Turn-Only-Once: Participatory Teamwork for 1-on-1 care.
Authors: De Clercq Jo 
Published: January 2024

Participatory team work leads to better quality of care. Rather than a string of separate hygiene and care actions for people with high care dependency, we should aim for a holistic approach that places the comfort of the client at the forefront. On the other hand, sustainable staffing organization and efficient use of care time become increasingly important in a context of limited resources. Combining both essential insights, we offer a workshop on multidisciplinary participatory teamwork in bed care for people with high care dependency.

Within the residential care facilities for elderly of Woonzorgnet-Dijleland, obtaining the involvement of all multidisciplinary stakeholders at all different levels of the care organization is something we work on increasingly, to ensure and improve the quality of care. While shifting the responsibility of bed care from a mono- to a multi-, inter- and transdisciplinary model, the multidisciplinary team is asked to actively contribute (each care discipline from their own specific expertise), think along, participate in consultations and in the decision-making process. Complex bed care is not reduced to making sure the client is hygienically washed, but tailored to individual care needs and care objectives. This includes a more positive care experience for the client, but also adds pressure ulcer prevention, contracture prevention, prevention of paratonia.

This integrated and person-oriented care can only be realized by:

-A multidisciplinary presence of a professional care team,

-That enters into an interdisciplinary dialogue with each other, in order to check and orientate the different perspectives and objectives correctly,

-On the basis of a pronounced informed consent, obtained through a transdisciplinary collaboration of all these different care disciplines.

To translate this to everyday practice, we looked at a structural project-based implementation of no-tech and non-digital innovations, including the application of incontinence material with belt closure, wet wash gloves and the service of care-specific clothing adaptation. This leads to the realization of the innovative transdisciplinary bed care concept “Turn-Only-Once” with a 1-on-1 care relationship.

By introducing such innovations, we can use available staff capacity in a more sustainable way. We not only work smarter with the available care time, but also reduce the physical workload and mental work pressure, thereby creating “workable work” without having to compromise on quality of care. We don’t ask staff to work harder, but to work more slowly and steadily together. The project results demonstrate that less care time is needed to realize this bedside care. This way, we created a win-win towards participatory collaboration and person-oriented integrated care. 

In a workshop for health care professionals interested in this approach, we will briefly explain our multidisciplinary bed care model and the “Turn-Only-Once” concept, then turning to practice-based cases to discuss and practice with (ca. 15’ introduction, 2x 30’ cases in groups, 15’ feedback and take home conclusions, depending on the allocated time). We are hoping to inspire our colleagues and learn from their additional insights to further enrich this model.