On 19 October 2021 a workshop organised thanks to the support of the AAL Forum and the European Week of Active and Healthy Ageing, explained why the transition towards hybrid care technologies is a solution to ensure the sustainability of Europe’s health and care systems. Using two hospitalisation@home use cases, it showed how the SCIROCCO Exchange tool can help hospital sites with understanding and applying change management approaches.
Change is taking place in the health and care offered to older adults throughout Europe. Shifts are occurring in how people live at home and the services offered to them by their regions’ hospitals. New solutions for older adults include keeping healthy; avoiding getting ill or getting more ill; and – in hospital terms – reducing over-hospitalisation and avoiding repeat hospital visits.
Hospitalisation@home is just one form of hybrid care. It is, however, an approach that is still in its infancy. In many settings, there is a clear lack of continuity between hospital and home. Nevertheless, digital solutions are helping to smooth this transition through their use of tele-centre support and virtual coaches. To achieve this shift, both individual and organisational changes are needed but they need to be adequately managed.
Change management can be particularly complex in health and care settings, due to the multiplicity of stakeholders involved and their respective agendas. For this reason, it is important to keep abreast of change management approaches, tools, and techniques.
Introduction to the tool
The 12 dimensions of the SCIROCCO Exchange tool were introduced by Andrea PAVLICKOVA, International Engagement Manager from the Scottish Government. Presenting this highly participatory and facilitative tool, the talk showed how easy the tool is to use.
Under development for five years since 2016, the tool has enabled over 30 regions or organisations, almost 500 individual people, and more than 1,000 assessments to assess the maturity of their health and care systems, with particular reference to digital technologies. It is already on offer in 10 different languages. Countries outside Europe that have used the tool include Australia and Saudi Arabia.
This was one of the few times that the model has been applied to hospitalisation@home.
Dr. PAVLICKOVA’s mentioned that there is a need to “focus on the bigger picture” (and not on the technologies), and “local context matters”. These messages were as relevant to hospitalisation at home as to other digital health and care settings in the past.
The two currently-running European initiatives that collaborated to explore how SCIROCCO Exchange model/tool could help them mature their work on hospitalisation at home were NWE-Chance and vCare. The session’s focus was on how the tool could be used by hospital managers and their colleagues.
The tool in practice
Wendy BRUINS, speaking on behalf of herself and her colleague, Astrid VAN DER VELDE of the Isala Heart Centre in the Netherlands, talked about how they had used the SCIROCCO Exchange tool to assess their system’s maturity. In the NWE-Chance project, through its Chance@Home system, Isala has focused on bringing clinical care to the home by incorporating a wide variety of uses of small and large technologies into the care pathway. The technologies include mobile phones, sensors, weighing scales, mainframes, and data centres. By using SCIROCCO Exchange, on the one hand, Isala has understood that among its strengths are its readiness to change and its process coordination. On the other hand, two of its relative weaknesses include capacity-building and evaluation methods. SCIROCCO Exchange provided the Isala colleagues with a quick-scan overview of their situation: they found it extremely easy to use and that it facilitated their multi-stakeholder discussions.
Looking to the future, they could see that the tool could be used by them to coach others about hospitalisation@home, and enable hospitalisation@home to be exploited further.
Hospitalisation@home – using a range of technologies
Massimo CAPRINO of CCP in Milano, Italy, introduced the way in which the vCare project had used the SCIROCCO Exchange model to explore the project’s maturity. In contrast to NWE-Chance, vCare applied the model on three different sites in Italy, Romania, and Spain. Together, the sites explored what was happening in terms of hospitalisation@home in three different clinical fields: heart attacks, strokes, and Parkinson’s condition. They got varied teams to use the tools – and included in the exercise cardiologists, neurologists, therapists, physiotherapists, and technicians. They found considerable agreement on their sites about how satisfied the tool users were with eight out of 12 of the SCIROCCO Exchange tool’s maturity dimensions.
In the future, vCare is keen to explore two ways of maturing their work on hospitalisation@home: learning from their own successful and/or satisfied sites, as well as through input from external sources.
Hospitalisation@home – covering a variety of conditions and pathways
Certainly, the speakers from the two hospitals had very positive experiences of the tool, and were keen to use it again. It will also be particularly exciting if several of the more than 20 sites that attended the session will start to use the SCIROCCO Exchange model in the future.
There is, indeed, every possibility that SCIROCCO Exchange tool will be expanded, extended, and exploited further in the future. Both the NWE-Chance and vCare initiatives are keen to enlarge their exploration of the tool, and to interact with others on the work that they do!