In December 2019, Accezz International started an improvement programme with Careyn, one of the largest healthcare providers in the Netherlands. The aim was to gain insights into work processes and implement changes to help Careyn run more smoothly. But then in March 2020, the world came to a standstill. For many of us, home became the new workplace. But for Careyn, work continued at full steam. Residents and clients had to be cared for under new and demanding circumstances, a feat that earned nothing short of our full respect. After a brief but challenging disruption, Accezz was able to resume work in all four Careyn districts. There was no time to waste as managing the workload had become vital.

Balancing care and staff deployment
With an optimal balance between residents’ needs and care provision now established, work processes at all Careyn locations are today more effective and efficient. Sylvia Moens, a trainee nurse at De Plantage in Brielle, says, “It initially felt a bit uneasy, as if someone was constantly looking over your shoulder. But this feeling soon disappeared as we all started contributing to finding solutions. ”Sylvia explains, “At first, we were afraid that it was an austerity programme and the focus would be on cutting shifts. But we were closely involved in the approach and soon saw many opportunities for improving our work.”

Finding your best way forward
Accezz took time with Careyn staff to analyse improvement assets and the quality of care for residents and clients. Were Careyn’s goals expressed using ‘SMART’ criteria? Were these goals translatable into concrete actions? And was staff scheduling sufficient to meet demands?

Looking back, Sylvia notes, “After talking through the entire care process with Accezz, we decided to reorganise the care pathways. It was very instructive, especially collaborating with colleagues to jointly determine points for improvement. We also consulted the residents. We were genuinely searching for solutions that everyone could contribute to.” She adds, “It was quite a puzzle, but analysing your own processes and working towards solutions became immensely gratifying. In the end, we were able to work with fewer shifts while improving the quality of care. We are now functioning better than ever as a team.”

More time for residents
After careful observations, staff were able to eliminate bottlenecks from the process. They now spend less time working on preventable issues and tasks that hamper efficiency. For example, restocking is not just about deciding on quantities of stock. It also depends on timeliness and who is ideally placed to do it.

Sylvia says, “More time can now be spent with residents. For instance, when a resident asks whether I shouldn’t be doing something else, it is very nice to be able to say ‘No, I have time to be with you right now’. Residents are also much more involved in processes and there is stronger alignment with other care disciplines, not least wellbeing and practical assistance.”

The new care pathways define each task and staff can now consult the client directory for specific information, which saves a considerable amount of time.

According to Sylvia, “This also applies to temporary staff. Unfortunately, due to the pandemic, we still experience high levels of staff absenteeism. For temporary workers, however, it is now easier to fill in flexibly and they feel better supported and more involved in the team. This encourages them to return, which is key in times of staff shortages.”

A smooth and structured result
The primary function of a care pathway is to open a dialogue, allowing for clear agreements on residents’ needs, including how care can be delivered to optimise wellbeing. Sylvia says, “It is important to consider what has been agreed on and what can be improved. When agreements are unclear, accountability is lost. It is all about behaviour.”

She states that in the sessions with Accezz staff learnt to hold one another accountable: “As a result, the atmosphere between us has improved a lot. It is important to know what others are doing. If, for example, you do not know

who administers medication, things can go wrong. We now evaluate ourselves to see what works and what does not. Improvements, when necessary, can be implemented and working methods adapted if needed.”

It can be confusing if a staff member is dressing a resident’s wounds in bed the first time and at the washstand during the next visit: “Coherence across procedures gives structure to residents and structure provides peace of mind, which is really important.”

Sylvia continues, “Now, residents feel free to correct us. They sometimes tell us to ‘take a good look at your pathway, you are not doing it correctly’. The new ways of working also provide us, as employees, with peace of mind and add variety to what we do. We do not look after the same residents every day, which is good because the work can be physically and mentally demanding, especially in complex care. We work with fewer colleagues yet do so much more efficiently and in a better atmosphere.”

Making the right choices together
Dineke de Boer, location manager at Grootenhoek in Hellevoetsluis, is also positive about the collaboration with Accezz: “We had already implemented many improvements at our location. Staffing was well matched to the demand for care. However, working with Accezz has further strengthened our processes.”

Dineke explains, “Together with Accezz, we looked at process efficiency. Newly collected data provided additional insight, helping us make the right choices more quickly. By comparing the demand for care with projected income based on long-term care needs, for example, we can make informed decisions on staff deployment and quality of care. This affords a better balance at location level while improving mutual collaboration at district level.”

She concludes, “Once you get a firmer grip on the workload, the pressure begins to reduce. There is then more harmony and everything can be focused on delivering the best possible care. Together, we make it work better!”

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Sylvia Moens

Location manager at Grootenhoek

"Once you get a firmer grip on the workload, the pressure begins to reduce. There is then more harmony and everything can be focused on delivering the best possible care."

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