Background: A quality improvement collaborative is an intensive project involving a combination of implementation strategies applied in a limited “breakthrough” time window. After an implementation project, it is generally difficult to sustain its success. In the current study, sustainability was described as maintaining an implemented innovation and its benefits over a longer period of time after the implementation project has ended. The aim of the study was to explore potentially promising strategies for sustaining the Enhanced Recovery After Surgery (ERAS) programme in colonic surgery as perceived by professionals, three to six years after the hospital had successfully finished a quality improvement collaborative. Methods: A qualitative case study was performed to identify promising strategies to sustain key outcome variables related to the ERAS programme in terms of adherence, time needed for functional recovery and hospital length of stay (LOS), as achieved immediately after implementation. Ten hospitals were selected which had successfully implemented the ERAS programme in colonic surgery (2006–2009), with success defined as a median LOS of 6 days or less and protocol adherence rates above 70%. Fourteen semi-structured interviews were held with eighteen key participants of the care process three to six years after implementation, starting with the project leader in every hospital. The interviews started by confronting them with the level of sustained implementation results. A direct content analysis with an inductive coding approach was used to identify promising strategies. The mean duration of the interviews was 37 minutes (min 26 minutes – max 51 minutes). Results: The current study revealed strategies targeting professionals and the organisation. They comprised internal audit and feedback on outcomes, small-scale educational booster meetings, reminders, changing the physical structure of the organisation, changing the care process, making work agreements and delegating responsibility, and involving a coordinator. A multifaceted self-driven promising strategy was applied in most hospitals, and in most hospitals promising strategies were suggested to sustain the ERAS programme. Conclusions: Joining a quality improvement collaborative may not be enough to achieve long-term normalisation of transformed care, and additional investments may be needed. The findings suggest that certain post-implementation strategies are valuable in sustaining implementation successes achieved after joining a quality improvement collaborative.
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LETTER TO THE EDITOR: Many doctors take on prescribing responsibilities shortly after they graduate [1, 2], but fnal-year medical students not only feel insecure about prescribing, but also lack adequate knowledge and skills to prescribe rationally and safely [3, 4]. To address this public health concern, the European Association for Clinical Pharmacology and Therapeutics (EACPT) recommended that education in clinical pharmacology and therapeutics (CP&T) in Europe should be modernized and harmonized [5]. The frst step towards harmonization was taken in 2018 when CP&T experts reached consensus on the key learning outcomes for CP&T education in Europe [6]. The next step was to assess these outcomes in a uniform examination during undergraduate medical training [7–9]. The Prescribing Safety Assessment (United Kingdom) and the Dutch National Pharmacotherapy Assessment (The Netherlands) are currently the only national CP&T examinations [10–13]. Implementing these examinations in other European countries is difcult because of related costs and diferences in available drugs and guidelines. Therefore, in 2019, together with nine European universities, the EACPT, and the World Health Organization Europe, we started a 3-year Erasmus+-project (2019–1-NL01-KA203-060,492) to develop, test and implement an online examination on safe prescribing for medical schools in Europe: “The European Prescribing Exam” (EuroPE+, https://www.prescribingeducation.eu/). The aim of The European Prescribing Exam is to ensure that medical students in Europe graduate with prescribing competencies for safe and efective clinical practice. During the frst stage of the project, we established that EuroPE+ should focus not only on safe prescribing (e.g. contraindications, interactions) but also on broader aspects of CP&T (e.g. deprescribing, communication, personalized medicine). We identifed 43 main learning objectives and 299 attainment targets, based on previous European studies of CP&T education and the Dutch National Pharmacotherapy Assessment [6, 14, 15]. The attainment targets concern eight drug groups that junior doctors should be confdent about prescribing because these drugs are commonly prescribed or are a major cause of adverse events [16]
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Interview ICT &Health: Living labs zijn in opkomst. Deze levende laboratoria zijn realistische experimentele omgevingen, waarin onderwijs, overheden, werkveld en andere partijen samen werken aan innovatieve oplossingen voor problemen. Ook op het gebied van gezondheidszorg en technologie bestaan living labs, zoals de Medical Delta Living Labs. Eén van deze labs is het Medical Delta Living Lab Geriatric Rehabilitation@Home. Het doel is om met de inzet van e-health zelfmanagement en kwaliteit van leven van thuiswonende geriatrische revalidanten te vergroten en hun mantelzorgers beter te ondersteunen.
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Erasmus project about training cultural workers for facilitating rural youths culture
Drones have been verified as the camera of 2024 due to the enormous exponential growth in terms of the relevant technologies and applications such as smart agriculture, transportation, inspection, logistics, surveillance and interaction. Therefore, the commercial solutions to deploy drones in different working places have become a crucial demand for companies. Warehouses are one of the most promising industrial domains to utilize drones to automate different operations such as inventory scanning, goods transportation to the delivery lines, area monitoring on demand and so on. On the other hands, deploying drones (or even mobile robots) in such challenging environment needs to enable accurate state estimation in terms of position and orientation to allow autonomous navigation. This is because GPS signals are not available in warehouses due to the obstruction by the closed-sky areas and the signal deflection by structures. Vision-based positioning systems are the most promising techniques to achieve reliable position estimation in indoor environments. This is because of using low-cost sensors (cameras), the utilization of dense environmental features and the possibilities to operate in indoor/outdoor areas. Therefore, this proposal aims to address a crucial question for industrial applications with our industrial partners to explore limitations and develop solutions towards robust state estimation of drones in challenging environments such as warehouses and greenhouses. The results of this project will be used as the baseline to develop other navigation technologies towards full autonomous deployment of drones such as mapping, localization, docking and maneuvering to safely deploy drones in GPS-denied areas.
Met huidige opleidings- en trainingsprogramma’s kan niet worden voldaan aan de groeiende vraag naar vakbekwame medewerkers op gebied van kunstmatige intelligentie (AI). Europa heeft daarom een innovatieve Europese AI-strategie nodig, die de bijscholing van werkenden kan versnellen om aan deze steeds toenemende vraag te voldoen. Doel Het project ondersteunt het Europese Pact for Skills door een strategie op het gebied van AI skills te ontwikkelen. Deze strategie moet leiden tot impact op het terugdringen van tekorten, hiaten en mismatches in skills op de arbeidsmarkt, en zorgen voor passende kwaliteit en niveaus van skills. Resultaten Verwachte resultaten en impactHet project omvat: de oprichting van een lange termijn partnerschap voor een innovatieve Europese alliantie voor AI; het ontwerpen en uitrollen van een innovatieve en duurzame strategie voor AI-skills op korte en lange termijn; het ontwikkelen, testen en uitrollen van opleidingscurricula in acht proeflocaties (5 universiteiten/hogescholen en 3 mbo-aanbieders); de aanpassing van programma's en kwalificaties aan de nieuwste marktbehoeften. het koppelen van micro-credentials aan het opleidingsaanbod Voordelen op lange termijnDe AI-skills strategie en de opleidingscurricula zullen, nadat ze zijn ontworpen en grondig getest in de praktijk, beschikbaar worden gesteld om te worden aangepast en opgeschaald in heel Europa. Op deze manier kan worden voldaan aan de huidige en toekomstige skills-behoeften van de AI-sector en kan de groei van AI-talent in Europa worden gestimuleerd. Looptijd 01 juni 2022 - 30 juni 2026 Aanpak Het project wordt als volgt uitgevoerd in negen werkpakketten: 1 – Projectbeheer en coördinatie 2 – Behoeftenanalyse 3 – Strategie voor AI-skills 4 - Ontwikkeling van een innovatief leerplan en trainingsprogramma 5 - Ontwikkeling van een certificeringssysteem 6 – Pilots in verschillende EU-landen 7 – Verspreiding en communicatie 8 – Duurzaamheid op lange termijn 9 – Kwaliteitsborging Inhoudelijk start het project met de behoeftenanalyse, waarin de skills mismatch op Europees niveau wordt geanalyseerd door o.a. de behoefte aan skills op basis van vacatures en beschikbaar relevant AI opleidingsaanbod te onderzoeken. Meer over ARISA Het vierjarige onderzoeksproject ARISA wordt gefinancierd door de Europese Unie via een Erasmus+ programma. Meer informatie vind je op de ARISA website, de ARISA Twitter en de ARISA LinkedIn. Lees ook dit artikel (ENG) over de start van ARISA.
