出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : Flanders (Belgium) is searching for innovative solutions to tackle the challenges in elderly care. A care living labs program was launched in 2013 as a testing and experimentation space. The objective was to create new care concepts, services, processes and products together with the end users, and to test them in practice in 23 care innovation projects. These projects are very diverse, with topics including technology, housing, informal care networks, mobility, care management and care and cure integration. From a prior plan evaluation study it became apparent that direct references to the organization of care and the quality of working life of the care professionals could seldom be found in the project plans. These issues could however be crucially important for the projects to be successful. Moreover, we did not find any previous study of care living labs which specifically focused on these issues. The main research question here is: what is the impact of the 23 care innovation projects on the organization of care and the quality of working life? Theory : Drawing on Sociotechnical Systems theory, we used an organizational model (Van Hootegem, 2000) to conceptualize the possible impact on the organization of care. The impact on the quality of working life was conceptualized by using the Job Demand / Control model of Karasek (1979). Methods : A mixed method approach was applied. A document analysis was made of the initial project proposals. Subsequently, near the end of each care innovation project, an in-depth interview was conducted with the project coordinator, using a semi-structured questionnaire. Results : All 23 care innovation projects resulted in minor or major changes in the organization of care (such as changes in task division). Each project did impact the quality of working life of at least one type of care professionals (e.g. nurses), and in many cases multiple types of care professionals were affected. During the projects, many care professionals experienced an increase in job demands and steady or slightly increased job controls. According to the project coordinators the increase in job demands was expected to be temporary, with a decrease following once the innovation would be fully established. We also noticed a different impact on the quality of working life between various types of care professionals. Conclusions : Although the 23 care innovation projects in general did not explicitly aimed at changing the organization of care or affecting the quality of working life of the care professionals involved, our study shows a clear impact on both dimensions. Lessons learned : Implementing care innovations is likely to have implications for the organization of care and the quality of working of life. In order to avoid unintended implications, future care innovation projects are advised to take this explicitly into consideration. Limitations and future research directions : Further research is needed to differentiate between possible impacts, depending on the type of care innovation involved.
关键词：care living labs ; organization of care ; quality of working life
