From harness to summer dress at the Van Neynselgroup for care
2010 – The Van Neynselgroep in ‘s-Hertogenbosch is committed to delivering quality care whereby the responsibility and skills of employees are put central in the client approach.
Why this is workplace innovation
The aim is to deliver quality care where not the jobs and tasks are the starting point, but the staff with its capabilities and talents and the resources the client has (yet) available. Responsibility and satisfaction in the care relationship are directive. They start thinking from possibilities instead of limitations. The employee has room for maneuver and there is multidisciplinary working around the client.
The Van Neynselgroep wants to use and develop the talents and abilities of employees better, they want to give room to the professionals to organize their own work in consultation with their clients and their relatives, to report about it and to improve the quality of the work systematically. This will lead to greater job satisfaction of professionals, a better quality of care and higher efficiency.
The Van Neynselgroep has involved three other nursing and care homes in the project and let develop a methodology to bring the objective really to flourish in practice. It began with a baseline measurement prior to the pilot. This measurement was about employee satisfaction, labor productivity and long-term illness. Then the needs of the residents were inventoried. To complement this survey there were also conversations with people in the social network of residents, such as family members and caregivers. Also there were held peer review meetings with staff to examine the staff’s view on providing needs-based care. Based on the needs of residents and the vision of employees in providing need-based care, employees in their teams have designed goals and interventions to get started with the new method. Interventions mainly concerned the breaking of thought and behavior patterns (do not fill in the needs of residents yourself). Talents and skills of employees were identified and linked to the contribution they want to make to the goals of the client. In addition, mentoring was introduced and the desired behavior was rewarded. Also, clients were encouraged to be critical and to make comments. The coordinator for care also got another role: in addition to the responsibility for the caring, he or she got a leading and coaching role. The ‘care coordinators’ are coaching staff to get more control in their work and to have more awareness of their own actions. To give employees the opportunity to pay more attention to the client, an ‘on-the-job coach’ made the employees aware of habits and the options to break them. And during the work process, there were evaluations and feedback on collaboration and improvement within the team were discussed. At the end of the pilot, which lasted about a year, there has been a final measurement. In this way, the results were made transparent and is measured whether the predetermined objectives have been achieved. To determine the effect of the approach as objectively as possible, this cycle was applied in three other care organizations except for Van Neynselgroep. This project is part of a series of subsidized transition projects in the long-term care, that put the improvement of the health care system in the center.
Initially both employees and clients hesitated, they did not understand quite well what was happening. But ultimately everybody is very enthusiastic. The employees feel that they have more time for residents and more rest when performing the health activities. Also, clients experience this peace and attention as positive. For example, this piece is a result of the deployment of an additional employee during the morning service. More importantly it is, that there has been a change in culture. Employees have been given more opportunities to take the initiative themselves. This made the collusion between employees more important than before. Because employees take more responsibility for their own work, they work with more pleasure. Employees are also more willing to learn from each other. The first measurements show a decrease in absenteeism from 12.8 to 4.1 per cent and in recruitment campaigns there are more applicants.
Inside the Van Neynselgroep work is optimized: roles and responsibilities are made clearer and there are shorter lines with the medical and paramedical services.
However cultural change takes time. At the end of the experiment on the pilot section, the method will be extended to other departments. It is already clear that other management skills are needed: more room for diversity. Regarding employees there will be a focus on a change of attitude (eligibility) to work in this way. There are employed new employees who – in their enthusiasm – had taken along old employees. The new method involves a new approach to the future care. Simply not all care will be given by the professionals. There are too few professionals and too few financial resources. Therefore, an appeal will be made to ‘sources’ in the environment of the client: family, friends, professionals, volunteers. They will not only be involved in “additional jobs”, but also in work which is care related.
More information about the Van Neynselgroep in ’s Hertogenbosch is available at www.vanneynselgroep.nl, about the project on www.vanharnasnaarzomerjurk.nl and about the transition program in the long-term care at www.tplz.nl.
See the article ‘Sociale innovatie in de zorg (VV&T) in Noord-Brabant. Onderzoek in opdracht van Transvorm’ (‘Social innovation in healthcare in North Brabant. Research commissioned by Transvorm’).