At the request of Hilde Crevits (the Flemish Minister for Welfare, Health and Family) and in collaboration with diverse intermediary organisations (employer umbrella organisations, trade unions and elderly care organisations), the researchers drew up a questionnaire. They asked about the organisational structure of nursing homes and about the services and care they provided during the corona crisis. A total of 318 nursing home boards answered the questionnaire. That data was compared with the COVID-19 data from the Care and Health Agency.
“The results are clear,” said Assistant Professor Lander Vermeerbergen (Radboud University/KU Leuven). “Although we had expected an effect, the clarity of the figures surprised us.”
Four organisational characteristics are related to fewer COVID-19 infections: the size of the group of residents, the size of the home, the breadth of the personnel’s tasks and the way in which healthcare teams are composed and assigned to residential groups.
“In nursing homes with only groups smaller than 17 residents, the average infections rate was 17.5%; in nursing homes with large groups of more than 32 residents, the rate was 27.5%,” said researcher Eveline Teppers (HIVA-KU Leuven). “The number of residents who died from COVID-19 was 2.5% and 5.1% respectively.”
But the personnel’s tasks and the size of the home are also crucial. Professor Geert Van Hootegem (KU Leuven): “The research showed that there were fewer infections in nursing homes with permanent multidisciplinary healthcare teams per residential group than in nursing homes that work with monodisciplinary or multidisciplinary healthcare teams for several groups of residents.” The research also showed that an approach involving smaller residential groups and permanent multidisciplinary teams results in a homier atmosphere during a pandemic even though this was affected by the Covid restrictions. Domestic habits such as preparing meals in the living room or doing the laundry in the resident’s home were infrequent during Covid. Previous research had already shown that healthcare personnel experienced a higher amount of stress in such healthcare settings.
Adjustments: from temporary to permanent
During the Covid crisis, many nursing homes had anticipated this and had implemented major organisational changes during the first waves of the pandemic. In the questionnaires, 80% of the boards said that they had worked with permanent teams per residential group and 40% said that they had made the residential groups smaller. But most of the respondents indicated that these changes were only temporary.
The transition to a more innovative organisation is crucial in the fight against future pandemics. But this is a drastic process of change that will require a lot of time, Vermeerbergen emphasised. “In addition to the will and motivation to do things differently, sufficient support, means, space and time are needed to make permanent changes in the organisational structure possible.”