To refine the admission criteria of the Acute Geriatric Community Hospital (AGCH) by defining its target group boundaries with (geriatric) hospital care and other bed-based intermediate care models in the Netherlands.
MULTIFILE
Introduction: The transition from hospital to home is often suboptimal, resulting in patients not receiving the necessary allied healthcare after discharge. This may, in turn, lead to delayed recovery, a higher number of readmissions, more emergency department visits and an increase in mortality and healthcare costs. This study aimed to gain insight into patients' experiences, perceptions, and needs regarding hospital-to-home transition, focusing on allied healthcare as a first step towards the development of a transitional integrated allied healthcare pathway for patients with complex care needs after hospital discharge. Methods: We conducted semistructured interviews with patients. Participants were recruited from universities and general hospitals in the Amsterdam region between May and July 2023. They were eligible if they (1) were discharged from the hospital minimally 3 and maximally 12 months after admission to an oncologic surgery department, internal medicine department, intensive care unit, or trauma centre, (2) received hospital-based care from at least one allied healthcare provider, who visited the patient at least twice during hospital admission, (3) spoke Dutch or English and (4) were 18 years or older. Interviews were audio-recorded and transcribed verbatim. We performed a thematic analysis of the interview data. Results: Nineteen patients were interviewed. Three themes emerged from the analysis. ‘Allied healthcare support during transition’ depicts patients' positive experiences when they felt supported by allied health professionals during the hospital-to-home transition. ‘Patient and family involvement’ illustrates how much patients value the involvement of their family members during discharge planning. ‘Information recall and processing’ portrays the challenges of understanding and remembering overwhelming amounts of information, sometimes unclear and provided at the wrong moment. Overall, patients' experiences of transitional care were positive when they were involved in the discharge process. Negative experiences occurred when their preferences for postdischarge communication were ignored. Conclusions: This study suggests that allied health professionals need to continuously collaborate and communicate with each other to provide patients and their families with the personalized support they need. To provide high-quality and person-centred care, it is essential to consider how, when, and what information to provide to patients and their families to allow them to contribute to their recovery actively. Patient or Public Contribution: The interview guide for this manuscript was developed with the assistance of patients, who reviewed it and provided us with feedback. Furthermore, patients provided us with their valuable lived experiences by participating in the interviews conducted for this study.
Background: Optimizing transitional care by practicing family-centered care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients’ healthcare also has negative consequences for patient safety. This study assessed the safety of family involvement in patients’ healthcare by examining the cause of unplanned events in patients who participated in a family involvement program (FIP) after major abdominal cancer surgery. Methods: This is a secondary analysis focusing on the intervention group of a prospective cohort study conducted in the Netherlands. Data were collected from April 2019 to May 2022. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analyzed, and root causes were identified using the medical version of a prevention- and recovery-information system for monitoring and analysis (PRISMA) that analyses unintended events in healthcare. Unplanned events were compared between patients who received care from family caregivers and patients who received professional at-home care after discharge. A Mann-Whitney U test was used to analyze data. Results: Of the 152 FIP participants, 68 experienced an unplanned event and were included. 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1–2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. Conclusion: Based on the insights from the root-cause analysis in this prospective multicenter study, it appears that unplanned emergency room visits and hospital readmissions are not related to the active involvement of family caregivers in surgical follow-up care. Moreover, surgical follow-up care by trained family caregivers during hospitalization was not associated with increased rates of unplanned adverse events. Hence, the concept of active family involvement by proficiently trained family caregivers in postoperative care appears safe and feasible for patients undergoing major abdominal surgery.
The pressure on the European health care system is increasing considerably: more elderly people and patients with chronic diseases in need of (rehabilitation) care, a diminishing work force and health care costs continuing to rise. Several measures to counteract this are proposed, such as reduction of the length of stay in hospitals or rehabilitation centres by improving interprofessional and person-centred collaboration between health and social care professionals. Although there is a lot of attention for interprofessional education and collaborative practice (IPECP), the consortium senses a gap between competence levels of future professionals and the levels needed in rehabilitation practice. Therefore, the transfer from tertiary education to practice concerning IPECP in rehabilitation is the central theme of the project. Regional bonds between higher education institutions and rehabilitation centres will be strengthened in order to align IPECP. On the one hand we deliver a set of basic and advanced modules on functioning according to the WHO’s International Classification of Functioning, Disability and Health and a set of (assessment) tools on interprofessional skills training. Also, applications of this theory in promising approaches, both in education and in rehabilitation practice, are regionally being piloted and adapted for use in other regions. Field visits by professionals from practice to exchange experiences is included in this work package. We aim to deliver a range of learning materials, from modules on theory to guidelines on how to set up and run a student-run interprofessional learning ward in a rehabilitation centre. All tested outputs will be published on the INPRO-website and made available to be implemented in the core curricula in tertiary education and for lifelong learning in health care practice. This will ultimately contribute to improve functioning and health outcomes and quality of life of patients in rehabilitation centres and beyond.
ALE organised an event with Parktheater Eindhoven and LSA-citizens (the Dutch umbrella organisation for active citizens). Five ALE students from the minor Imagineering and business/social innovation took responsibility for concept and actual organisation. On Jan 18th, they were supported by six other group members of the minor as volunteers. An IMEM-team of 5 students gathered materials for a video that can support the follow-up actions of the organisers. The students planned to deliver their final product on February 9th. The theatre will critically assess the result and compare it to the products often realised by students from different schools or even professional ones, like Veldkamp productions. Time will tell whether future opportunities will come up for IMEM. The collaboration of ALE and IMEM students is possible and adding value to the project.More than 180 visitors showed interest in the efforts of 30 national and local citizen initiatives presenting themselves on the market square in the theatre and the diverse speakers during the plenary session. The students created a great atmosphere using the qualities of the physical space and the hospitality of the theatre. Chair of the day, Roland Kleve, kicked off and invited a diverse group of people to the stage: Giel Pastoor, director of the theatre, used the opportunity to share his thoughts on the shifting role of theatre in our dynamic society. Petra Ligtenberg, senior project manager SDG NL https://www.sdgnederland.nl/sdgs/ gave insights to the objectives and progress of the Netherlands. Elly Rijnierse, city maker and entrepreneur from Den Haag, presented her intriguing efforts in her own neighbourhood in the city to create at once both practical and social impacts on SDG 11 (sustainable city; subgoal 3.2). Then the alderman Marcel Oosterveer informed the visitors about Eindhoven’s efforts on SDGs. The plenary ended with very personal interviews of representatives of two impressive citizen initiatives (Parkinson to beat; Stichting Ik Wil). In the two workshop rounds, ALE took responsibility for two workshops. Firstly the workshop: Beyond SDG cherrypicking: using the Economy for the common good’, in cooperation with citizen initiative Ware winst Brabant en Parktheater (including Social innovation-intern Jasper Box), secondly a panel dialogue on local partnerships (SDG 17) for the sustainable city (SDG 11) addressing inclusion (SDG 10) and the livability (SDG 3) with 11 representatives from local/provincial government, companies, third sector and, of course: citizen initiatives.
Historical sites, specifically former military fortifications, are often repurposed for tourism and recreation. While some of over 100 Dutch forts are recognized as UNESCO World Heritage sites, a substantial number are currently underdeveloped, putting their heritage value and biodiversity at risk. This demands action, as forts are well-positioned to relieve overtourism in other locations, responding to the Netherlands Board of Tourism and Convention's call to spread visitors to lesser-known areas. Furthermore, developing lesser-known fort sites could provide tourism and recreation opportunities near populated areas, thus contributing to the well-being not only of visitors but also the environment. Development initiatives depend on a transition from isolation to cooperation across sites. However, for cooperation to be effective, enterprises and agencies managing these forts still lack data regarding visitor expectations and experiences. We will employ a multidisciplinary approach to capturing visitor demographics, motivations, and experiences, through conducting quantitative questionnaires, lab-driven physiological experience measurement, and location tracking. This proposal builds on the previous project, “Experiencing Nature”, funded by Centre of Expertise in Leisure, Tourism, and Hospitality, which utilized Breda Experience Lab technologies to explore visitor experiences at Fort de Roovere. In sum, the purpose of the present project is to measure and analyze visitor demographics, motivations, and experiences at less-developed forts, and to develop a toolkit to inspire, support, and monitor development of these forts for heritage preservation, visitor experience, and biodiversity. The project will be conducted in collaboration with Flemish partners, thereby forming the consortium comprised of the Alliantie ZuiderWaterlinie (NL), Regionale Landschappen (VL), and Agentschap Natuur en Bos (VL), with support from municipalities in both countries. The project will promote regional synergies and facilitate long-lasting cross-border collaboration, especially toward coming Interreg EU proposals, whilst informing the design of interregional marketing campaigns and supporting planning for visitor flows and biodiversity conservation efforts. Collaborative partnersNHL Stenden, Alliantie Zuidwaterlinie, RLRL, Agentschap Natuur en Bos.
