Quality issues, an increasing average care intensity and higher demands from society combined with a policy change caused an urgent need for a national approach to the quality improvement of nursing homes.
Early in 2015, Martin van Rijn (ministry of VWS: Health, Welfare and Sport), former Secretary of State, presented the long-term plan ‘Dignity and pride, loving care for our elderly’. This plan combined a large number of existing initiatives and new plans in order to improve the nursing home care on a national level through one widely supported vision.
You can watch this video for a glimpse into the benefits of Room for nursing homes.
The Dignity and pride programme focuses on the following points: quality from the client’s perspective, a wide open door to informal caregivers, proud healthcare professionals, and ample room for good, ambitious nursing homes.
Who is involved in Dignity and pride?
The innovation programme Dignity and pride is an initiative by the ministry of VWS and the task force ‘Dignity and pride’. The latter consists of representatives from patient organisations, professional organisations, sector associations, the national regulator, and the ministry of VWS. As the national centre of expertise for long-term care, Vilans is responsible for two components: Room for nursing homes and the Support programme Quality improvement for nursing homes.
Room for nursing homes
The programme ‘Room for nursing homes’ was directed at a better visibility for good practices in nursing homes, since a large number of good examples would demonstrate that high-quality nursing home care is not only possible, but could also serve as a starting point for a new standard.
In 2016, all nursing homes – 450 nursing homes at approximately 2350 locations – in the Netherlands were asked to submit improvement plans in collaboration with the client council, the VAR (Nursing Advisory Council) and the Executive Board. On the basis of this programme, 168 healthcare providers with one or more improvement plans were selected. In the course of 2017 and 2018, almost all improvement plans were implemented.
Strategy: Room for nursing homes
The following strategy was used:
- Working on improvement plans within thematic groups
Healthcare organisations started to work on their improvement plans in 20 thematic groups. They focused on topics ranging from ‘Client-oriented approach’ to ‘Needs assessment’ and from ‘Cross-domain financing’ to ‘Food safety – HACCP’.
- Sharing knowledge and experience with other healthcare providers
Participants exchanged knowledge and experiences within these thematic groups in order to learn from each other.
- Support from theme coordinators
Care providers were supported by theme coordinators. They would answer questions, connect people with each other, bounce ideas around and motivate people where needed.
- National communication
Dignity and pride’s communication had two main goals: sharing good examples from the sector (yes we can!), and offering a realistic view of the nursing home sector. Dignity and pride have published a lot of material through their own channels as well as other media outlets: practical examples, articles about meetings and conferences, policies and tools. Over the last two years, their reach has continued to increase in terms of visitors to the website, Facebook and LinkedIn, and readers of the newsletter. (See Facts and stats.)
- Direct interaction between employees of care organisations, knowledge organisation and ministry of VWS policy provides considerable added value for all parties concerned.
Effects on clients, healthcare professionals and informal caregivers
150 of the 168 improvement plans were implemented by healthcare providers. The most important results are:
- An increase in focus on the individual needs of clients. Healthcare providers and client councils indicate that the client or resident experiences more control and ownership, better matched to their point of view.
- The results for healthcare providers mainly concern an increase in expertise and behavioural change in the approach of residents, as well as the involvement of relatives in the care and life of clients. The increased learning and improvement culture among care professionals is part of this.
- Each healthcare provider has provided a fact sheet reporting the approach and its results. The results at theme level were translated into a number of general publications, aiming to pass on knowledge and inspiration to all nursing homes.
New enthusiasm in the sector
Room for nursing homes has contributed to a new enthusiasm in the sector. This has triggered a strong drive towards constant improvement, where the client is the focal point and professionals take pride in their work. Healthcare providers are learning to think and act differently, and they are learning from each other. The arrival of the quality framework Nursing home care and the innovative Assessment framework of the Health and Youth Care Inspectorate in 2017 have given the trend with an extra boost.
Facts and stats Room for nursing homes
- 168 healthcare providers took part.
- 188 fact sheets with results of the improvement plans
- The organisations participated within 13 themes: the triangle of client – professionals – informal caregivers, client-oriented approach, quality measurement and accountability, freedom and safety, food safety, needs assessment, personal budget within the institution, personal budget within the chain, budget for geriatric specialist outside nursing homes, cross-domain financing, increasing expertise in professionals, technology, control.
- 410,000 individual visitors to waardigheidentrots.nl
- 7,000 subscribers to the weekly newsletter
- 5 conferences with 7,000 visitors
- 262 meetings with 5,000 participants
- 3,200 followers on Twitter
- 525 members of the LinkedIn group Waardigheid en trots
- 5,500 followers on the Facebook page Waardigheid en trots
Support programme Quality improvement for nursing homes
Another part of Dignity and pride is the support programme Quality improvement for nursing homes. This support programme is aimed at the quality improvement of care in nursing homes (locations) with urgent quality issues as determined by the Health and Youth Care Inspectorate, the Wlz-executive and/or director. Healthcare providers receive help from a coach to work on this in an efficient and focused manner.
The first support programmes have been completed. The last will probably be completed in the course of 2019.
Download this article (pdf).