“We can be proud of the fact that Connecting Conversations is still of interest”

How can we accurately describe the experienced quality of care in nursing homes from the resident’s perspective? Six years ago, the healthcare organisations that are part of the Living Lab in Ageing and Long-Term Care Limburg (AWO-L) were in need of an answer to this question. The resulting research project led to the development of an assessment method called Connecting Conversations (Ruimte voor Zorg) and to several follow-up studies. “I think that now, six years later, we can be proud of the fact that our method is still of interest”, says Katya Sion, researcher at the Living Lab, who won the UM Impact Prize 2021 for her work.

Healthcare organisations that have implemented the method, she says, are enthusiastic about it. “They often say, ‘Wow, this is exactly what we wanted to know from our clients.’ The method helps organisations become better and often more efficient at meeting their clients’ needs, which is exactly what we wanted to achieve”, says Katya. She completed her PhD thesis on Connecting Conversations in 2021 and is the project leader of the national implementation of the method, which is still being further developed. The project falls within the Living Lab’s line of research that focuses on assessing quality, headed by Professor Jan Hamers. “Specifically, it falls under the topic of client experience”, says Katya.

The research line is based on a quality model the Living Lab in Ageing and Long-Term Care Limburg designed together with healthcare professionals, nursing home residents, and informal carers, among others. “To measure client satisfaction, after all, you must first define quality of care. Together we arrived at a definition of care that is primarily about the everyday interactions with others and the wellbeing of residents.” The conversations with care triads that characterise the Connecting Conversations method are based on this definition of care. An employee, preferably from another health organisation, conducts three separate conversations – with a nursing home resident, a family member of that resident, and a professional caregiver involved in their care. These three conversations, referred to as “triads”, are recorded and summarised in a report. An app for this specific purpose has been developed with CodeArt.

The assessment method was developed in collaboration with healthcare professionals and client representatives, and tested in practice. Professor Gaby Odekerken-Schröder of the School of Business and Economics was involved because she specialises in customer-centric service, explains Judith Urlings, external cooperation coordinator at the Living Lab in Ageing and Long-Term Care Limburg. Steps were then taken to develop a similar method for home care. Connecting Conversations turned out to act as a catalyst for further research. For example, LEEV is a project about what healthcare professionals can learn from and do with the data collected from triads. Researchers have also begun to use text mining to analyse the summaries of the conversations.

Be flexible

“We’ve learnt that it’s important to be flexible. For example, we’ve found that it is often difficult for organisations to exchange employees. Alternatively, an employee of a specific organisation may conduct triads in another part of that organisation”, says Katya. “But exchanging employees is preferable to promote cross-organisational learning”, adds Judith.

Both Katya and Judith are excited about the current reach of Connecting Conversations. The project is supported by a steering committee that includes representatives from the Dutch Ministry of Health, Welfare and Sport (VWS), the National Client Council (LOC), and health insurance company CZ. In addition, the Netherlands Organisation for Health Research and Development (ZonMw) is funding research on adapting the method for assessing the experiences of residents who struggle to express themselves verbally. ZonMw also wants to find out how to implement the method nationally in a cost-effective way and how to include it in existing education programmes.