Innovation in care: new horizons for a grey area
For us, the starting point for innovation and improvement in care is engaging with everyone who is directly involved with care. What society expects from the care sector is also constantly changing. The questions and solutions required are not limited to care itself, but also concern housing and how we live together as a society. This makes “care” an issue for everyone. Everyday stories and personal anecdotes often reveal much more than facts and figures alone.
The home care service visits Mr Versteeg every day. His carer, Marja, knows her way around his home. They have developed a routine together. He’s ready when she arrives, and she quickly completes her tasks. If Marja has a quieter day, then they’re in luck: coffee time! Needless to say, this is in her own time. Mr Versteeg really enjoys these moments. For as long as it lasts… because Marja is about to retire. She’ll be replaced by the fourth new face in less than a year and a half. Welcome to Mr Versteeg’s world.++StoriesMr Versteeg’s story is just one part of a wider picture. You can read a selection of the stories we collected during our action research in the Buitenhof care home here (in Dutch).
For some, his story is a typical example. For others, it’s too romantic or even unrealistic. We believe it illustrates the challenges faced by the (home) care sector today: cost-effectiveness, staff turnover, limited attention and, most of all, a lack of human contact. At the same time, more people are growing old: we all live longer, and live at home for longer. This means we expect different things from the care we receive, whether it’s home care, nursing care or healthcare in general. The questions and solutions required are no longer limited to care itself, but also concern housing and how we live together as a society.The questions and solutions required are no longer limited to care itself, but also concern housing and how we live together as a society. This makes “care” an issue for everyone.++KL and careSee the topic page “KL shifts the healthcare drawing table” here.
Shared engagement and the stories behind the figures
Innovation and improvement in care starts with engaging with everyone who is directly involved with care: care providers, care receivers, their families, experts, future hands-on experts (people who will later require care themselves), policy-makers and local residents. It’s all about people. This is the starting point for all our care-related projects.
We put these people at the heart of the story by listening carefully to their stories. In our projects, we do so through investigation: via action research++Action researchA type of research that combines learning and change. The action researcher focuses not just on research, but also on developing solutions through action (and subsequently investigates whether these have the desired effect).. In our research for the Buitenhof care home, for example, we collected stories from residents, neighbours, staff and policy-makers. In this way, we harness the knowledge of those directly involved, knowledge that is generally untapped. This also results in an inclusive research methodology, where everyone takes part and can make a difference. Everyday stories and personal anecdotes often reveal much more than facts and figures alone (about a neighbourhood, a population or an organisation). Based on these personal insightsInnovation and improvement in care starts with engaging with everyone who is directly involved with care., we developed relevant and appropriate future scenarios for the care home. These can be expected to enjoy broad support, because we engaged with the entire community. This shows how people can shape their own future together in a sustainable way.
Action research and fieldwork in care
We also design the care of the future by examining what growing old better means in, and for, the living environment. This may be care institutions, neighbourhoods or even cities. The increasing number of older people and changing demands and wishes require new types of housing, new (local) networks, but also greater engagement from society. Care is not just a matter for care professionals, but increasingly a matter for everyone.
For us, innovation in care starts with people’s own experiences. For example, when the Municipality of Amsterdam asked us to carry out research into “growing old well”, we spent two weeks in the Amsteldorp district.++Trust, listeningObtaining an understanding of people’s living environment and engaging with them first of all means gaining their trust. To this end, we lived for two weeks non-stop in the neighbourhood. We had our own office there, but we spent most of the time outside, on the street. We had as many conversations as possible, without an agenda, and discovered which topics resonated. Because to really understand what growing old well means for these residents, you need knowledge and experience.To really understand what growing old well means for these residents, you need knowledge and experience. Via a social lab, we became familiar with the local residents’ living environment. This gave us starting points for innovation in the district – innovation that residents themselves identified with, and that they devised and implemented themselves. Working with social labs has led to a method that we call “Feed Forward”. We often use this as the starting point for action research.++What we doRead an overview of our most important approaches, instruments and methods here.
When we helped the Prins Hendrik nursing home in Egmond aan Zee to implement a technological innovation, we also began by collecting stories from all those affected. Within the context of Challenge Nursing Homes of the Future, Kennisland supported this nursing home in experimenting with, and simultaneously investigating, the effects of a video observation system. This technology was intended to promote more restful nights, and to create more time for high-quality attention from staff. In the care sector, technology is often seen as something that will lead us towards a remote, impersonal future. By starting with the residents and the most closely-involved professionals and staff – what are their experiences and wishes? – we can overcome that resistance.In the care sector, technology is often seen as something that will lead us towards a remote, impersonal future. By starting with the residents and the most closely-involved professionals and staff we can overcome that resistance. We allow them to design and play with the experiments themselves, and to learn from this together. By harnessing everyone’s expertise and innovative capacity, this technology was embraced to everyone’s satisfaction. This project demonstrated that technology can make a positive contribution to a feeling of freedom and greater control++AutonomyA sense of autonomy (or freedom) is one of three human needs (once the fundamental needs are met). The other two are connectedness and competence (Renes en Hermsen, Draaiboek voor gedragsverandering (Handbook for behavioural change), 2016). among residents and care staff alike. This not only contributes to growing old comfortably, but also to the job satisfaction of care staff. In a sector experiencing increasing labour shortages, this is a valuable insight.++Flexible working in the care sectorThe Dutch Ministry of Public Health, Welfare and Sport states that if we do not take action, there will be a shortage of 100 to 125 thousand staff in the care sector by 2022 (Action programme Working in Care). We are currently carrying out action research into flexible working in the care sector (in Dutch).
Healthcare innovation takes off
We will add new stories, pictures and figures to the story of Mr Versteeg in the introduction. Through field research, action research and social labs, those stories will come to life, figures will gain meaning and innovation in care will take off. Do you have a challenging problem for us? We’d love to get involved!