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Living at home longer - a 2025 vision for elderly care

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In 2014, the Authority of Elderly Care in Oslo decided to use service design methodology to put the future user at the centre when developing a strategic roadmap for its services in 2025.

Published in: Healthcare
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Living at home longer - a 2025 vision for elderly care

  1. 1. London Oslo Rotterdam São Paulowww.liveworkstudio.com Living at home longer - a 2025 vision for elderly care CASE DESCRIPTION City of Oslo 15 March, 2016Livework © 2015 Foto: Patrick Doheny The Nursing Home Agency
  2. 2. Current healthcare services are not economically sustainable in the future. This future is already upon us in 2017.
  3. 3. Demographic changes Urbanisation Non-sustainable public expenses Decreasing volunteerism Those who are sick become sicker Welfare technology Smarter patients MEGATRENDS ECONOMIC SITUATION Reduced income from oil Low long-term interest rates Rich generation of elders Nursing homes are costly Digitalisation Municipality 3.0 Competing for competence Private healtcare providers Loneliness Public health polarization Multi cultural Big data Increased expectations and demands
  4. 4. The Nursing Home Agency (Sykehjemsetaten) Norway's largest operator of nursing homes and the second biggest municipal agency within the City of Oslo • 4 short term care and rehabilitation health houses • 44 long-term nursing homes • Professional Development and Research • Apprenticeship Training Office for Health, Childhood and Youth Services • 9,000 residents and patients annually • 1.6 million nights annually • 12,000 employees • 5 Billion NOK / 410 Million GBP annual budget
  5. 5. Target The citizens of Oslo should live as long as possible in their own home, with a high quality of life and minimal use of publicly financed services. Livework © 2015
  6. 6. Home Specialised Health Services City council Nursing homes Healthcare Centre Users and caretakers at the centre
  7. 7. Homely Treat & care Ensure value Long-term Capture Prevent Holistic
  8. 8. Triggers for moving to a Nursing Home 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Non-disease dependent triggers 0 2 4 6 8 10 12 14 16 Average home care h/w Oslo St.Hanshaugen Economical triggers Potential annual cost reduction - 923 MNOK Threshold value: Nursing home > 15 h/w home care
  9. 9. Solution
  10. 10. Planning and facilitation in addition to long-term comprehensive efforts Ownership of inhabitant Individual home with a separation between private and public Accurate, holistic efforts towards common goals Future care for the elderly will provide early help to plan own aging, facilitate different forms of housing and provide accurate care services at best timing in each home, customised the individual and their holistic situation
  11. 11. Home
  12. 12. Video
  13. 13. Healthcare Centre
  14. 14. 1. Predictable and smooth transition 2. Accurate reception and early clarification 3. Targeted stay 4. Safe and smooth transition back home 1 2 34 1 2 3 4
  15. 15. Nursing home
  16. 16. • Facilitate a range of different adapted properties • All permanent locations are a home • All services available at all locations • The 24/7 nursing home is a home equal to other homes. • 24/7 consist of a range of different forms of living. • 24/7 are flexible in degree and level of services Original home Property with a life-long standard Care homes 24/7-offering
  17. 17. NURSING HOME Treatment, care and nursing Experience of one’s own home Safety & Quality of Life
  18. 18. Pilot
  19. 19. Long-term interdisciplinary assessment
  20. 20. INNSATS OG EFFEKTVURDERING BRUKER MÅNED 1 2 3 4 5 6 7 8 9 10 11 12 ROLLE FORLØP KR/TIME IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP 0,33 0,33 0,33 0,33 0,33 0,33 0,33 0,33 0,33 0,33 0,33 0,33 IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP 4 2 STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP 1 STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP 15 15 15 15 15 15 15 15 15 15 15 15 STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP 2,5 1,5 1 1 1 1 STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP STANDARD FORLØP IDEELT FORLØP 0,5 STANDARD FORLØP IDEELT FORLØP 0,5 0,5 STANDARD FORLØP 2010 HELSEHUS 2 000 DAGSENTER 105000 267 267 0 EKSTRAORDINÆR LEGE (HELSEHUS) 440 250 250 240 EKSTRAORDINÆR FYSIOTERAPEUT (HELSEHUS) EKSTRAORDINÆR ERGOTERAPEUT (HELSEHUS) EKSTRAORDINÆR SYKEPLEIER (HELSEHUS) 215 INNSATSTEAM FYSIO/ERGO FAGKONSULENT (H.REHAB.) 237 250 250 250 HJEMMETRENER (H.REHAB.) STUDENT/LÆRLING/ELEV SENIORSENTER OG ANDRE ELDRE TJENESTER NAV BESTILLERKONTOR RUS OG PSYKIATRI ASYL BARN OG UNGE ØKONOMISK RÅDGIVNING DEMENSTEAM EKSTRAORDINÆR HJELPEPLEIER (HELSEHUS) HJEMMESYKEPLEIE PSYKISK HELSEARBEIDER PRAKTISK BISTAND/HJEMMEHJELP HJELPEARBEIDER/HELSEFAGARBEIDER 559 267 435 435 250 250
  21. 21. Case Description Female, 70 years If the city of Oslo had invested accurate and timely from first contact in 2013, they would have saved 1,850,000 NOK by 2018 -1000000 -800000 -600000 -400000 -200000 0 200000 400000 600000 800000 1000000 2010 2011 2012 2013 2014 2015 2016 2017 2018 IDEAL STANDARD DIFFERENCE - 1 850 000 0 500000 1000000 1500000 2000000 2500000 IDEAL STANDARD
  22. 22. Case Summary 1. Male, 84: - 1 450 000 2. Female, 40: - 200 000 3. Male, 75: - 900 000 4. Female, 70: - 1 850 000 5. Male, 79: + 600 000 Total cost reduction for entire period: 3,750,000 NOK Average cost reduction per year: - 3 750 000 # users in Oslo municipality > 67: 20% = 12 600 # users in Oslo municipality < 67: 0,5% = 2 700 # users interdisciplinary assessment: 50% Estimated annual cost reduction: 880 MNOK - 1000 000 2000 000 3000 000 4000 000 5000 000 6000 000 7000 000 8000 000 STANDARD IDEAL
  23. 23. Healthcare Centre
  24. 24. Four Patient Experiences Testing four different patient experiences WELCOME ACCURATE START ADVICE AND GUIDE RETURNING HOME
  25. 25. Estimated Effect 21 users in pilot II. Estimated effect is not hypothetical, but realised in 2015/16 Cost reduction by running pilot: 2,225,000 NOK Average cost reduction per user: 105,000 NOK Annual # of users in health house: 4,500 Estimated annual cost reduction: 475 Million NOK - 2 225 000 - 1000 000 2000 000 3000 000 4000 000 5000 000 6000 000 7000 000 Standard Ideal - 100 000 200 000 300 000 400 000 500 000 600 000 700 000 800 000 900 000 Female,92 Male,86 Female,88 Male,75 Female,93 Female,92 Male,85 Male,90 Female,76 Female,91 Male,93 Male,90 Male,80 Female,77 Male,85 Female,67 Female,91 Female,84 Female,85 Female,91 Male,90 Ideal Standard
  26. 26. Key Takeaways
  27. 27. Key Takeaways • Trust • Visionary balance • Time-consuming • Several takes • Political skills • Numbers • Road ahead
  28. 28. London Oslo Rotterdam São Paulowww.liveworkstudio.com www.liveworkstudio.com Rune Yndestad Møller Livework © 2015 15 March 2016 rune@liveworkstudio.com +47 90 24 26 22 @Liveworkstudio /sding Bjørg Torill Madsen bjorgtorill.madsen@sye.oslo.kommune.no +47 91 76 57 76 CONTACT

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