In 2019, ZonMw has honoured 13 projects for optimisation of continuous learning and improvement in the Dutch health care system. The Athena Institute monitors and evaluates these projects to gain insights into how learning and improvement is applied and how impact is generated.
Background
Health care is constantly evolving. New knowledge is acquired every day. Therefore, it is important that current and future health care professionals continue to learn and improve. Health care professionals and organisations have the responsibility to continuously work together on better quality of care. Learning and improving are not optional, but the norm for good quality care. This requires a culture in which it is normal to reflect on what is going well and what can be improved. Building and maintaining such a learning and improvement culture is an ongoing process, which can only be achieved if this process is implemented in all layers of the organisation.
The ZonMw programme “Ondersteuning Zorginstituut” honoured 13 projects which aim to improve the quality of health care. Their central question is: How do health care professionals contribute to quality of care? The projects generate knowledge, insights and methodologies on and for sustainable and systematic learning and improvement by health care professionals in different sectors, namely: nursing home care, geriatric rehabilitation care, district nursing, hospital care and integrated birth care.
Each project has a different definition of learning and improvement, that fit its own context. It is of great value to gain insight into how the projects give interpretation to learning and improvement, its impacts, its assurance, and its availability to other parties in health care. Not so much to distil a unanimous measuring instrument and learning & improving process for each organisation; but to map a spectrum of instruments and processes, including rich stories. This provides the projects, the ZonMW programme and other parties with tools to give context-specific and valuable interpretation to 'continuous learning and improvement' in health care.
Objectives & approach
The Athena Institute aims to monitor and evaluate the 13 ZonMw 'learning and improvement' projects, both at the level of individual projects and at programme level. We do this through a participatory approach based on the validated methodology Reflexive Monitoring in Action (RMA). This methodology combines evaluation research with the facilitation of learning processes among all stakeholders. The RMA methodology is applied in two work packages running in parallel throughout the duration of the proposed research:
- Programme-level monitoring: monitoring of the 13 projects together through a customised monitoring & evaluation framework.
- Project-level-monitoring: learning and improving in practice. What has been learned and improved at the project level? And how is that sustainably and systemically embedded?
Within these two work packages, continuous learning and reflection is operationalised at three levels: learning within, between and from projects. Learning within projects receives particular attention in work package 2. Learning between and from projects in work package 1.
Lessons and outcomes
The monitoring of the programme as a whole (work package 1) results in a final report and infographic summarising scientific, practical and societal impacts of the Learning & Improvement programme line. The monitoring of the 13 projects (work package 2) results in interim reports and videos on learning and improvement in practice. Results become available in a toolbox. The two work packages run in parallel throughout the duration of the project and reinforce each other continuously.
Find here more information on the measurement tools used in the 13 projects.