Work organization and elderly care: plan evaluation findings from the Flemish Care Living Labs (Belgium)

Abstract

Introduction: An extensive, three-year, _living labs_ based program has been initatied in Flanders (Belgium) to stimulate innovation in the domain of elderly care. The program kicked off in September 2013, and comprises 23 projects, grouped in 6 regional platforms. A scientific consortium is entrusted with the scientific support of the program. One of the disciplinary aspects is the organization of work, which is studied in three steps: 1) evaluation of the platform and project plans; 2) survey on quality of labor (karasek) and relational coordination (Gittell) among care professionals, at the start and at the end of each project; 3) qualitative study on the cooperation between professionals and informal caregivers. This abstract treats the first step. Theory/methods: The research combines concepts from sociotechnical systems (de Sitter) and relational coordination theory. The projects are very diverse, with topics including technology, housing, informal care networks, mobility, care management, care and cure integration and career platforms for care professionals. A quick scan of the platform and project plans revealed that direct references to aspects of work organization could usually not be found. The plan evaluation is therefore based on whether following three goals were present, which each imply challenges with regard to the organization of work: 1) integrating care; 2) realizing community based care; 3) improving care quality. Information was gathered by qualitative document analysis and semistructured interviews with platform coordinators. Results: Out of the 6 platform plans, 3 explicitly mentioned integrating care as a goal, referring to cooperation between organisations. While the other 3 platform plans did not stated integrated care as an explicit goal, they all stressed the importance of cross-organisational cooperation. Four plans explicitly aimed at the realization of community based care systems, while one plan did this in a rather implicit way. The last platform plan did not contain any reference to community based care. All six platform plans explicitly aimed at improving care quality. At the project level, 22 out of 23 project plans explicitly (17) or implicitly (5) aimed at integrating care. Ten project plans explicitly (9) or implicitly (1) referred to the realization of community based care, while all 23 project plans explicitly aimed at improving care quality. International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-116968 – http://www.ijic.org/ 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 2 Discussion: The results suggest that aspects of work organization could be crucially important for the projects within the six platforms. An example is that various project plans strive to apply technological tools to increase cross-organisational coordination, encompassing a possible risk for increased bureaucratization. Another example is that the introduction of care managers could draw attention away from the underlying problem, being the underlying fragmentation of the work organization. A third example is that various projects are focused on care integration at the micro-level of care professionals and informal caregivers, which could affect tasks and roles of both groups. Conclusion: The various platform and project plans offer good leads for studying aspects of work organization in the next research steps.