Be.Hive: buzzing with ideas for effective primary care
A beehive is not built by a single bee; many thousands of them all work together. Be.Hive, the French-language interdisciplinary chair of primary care, aims to bundle the expertise and knowledge of players in primary care and initiate a debate that will lead to a stronger primary care sector in Brussels and Wallonia.
The Chair is not only a consortium of three universities (ULB, UCLouvain, Uliège) and three university colleges (HELB, Henallux, Haute Ecole Léonard de Vinci) in French-speaking Belgium, but it also forms a network involving professionals and policymakers. The aim is to develop a shared vision of primary care among all the parties involved. This is intended to deliver not only excellent care for people who need help and care in their home environment, but also better health for individuals and communities. The Chair is intended to give health prevention and health promotion the place they deserve.
French-speaking Belgium does not yet have the kind of structured primary care that already exists in Flanders, which has been organised into primary care zones since 2017. The team there are therefore watching events on the other side of the language border with great interest, while also seeking to draw lessons from what takes place there on ways to organise a shared vision in their part of the country. “The approach in Flanders is viewed as top-down, but we want to work from the bottom up,” says Thérèse Van Durme from the Institute of Health & Society at UCL.
“Based on a joint literature study on primary care, carried out in Wallonia and Brussels but also internationally, we first obtained an overview of the elements that make primary care stronger. In a second phase we organised a survey among ten target groups, including patients, family carers, professional care providers and policymakers, to find out about the strengths and weaknesses of the current primary care system.” Almost 6,000 people responded to the first questionnaire in October 2019. The initial results were discussed with the target groups in discussion workshops in December. The venues for these include various locations in Brussels and Wallonia to take into account differences in people’s circumstances.
Focus on dialogue
One key theme of this exercise is goal-oriented care, which focuses on patients’ wishes and goals. A dialogue with the patient can make medical care more effective and even avoid unnecessary interventions. “When parents are hesitant about vaccination, for example, you can achieve more by talking to them about what is important to them, rather than just dismissing their objections.”
People are in charge of their own health, and professionals are there to act as a partner. This means that health skills and digital skills are also an important area. Task shifting is another essential element: here researchers have been looking for advantages and disadvantages of shifting tasks within primary care on the basis of skills, such as having vaccinations carried out by pharmacists. The results of the survey form the basis for the next stage, which will go into it in greater detail. In this way research and teaching in primary care can make progress.
Ambitious agenda for the future
Initially players in primary care will be working in discussion workshops, using the World Café method. This method involves discussing a theme in small groups, led by a moderator, and after half an hour the group moves along and a new group continues to work on the findings of the previous group. The results are bundled.
The aim is to produce a first white paper for care providers, teachers and policymakers on existing and future good care practices “so that we don’t reinvent the wheel and differences in circumstances are taken into account”, on ways in which the process can be supported, and on the hindrances that need to be overcome.
“There is a huge field for action research in primary care. Be.Hive views this as a start. We want to make discoveries, open up the debate and create space for new ideas with our stakeholders.” The work of Be.Hive is being monitored and supported by the steering committee for the Chair, which consists of representatives of sixteen primary care professions, together with patient and carer associations, policymakers in the area of health, teachers and the King Baudouin Foundation. It is also being followed by international experts in primary care.
Be.Hive ultimately wants to create an ambitious agenda for research and teaching in primary care so that this knowledge can be shared with policymakers and the general public. The white paper, together with the results of the study, will be presented at a public event in February 2020.
Initiative supported 2019-2023 ‘Chair of Primary Care’