Coordinating acute care at a regional level is not a solution. This is what chairman and emergency physician David Baden of the NVSHA (Dutch Association of Emergency Care Physicians) says about the plans that VWS minister Kuipers has to set up regional care coordination centers for acute care.
Kuipers has decided that every ROAZ (Regional Consultation Acute Care Chain) region must have a care coordination center by 2025. Such a care coordination center (zcc) is a place where various care disciplines (general practitioners, ambulance facilities, primary care accommodation, district nurses and mental health care) work together in triage and thus determine where and when a patient with an acute, but not life-threatening care need during ANW hours is best. can rightly.
Information point
A zcc must also be the central point that has up-to-date information about available care capacity and beds in that region, such as hospitals, nursing homes, disabled care, rehabilitation care and birth care. A zcc must therefore be available 24/7 for care providers. The centers must have at least one physical location per region. Kuipers hopes that such centers will reduce the pressure on acute care and result in care providers spending less time looking for a suitable place for patients.
NVSHA chairman Baden would rather see local cooperation in acute care improved where possible than adding a regional ‘entity that the patient does not know’. According to him, the distance within such a region is too great for care providers to know the patients and the local conditions. ‘Due to large scale you lose continuity of care.’ According to him, Dutch pilots have already shown that a regional layer yields little, and experiences in England and Denmark have shown that comparable regional centers led to more telephone requests for help and A&E visits.
Triage protocols
Baden thinks that more can be gained if the Dutch triage protocols are looked at. ‘If the same protocols are used within a ZCC, little will change and overtriage will still occur. And the shortage of home care and ELV places will not disappear with a layer above it,’ says Baden, who argues for investments to expand that capacity. He does think that part of the proposal, namely the regional insight into capacity and the exchange of patient data, can be of added value.
Care regions must now further develop the plans. Kuipers ultimately wants to work towards a national system for sharing capacity information, and is considering introducing a statutory obligation to provide this information.
