First evaluation Dutch National Programme Geriatric Care (NPGC)

This research proposal concerns the evaluation of the Dutch National Programme Geriatric Care (NPGC). The NPGC is one of the instruments to improve (health) care and support to elderly people with complex problems. The focus is on the demand of vulnerable elderly people and the objective is a coherent supply of care services which are better tailored to the individual needs of the elderly. The NPGC is a programme in which transition experiments and quality collaboratives (QCs) are combined within a network structure. This evaluation will lead to an increased understanding of the functioning and nature of QCs, networks and transitions in the organisation and financing of geriatric care. Moreover, this evaluation will generate knowledge on the usefulness and effective ness of networks as a coordinating mechanism in geriatric care. In view of the increasing extent to which QCs and networks are used as a concept both nationally and internationally, there is a large need for this knowledge. The objective of this evaluation is to gain insight into meeting the intended results regarding the process, structure and effect of the NPGC at the level of the programme and the regional networks, including the corresponding projects and (representatives of) clients. On the basis of the research results recommendations must be made for the possible adaptation or continuation of the programme as a whole. The basic research questions are subdivided in process and structure questions (1-6) and effect questions (7-9) and read as follows: 1.To what extent have the University Medical Centres (UMCs) succeeded in establishing regional networks with the intended structure for better geriatric care? 2.Does the network increase, which parties have joined in and does this result in regional and national coverage? 3.Have all the identified national themes concerning content been incorporated in the programme/the regional networks? 4.Do the networks succeed in taking the questions and needs of elderly people themselves as the starting point of their experiments and projects? If so, how? 5.Have agreements been made and with whom have agreements been made about financing developed products or forms of care provision after the project period? 6.To what extent and in what way has the continuity of the network been guaranteed? Have agreements been made with regard to this and with whom? 7.Do the experiments and projects indeed result in better geriatric care, which translates itself into increased ability to do things independently, increased function preservation, decreased use of care services and decreased care/treatment burden? 8.Has the embedding of results been organised sufficiently thorough? If so, in what way and by who? 9.Which critical success and failure factors (with regard to content, organisation, financing and management) within the NPGC at the level of the programme, the regional networks, and projects/ experiments can be included as recommendations for the purpose of future implementation/continuation of the programme and new QCs in health care? By introducing a combination of three levels of data collection and different strategic methods, this study will provide answers to these research questions. In the first inventory phase, a document study and face to face interviews will provide insight into the precise activities that are being carried out within the NPGC, at the level of the programme, the regions and the projects/experiments. In the second phase of the research, indicators and instruments will be further developed to measure the results and effects of the NPGC at the various different levels. Given that a pre-post study design will be used in this research, there will be three moments of data collection carried out in the field. By means of various quantitative and qualitative methods, the data collection provides insight into a number of aspects (results, effects, costs) at the various levels (programme, regions and projects/experiments). After the three rounds of data collection respectively two interim reports and one final report will be produced and discussed with ZonMw. Disseminating the research results among the parties concerned is crucial, in order to bring about and optimise the effect of learning evaluation. The evaluation of the NPGC will be carried out by researchers of Regioplan Policy Research and two prominent academic experts in the (medical) field of geriatric care and its organisational context. The researchers have a lot of knowledge and expertise in the field of care for (demented) elderly people, programme evaluation, measuring the quality of care, and financial consequences of change and innovation in the care sector. Moreover, a number of researchers have gained ample practical experience in carrying out the ongoing evaluation of the National Dementia Programme and in supervising a number of improvement projects concerning care for (demented) elderly people and patients.