Improving professional collaboration and

person-centredness bottom-up in the

region of West-

West-Friesland, The

In the past years, the region of West-Friesland, in First, it was deemed necessary to further align the of North of the Netherlands, communication and cooperation between different has been working particularly hard to improve professionals and increase their understanding of integrated care that targets older people living at one another’s’ roles and responsibilities. Second, home with complex care needs. New activities the steering group saw that the care approach include the Geriatric Care Model (GCM) introduced could still be more person-centred and in 2010, the use of Case Managers for people with comprehensive, as professionals often dementia, and the introduction of a Social demonstrated difficulties with putting the needs Community Team. In a region of 200,000 and priorities of the older persons at the centre of inhabitants, in co-operation with several local their activities. Finally, the pilot was aimed to organisations and stakeholder groups, all these facilitate further development of collaboration efforts have required shared vision, commitment agreements. and will to overcome various challenges on the way. This story will have a closer look at the Pilot design and contents implementation process in West-Friesland, of a pilot project which provides valuable lessons To address the challenges described, a bottom-up related to the importance of bottom-up small-scale pilot was started for professionals approaches and local key resources in introducing working in health and social care in two villages of new working methods for professionals. West-Friesland ( & Wervershoof). The goal of this pilot project was three-fold: Establishing needs and priorities a) To improve communication and collaboration between participating The West-Friesland region was included as one of professionals, by improving their the Dutch case sites in the SUSTAIN project due to understanding of each other’s way of the earlier experiences seen in the implementation working and building trust; of the Geriatric Care Model. The improvement project was kick-started in June 2016 with the first b) To increase professionals’ awareness of local steering group meeting. The steering group what matters to the older person by consisted of two big home care organisations, reflecting on how they approach their older organisation providing dementia care, the social clients in their daily work; care organisation, the municipality of and a GP representative. c) To use the results following from the first In addition, someone representing a regional two aims to facilitate new collaboration advocacy organisation for older people - the agreements between participating ‘Elderly Panel’ - was included as a member of the professionals. steering group, as well as a regional ‘champion’ who used to be an elderly care physician in the region before retiring. This pilot consisted of two main activities: regular (every 6 weeks – 2 months) intervision meetings and visits to different professionals’ workplaces. Intervision meeting are meetings in which peer due to the site champion, who was a member of the supervision and methodical discussions help original project steering group and invited to participants to reflect on their personal and become further involved in the every-day project professional development. The professionals arrangements and development due to her participating in the intervision meetings included extensive knowledge and experience of people, geriatric practice nurses from the GP’s office, organisation and processes in the region. Already community nurses, case managers for people with known to and trusted by many of the professionals dementia, a municipality consultant and a social and managers engaged in the project, the site worker. The number of professionals ranged from champion was not representing any specific 5-9 during the project. During the meetings that organisation and could thus act as a somewhat started in May 2017, participants were invited to neutral connector between individual professionals reflect on their own and others’ ways of working and the management and operational levels. The through facilitated methodical discussion. The pilot also benefited from the active coordination meetings were guided by a nominated site provided by the SUSTAIN project researchers who champion (i.e. a person who knows the region and organised and facilitated the meetings. In their the people at both management and operational coordination tasks, the researchers were careful levels) and held in a safe and informal environment not to overburden the such as the site champion’s home. The workplace participants but to rather visits were up to half-a-day-long and aimed to motivate/stimulate them to provide an understanding of one’s colleagues’ let the improvements run roles, responsibilities and ways of working. their natural course. The meetings held outside Challenges in the process working hours allowed the participants to have fun and Looking back today, the current high levels of to get to know each other involvement and willingness to work together as outside the formal work well as the shared vision and collaboration settings. The regular agreements for older people’s care, were not meetings gave sufficient time for the building of achieved without challenges. To begin with, the trust among the professionals. The small size and making of arrangements was complicated between bottom-up approach of the pilot supported the the organisations who had different structures and overcoming of the challenges in coming into interests. Before the project started, one of the agreements on the management level. The lead organisations had to back out of the project, motivation and enthusiasm rising from the leaving it with no leadership, nor an organisation operational level could hence lead the change. with the ‘power’ to make decisions. Furthermore, the organisations presented in the steering group Looking back and future developments did not always agree on the means to achieve the two project objectives, person-centredness and The initial disagreement between professionals professional collaboration. Together these regarding the priorities between the two project challenges complicated the formulation of the objectives, person-centredness and professional project plan as well as the general cooperation on collaboration, turned out to be fruitful for the the management level. project in the process, guaranteeing that both areas were bound together and given sufficient Key enablers: people, time and setting attention. The resulting collaboration between professionals hence reflects not just what matters The factors that enabled the conversion of for professionals but what makes a difference for challenges into successes were the people, time the older people using the services. Researcher and the settings. The contribution of people was taking part in the intervision meetings observed evident from the high motivation of the team of changes in the group of participants, in how they professionals to improve both services and their behave towards each other, how they identify own way of working. Specifically, the success was issues and think of solutions together. The impact highlights the importance of bottom-up approaches in improving professionals’ cooperation and skills as well as the significance of the role of a trusted coordinator and a connector (here: site champion) in getting professionals together. The positive impact of the pilot has encouraged the steering group to use these experiences in other projects they are involved in. An improvement identified for the future is the development of a shared way to collect information on the service users and share this between the professionals. This improvement, as well as others, may be investigated as part of the planned securing and rolling out of the good experiences in the West- Friesland region as well as in other parts of North- Holland.

The SUSTAIN project is funded under Horizon 2020 – the Framework Programme for Research and Innovation (2014-2020) from the European Union under grant agreement No. 634144. The content of this document reflects only the SUSTAIN consortium’s views. The European Union is not liable for any use that may be made of the information contained herein.