Cultivating quality awareness in corona times

Abstract

The Covid-19 pandemic is a tragedy for those who have been hard hit worldwide. At the same time, it is also a test of concepts and practices of what good care is and requires, and how quality of care can be accounted for. In this paper, we present our Care-Ethical Model of Quality Enquiry (CEMQUE) and apply it to the case of residential care for older people in the Netherlands during the Covid-19 pandemic. Instead of thinking about care in healthcare and social welfare as a set of separate care acts, we think about care as a complex practice of relational caring, crossed by other practices. Instead of thinking about professional caregivers as functionaries obeying external rules, we think about them as practically wise professionals. Instead of thinking about developing external quality criteria and systems, we think about cultivating (self-)reflective quality awareness. Instead of abstracting from societal forces that make care possible but also limit it, we acknowledge them and find ways to deal with them. Based on these critical insights, the CEMQUE model can be helpful to describe, interrogate, evaluate, and improve existing care practices. It has four entries: (i) the care receiver considered from their humanness, (ii) the caregiver considered from their solicitude, (iii) the care facility considered from its habitability and (iv) the societal, institutional and scholarly context considered from the perspective of the good life, justice and decency. The crux is enabling all these different entries with all their different aspects to be taken into account. In Corona times this turns out to be more crucial than ever.

Organizational attributes that contribute to the learning & improvement capabilities of healthcare organizations: a scoping review

“…Finally, our results suggest that an aligned organizational strategy to achieve client-centeredness, family involvement and service maximization contributes to L&IC. These results are in line with recent literature [ 1 , 7 – 9 ] that emphasizes the role of the client in the learning and improvement process of healthcare organizations.…”

“…Citizens count on good quality of care when they need it, but in practice, there can be large differences between healthcare organisations in regard to quality, despite quality management systems, procedures for accreditation, regulation and the intrinsic motivation and efforts of healthcare workers to provide the best quality of care [ 1 – 6 ]. According to contemporary insights, quality of care is more of a dynamic concept than a static concept; it is not only relationally but also organizationally determined [ 7 – 9 ]. In addition, the context can also change and lead to new insights about quality of care.…”

“…In addition, the context can also change and lead to new insights about quality of care. For instance, the recent COVID-19 pandemic demonstrates the importance of healthcare organisations having the ability to learn in rapidly changing circumstances and adapt and improve the quality of care accordingly [ 9 , 10 ]. The simultaneous occurrence of significant differences in quality, the awareness that quality of care is strongly relationally and organizationally determined, and the intrinsic motivation of healthcare professionals stresses the importance of the learning and improvement processes that take place within healthcare organizations.…”

The continuing formation of relational caring professionals

“…It looks at the entire process, including the person counting and accounting, and thus keeps together the different ways of looking at quality and the different ways of learning. A powerful way to cultivate quality awareness is to engage in a sort of 'quality deliberation', a joint inquiry into care from four perspectives: of the care receiver(s), including their relatives, of the caregiver(s), of the organization, and of society (Baart 2018b;Timmerman et al 2021).…”

Effective Relationships Between Younger Caregivers and Older Care Recipients Across a Continuum of Formal Residential Care Settings: A Scoping Review and a Critical Analysis

“…Drawing on an ethic of care philosophy [20], PCC highlights the context in which caregiving takes place, and the quality of the relationship involving both CGs and OPs [15,21,22]. Research clearly associates effective relationships with healthy ageing [23,24], but to date, research on the nature of relationships between OPs and CGs in formal care reports ineffective relationships [7,17]; or focuses (punctuates) on the intrapersonal level (the subjective experiences) [7,14,17].…”