Abstract Introduction: In 2017, the role of coordinating practitioner was introduced in the Netherlands in order to improve quality of care for patients who receive treatment in specialized mental health care. Psychiatric-mental health nurse practitioners (PMHNPs) can fulfil this role. Aim/Question: The aim was to obtain insight into how PMHNPs fulfil the coordinating practitioner role and what is needed to improve fulfilment of this role. Method: A survey among PMHNPs in the Netherlands was conducted between July-September 2018. In total, 381 PMHNP filled out the questionnaire; the response rate was 47.6%. Descriptive analyses were performed using SPSS 22® (IBM). Results: 92% Of the PMHNPs fulfilled the coordinating practitioner role and were generally satisfied with their role performance. The following conditions were formulated to improve this role: 1) recognition and trust in the expertise of PMHNPs, 2) a clear description of their role as coordinating practitioner, 3) strengthening multidisciplinary collaboration, and 4) sufficient training budget and opportunities. Discussion: In Dutch mental health care, PMHNPs have strengthened their position as coordinating practitioner in a short period of time. Follow-up research should be conducted to obtain further insights into elements that contribute to an optimal role as coordinating practitioner. Implications for Practice: Having PMHNPs act as coordinating practitioners can contribute to solving the challenges in mental health care regarding coordination of care and effective multidisciplinary collaboration.
BACKGROUND: General Practitioners (GPs) play a key role in the healthcare trajectory of patients. If the patient experiences problems that are typically non-life-threatening, such as the symptoms of post-intensive-care syndrome, the GP will be the first healthcare professional they consult. The primary aim of this study is to gain insight in the frequency of GP consultations during the year before hospital admission and the year after discharge for ICU survivors and a matched control group from the general population. The secondary aim of this study is to gain insight into differences between subgroups of the ICU population with respect to the frequency of GP consultations.METHODS: We conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry for ICUs. Clinical data of patients admitted to an ICU in 2013 were enriched with claims data from the years 2012, 2013 and 2014. Poisson regression was used to assess the differences in frequency of GP consultations between the ICU population and the control group.RESULTS: ICU patients have more consultations with GPs during the year before and after admission than individuals in the control group. In the last four weeks before admission, ICU patients have 3.58 (CI 3.37; 3.80) times more GP consultations than the control group, and during the first four weeks after discharge they have 4.98 (CI 4.74; 5.23) times more GP consultations. In the year after hospital discharge ICU survivors have an increased GP consultation rate compared to the year before their hospital admission.CONCLUSIONS: Close to hospital admission and shortly after hospital discharge, the frequency of GP consultations substantially increases in the population of ICU survivors. Even a year after hospital discharge, ICU survivors have increased GP consultation rates. Therefore, GPs should be well informed about the problems ICU patients suffer after discharge, in order to provide suitable follow-up care.
Aim. To report the expectations and experiences of general practitioners and practice nurses regarding the U-CARE programme, to gain a better understanding of the barriers and facilitators in providing proactive, structured care to frail older people and to determine whether implementation is feasible. Background. Care for older patients with complex care needs in primary care is fragmented, reactive and time consuming. A structured, proactive care programme was developed to improve physical functioning and quality of life in frail older patients. Design. An explanatory mixed-methods study nested in a cluster-randomized trial. Methods. The barriers to and needs for the provision of structured, proactive care, and expectations regarding the U-CARE programme were assessed with prequestionnaires sent to all participating general practitioners (n = 32) and practice nurses (n = 21) in October 2010. Postquestionnaires measured experiences with the programme after 5 months. Twelve months later, focus group meetings were conducted. Results. Practice nurses and general practitioners reported that it was difficult to provide proactive and structured care to older patients with multi-morbidity, different cultural backgrounds and low socioeconomic status. Barriers were a lack of time and financial compensation. Most general practitioners and practice nurses indicated that the programme added value for the coordination of care and allowed them to provide structured care. Conclusion. This explanatory mixed-methods study showed that general practitioners and practice nurses perceived the U-CARE programme as feasible in general practice. A transition was made from reactive, ad hoc care towards a proactive and preventive care approach
Every year the police are confronted with an ever increasing number of complex cases involving missing persons. About 100 people are reported missing every year in the Netherlands, of which, an unknown number become victims of crime, and presumed buried in clandestine graves. Similarly, according to NWVA, several dead animals are also often buried illegally in clandestine graves in farm lands, which may result in the spread of diseases that have significant consequences to other animals and humans in general. Forensic investigators from both the national police (NP) and NWVA are often confronted with a dilemma: speed versus carefulness and precision. However, the current forensic investigation process of identifying and localizing clandestine graves are often labor intensive, time consuming and employ classical techniques, such as walking sticks and dogs (Police), which are not effective. Therefore, there is an urgent request from the forensic investigators to develop a new method to detect and localize clandestine graves quickly, efficiently and effectively. In this project, together with practitioners, knowledge institutes, SMEs and Field labs, practical research will be carried out to devise a new forensic investigation process to identify clandestine graves using an autonomous Crime Scene Investigative (CSI) drone. The new work process will exploit the newly adopted EU-wide drone regulation that relaxes a number of previously imposed flight restrictions. Moreover, it will effectively optimize the available drone and perception technologies in order to achieve the desired functionality, performance and operational safety in detecting/localizing clandestine graves autonomously. The proposed method will be demonstrated and validated in practical operational environments. This project will also make a demonstrable contribution to the renewal of higher professional education. The police and NVWA will be equipped with operating procedures, legislative knowledge, skills and technological expertise needed to effectively and efficiently performed their forensic investigations.
During the coronavirus pandemic, the use of eHealth tools became increasingly demanded by patients and encouraged by the Dutch government. Yet, HBO health professionals demand clarity on what they can do, must do, and cannot do with the patients’ data when using digital healthcare provision and support. They often perceive the EU GDPR and its national application as obstacles to the use of eHealth due to strict health data processing requirements. They highlight the difficulty of keeping up with the changing rules and understanding how to apply them. Dutch initiatives to clarify the eHealth rules include the 2021 proposal of the wet Elektronische Gegevensuitwisseling in de Zorg and the establishment of eHealth information and communication platforms for healthcare practitioners. The research explores whether these initiatives serve the needs of HBO health professionals. The following questions will be explored: - Do the currently applicable rules and the proposed wet Elektronische Gegevensuitwisseling in de Zorg clarify what HBO health practitioners can do, must do, and cannot do with patients’ data? - Does the proposed wet Elektronische Gegevensuitwisseling in de Zorg provide better clarity on the stakeholders who may access patients’ data? Does it ensure appropriate safeguards against the unauthorized use of such data? - Does the proposed wet Elektronische Gegevensuitwisseling in de Zorg clarify the EU GDPR requirements for HBO health professionals? - Do the eHealth information and communication platforms set up for healthcare professionals provide the information that HBO professionals need on data protection and privacy requirements stemming from the EU GDPR and from national law? How could such platforms be better adjusted to the HBO professionals’ information and communication needs? Methodology: Practice-oriented legal research, semi-structured interviews and focus group discussions will be conducted. Results will be translated to solutions for HBO health professionals.
298 woorden: In the upcoming years the whole concept of mobility will radically change. Decentralization of energy generation, urbanization, digitalization of processes, electrification of vehicles and shared mobility are only some trends which have a strong influence on future mobility. Furthermore, due to the shift towards renewable energy production, the public and the private sector are required to develop new infrastructures, new policies as well as new business models. There are countless opportunities for innovative business models emerging. Companies in this field – such as charging solution provider, project management or consulting companies that are part of this project, Heliox and Over Morgen respectively – are challenged with countless possibilities and increasing complexity. How to overcome this problem? Academic research proposes a promising approach, namely the use of business model patterns for business model innovation. In short, these business model patterns are descriptions of proven practical solutions to common business model challenges. An example for a general pattern would be the business model pattern “Consumables”. It describes how to lock in a customer into an ecosystem by using a subsidized basic product and complement it with overpriced consumables. This pattern works really well and has been used by many companies (e.g. Senseo, HP, or Gillette). To support the business model innovation process of Heliox and Over Morgen as well as companies in the electric mobility space in general, we propose to systematically consolidate and develop business model patterns for the electric mobility sector and to create a database. Electric mobility patterns could not only foster creativity in the business model innovation process but also enhance collaboration in teams. By having a classified list of business model pattern for electric mobility, practitioners are equipped which a heuristic tool to create, extend and revise business models for the future.
