“We can be proud of the fact that Connecting Conversations is still of interest”
Method to assess experienced quality of care continues to generate enthusiasm among organisations
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.
- Start project: 2016
- This project has received funding from: ZonMw
- Project website: https://www.awolimburg.nl/nl/projecten/ruimte-voor-zorg
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.
“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.
"Connecting Conversations captures what health care is all about – providing loving care."
A client representative
Education and training
The educational institutions that are part of the Living Lab in Ageing and Long-Term Care Limburg have already been looking into this. For example, Zuyd University of Applied Sciences has introduced a module to train future nurses to conduct triads. Vocational training schools such as Gilde Opleidingen and VISTA college are also either already experimenting with or interested in experimenting with the method.
To facilitate the national implementation of Connecting Conversations, the Living Lab now offers a training course – developed in collaboration with UMIO, the executive branch of Maastricht University School of Business and Economics – to teach healthcare professionals across the Netherlands how to conduct triads. The goal is to develop another training course to train coordinators within organisations to take over the organisation of triads from the Living Lab. “This would free up more time and resources for us to continue to develop new knowledge here”, explains Judith. One need only look at Connecting Conversations to see the kind of success this knowledge development may lead to. “Connecting Conversations has had both social and scientific impact”, says Katya. “We’ve shown that it is a valid qualitative method to accurately capture experienced quality of care. The project is also a great example of interdisciplinary research and citizen science.”
Text: Karin Burhenne
Training Connecting Conversations
Picture: Harry Heuts
- Katya Sion, Assistant Professor, AWO-L
- Jan Hamers, Professor of Care of Older People and chair AWO-L
- Gaby Odekerken-Schröder, Professor in Customer-Centric Service Science, Department of Marketing and Supply Chain Management (SBE)
- Suzanne Rijcken, Research Associate, AWO-L
- Judith Urlings, Network Coordinator AWO-L
- Hilde Verbeek, Professor of Long-Term Care Environments and vice chair AWO-L
- Erica de Vries, Research Associate, AWO-L
Involved research line
- Ageing and Long-Term Care
Our most important societal relevance output
- Factsheet thesis 'Connecting conversations' (in Dutch): link
- Information flyer training 'Connecting conversations' (in Dutch): link
Webinar 'Measuring quality of care', in collaboration with Noordhoff. link
Podcast Methods Matter - Oral Histories & Story Telling. link
Article in Dutch professional journal:
Sion KYJ, Verbeek H, De Vries E, Zwakhalen SMG, Odekerken-Schröder GJ, Schols JMGA, Hamers JPH. Ruimte voor Zorg Meet Ervaren Kwaliteit in Verpleeghuizen door Verhalen te Verbinden. SENIOR, 2020; 1(4):3-9
Our most important scientific output
- Sion, K. Y. J. (2021). Connecting conversations: experienced quality of care from the resident’s perspective: a narrative method for nursing homes. [Doctoral Thesis, Maastricht University]. Maastricht University. https://doi.org/10.26481/dis.20210317ks
- Sion, K. Y. J., Rutten, J. E. R., Hamers, J. P. H., de Vries, E., Zwakhalen, S. M. G., Odekerken-Schroder, G., Schols, J. M. G. A., & Verbeek, H. (2021). Listen, look, link and learn: a stepwise approach to use narrative quality data within resident-family-nursing staff triads in nursing homes for quality improvements. BMJ Open Quality, 10(3), [e001434]. https://doi.org/10.1136/bmjoq-2021-001434
- Sion, K. Y. J., Verbeek, H., de Boer, B., Zwakhalen, S. M. G., Odekerken-Schroder, G., Schols, J. M. G. A., & Hamers, J. P. H. (2020). How to assess experienced quality of care in nursing homes from the client's perspective: results of a qualitative study. BMC Geriatrics, 20(1), . https://doi.org/10.1186/s12877-020-1466-7
- Sion, K., Verbeek, H., de Vries, E., Zwakhalen, S., Odekerken-Schröder, G., & Schols, J. (2020). Ruimte voor Zorg meet ervaren kwaliteit in verpleeghuizen door verhalen te verbinden. Senior, 1(4), 3-9. https://gompel-svacina.eu/product/senior-jrg-1-nr-4/
- Sion, K., Verbeek, H., de Vries, E., Zwakhalen, S., Odekerken-Schroder, G., Schols, J., & Hamers, J. (2020). The Feasibility of Connecting Conversations: A Narrative Method to Assess Experienced Quality of Care in Nursing Homes from the Resident's Perspective. International Journal of Environmental Research and Public Health, 17(14), 1-22. . https://doi.org/10.3390/ijerph17145118
- Sion, K. Y. J., Verbeek, H., Zwakhalen, S. M. G., Odekerken-Schroder, G., Schols, J. M. G. A., & Hamers, J. P. H. (2020). Themes Related to Experienced Quality of Care in Nursing Homes From the Resident's Perspective: A Systematic Literature Review and Thematic Synthesis. Gerontology and geriatric medicine, 6, . https://doi.org/10.1177/2333721420931964
- Sion, K., Verbeek, H., Aarts, S., Zwakhalen, S., Odekerken-Schroder, G., Schols, J., & Hamers, J. (2020). The Validity of Connecting Conversations: A Narrative Method to Assess Experienced Quality of Care in Nursing Homes from the Resident's Perspective. International Journal of Environmental Research and Public Health, 17(14), . https://doi.org/10.3390/ijerph17145100
- Sion, K. Y. J., Haex, R., Verbeek, H., Zwakhalen, S. M. G., Odekerken-Schroder, G., Schols, J. M. G. A., & Hamers, J. P. H. (2019). Experienced Quality of Post-Acute and Long-Term Care From the Care Recipient's Perspective-A Conceptual Framework. Journal of the American Medical Directors Association, 20(11), 1386-1390. https://doi.org/10.1016/j.jamda.2019.03.028
- Maastricht University Impact Prize Katya Sion received the Impact Prize for her thesis "Connecting conversations: experienced quality of care from the resident’s perspective: a narrative method for nursing homes". PhD candidates at Maastricht University are required to write a paragraph on how their research can be translated into social or economic value. The annual Impact Prize rewards research that has the greatest impact on society. The prize consists of € 3,000 - made available by UM and the University Fund / SWOL together - plus a work of art. Read more
The whole research trajectory is supported by a national steering committee, consisting of representatives from the Ministry of Health (VWS), the National Health Care Institute (ZIN), the National Client Council (LOC), the Professional Association of Nurses (V&VN), the Health and Youth Care Inspectorate (IGJ) and the Board of Nursing Home Organizations.