Kwaliteitsmanagement is lange tijd gekenmerkt geweest door wat je het empirisch paradigma (Van Kemenade & Hardjono, 2018) zou kunnen noemen. Binnen die manier van denken is kwaliteitskunde meten en gaat het onder andere om prestatie-indicatoren. Kwaliteit is voldoen aan de vereisten. Verbetering en verandering is te plannen. Statistiek is zijn belangrijkste wetenschap. De manager controleert. Een risico echter van dit kwaliteitsparadigma is, dat er een enorme bureaucratie ontstaat. Erger nog: ze houdt onvoldoende rekening met de complexiteit van het huidige tijdsgewricht.
Technological developments have a major impact on how we live, work and learn together. Several authors refer to a fourth revolution in which robots and other intelligent systems take over an increasing number of the current (routine) tasks carried out by humans (Brynjolfsson & McAfee, 2014; Est et al., 2015; Ford, 2016; Helbing, 2014; Ross, 2017; Schwab, 2016). The relationship between man and machine will change fundamentally as a result. We are already noticing this shift, most specifically in the workplace. E.g., in the field of health care, digitalisation and robotisation can empower patients and their families. Hospitals are primarily intended for clients with complex care needs. This has consequences for the tasks carried out by nurses, who become more of a ‘care director’ or ‘research nurse’. Hospitals approach this in different ways, resulting in considerable diversity as to how these roles are fulfilled. These changes, albeit diverse, can also be seen in the roles of accountants, police officers and financial advisers at banks (Biemans, Sjoer, Brouwer and Potting, 2017). The traditional occupational profiles no longer exist and the essence of these professions is shifting. This does not make such occupations less attractive, but requires different qualities. The demand for more highly educated professionals who can carry out complex tasks in a creative and interdisciplinary manner will increase (McKinsey, 2017). Also, other social developments, such as migration and greenification, prompt us to ask new questions, resulting in new paths towards identifying solutions.
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Purpose: To describe nurses' support interventions for medication adherence, and patients' experiences and desired improvements with this care. Patients and methods: A two-phase study was performed, including an analysis of questionnaire data and conducted interviews with members of the care panel of the Netherlands Patients Federation. The questionnaire assessed 14 types of interventions, satisfaction (score 0-10) with received interventions, needs, experiences, and desired improvements in nurses' support. Interviews further explored experiences and improvements. Data were analyzed using descriptive statistics and a thematic analysis approach. Results: Fifty-nine participants completed the questionnaire, and 14 of the 59 participants were interviewed. The satisfaction score for interventions was 7.9 (IQR 7-9). The most common interventions were: "noticing when I don't take medication as prescribed" (n = 35), "helping me to find solutions to overcome problems with using medications" (n = 32), "helping me with taking medication" (n = 32), and "explaining the importance of taking medication at the right moment" (n = 32). Fifteen participants missed ≥1 of the 14 interventions. Most mentioned the following: "regularly asking about potential problems with medication use" (33%), "regularly discussing whether using medication is going well" (29%), and "explaining the importance of taking medication at the right moment" (27%). Twenty-two participants experienced the following as positive: improved self-management of adequate medication taking, a professional patient-nurse relationship to discuss adherence problems, and nurses' proactive attitude to arrange practical support for medication use. Thirteen patients experienced the following as negative: insufficient timing of home visits, rushed appearance of nurses, and insufficient expertise about side effects and taking medication. Suggested improvements included performing home visits on time, more time for providing support in medication use, and more expertise about side effects and administering medication. Conclusion: Overall, participants were satisfied, and few participants wanted more interventions. Nurses' support improved participants' self-management of medication taking and enabled patients to discuss their adherence problems. Adequately timed home visits, more time for support, and accurate medication-related knowledge are desired.
Het onderzoek richt zich op teacher noticing, de competentie van het herkennen van en reageren op situaties in de klas die vragen om wiskundig didactische interventie. Is deze competentie te trainen door wiskundeleraren in opleiding met resources?Doel Het doel is te onderzoeken of wiskundeleraren in opleiding beter worden in het herkennen van situaties in de klas die vragen om een vakdidactische interventie (teacher noticing) na de inzet van rijk multimediaal materiaal (rich-resources). Hiertoe wordt eerst een meetinstrument ontwikkeld. Resultaten Dit onderzoek is nog maar net van start gegaan. Na afloop lees je hier meer over de resultaten. Looptijd 01 september 2019 - 01 september 2023 Aanpak Een literatuuronderzoek leidt tot ontwerpcriteria voor resources en een meetinstrument voor noticing, gevalideerd in een pilotstudie. Het onderwijsmateriaal aan de hand van resources wordt daarna volgens een HLT ontwikkeld en uitgeprobeerd. Een comperative multiple case study beantwoordt de vraag in hoeverre het lesontwerp bijdraagt aan noticing. Onderzoek door studenten Studenten kunnen bijdragen aan dit onderzoek koppelen aan hun eigen beroepsproduct. Bijvoorbeeld door samen resources te verzamelen op de stageschool en daar een onderzoek en beroepsproduct op te richten. Interesse? Neem contact op met Jop (jop.schaap@hu.nl).
