Abstract
Background:
The 2019 care-related harm and mortality monitor (Van Schoten et al., 2019) reveals
in the Netherlands approximately 10 patients per hospital per year still die of potentially avoidable
harm. The associations of healthcare organizations, professional bodies of nurses and physicians,
and the Dutch patient representative organization, joined forces to reduce this in the Dutch
National Safety II program Time to Connect. This program focusses on supporting the intrinsic
motivation of healthcare professionals and transferring good examples already up and running in
hospitals of anticoagulation, frail elderly and multimorbidity care.
Objective:
The twofold aim was:
1) to understand complex adaptive systems by studying positive deviant examples of healthcare
professionals’ mundane resilient practices of and ‘smart solutions’ and ‘practical wisdom’;
2) to unravel human and organizational components to mitigate risks and prevent harm.
Methods:
We performed action research (e.g., Reason & Bradbury, 2008; McNiff, 2013) consisting
of multiple data collection cycles on different program levels: wards, in hospitals, between
hospitals and national program. We conducted observations (~ 100 hours), 30 (in)formal interviews
and 25 focus groups to reflect on the findings. Observations were documented in thick descriptions
and interviews/focus groups were transcribed verbatim. Data were analyzed using the thematic
coding steps of Braun & Clark (2006).
Results:
The program started by bottom up collecting positive deviant examples. All examples were
described or videotaped from a perspective of healthcare professionals in Work as Done. Also,
webinars and live meetings were organized to share tips and tricks on both content (how to
organize this) and process (what did we learn/overcome). Next, healthcare professionals, patients,
quality policy advisors together with researchers distilled the most important 'key components' of
the collected examples on a specific topic. Additionally, several syntheses of scientific literature
were made to underpin these key components and to give directions for the program. The
combined knowledge from daily practice and literature, were pooled in tools, animations,
information films and infographics to support the spread and transferability to other organizations.
We now start to study improvement networks using the Quality Collaborative methodology
(Zambioni et al., 2020) to support transferability of good examples in the local complex adaptive
system. For further boosting an ambassadors network of ~130 professionals provides the
connection between local grassroots into a ripple effect on national level (Nardini et al., 2021).
The 2019 care-related harm and mortality monitor (Van Schoten et al., 2019) reveals
in the Netherlands approximately 10 patients per hospital per year still die of potentially avoidable
harm. The associations of healthcare organizations, professional bodies of nurses and physicians,
and the Dutch patient representative organization, joined forces to reduce this in the Dutch
National Safety II program Time to Connect. This program focusses on supporting the intrinsic
motivation of healthcare professionals and transferring good examples already up and running in
hospitals of anticoagulation, frail elderly and multimorbidity care.
Objective:
The twofold aim was:
1) to understand complex adaptive systems by studying positive deviant examples of healthcare
professionals’ mundane resilient practices of and ‘smart solutions’ and ‘practical wisdom’;
2) to unravel human and organizational components to mitigate risks and prevent harm.
Methods:
We performed action research (e.g., Reason & Bradbury, 2008; McNiff, 2013) consisting
of multiple data collection cycles on different program levels: wards, in hospitals, between
hospitals and national program. We conducted observations (~ 100 hours), 30 (in)formal interviews
and 25 focus groups to reflect on the findings. Observations were documented in thick descriptions
and interviews/focus groups were transcribed verbatim. Data were analyzed using the thematic
coding steps of Braun & Clark (2006).
Results:
The program started by bottom up collecting positive deviant examples. All examples were
described or videotaped from a perspective of healthcare professionals in Work as Done. Also,
webinars and live meetings were organized to share tips and tricks on both content (how to
organize this) and process (what did we learn/overcome). Next, healthcare professionals, patients,
quality policy advisors together with researchers distilled the most important 'key components' of
the collected examples on a specific topic. Additionally, several syntheses of scientific literature
were made to underpin these key components and to give directions for the program. The
combined knowledge from daily practice and literature, were pooled in tools, animations,
information films and infographics to support the spread and transferability to other organizations.
We now start to study improvement networks using the Quality Collaborative methodology
(Zambioni et al., 2020) to support transferability of good examples in the local complex adaptive
system. For further boosting an ambassadors network of ~130 professionals provides the
connection between local grassroots into a ripple effect on national level (Nardini et al., 2021).
| Original language | English |
|---|---|
| Publication status | Published - 2024 |
| Event | Resilient Health Care Society - Stavanger Duration: 5 Nov 2024 → … |
Conference
| Conference | Resilient Health Care Society |
|---|---|
| Period | 5/11/24 → … |