Using Design Thinking for Co-Creating an Integrated Care Pathway Including Hospital at Home for Older Adults with an Acute Moderate-Severe Respiratory Infection in the Netherlands

International Journal of Integrated Care, vol. 23, pp. 30

Abstract

Introduction: Acute respiratory infections are common in frail, community-dwelling older people and are accompanied by considerable diagnostic and prognostic uncertainties. Inadequately coordinated care is associated with unnecessary hospital referral and admission with potential iatrogenic harm. Therefore, we aimed to co-create a regional integrated care pathway (ICP), including a hospital at home journey. Developing the ICP: Tasked with using design thinking methodology, stakeholders from regional healthcare facilities, together with patient representatives, were assigned to different focus groups based on their expertise. The focus of each session was to co-create ideal patient journeys suitable for embedding in the ICP. Results: Based on these sessions, a regional cross-domain ICP was developed that comprises three patient journeys. The first journey included a hospital at home track, the second a tailored visit, with priority assessment, to regional emergency departments, and the third concerned referral to readily available nursing home 'recovery-beds' under the supervision of an elderly care medicine specialist. Conclusion: Using design thinking and involving end-users during the whole process, we created an ICP for community-dwelling frail older people with moderate-severe acute respiratory infections. This resulted in three realistic patient journeys, including a hospital at home track, which will be implemented and evaluated in the near future.

Authors 7

1. Rianne M. C. Pepping corresponding Aachen Department of Public Health and Primary Care/Health Campus The Hague

   Leiden University Medical Center · Haga Hospital

   Affiliation as printed

   Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands ; Department of Internal Medicine,

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands; Department of Internal Medicine,

   Haga Teaching Hospital, The Hague, The Netherlands

   of Health Care / Health The ;

2. Maarten O. van Aken Aachen Department of Public Health and Primary Care/Health Campus The Hague

   Leiden University Medical Center · Haga Hospital

   Affiliation as printed

   Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands ; Department of Internal Medicine,

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands; Department of Internal Medicine,

   Haga Teaching Hospital, The Hague, The Netherlands

   of Health Care / Health The ;

3. Rimke Cathelijne Vos Aachen Department of Public Health and Primary Care/Health Campus The Hague

   Leiden University Medical Center · Haga Hospital

   Affiliation as printed

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands ; Department of Internal Medicine,

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands; Department of Internal Medicine,

   Haga Teaching Hospital, The Hague, The Netherlands

   of Health Care / Health The ;

4. Mattijs Everard Numans corresponding Aachen Department of Public Health and Primary Care/Health Campus The Hague

   Leiden University Medical Center

   Affiliation as printed

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague

5. J. Berg corresponding

   Haga Hospital

   Affiliation as printed

   Department of Pulmonology, Haga Teaching Hospital, The Hague, The Netherlands

   Department of Pulmonology, Haga Teaching Hospital, The Hague

6. Ingrid Kroon corresponding

   Florence (Netherlands) · Haga Hospital

   Affiliation as printed

   Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands

   Elderly Care Medicine, Florence Health & Care, The Hague, The Netherlands

   Department of Internal Medicine, Haga Teaching Hospital, The Hague

   Elderly Care Medicine, Florence Health & Care, The Hague

7. Cees van Nieuwkoop corresponding Aachen Department of Public Health and Primary Care/Health Campus The Hague

   Leiden University Medical Center · Haga Hospital

   Affiliation as printed

   Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands

   Department of Internal Medicine, Haga Teaching Hospital, The Hague

   Department of Public Health & Primary Care/Health Campus The Hague, Leiden University Medical Center, The Hague