Background: The use of patient-reported outcomes to improve burn care increases. Little is known on burn patients’ views on what outcomes are most important, and about preferences regarding online Patient Reported Outcome Measures (PROMs). Therefore, this study assessed what outcomes matter most to patients, and gained insights into patient preferences towards the use of online PROMs. Methods: Adult patients (≥18 years old), 3–36 months after injury completed a survey measuring importance of outcomes, separately for three time periods: during admission, short-term (< 6 months) and long-term (6–24 months) after burn injury. Both open and closed-ended questions were used. Furthermore, preferences regarding the use of patient-reported outcome measures in burn care were queried. Results: A total of 140 patients were included (response rate: 27%). ‘Not having pain’ and ‘good wound healing’ were identified as very important outcomes. Also, ‘physical functioning at pre-injury level’, ‘being independent’ and ‘taking care of yourself’ were considered very important outcomes. The top-ten of most important outcomes largely overlapped in all three time periods. Most patients (84%) had no problems with online questionnaires, and many (67%) indicated that it should take up to 15 minutes. Patients’ opinions differed widely on the preferred frequency of follow-up. Conclusions: Not having pain and good wound healing were considered very important during the whole recovery of burns; in addition, physical functioning at pre-injury level, being independent, and taking care of yourself were deemed very important in the short and long-term. These outcomes are recommended to be used in burn care and research, although careful selection of outcomes remains crucial as patients prefer online questionnaires up to 15 minutes.
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Background: Only a few papers are published on the safety and effectiveness of acute burn care in low-income countries. A cohort study was therefore carried out to determine such outcomes.Methods: The study was conducted in a rural Tanzanian hospital in 2017-2018. All patients admitted with burns were eligible. Complications were scored during admission as an indication for safety. Survivors of severe burn injuries were evaluated for time of reepithelialization, graft take, disability (WHODAS2.0) and quality of life (EQ5D-3L) up to 3 months post-injury, as an indication of effectiveness.Results: Patients presented on average at 5 days after injury (SD 11, median 1, IQR 0-4). Three patients died at admission. The remaining 79 were included in the cohort. Their median age was 3 years (IQR 2-9, range 0.5-49), mean TBSA burned 12% (SD10%) and mortality rate 11.4%. No surgery-related mortality or life-threatening complications were observed. Skin grafting was performed on 29 patients at a delayed stage (median 23 days, IQR 15-47). Complications of skin grafts included partial (25% of procedures) and complete graft necrosis (8% of procedures). The mean time to reepithelialization was 52 (SD 42) days after admission. Disability and quality of life improved from admission to 3 months after injury (p<0.001, p<0.001, respectively).Conclusion: In this resource-limited setting patients presented after a delay and with multiple complications. The mortality during the first two weeks after admission was high. Surgery was found to be safe and effective. A significant improvement in disability and quality of life was observed.
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OBJECTIVE: This study aimed to examine the prevalence and predictors of reconstructive surgery among pediatric burn patients in the Netherlands.METHODS: Pediatric burn patients were identified through the Dutch Burn Repository R3. Eligibility criteria included a burn requiring hospital admission or surgical treatment at one of the Dutch burn centers in 2009-2019. First, patient, burn, and treatment characteristics were summarized using descriptive statistics. Second, time to the first reconstructive surgery was modelled using Kaplan Meier curves. Third, a prediction model was developed using univariate and multivariate logistic regression. The model's performance was assessed using calibration, discrimination, and explained variance. Fourth, internal validation was performed using bootstrapping.RESULTS: Approximately three percent (n = 84) of pediatric patients (n = 3072) required reconstructive surgery between the initial burn-related hospital admission and September 2021. Median time to the first reconstructive surgery was 1.2 (0.7-1.6) years. Most surgeries were performed on the face, arm, neck, hand, or anterior trunk, owing to contractures or hypertrophic scarring. Predictors of reconstruction included the etiology, anatomical site, extent of full-thickness burn, surgical treatment in the acute phase, and length of hospital stay.CONCLUSION: Our study provided an overview of the prevalence and independent predictors of reconstructive surgery in the pediatric burn population.
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Youth care is under increasing pressure, with rising demand, longer waiting lists, and growing staff shortages. In the Netherlands, one in seven children and adolescents is currently receiving youth care. At the same time, professionals face high workloads, burnout risks, and significant administrative burdens. This combination threatens both the accessibility and quality of care, leading to escalating problems for young people and families. Artificial intelligence (AI) offers promising opportunities to relieve these pressures by supporting professionals in their daily work. However, many AI initiatives in youth care fail to move beyond pilot stages, due to barriers such as lack of user acceptance, ethical concerns, limited professional ownership, and insufficient integration into daily practice. Empirical research on how AI can be responsibly and sustainably embedded in youth care is still scarce. This PD project aims to develop practice-based insights and strategies that strengthen the acceptance and long-term adoption of AI in youth care, in ways that support professional practice and contribute to appropriate care. The focus lies not on the technology itself, but on how professionals can work with AI within complex, high-pressure contexts. The research follows a cyclical, participatory approach, combining three complementary implementation frameworks: the Implementation Guide (Kaptein), the CFIR model (Damschroder), and the NASSS-CAT framework (Greenhalgh). Three case studies serve as core learning environments: (1) a speech-to-text AI tool to support clinical documentation, (2) Microsoft Copilot 365 for organization-wide adoption in support teams, and (3) an AI chatbot for parents in high-conflict divorces. Throughout the project, professionals, clients, ethical experts, and organizational stakeholders collaborate to explore the practical, ethical, and organizational conditions under which AI can responsibly strengthen youth care services.
The Dutch hospitality industry, reflecting the wider Dutch society, is increasingly facing social sustainability challenges for a greying population, such as increasing burnout, lifelong learning, and inclusion for those distanced from the job market. Yet, while the past decades have seen notable progress regarding environmental sustainability and good governance, more attention should be paid to social sustainability. This concern is reflected by the top-sector healthcare struggles caused by mounting social welfare pressure, leading to calls by the Dutch government for organizational improvement in social earning capacity. Furthermore, the upcoming EU legislation on CSRD requires greater transparency regarding financial and non-financial reporting this year. Yet, while the existing sustainability accreditation frameworks offer guidance on environmental sustainability and good governance reporting, there must be more guidance on auditing social sustainability. The hospitality industry, as a prominent employer in the Netherlands, thus has a societal and legislative urgency to transition its social earning capacity. Dormben Hotel The Hague OpCo BV (Dormben) has thus sought support in transitioning its social sustainability standards to meet this call. Hotelschool, the Hague leads the consortium, including Green Key Nederland and Dormben, by employing participatory design to present a social sustainability accreditation framework. Initially, Dr. David Brannon and Dr. Melinda Ratkai from Hotelschool The Hague will draft a social sustainability accreditation framework informed by EFRAG. Subsequently, Erik van Wijk, from Green Key Nederland, the hospitality benchmark for sustainability accreditation, and Sander de Jong, from Dormben, will pilot the framework through four participatory workshops involving hospitality operators. Later, during a cross-industry conference, Dr. David Brannon and Dr. Melinda Ratkai will disseminate a social sustainability toolkit across their academic and industry networks. Finally, conference and workshop participants will be invited to form a social sustainability learning community, discussing their social earning capacity based on the revised sustainability accreditation.
Despite Dutch Hospitality industry’s significant economic value, employers struggle to attract and retain early career professionals at a time when tourism is forecasted to grow exponentially (Ruël, 2018). Universally, hospitality management graduates are shunning hospitality careers preferring other career paths; stimulating the Dutch Hospitality to find innovative ways of attracting and retaining early career professionals. Following calls from the Human Resource Management (HRM) community (Ehnert, 2009), we attribute this trend to personnel being depicted as rentable resources, driving profit’’ often at personal expense. For example, hotels primarily employ immigrants and students for a minimum wage suppressing salaries of local talent (Kusluvan, et al 2010, O’Relly and Pfeffer, 2010). Similarly, flattening organizational structures have eliminated management positions, placing responsibility on inexperienced shoulders, with vacancies commonly filled by pressured employees accepting unpaid overtime jeopardizing their work life balance (Davidson, et al 2010,). These HRM practices fuel attrition by exposing early career professionals to burnout (Baum et al, 2016, Goh et al, 2015, Deery and Jog, 2009). Collectively this has eroded the industry’s employer brand, now characterized by unsocial working hours, poor compensation, limited career opportunities, low professional standing, high turnover and substance abuse (Mooney et al, 2016, Gehrels and de Looij, 2011). In contrast, Sustainable HRM “enables an organizational goal achievement while simultaneously reproducing the human resource base over a long-lasting calendar time (Ehnert, 2009, p. 74).” Hence, to overcome this barrier we suggest embracing the ROC framework (Prins et al, 2014), which (R)espects internal stakeholders, embraces an (O)pen HRM approach while ensuring (C)ontinuity of economic and societal sustainability which could overcome this barrier. Accordingly, we will employ field research, narrative discourse, survey analysis and quarterly workshops with industry partners, employees, union representatives, hotel school students to develop sustainable HRM practices attracting and retaining career professionals to pursue Dutch hospitality careers.
