the current and potential customers that they will receive quality service from a socially-responsible company.

It was two years into the business until NurseWatch achieved breakeven. When Kate first started NurseWatch in 2017 with her own savings, she considered herself lucky to have found the first client whose order became the lifeline of the business to keep it running, on top of her personal fundings. When clients come to join NurseWatch, they are charged a one-off onboarding fee which will give them an all-rounded health assessment to create a holistic health portfolio including medical history, body and blood measurement, genealogy resting, et cetera. The information will then be inputted into the NurseWatch digital system which can be accessed by nursing professionals. This system ensures that the clients are receiving the optimal and suitable services they need. Onboarded clients are paired with a designated nurse who will provide health and home care. Unlike most of the other healthcare service providers who arrange different nurses every time and with service hours of about two horses each shift, the clients of NurseWatch will be served by the same nurse every time they meet, usually over an eight-hour shift, and sometimes 16-hour if required. Regularly, NurseWatch organises social events for the elderly under their care, they partner with external service providers such as theatres, dance
schools, and art studios to enrich their clients’ social life. The clients are not charged for joining these social events, instead the service providers are charged a one-time referral fee.

When looking into the business model and positioning of NurseWatch, I believe the success factor lies in its clear understanding of their target customer segment and its ability to provide services and products that fulfil a gap in the market and address the pain points of their target audience. Instead of trying to target the massive ageing population, NurseWatch strategically chose to focus on those who are financially well off and wish to receive premium quality service. Currently, the market lacks aged care institutions that provide tailored and white-glove service even if people are willing to pay. What Kate has identified as the closest competitor on the market is the home-care packages backed by the Australian government. It is carried out by commercial healthcare institutions with the financial support of the government. The home-care packages of the highest level, which are reserved to people who are bed-bound, provide 2-hour a day support on household care such as cooking, cleaning, and helping with showers, et cetera, with no professional medical support. One nurse will be assigned to multiple clients each day, and they have to run from one house to another. During the Covid-19 pandemic, this drastically increased the chance of cross-contamination and illness spreading. The nurses working under these packages are also often stressed, and due to the lack of longer-term connection with the client, the service is impersonal and is often carried out as a routine rather than a personal care. Because the home-care packages are financially backed by the government, there is a fixed quota for how many people can have access to it. People have to be screened and deemed eligible before receiving this help, resulting in a long waiting time. Kate remarked that it is not uncommon to have people pass away before they could get the support. Instead of fighting in the red ocean where the majority of healthcare providers are providing basic care at a cheaper price or with the government’s subsidy, Kate adopted the blue ocean strategy and created a niche and uncontested market space for NurseWatch. Steering away from offering the same basic healthcare services and trying to compete via lower cost, Kate made the competition irrelevant by providing white-glove tailored products to NurseWatch’s clients and created new demand for premium aged care services. NurseWatch’s key activities are in alignment to pursuing such differentiation that sets the company apart from the rest of the competitors.

Another, if not the most important, key to NurseWatch’s success lies in its founder, Kate Alexander. It is through her strong expertise, professional background, and personal commitment that NurseWatch was set to thrive. Every part of the business shows Kate’s dedication into providing quality healthcare to elderly, encompassing all their needs to live their lives to the fullest. Kate instilled the concept of “care” and “leading with heart” not only in treating her clients but also her staff and external partners. She shows integrity and kindness that are then translated into her day-to-day management of NurseWatch; this helps to build a like-minded team and community that are keen to serve as well. Kate has faced tremendous financial pressure during the early stage of NurseWatch. Facing her were two paths: to stand firm and stick to the nicher market, or to participate in the government-backed home-care packages like the rest of the competitors. By standing firm on its unique business model and not following the crowd, Kate led NurseWatch away from the red ocean competition and avoided diluting its brand. With a personal conviction on how quality healthcare should be, she has done every part of the business hands-on from the start so she is aware of the pain points of each role, how they can be improved, and by doing so, she stands alongside her staff in providing top-tier care services.

The interview with Kate has been incredibly insightful. It was a valuable opportunity to get a glimpse of her entrepreneurial journey, the challenges she faced and how she overcame them, and how she came to the business model that works best for NurseWatch. I have learnt that it is crucial to have a clear understanding of what unique advantages the company aims to offer, to either solve pain points of the target customer segments or fill in a gap in the market. To ensure a consistent branding and a strong foundation for the business, we need to identify the parts within the business that are most important to the successful delivery of the company’s value. Those areas should be kept and carried out in-house while other areas that need to be done but do not add value can be outsourced. Through this, resources and efforts can be focused on delivering the value proposition that makes the business successful instead of being wasted on non-value-added processes. This smart allocation of resources also extends to avoiding the urge to grow too quickly or seeking to expand the client base without having solid ground and track record. While growth is an important goal for a start-up to quickly gain traction, it is dangerous as it might not have adequate resources to sustain itself if it scaled up too quickly over a short period of time. Kate has successfully identified NurseWatch’s target audience and focused its resources to grow its business steadily in the long run. I believe it is one of the key reasons why it managed to survive through the last three years with the global pandemic as they were able to keep costs at a minimum and sustained valuable relationships with their clients. It is also important to know when to say no; Kate could have given in to the financial pressure and joined the rest of the competition in offering home-care packages. But by doing so, NurseWatch would have lost its unique position as the premium healthcare provider and diluted its brand image and value proposition. Lastly, it is vital to lead by example. As an entrepreneur who is setting up a company from scratch, so much of the founder’s personal ideals and values are instilled into the business. Through my interaction with Kate, she is charismatic, easy to talk to, and definitely passionate about not only NurseWatch but also the healthcare industry. She also is curious and
driven, which leads to her always seeking to better the services provided by NurseWatch. I strongly believe that only someone with a mission larger than just financial gains can succeed in the long term, and Kate is a prime example of an entrepreneur who is there to make a change in the world and lead by example.

For more from NurseWatch about how they care for people in their own homes, visit here.

For more information on NurseWatch, click here.
Or call the NurseWatch team for more information on (02) 9167 8129.