Dissatisfaction with Visit Schedule Planning in Home Care – Helsinki Takes Action

Dissatisfaction with Visit Schedule Planning in Home Care – Helsinki Takes Action

The objective was to understand why visit schedules were not working and to establish methods to improve both the daily work of care staff and client service.

Time pressure and a sense of losing control over one’s work are frequent occurrences in the daily lives of home care professionals. This was also noticed in the City of Helsinki home care services when the wellbeing reported by care staff was compared with other wellbeing services counties. Thousands of home visits are made in Helsinki every day.

Particular room for improvement was identified in the operational planning of client visits and associated travel times. Operational planning solves a crucial everyday problem: how to ensure the right number of care staff are in the right place at the right time.

Helsinki home care centralized its operational planning in 2024, and other development measures had been implemented prior to that. Nonetheless, care staff remained dissatisfied with the quality of their visit schedules. Development had somehow stalled.

“We had identified certain challenges and their underlying factors, but we weren’t entirely sure whether these were precisely the right problems to solve,” says Heidi Sipiläinen, Home Care Manager for Centralized Services in Helsinki.

“We had identified certain challenges and their underlying factors, but we weren’t entirely sure whether these were precisely the right problems to solve.”

Heidi Sipiläinen, Home Care Manager for Centralized Services, City of Helsinki

Quality is created together

A high-quality visit schedule must simultaneously account for multiple background factors: the client’s needs and how to address them, the timing, content, and duration of the visit, the competencies of the care worker, the care worker’s mode of transport, and more.

“For instance, reporting known absences in advance must also support the cycle of visit planning,” says Antti Niemi.

Home care is coordinated simultaneously by multiple actors across various roles. Different teams use their respective expertise to plan shifts, client care, and home visits. The role of operational planning is to assemble this puzzle so that client needs are met while ensuring the schedule is practical from the care worker’s perspective.

“You can’t just drop one care worker here and another there,” summarizes Mira Aisamaa, Operational Planning Supervisor.

If different parties optimize only their own operations, the whole inevitably suffers. Therefore, the most important realization gained with NHG was simple yet demanding.

“No one delivers high-quality home care alone. Quality is created through collaboration between different teams,” Aisamaa notes.

“No one delivers high-quality home care alone. Quality is created through collaboration between different teams.”

Mira Aisamaa, Operational Planning Supervisor, City of Helsinki

Work has already begun on building a collaborative model. For example, specific agreed-upon topics will henceforth be systematically reviewed in various team meetings. The project’s other recommendations concerned, among other things, the planning of nursing visits, ensuring the availability of the right number of care staff, shift times, accounting for different means of transport when planning travel times, designated responsible nurses, and how to make the best possible use of the enterprise resource planning system.

“The operational planning challenges in Helsinki are common in other wellbeing services counties as well. Daily home care runs smoothly when each team has the right number of skilled staff at the right time and additional help is available when needed, for example from the organization’s own staff pool. Strict constraints on client visits, such as time windows, also make drawing up visit schedules demanding. That is why close collaboration between responsible nurses and operational planners is important,” says Mikko Ikivuo, Director responsible for elderly care services at NHG.

While the impact of these new measures will not be seen immediately, expectations are clear.

“In a year’s time, care staff will be more satisfied with their visit schedules, and clients will receive their visits when needed and from the right care worker. We will also be able to better account for care workers’ travel times,” says Heidi Sipiläinen.