Imagine: a freelance caregiver or agency worker arrives at a location for the first time. She’s experienced, knows the ropes, and is motivated. But which protocol should she follow? The medication policy she saw last week at Location A, still saved on her phone? Or the updated version, tucked away somewhere in a shared folder she hasn’t found yet? Sadly, this situation occurs all too often in elderly and disability care. In this blog, we take a closer look and share three practical, accessible tips to help you ensure work instructions remain consistent.
With rotating teams, agency workers, and freelancers in elderly and disability care, sharing information becomes a challenge in itself. Permanent staff pass on knowledge through colleagues, informal conversations, and their own interpretation of what “the agreed-upon approach” is. Newcomers lack that context and have no time to build it up. A freelancer working two days a week has even fewer opportunities to learn the local ways of working.
At the same time, many organizations in elderly and disability care operate across multiple locations. And each location tends to develop its own practices—not because people ignore guidelines, but because protocols are embedded in the minds of those who have been there for years. As soon as those people change, so does the interpretation.
The result: two locations within the same organization operate differently. A temporary worker adapts to the location, not to the policy. And the quality manager is aware of this, but has no straightforward way to correct it.
The consequences are rarely dramatic. Things don’t go wrong immediately, but the risks do accumulate.
Staff work with outdated versions of protocols they once printed or saved. Consider a hygiene protocol updated after an inspection, where the old version is still in circulation on the ward. Or a protocol on boundary-crossing behavior that exists on paper but which new staff never actively encounter. Even though situations involving inappropriate behavior are not uncommon in elder care, and recognition is essential.
In disability care, the same applies to medication policies. Guidelines are becoming stricter, but the question is whether all permanent staff, agency workers, and freelancers receive the same information at the same time.
When an incident or inspection occurs, it becomes clear that two teams handled the same situation differently—not because they performed poorly, but because they had different information. For quality managers, this means constantly putting out fires: checking, correcting, and explaining—for every new staff member, at every location, over and over again.
There’s no magic solution to the complexity of rotating teams. We wish there were. But here’s the good news: there are choices that make it structurally easier to keep work instructions consistent across multiple locations. Get your pen or keyboard ready:
Choose to have a single, up-to-date version of each work instruction available in one place. Not on the intranet, in a folder, or in an old email. Whether it’s a long-time employee or a new temporary worker walking through the door, everyone needs to be confident that the protocol they’ve found is correct. That sounds obvious, but ask yourself how many versions of your most-used protocol are currently in circulation.
A protocol that’s hard to find won’t be found. It’s that simple. Especially not by a freelancer or agency worker who is short on time and isn’t yet familiar with the system. It pays to think carefully about how information is organized. Are protocols arranged logically? Can they be searched by keyword? Can someone find them without having to ask a colleague?
Agreements become outdated when no one is responsible for maintaining them. Every document should have an owner, and that owner should be actively reminded of a review date—not retrospectively, when someone happens to notice that a protocol no longer reflects reality. When documents are systematically maintained and reviewed, you prevent outdated agreements and the confusion that follows.
Dichterbij, a disability care organization, recognized this situation as well. Documents were scattered across multiple systems, were not always up to date, and multiple versions were circulating simultaneously. Project leader Henri Pijnappels clearly describes the desired situation:
“Colleagues need to be able to rely on the fact that information can be found quickly and that it is up to date, regardless of which system it comes from. You don’t want three different versions of a document floating around.”
The goal isn’t perfect uniformity. That’s neither realistic nor necessary. But when the right information is always accessible to whoever needs it and is properly maintained, your permanent staff, agency workers, and freelancers can work with greater confidence, even across different locations.
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