How Elsinore Municipality strengthens the present citizen conversations in elderly care

This was the problem formulation in a large project in Elsinore Municipality, which Christina Hjulmann Schneekloth has been project manager for. She is a health consultant in the municipality's Center for Health and Care and has managed the process for two units, namely the Montebello nursing home and Elsinore Rehabilitation Center.

But how do you break down such an overarching vision into concrete action?  

What does it look like on Tuesday morning at a nursing home and rehabilitation center when you 'strengthen the present encounters'?  

Of course, it all depends on the context. The solution was different in the two units, so that it actually fit the employees' everyday lives - and so that it benefited the citizens as much as possible. Feedworks Mikkel, together with Christina and a small group of employees from each unit, developed two conversation tools that their colleagues could implement in their everyday work.  

"The tools provide a framework for a systematic approach to citizen conversations and for employees to spar with each other," says Christina.

Here are the stories from the Montebello nursing home and Elsinore Rehabilitation Center, which participated in the project:

Care home Montebello: "We are much more proactive with relatives now."

At the Montebello nursing home, we quickly agreed that the employees could use a tool for better sparring with each other on a daily basis.

Employees have daily meetings where they coordinate tasks internally. But there was one item on the agenda that was missing:

"Even though we are good at coordinating the day, we lacked a framework and a language to talk about the things we have challenges with relatives and residents," says Christina. "For example, how do you tell a relative in a good way that you can't bring your dog inside? It's important to be able to say something like that, but some relatives can be offended by it. So how did we create this space to discuss these challenges with each other in a more professional way?"

The solution was an internal sparring tool that Mikkel developed in close collaboration with employees. Because as Christina says:

"Mikkel made a good presentation, but if employees felt that 'I would never say that myself', then it wouldn't be used in everyday life. So it has been adjusted in a way that it is actually used by both experienced and new employees."

The sparring tool is a practical way to start a conversation with a colleague with questions such as "How much does the situation affect you in your daily life?" and "How would you like things to be?"

Does it work? Yep, says Christina:

"The employees have been given a tool to talk in a new way about the things that can be challenging with residents and relatives. The employees themselves say: 'We get good feedback from the relatives. We anticipate the relatives much more now and meet them with presence'. We are very proud of this, and our vision is that the tool can also be used at other nursing homes in Elsinore."

That was one example of how we helped create better citizen conversations with a concrete sparring tool in a nursing home. Now we go to Elsinore Rehabilitation and Training Center, where the challenge was different:

How Elsinore Rehabilitation and Training Center made the first meeting more present

Elsinore Rehabilitation and Training Center can be seen as a kind of mini hospital, where the citizen has a course of treatment before going home or possibly to a nursing home. In this context, employees hold an initial meeting with the patient and relatives.

"That meeting was really mostly for the employees, we found out. They told us a lot of things, but often the citizen just wants to know where they can read the newspaper. We therefore decided that this first meeting was a concrete situation where we could work on making the meeting with the citizen more present."

The solution was a conversation guide that divides the meeting into a beginning, middle and end. And with different angles on good questions to ask the citizen and relatives to get them involved.

"The employees have really embraced it," says Christina. "The conversation guide has been adapted by them so that it is used in the first meeting to get to know the citizen's needs better - rather than just the employees primarily providing information. Of course, it takes time to change culture, but with this conversation guide, we have a concrete tool to do it."

So, how has the two entities fared overall since the end of the project in the summer of 2022?

"The general feedback on the project has been that the employees have come a long way in a short time and with great commitment," Christina concludes:

"The collaboration with Feedwork has been characterized by enormous flexibility and responsiveness. And even though we were initially a little skeptical about whether these military-trained consultants could work in a municipal context and with healthcare assistants, there is something these guys can do."