BackgroundSurvivors of critical illness experience long-term functional challenges, which are complex, heterogeneous, and multifactorial in nature. Although the importance of rehabilitation interventions after intensive care unit (ICU) discharge is universally recognized, evidence on feasibility and effectiveness of home-based rehabilitation programs is scarce and ambiguous. This study investigates the feasibility of an interdisciplinary rehabilitation program designed for patients with Post-Intensive Care Syndrome (PICS) who are discharged home.MethodsA mixed method, non-randomized, prospective pilot feasibility study was performed with a 6-month follow-up, comparing the intervention (REACH) with usual care. REACH was provided by trained professionals and included a patient-centered, interdisciplinary approach starting directly after hospital discharge. Primary outcomes were patient safety, satisfaction, adherence, referral need and health care usage. Secondary outcomes, measured at 3 timepoints, were functional exercise capacity, self-perceived health status, health-related quality of life (HRQoL), return to work and psychotrauma. Risk of undernutrition was assessed at baseline.Results43 patients with a median mechanical ventilation duration of 8 (IQR:10) days, were included in the study and 79.1% completed 6-month follow-up. 19 patients received the intervention, 23 received usual care. Groups were similar for gender distribution and ICU length of stay. No adverse events occurred. REACH participants showed higher satisfaction with treatment and reported more allied health professional visits, while the usual care group reported more visits to medical specialists. Qualitative analysis identified positive experiences among REACH-professionals related to providing state-of-the-art interventions and sharing knowledge and expertise within an interprofessional network. Similar recovery was seen between groups on all secondary outcomes, but neither group reached reference values for HRQoL at 6 months. Larger return to work rates were seen in the REACH group. Prevalence of undernutrition at hospital discharge was high in both groups (> 80%), warranting the need for careful tuning of physical therapy and nutritional interventions.ConclusionsThis study shows that providing early, home-based rehabilitation interventions for patients with PICS-related symptoms is feasible and perceived positively by patients and professionals. When provided in an interdisciplinary collaborative network state of the art, person-centered interventions can be tailored to individual needs potentially increasing patient satisfaction, adherence, and efficacy.Registered in the Dutch Trial register: NL7792: https://www.trialregister.nl/trial/7792, registered 7-06-2019.
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Background: A hematopoietic stem cell transplantation (HSCT) has a major impact on the functioning and perceived quality of life of patients. To describe the functioning of patients, a preliminary set of 53 categories of the International Classification of Functioning, Disability and Health (ICF) as relevant for HSCT patients has been selected earlier by a Delphi study. For the implementation of this preliminary ICF core set for patients after HSCT in clinical practice, a feasibility study was requested.Methods: A feasibility study was conducted in an explanatory mixed-methods research design. Qualitative data were collected cross-sectionally by semi-structured interviews based on specific topics related to feasibility regarding the use of the preliminary ICF core set for HSCT patients from the perspective of nurses (five in ICF-trained nurses and five regular, untrained, nurses). Quantitative data, were collected longitudinally by using a mobile health application based on ICF in which the ICF trained nurses registered HSCT patients ' functioning.Results: Qualitative analysis indicated that using the preliminary ICF core set is practical and acceptable for providing information about the functioning of HSCT patients from the perspective of nurses. In addition, nurses indicated a demand for this information due to its impact on multidisciplinary meetings and clinical decision-making by involving relevant aspects of the functioning of patients. Management support, trained staff, and designated time to focus on functioning are mentioned as requirements for successful implementation. Quantitative analysis demonstrated that the most used 30% (n = 17) ICF categories are included in the preliminary ICF core set for HSCT patients (n = 24). Energy (b130) was the most used ICF category. Family relationships (d760) was the most frequently and highly positively associated ICF category.Conclusions: From the perspective of nurses, the preliminary ICF core set for HSCT patients is feasible and relevant in gaining information regarding functioning. Applying this preliminary ICF core set for HSCT patients in the anamnesis and the nursing consultations contributes to this information. Further research is needed to look at the perspective of other professionals and HSCT patients themselves.
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Background: Due to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people. Method: A feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis. Results: The IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program. Conclusions: This study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.
The focus of this project is on improving the resilience of hospitality Small and Medium Enterprises (SMEs) by enabling them to take advantage of digitalization tools and data analytics in particular. Hospitality SMEs play an important role in their local community but are vulnerable to shifts in demand. Due to a lack of resources (time, finance, and sometimes knowledge), they do not have sufficient access to data analytics tools that are typically available to larger organizations. The purpose of this project is therefore to develop a prototype infrastructure or ecosystem showcasing how Dutch hospitality SMEs can develop their data analytic capability in such a way that they increase their resilience to shifts in demand. The one year exploration period will be used to assess the feasibility of such an infrastructure and will address technological aspects (e.g. kind of technological platform), process aspects (e.g. prerequisites for collaboration such as confidentiality and safety of data), knowledge aspects (e.g. what knowledge of data analytics do SMEs need and through what medium), and organizational aspects (what kind of cooperation form is necessary and how should it be financed).
Due to the exponential growth of ecommerce, the need for automated Inventory management is crucial to have, among others, up-to-date information. There have been recent developments in using drones equipped with RGB cameras for scanning and counting inventories in warehouse. Due to their unlimited reach, agility and speed, drones can speed up the inventory process and keep it actual. To benefit from this drone technology, warehouse owners and inventory service providers are actively exploring ways for maximizing the utilization of this technology through extending its capability in long-term autonomy, collaboration and operation in night and weekends. This feasibility study is aimed at investigating the possibility of developing a robust, reliable and resilient group of aerial robots with long-term autonomy as part of effectively automating warehouse inventory system to have competitive advantage in highly dynamic and competitive market. To that end, the main research question is, “Which technologies need to be further developed to enable collaborative drones with long-term autonomy to conduct warehouse inventory at night and in the weekends?” This research focusses on user requirement analysis, complete system architecting including functional decomposition, concept development, technology selection, proof-of-concept demonstrator development and compiling a follow-up projects.
This proposal is a resubmission of an earlier proposal (Dossier nr: GOCH.KIEM.KGC02.079) which was not approved because of the too ambitious planning. As advised by the commission, the focus is kept only on the recycling of the mattress cover. The Netherlands has 180,000+ waterproof mattresses in the healthcare sector, of which yearly 40,000+ mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these waterproof mattresses in the consumer sector as well. Considering the complex nature of functional mattresses, these valuable resources are partly incinerated. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials in five key economic sectors including ‘consumer products’ by 2030. Within the scope of this research, Saxion together with partners (CFC BV, Deron BV, MRE BV & Klieverik Heli BV) will bring emphasis on Recycling (sustainable chemistry) of mattress covers. Other aspects such as reuse and re-designing are beyond the scope of this project proposal, for which a bigger consortium will be built during the course of this project. A case under study is a water-impermeable mattress cover made of 100% polyester with polyurethane (PU) coatings. The goal is to enable the circular use of textiles with (multilayer) ‘coatings’, which are not recyclable yet. These ‘coatings’ comprise functional coatings as well as adhesion layers. Therefore, novel triggerable molecular systems and the corresponding recycling processes will be developed. The coatings will be activated by a specific trigger (bio)-chemical solvation, heat, pressure, humidity, microwave, or combination of thereof. The emphasis is to develop a scalable coating removal process. Learnings will be used to build larger (inter)-national consortia to develop multiple industry closed-loop solutions required for 100% mattress circularity with desired functionality. The generated knowledge will be used for education at Saxion.
