Innovation-driven care for elderly with multiple diagnosis

Important results from the project

The main goal of the project was to develop a future care unit and contribute to an improved collaboration in the care chain for multi-sick elderly. The future care unit provides care in two main areas: an emergency flow with monitoring of patients after the first assessment in the emergency unit and a planned flow with a day care for planned treatments. Collaborative meetings between the primary care, the hospital and the municipal care led to an increased understanding of each other´s responsibilities and laws and resulted in concrete improvements for both patients and employees.

Expected long term effects

The project has contributed to knowledge about how care for multi-sick elderly can be developed in the future. The future care unit has developed and tested new strategies, processes, working methods as well as digital and technical aids to improve care for multi-sick elderly people and create more attractive workplaces. The project has also contributed to knowledge about how primary care, specialized care and municipal care can collaborate to successfully conduct improvement work across the organization´s boundaries and develop more coordinated and effective care chains.

Approach and implementation

The project has been a joint research and development project between Region Skåne, Trelleborg Municipality and Linköping University. The project was carried out according to the interactive and collaborative research model. Researchers have participated in ongoing development activities and developed together with practitioners a research-based knowledge and a practical knowledge that could be directly used in the development work. The project was based on several cycles of development activities, mapping, theory reviews, data collection and evaluation.