Participation is the foundation - IBIC or ÄBIC

How a granted effort for an elderly person should be implemented must be documented in an implementation plan. The implementation plan should be designed together with the individual and relatives or close associates. The purpose of the implementation plan is to create a clear structure for the implementation and follow-up of an agreed effort. The plan clarifies both for the individual and employees what should be done, who should do what, when, and how. IBIC or ÄBIC is a method for the plan to be the resident's plan. Read more: IBIC - Socialstyrelsens kunskapsstöd

The implementation plan is based on the planning that begins upon moving in. It is the resident's implementation plan, but it is written and updated by employees, usually the contact person. In a special accommodation, it is about seeing what the resident needs help with and finding out how the help should be provided. With a good arrival conversation, a basis for trust is built and the resident gets the opportunity to tell about their habits and wishes.

First comes a planning phase with preparations, meeting opportunities, follow-up, and revision.

Measurable goals that are followed up contribute to the quality development of care

There should also be goals with the efforts. It should be clear what should be done, who should do what, when, and how. When a person moves into a retirement home, it is because the person has needs that cannot be met in ordinary housing. The business is obliged to document how these needs are met so that the resident can complain if the efforts are insufficient for the resident to have a reasonable life. Follow-up and evaluation as well as adjustments as a result of these are also documented in the implementation plan.

The implementation plan also becomes a basis for what should be documented in the journal, as much of the documentation should be about evaluating the efforts that the resident receives. The resident's goals become the employees' map, a valuable tool to support the resident in continuing to live the life they wish. It is always the resident's perspective that should be the starting point in the implementation plan. It's about ability, interests, wishes, and needs.

Previously, the implementation plan was often on a special form. Now it is usually in the journal system. There may be keywords or checklist that facilitate the design of the implementation plan in the business either in the journal system or as part of the management system.

Listen actively so that you understand

Sometimes employees have a pre-understanding and have essentially decided what should be in the implementation plan before the planning itself begins. If this happens, the resident's influence over the implementation plan decreases and it tends to become more of a job description than an implementation plan in its true sense. This often leads to the residents feeling that it is pointless to participate in the implementation planning.

An important part is to find out what interested the resident earlier in life. For someone it could be books, forest walks, scientific journals or dance. Others have had completely different interests. Some may not have had any general interests but spent their leisure time watching TV. For someone, appearance with makeup, hair, and exercise may be the most important thing in life. Unpainted nails may take away much of the joy of life.

For the plan to be good, the resident may need to have a person they trust and that there is a culture where the resident dares to bring up sensitive issues, including criticism. It is also important that employees use words that are easy to understand. We easily end up in jargon when working with employees.

The needs change over time, the plan needs to be updated

In a retirement home, the implementation plan should be updated about every three months or when needs change. A good way to work is to also have the health plan included in the meeting. Maybe the work to prevent falls needs to be included in the planning. The resident may have wishes about diet that contribute to reducing the risk of falling. A well-worked-out implementation plan contributes to good contact between the contact person and the resident, provides good support for other care staff, and contributes to a function-preserving work method, reduced risk of malnutrition, pressure injuries, and other healthcare injuries.

If the resident says no to the implementation plan, there will not be one. Document that the resident for the time being does not want to participate. For the contact person, it is about building trust and understanding why the resident does not want to participate. To still get to know the resident and their interests. Often it is possible to build trust and get started with the implementation plan after a while when the resident may also see more the advantages of the employees knowing how the resident wants it.

What is an implementation plan in healthcare and care?
An implementation plan is a detailed plan developed to ensure that a person's care or care needs are met in a systematic and efficient way. It contains information on what actions should be taken, when they should be performed, by whom, and with what resources.

Why do we need an implementation plan?
The implementation plan is important because it ensures that healthcare and care services are individually adapted and meet the person's specific needs. It serves as a guide for healthcare staff and guarantees that no important task or aspect of care or care is forgotten.

What is usually included in an implementation plan?
An implementation plan usually contains information about the person's goals and wishes, medical needs, timeframes for actions, the names of caregivers or those responsible, and any resources or equipment needed.

Who is responsible for setting up an implementation plan?
The implementation plan is usually drawn up by the contact person for the resident. Some nursing homes have an experienced nursing assistant who is a coordinator or documentation supporter. It is a collaborative process where the person receiving care or care and their relatives usually also participate.

How is an implementation plan revised or updated?
An implementation plan should be regularly revised and updated to ensure that it continues to meet the person's needs. This is usually done through regular evaluations and conversations between healthcare staff and the person receiving care or care.

As a relative, can I participate in the design of the implementation plan?
Yes, as a relative you have the right to participate in the design of the implementation plan and express your views and wishes. It is important that healthcare staff take into account both the resident's and relatives' perspectives.

What happens if the implementation plan is not followed?
If the implementation plan is not followed, it can lead to the person's care or care needs not being met in a satisfactory way. It is important that all care staff are aware of changes in the plan so that the method of work is adapted to the new agreement.

Reflection questions - implementation plan
Care staff:
- Does it happen that residents say no to the implementation plan?
- How do you handle it then with you?

Manager, nurse, occupational therapist, and physiotherapist:
- Is there a common thread between the implementation plan and health plans/care plans?
- How can you work to help nursing assistants develop work with implementation plans?
- Are the implementation plans of good quality?

Resident and relative:
- Do you feel that it is the resident's implementation plan or does it feel like it is the employees' work tool?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day