Figure 1
Phases and steps of design thinking.
Figure 2
Schematic time display with meetings and activity examples. With the design thinking phases below. ICP: integrated care pathway.
Figure 3
The ICP includes three possible patient journeys. The acute care team consists of a daily visiting nurse, the responsible home care organisation and an emergency call centre for the patient and their caregiver. Thicker lines indicate the three described journeys. The dotted lines showing optional redirections. GP: general practitioner, ECM: specialist elderly care medicine.
Table 1
Inclusion criteria for hospital at home journey.
| The patient has a (suspected) respiratory infection |
| Patient and caregiver are motivated and able to learn monitoring skills* |
| Patient and caregiver are able to use measuring devices to measure vital values |
| Home care is already sufficient or initiated by the GP |
| A concise individual care plan has been formulated by the GP and patient |
| Oxygen saturation SpO2 =/> 92%, with a maximum of 5 litres oxygen suppletion and a breathing rate =/< 24 per minute** |
[i] * Assessed by own GP.
** Or adjusted values relevant to the individual patient.
Figure 4
Hospital at home journey, acute home care team.
Table 2
Example barriers encountered per patient journey.
| PATIENT JOURNEY | PRACTICAL BARRIERS | BARRIERS REGARDING COMMUNICATION |
|---|---|---|
| 1. Hospital at Home | POCT at home by GP, financial health insurer means for oseltamivir at home, language barriers in our urban region. | Communication application between patients and healthcare professionals. |
| 2. Tailored visit to the Emergency Department | Waiting times at the ED, using the new referral template by GPs, same workflow at two different hospitals. | Communication between hospital specialist and GP regarding discharge to home after office hours. |
| 3. Admittance to a readily available recovery bed | After hours admittances at the nursing homes, transportation waiting times, financial barriers for the availability of a recovery bed. | Involving all ECMs in the region to adhere workflows, even when not working for the involved nursing homes. |
| 4. Side-stepping the Emergency Department | Waiting time for the ambulance at the hospital, legal responsibility for the patient when in the hospital, transportation to radiology and chemistry department. | Communicating results from radiology or chemistry lab to GP. |