Triple aim improvement for individuals, services and society in dementia care

Abstract

BackgroundA redesigning of primary care is required to meet dementia patients’ needs. In the Netherlands, current dementia care still falls short in areas including ad hoc collaboration, lack of feedback on quality to professionals involved, and insufficient implementation of established multidisciplinary guidelines.ObjectiveDementiaNet is a collaborative care approach, which aims to reduce the burden of the disease on individuals, healthcare services and society via network-based care that encourages collaboration, enhances knowledge and skills and stimulates quality improvement cycles.Material and methodsDementiaNet was developed to support primary care networks through implementation of five core processes: network-based care, clinical leadership, quality improvement cycles, interprofessional practice-based training and communication support tools, following a stepwise tailor-made approach. Alongside this, a mixed method study was designed to evaluate innovation and effectiveness.ResultsCurrently, 18 networks have been formed. These vary in quality of care and strength of collaboration due to local circumstances. Initial activities and goals of each network also vary, ranging from acquaintance to shared care plans. Ongoing research will identify barriers, facilitators and merits of the approach in increasing quality of care and ultimately improving outcomes for patient, carer, health service and society.ConclusionInitial results show that clinical practice varies and the DementiaNet approach can lead to quality improvement. Complexity and variety of local care requires complex interventions and evaluation methods that account for this in order to safeguard the value for practice. Strict methodology lessens external validity.

Evaluation of DementiaNet, a network-based primary care innovation for community-dwelling patients with dementia: protocol for a longitudinal mixed methods multiple case study

“…More detailed information on the development of the DementiaNet innovation are described elsewhere. 17 study design and population The evaluation study is designed as a longitudinal, mixed methods, multiple case study. 18 Each participating network serves as a case in this study.…”

110 years after Auguste Deter

“…As an example for such an approach Nieuwboer et al [17] describe a network focused on a collaborative care model in the Netherlands. They describe in detail the implementation of five core processes into routine care and the scientific evaluation-a mixed method study to test the innovation and effectiveness.…”

Necessidades educacionais de profissionais da estratégia saúde da família no atendimento às demências

“…A falta de compreensão sobre o quadro demencial resulta em estigmatização do paciente. As barreiras vão do diagnóstico aos cuidados de saúde, com impactos negativos na vida dos cuidadores e familiares nos aspectos físico, psicológico e emocional, razão pela qual os cuidadores necessitam não só de informações sobre a doença e suas manifestações, mas, sobretudo, que suas limitações e inseguranças sejam conhecidas e valorizadas pela equipe de saúde (Nieuwboer, Richters, Van der Marck, 2017;Silva, Passos, Barreto, 2012;World Health Organization, 2012;Santos et al, 2011).…”

“…Para os profissionais de saúde, saber reconhecer os sintomas da doença e orientar os cuidadores de forma efetiva pode colaborar para diminuir a tensão entre ambos. Na maioria das vezes, os cuidadores beneficiam-se do suporte educacional e emocional proveniente de profissionais especializados (Nieuwboer, Richters, Van der Marck, 2017;Brodaty et al, 2014;Silva, Passos, Barreto, 2012;Santos et al, 2011).…”

“…Isso ocorre tanto em ambientes hospitalares quanto na coletividade e constitui uma preocupação em nível internacional (Nieuwboer, Richters, Van der Marck, 2017;Tullo, Allan, 2011).…”