Incontinence care 2.0

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Initiator(s):

vzw Zorg-Saam ZKJ

Theme:

Digitalisation

Domain:

Care and Health

Active state:

In execution

Contact:

vzw Zorg-Saam ZKJ
Filip Vandaele
T +32 9 250 04 22

PIP
An Schrijvers
T +32 486 35 43 99

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Challenge

More than 80% of the residents in residential care for the elderly suffer from unwanted urine loss. Day and night incontinence rounds are therefore carried out systematically.

On the one hand, this is disturbing for the care recipients themselves and, on the other hand, it takes up a lot of time and resources of the caregiver, which can be better spent on the provision of coordinated care.

With this project, the non-profit organisation Zorg-Saam ZKJ wants to develop and test a solution to offer more comfort to residents who suffer from unwanted urine loss in residential elderly care.

At the same time, such a solution can save an important amount of time for the caregivers. They wish to pursue an innovative solution that eliminates the need for systematic checking of incontinence panties, with numerous advantages for both care recipients and caregivers. They wish to deploy new technology that detects when an incontinence pant is saturated, linked to a call system.

The aim is to collect data that can support and improve approaches and policies on incontinence.

Preparation

To better define the challenge, Zorgsaam together with PIP decided at the end of 2019 to engage Addestino for the preparation of the procurement.

In the course of January 2020, Addestino mapped and validated the needs of elderly care (residents, caregivers, technicians, etc.) during workshops in preparation for a market consultation.

The market consultation was initially planned for 17 March in Brussels, but due to Covid19 it was held online on Tuesday 16 June 2020 in the afternoon.

The results of the needs analysis and market consultation were compiled in a report. The report is written in Dutch, but an English summary can be found at the front of the report.

Eindverslag_Incontinentiezorg2.0

Procurement

The preliminary process, supported by Addestino Innovation Management, revealed that various solutions (smart nappies, sensors, etc.) already exist on the market and could provide an answer to the needs of vzw Zorg-Saam. Nevertheless, there were doubts about the maturity and performance of the solutions in practice and how they can best be embedded in the daily incontinence policy of residential care centres. Therefore it was advisable to set up one or more pilots. Only a real setting would allow for a thorough validation of the added value of the smart technologies for the care user and caregiver.

Call for tender to assign evaluator for 'smart diapers' pilot projects.

In order to come to an objective definition and evaluation of the pilot projects, Zorg-Saam launched a tender to appoint a neutral evaluator with the following tasks:

Defining the pilot set-up
Drawing up the evaluation framework
Advice on selection of participating pilots
Evaluation of pilot set-ups
Reporting the results

The call for tender (in Dutch) can be found here. Deadline offers: 27 October 2020.

Zorgsaam_Incontinentiezorg2.0_Bestek_Evaluator.pdf

More information about the task of evaluator was provided during an online information session on Friday 9 October 2020 from 13:30 to 14:30.

Call for participation in pilot projects on 'smart diapers'.

Together with the evaluator, ZorgSaam created clarity in late 2020 and early 2021 about the design of the pilots and how they will be evaluated and compared using objective criteria.

The criteria on which suppliers of smart incontinence materials will be allowed to participate in the pilots and on which basis the evaluation of those (max. four) pilots will take place are listed below. The call for participation (in Dutch) was sent out to suppliers on 9 February 2021. Bids were expected by 3 March 2021, 12:00.

oproepdocument_deelname_leveranciers.pdf

Execution

Award of contract to Kunigi as evaluator of pilot projects

On 30 October 2020 the contract to evaluate the pilot projects on 'Incontinence 2.0' was awarded to Kunigi. Together with ZorgSaam, Kunigi defined the test environment, including the criteria for selection and evaluation of the pilot projects. These criteria are included in the specifications for the call for pilots addressed to suppliers of smart incontinence materials.

Once the suppliers were selected and the pilots were underway, Kunigi was present to evaluate them and compile the resulting knowledge in a report.

Award of contract to Ontex and Essity to participate in pilotes

On 13 July 2021, the contract to participate in the pilot projects was awarded to Ontex and Essity. Each supplier was given the opportunity to test its technology and service successively for eight weeks each in two different residential care centres under the ZorgSaam umbrella, namely WZC Sint-Eligius in Zeveneken and WZC Moervaartheem in Wachtebeke. Kunigi was involved for the purpose of systematic and objective evaluation of products and services.

Ontex - ORIZON

Preparations for the first pilots started in late August - early September 2021. Initially, the added value of ORIZON, a smart incontinence management solution from Ontex, was validated by the care staff and residents of the two nursing homes.

The ORIZON incontinence material looks like an ordinary diaper, but it incorporates an ink sensor. In addition, the diaper is fitted with a clip that transmits data from the smart diaper. That clip connects to a software program which provides through a mobile app and web portal, information and alerts to care staff. When the protection is saturated, a notification arrives on the caregivers' screen. Colour coding is used to indicate the degree of saturation and provide specific suggestions for action. Every resident within the pilot project has a personalised clip attached to their absorbing aid, so that caregivers know which person's diaper needs to be changed.

Communication from Zorg-Saam about these pilots can be found here (in Dutch). See also PIP news release (in Dutch) of 6 October 2021.

Essity - TENA Smart Care Identifi en Change indicator.

At the end of November 2021, Essity started preparing its pilots to effectively start running them in January 2022 on selected wards of ZorgSaam's two WZCs.

The Essity Smart Care solution uses two phases. First, using the TENA Identifi, equipped with a logger, the resident's urination pattern is charted over 72 hours. Once the pattern is known, the TENA Change Indicator is used. This is an electronic moisture indicator in the form of a reusable strip that is attached to the TENA bandage and indicates when the material is saturated. When the bandage is saturated, a notification arrives on the smartphones of the caregivers, so the they know in which person's incontinence pants need to be changed.

Communication from Zorg-Saam about these pilots can be found here.

Results

Presenting the results

On 29 September 2022, ZorgSaam employees presented their experiences with the solutions to the two suppliers Ontex and Essity. They also formulated points for improvement for future developments.

Evaluator Kunigi summarised the conclusions in two presentations (in Dutch).

Positive experience: 'More comfort - less work'

The ZorgSaam care staff is very satisfied with the way the pilots were run. The staff participated with enthusiasm and drive, and this in extremely difficult and uncertain Covid times (with staff shortages, temporary interim personell, etc.).
The guidance and training they received from the suppliers on how to use the solutions was much appreciated, as was their hands-on support on the work floor and easy reachability in case of problems.
After a short run-in period of 'trial and error', the solutions have proven to add value for ZorgSaam's residents (at least the target group identified in the pilots of residents with relatively severe incontinence problems) and carer givers, and also reduce waste of materials. The smart technologies enable incontinence policies tailored to each resident. ZorgSaam's staff were disappointed that the pilots were completed after eight weeks. They would have liked to continue using the smart equipment.

Success factors:

Accuracy of solutions: false positive alarms cause frustration, stress and reduce staff confidence in the solutions
A strong network
Easy to use (minimal extra handling for care staff)
Good education and training provided to introduce the changes on the work floor step by step
Easy accessibility and approachability of suppliers in case of problems

Points for improvement - Suggestions for future developments:

Smart incontinence solutions that can also detect stool. This would be a big plus, for both residents and care givers.
Integration with the existing systems (call system, care file) is recommended, so that all information can be entered and consulted by care staff on one device.
Continue to focus on maximum user-friendliness. When care personnel are under time pressure, inaccuracies sometimes slip into their actions (wrong setting, wrong combination of bandage and strip, etc.) so that the smart solution does not function properly.

Added value of pilots: public-private cooperation aimed at creating a win-win

Suppliers Ontex and Essity have indicated that ZorgSaam's suggestions are very high on their agenda and they will continu working on them in the near future. In this way, the pilots not only provided useful insights for ZorgSaam's staff, but also for the suppliers. The pilots have offered them the opportunity to optimise their products and services and adapt them where relevant in the future.

Press conference

Subsequently, ZorgSaam ZKJ organised a press conference at WZC Sint-Eligius in Lochristi on 29 September 2022 to publicly announce the results of the pilots.

All parties involved signed present and took the floor. The results showed that technology and qualitative care go hand in hand and mutually support and reinforce each other.

"A successful project, where the lived experience of residents with dementia was our guide and where we have come to innovative and quality incontinence care in a cross-sectoral and multidisciplinary co-creation. This intensive collaboration prevents 'plug & play' innovations from ending up in the cupboard after a few months. The project has made it clear that innovation in care, is not a nice-to-have, but a must-have," Filip Van Daele, the IT manager at Zorg-Saam who initiated this project at PIP in 2019, concluded his speech.

Smart incontinence materials increase residents' comfort and ease the work of caregivers. More sleep. Better tailored care. Workable work and less waste.

Appreciation from Hilde Crevits and Jo Brouns

Hilde Crevits, Deputy Minister-President of the Flemish Government and Flemish Minister for Welfare, Public Health and Family, and Jo Brouns, Flemish Minister for Economy, Innovation, Work, Social Economy and Agriculture, were also virtually present and expressed their appreciation for this project.

Re-view Hilde Crevits' video message (in Dutch) here.

Re-view Jo Brouns' video message (in Dutch) here.

Press and media (in Dutch):

Which 'smart nappy' is the best? Residential care centres in Wachtebeke and Lochristi take the test. "This saves nurses unnecessary work (in Dutch)", by Cedric Matthys, Het Laatste Nieuws, 29 September 2022.
Caregivers spend time more efficiently thanks to 'smart nappy (in Dutch)', Zorgmagazine of 30 September 2022.
Pilootproject "Slimme luiers: incontinentiezorg 2.0", ZorgNet Icuro, 25 oktober 2022.