‘ElderlyCare (ER-)Spots’ in Rotterdam

The case/initiative described is all about creating time, attention and expertise to take better care of multi complex elderly people, create more value AND lowering costs by organizing this care in a better way. I am very curious for your experiences, ideas and feedback on this initiative!



This video inspires me to see the possibilities in taking better care of our growing population of multicomplex elderly people (dementia, alzheimer, etc). The case/initiative described here is all about this: creating time, attention and expertise to take better care, create more value AND lowering costs by organizing care in a better way. I am very curious for your experiences, ideas and feedback on this initiative!

(Part of) the Situation

The case occurs in the Dutch ‘Randstad’ region: a region with the second largest city of the country, with approximately 600.000 inhabitants, 1 university hospital, 8+ city and regional hospitals (2 of them underperforming financially), 3 big elderly care organisations (all underperforming financially and qualitatively), a lot of ‘fragmented’ GP’s (most GP’s are united in small health care centers with some other GP’s (2 to 8 GP’s). Furthermore there are two or three regional interest groups for GP’s to join. The national policy in the Netherlands is to keep elderly people at home as long as possible (quality driven, financially driven and social trend to ‘stay in charge’ as a patient)

(One of the) Problems

There is a fragmented care landscape with a lot of care organisations who take care of parts of the elderly care processes. Togehther with the trend / policy to take care of elderly people at home for as long as possible this creates several problems. Among others this group of elderly, often mutlicomplex, patients end up in ER and hospitals faster and earlier as needed (by GP referral). Also they tend to stay longer as needed because of the lack of focus and knowledge of this kind of patients in hospitals and because of the lack of cooperation with relevant caretakers.

(One of the) Ideas / solutions

One of the solutions, being initiated by one of the Rotterdam hospitals (lead by CEO of this small and financially threatened hospital, hospital X, part of university hospital), is the creation of ‘care-spots’ in different parts of the city/region specialised in multi-complex elderly (ER-) care. Using existing ‘care’ buildings/facilities and organisation of care in flexible ‘ambulant’ way: make sure that professionals come to ‘care-spots’ during total process and patients stay in fort his target group more familiair and equipped care spot. Pilot current situation: dermatology. Partners who cooperate in pilot: 2 large elderly care organisations, hospital X, a few GP’s, psychiatric care organisation, insurance company.

Question(s) to HBS MHCD 2016/2017 group

Is the suggested solution a good one and what is necessary to realize this concept and make a success of it?

  • Other possible solutions?
  • Experiences?
  • Possible risks and challenges?
  • Strengths & weaknesses of the suggested solution?
  • Types of care that could be organised in this way (same target group: multi complex elderly care)?
  • ….


Primary Care Growth Strategy


Capacity problems in the OR

Participant comments on ‘ElderlyCare (ER-)Spots’ in Rotterdam

  1. We have approximately 89 admitted patients designated as alternative level of care and of those 58 are awaiting for LTCH placement. We have a shortage of nursing home beds in our community. We partnered with Community Housing to develop an 80 unit seniors supportive housing complex that will provide 24/7 Personal Support Worker care for 50 of the residents. 20 of the units will be designated for discharge planning. The goal of this initiative is to build capacity in the system and to support the frail elderly to remain in the community. Clustered care is an alternative to traditional care for patients requiring assistance with activities of daily living. Community Housing is funding the capital for the building and the Local Health Integrated Network is funding the on-going operating funds for the care services. The complex will serve as a hub for other healthcare services. The residents old age security will cover the monthly charge.

  2. As medical advances continue to bring about improvement in longevity the proportion of elders not only in Rotterdam but around the globe continue to rise .According to United Nations there is continuing trend towards lower birth rate and death rate around the world. With increasing globalization therefore social needs such provision of medical care and psychological care to the elderly is becoming an international challenge, even in African where elderly are given high esteem and social status. This global challenge needs a global solutions which will be addresseed in our third and last module by Prof Rob, all the faculty and the interactions of all the students.

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