Speaking Up for Fundamental Care: the ILC Aalborg Statement

Abstract

ObjectiveThe International Learning Collaborative (ILC) is an organisation dedicated to understanding why fundamental care, the care required by all patients regardless of clinical condition, fails to be provided in healthcare systems globally. At its 11th annual meeting in 2019, nursing leaders from 11 countries, together with patient representatives, confirmed that patients’ fundamental care needs are still being ignored and nurses are still afraid to ‘speak up’ when these care failures occur. While the ILC’s efforts over the past decade have led to increased recognition of the importance of fundamental care, it is not enough. To generate practical, sustainable solutions, we need to substantially rethink fundamental care and its contribution to patient outcomes and experiences, staff well-being, safety and quality, and the economic viability of healthcare systems.Key argumentsWe present five propositions for radically transforming fundamental care delivery:Value: fundamental care must be foundational to all caring activities, systems and institutionsTalk: fundamental care must be explicitly articulated in all caring activities, systems and institutions.Do: fundamental care must be explicitly actioned and evaluated in all caring activities, systems and institutions.Own: fundamental care must be owned by each individual who delivers care, works in a system that is responsible for care or works in an institution whose mission is to deliver care.Research: fundamental care must undergo systematic and high-quality investigations to generate the evidence needed to inform care practices and shape health systems and education curricula.ConclusionFor radical transformation within health systems globally, we must move beyond nursing and ensure all members of the healthcare team—educators, students, consumers, clinicians, leaders, researchers, policy-makers and politicians—value, talk, do, own and research fundamental care. It is only through coordinated, collaborative effort that we will, and must, achieve real change.

The culture conversation: Report from the 2nd Australasian ILC meeting—Auckland 2019

“…Aotearoa New Zealand (NZ) has the fastest growing membership of the International Learning Collaborative (ILC), and in December 2019, a collaboration between health and education brought the second Australasian ILC Conference and Summit to Auckland. Inspired by the Aalborg Statement (Kitson et al., 2019) and the success of the previous 11 ILC annual events, the conference responded to a call to action to move beyond nursing to involve wider members of the healthcare team (such as educators, consumers, clinicians, executives, managers, leaders, researchers and policymakers) to work together to initiate change. Speakers from the Ministry of Health (MOH), the Health Quality and Safety Commission (HQSC), the Nursing Council of New Zealand (NCNZ) and the New Zealand Nurses Organisation (NZNO) took the floor alongside consumer representatives, nurses, doctors, nurse leaders, educators and researchers.…”

Fundamentals of care: Methodologies, metrics and mobilisation

“…This is why at the International Learning Collaborative's (ILC) 11th meeting in Aalborg, Denmark, members came together to product the Aalborg statement (Kitson et al, 2019). While research investment is necessary, it alone is not sufficient to make fundamental care more valued and visible across our health and care systems.…”

Observational research on fundamental nursing care: Enough already!

“…As such, they can be said to have successfully actioned one of the five propositions articulated in the “ILC Aalborg Statement” (Kitson et al, ): to “talk” fundamental care. Of the other four propositions, three are difficult to assess—“valuing,” “doing” and “owning”—being properties of the systems, groups and individuals that provide nursing care to individuals and families in need of it.…”

“…The ILC Aalborg statement proposes that “fundamental care must undergo systematic and high‐quality investigations to generate the evidence needed to inform care practices and shape health systems and educational curricula” (Kitson et al, ). In an era of evidence‐based practice (Sackett, Rosenberg, Gray, Haynes, & Richardson, ), such sentiments fit squarely within the current scientific paradigm driving improvements in health care.…”

“…In the light of these significant advances in applied health services research methods for complex interventions, there is certainly no moral or ethical argument for abandoning the scientific method in favour of continuing untested custom and practice, practice that may in fact actively or passively harm the very people we are trying to care for. Rather, those researchers in nursing aiming to meet Kitson and colleague's challenge to research fundamental care (Kitson et al, ), should at the very least cease further observational research unconnected to intervention testing, and combine their observational insights with robust experimental methods in large scale clinical trials.…”