32. Excellence in CARE • SEPTEMBER 2018 Care Metric Healthcare Study Tour of the Netherlands In mid-April this year I was fortunate enough to attend a study tour of the Netherlands arranged by Jan and Marian Weststrate of Care-Metric (http://www.care-metric.com/). Jan and Marian managed to attract a varied cross section of people with health experience in both aged care and the tertiary sector from both New Zealand and Australia. The aim of the tour was to provide exposure to a variety of innovative solutions to health care issues in the Netherlands with particular focus on the elderly. The diversity of the group was ideal for both networking and sharing different opinions of issues within the health system. The tour was structured to give an over view of how the Netherlands health system is funded, monitored and to explore innovative solutions that have been implemented to improve the quality of care provided to the elderly. My overarching impression from the week was that all the organisations and people we met were committed to moving away from micro regulation and oversight to a macro view of the systems being used for providing care for their elderly. An important aspect of this approach was to build “Trust” into the system so that innovative approaches could be attempted without barriers and bureaucracy getting in the way. The tour presented a wide range of experiences and initiatives that were being introduced in the Netherlands. I will highlight two that made the most impressive changes. Included in the tour was a visit to the De Hogeweijk village in Weesp which was one of the highlights of the trip. I have previously attended presentations on this facility and how they have developed a community environment to support people with severe dementia. It was inspiring to be able to walk around in this environment and get a feel and understanding for how this community worked. In the arcade area which included a café and mini market, it was exactly what you would expect to encounter in any town centre. The complex didn’t give a feeling of being enclosed it just felt like a small community not a care home. It was obvious that there had been a lot of thought into how to assist people with dementia to lead normal lives. A good example of this was in the lift. The complex is over two levels with lift access. The lift had an automatic override function so that if no buttons are pushed it would automatically go to the next level with the door opening which allowed the residents to easily access the village. Another unexpected surprise I experienced was visiting De Herbergier (the Innkeeper) in The Hague, which was described as a small care environment for people with dementia. At this care home we had a presentation from Dr. Frans Hoogeveen about his work on the learning capacity of people with dementia and how this can be used to develop strategies to improve their lives. This was an excellent presentation as it demonstrated that a person with even severe dementia can still learn and I found the concepts presented certainly challenged the traditional view of dementia. The home itself was an interesting place to visit as it also catered for people with severe dementia in an open environment structured on a house hold concept. This facility is over three floors with both stairs and one lift. The mantra of this home was that people with dementia didn’t wander but had somewhere to go and we just need to understand where this was for them. Staff worked with residents in a home environment where they got the