Verpleegkundige middenmanagers verkeren in een ideale positie om patiëntgecentreerde zorg te faciliteren. Hun bijdrage is echter onderbelicht inde literatuurd, omdat dit in de praktijk moeilijk te verwoorden is. In dit artikel wordt bestudeerd hoe in ziekenhuizen middenmanagers aan de patiëntgecentreerde zorg bijdragen. Hierbij werd een combinatie gebruikt van analyse van tijdsbesteding an etnografisch werk, om op microniveau de bijdrage van de middenmanagers aan patiëntgecentreerde zorg te bekijken. Zestien managers werden gedurende 560 uur geschaduwd tijden hun werk in vier ziekenhuizen.
Background: The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with chronic illnesses. This study aims to get an overview of the scientific literature on developing interprofessional shared care plans. Methods: We conducted a scoping review of the scientific literature regarding the development of interprofessional shared care plans. A systematic database search resulted in 45 articles being included, 5 of which were empirical studies concentrating purely on the care plan. Findings were synthesised using directed content analysis. Results: This review revealed three themes. The first theme was the format of the shared care plan, with the following elements: patient’s current state; goals and concerns; actions and interventions; and evaluation. The second theme concerned the development of shared care plans, and can be categorised as interpersonal, organisational and patient-related factors. The third theme covered tools, whose main function is to support professionals in sharing patient information without personal contact. Such tools relate to documentation of and communication about patient information. Conclusion: Care plan development is not a free-standing concept, but should be seen as the result of an underlying process of interprofessional collaboration between team members, including the patient. To integrate the patients’ perspectives into the care plans, their needs and values need careful consideration. This review indicates a need for new empirical studies examining the development and use of shared care plans and evaluating their effects.
Lifelong learning is necessary for nurses and caregivers to provide good, person-centred care. To facilitate such learning and embed it into regular working processes, learning communities of practice are considered promising. However, there is little insight into how learning networks contribute to learning exactly and what factors of success can be found. The study is part of a ZonMw-funded research project ‘LeerSaam Noord’ in the Netherlands, which aims to strengthen the professionalization of the nursing workforce and promote person-centred care. We describe what learning in learning communities looks like in four different healthcare contexts during the start-up phase of the research project. A thematic analysis of eleven patient case-discussions in these learning communities took place. In addition, quantitative measurements on learning climate, reciprocity behavior, and perceptions of professional attitude and autonomy, were used to underpin findings. Reflective questioning and discussing professional dilemma's i.e. patient cases in which conflicting interests between the patient and the professional emerge, are of importance for successful learning.
MULTIFILE
