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BMJ Open. 2015 Aug 25;5(8):e008632. doi: 10.1136/bmjopen-2015-008632.

Supervision of care networks for frail community dwelling adults aged 75 years and older: protocol of a mixed methods study.

Author information

Department of Public and Occupational health, EMGO+Institute/VU University Medical Centre, Amsterdam, The Netherlands.
Dutch Healthcare Inspectorate (IGZ), Utrecht, The Netherlands Institute of Health Policy and Management (iBMG), Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands.
Department of Public and Occupational health, EMGO+Institute/VU University Medical Centre, Amsterdam, The Netherlands The Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.



The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation.


This study consists of four phases. The first phase identifies risks for community dwelling frail older adults in the existing literature. In the second phase, a qualitative pilot study will be conducted to assess the needs and wishes of the frail older adults concerning care and well-being, perception of risks, and the composition of their networks, collaboration and coordination between care providers involved in the network. In the third phase, questionnaires based on the results of phase II will be sent to a larger group of frail older adults (n=200) and their care providers. The results will describe the composition of their care networks and prioritise risks concerning community dwelling older adults. Also, it will provide input for the development of a new supervision framework by the IGZ. During phase IV, a second questionnaire will be sent to the participants of phase III to establish changes of perception in risks and possible changes in the care networks. The framework will be tested by the IGZ in pilots, and the researchers will evaluate these pilots and provide feedback to the IGZ.


The study protocol was approved by the Scientific Committee of the EMGO+institute and the Medical Ethical review committee of the VU University Medical Centre. Results will be presented in scientific articles and reports and at meetings.


care network; frail older adults; healthcare; risks; supervision

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