Dignity Care – An action research project
Persons with multimorbidity and complex long-term needs (CLNs) consume up to 2/3 of specialist care resources. In a fragmented and specialized care system, their care is often both costly and of poor quality due to gaps in care. In light of the “silver tsunami”, we expect this group to grow. Finding better and more cost effective ways to deal with this growing patient group is key to sustainable and high quality care systems.
There is a general agreement that this group will benefit from a digitally supported, person-centered, integrated and proactive care system (short: Dignity Care). Persons with CLNs will benefit most from One Citizen – One record (1C1R) because 1C1R offers the tools to create Dignity Care patient pathways. We expect Dignity Care to produce the quadruple aim of improved: 1) patient experience, 2) health and function, 3) cost-benefit ratio and 4) professional experience.
1C1R will be introduced into a complex network of organizations, departments and professionals. 1C1R will create new information flows which in turn will create new work-patterns and ultimately patient pathways. The patient pathways should be meaningful seen from both the patient, health professional and health system owner’s perspective.
There is no “methodology” that can fully direct decision makers to create an information flow in this network that results in Dignity Care locally. The new work patterns will have to be negotiated across stakeholders. Such a negotiation is easier if all parties share a common vision which can be used to assess alternatives. However, this depends on a good enough common understanding of the goal, and a continuous valuation of whether the decisions move the goal in question closer or further away.
A common goal?
We aim to track the various stakeholder’s formulation and understanding of the goals that guide their decisions in the implementation process. This will be done both through observation in meetings in the implementation process, and through interviews with central stakeholders. Tentative title: “Which goals do stakeholders hope to achieve by a dynamic socio-technical innovation directed at persons with complex and long-term care needs?”
Are we closing in on the goal?
Since 1C1R is not “going live” until fall 2021 (Central region), it will not be possible to observe the impact on the patient pathway for some time yet. We therefore introduce feedback sessions: A meeting between the researchers and the HP-implementation team. In these meetings, the observations made will be discussed and reviewed in terms of the desired outcome. Tentative publication title: Formative evaluation in complex implementation processes – What kind of feedback do decision makers find useful in their quest for Dignity Care?