Table 3 Capacities for improvement in the quality of care for people on HMV

I. Outcomes and impact

• Eliminate financial disincentives to support transition management, the exploitation of rehabilitation and weaning potential, and the independent choice of long-term care setting.

• Decelerate complex processes (e.g., support guideline-based transition management).

• Support home visits and avoid hazardous transport and hospitalisation whenever possible.

• Promote person-centred attitude and focus on the needs of patients on HMV and their families.

• Provide clear information and involve all stakeholders to support shared-decision making.

• Ensure staff wellbeing and support staff via supervision.

• Support integrated care structures to enable interprofessional networking and collaboration.

• Engage the local community, build networking structures, and implement independent counselling.

• Establish mandatory quality criteria and support guideline implementation.

II. Service delivery

• Enable ventilated patients to be an active part of the care process.

• Accompany ventilated patients on the journey through different settings (e.g., case management).

• Be involved in interprofessional networks.

• Implement quality insurance systems and review processes.

• Ensure a supporting infrastructure to implement recognised standards and agreed-upon best practices.

• Implement safety policies and support proactive risk management.

• Cooperate with highly qualified nursing experts to close gaps in the provision of medical care (e.g., delegation of medical services).

• Ensure that planning is flexible enough to respond to individual needs (e.g., anticipated needs for respiratory equipment).

• Qualify staff to deliver safe care and ensure effective introduction, training and supervision to support staff.

• Support training in family-centred care and ensure empathy and respect for the individual.

• Ensure skill mixes to allow staff to learn from each other and improve internal processes.

• Support interprofessional teamwork and communication (e.g., case conferences).

• Ensure collaboration and develop common treatment plans to improve collaboration and outcomes.

III. Vision and leadership

• Share a clear vision and understandable strategy to support person-centred care.

• Motivate and empower staff to be an active part of the intensive care service.

• Support staff to develop competencies needed for expertise in HMV.

• Encourage staff to be an active part of improvement through a visible, participatory, and open leadership.