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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In an auctorate, secondary schools conduct research that contributes directly to the practice of education (www.auctoraat.nl). The Auctorate for Promising Education creates more knowledge and awareness of how secondary education can (continue to) offer learning opportunities to students from different backgrounds. The lecture first explains why applied research is necessary in education and how the auctorate can contribute to this. It then explains why promising education is needed from three perspectives: language-aware, flow-aware, and career-aware education. First, we investigate the role of language as an (un)equalizer. Secondly, we discuss how later selection and promising advancement can contribute to promising education. Finally, we investigate how secondary education can contribute to a focus on a suitable career for pupils in which the upward pressure in education ('the more theoretical, the higher, the better') can decrease.
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Over the past decade, the maker movement and in its slipstream maker education have attained worldwide popularity among educators, politicians, and the media. Makers’ enthusiasm for creative design and construction, using old and new tools has proven contagious, and is worth exploration and critical reflection by the community of engineering and technology education (ETE). This chapter describes what has been said about “making” by philosophers and educators; what maker education is, and what is new and not so new about it; why it has gained momentum; what the evidence is about its effectiveness and its possible weaknesses; and how mainstream technology education may benefit from maker education. This chapter concludes with ideas for a research agenda.
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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.
Manual labour is an important cornerstone in manufacturing and considering human factors and ergonomics is a crucial field of action from both social and economic perspective. Diverse approaches are available in research and practice, ranging from guidelines, ergonomic assessment sheets over to digitally supported workplace design or hardware oriented support technologies like exoskeletons. However, in the end those technologies, methods and tools put the working task in focus and just aim to make manufacturing “less bad” with reducing ergonomic loads as much as possible. The proposed project “Human Centered Smart Factories: design for wellbeing for future manufacturing” wants to overcome this conventional paradigm and considers a more proactive and future oriented perspective. The underlying vision of the project is a workplace design for wellbeing that makes labor intensive manufacturing not just less bad but aims to provide positive contributions to physiological and mental health of workers. This shall be achieved through a human centered technology approach and utilizing advanced opportunities of smart industry technologies and methods within a cyber physical system setup. Finally, the goal is to develop smart, shape-changing workstations that self-adapt to the unique and personal, physical and cognitive needs of a worker. The workstations are responsive, they interact in real time, and promote dynamic activities and varying physical exertion through understanding the context of work. Consequently, the project follows a clear interdisciplinary approach and brings together disciplines like production engineering, human interaction design, creative design techniques and social impact assessment. Developments take place in an industrial scale test bed at the University of Twente but also within an industrial manufacturing factory. Through the human centered design of adaptive workplaces, the project contributes to a more inclusive and healthier society. This has also positive effects from both national (e.g. relieve of health system) as well as individual company perspective (e.g. less costs due to worker illness, higher motivation and productivity). Even more, the proposal offers new business opportunities through selling products and/or services related to the developed approach. To tap those potentials, an appropriate utilization of the results is a key concern . The involved manufacturing company van Raam will be the prototypical implementation partner and serve as critical proof of concept partner. Given their openness, connections and broad range of processes they are also an ideal role model for further manufacturing companies. ErgoS and Ergo Design are involved as methodological/technological partners that deal with industrial engineering and ergonomic design of workplace on a daily base. Thus, they are crucial to critically reflect wider applicability and innovativeness of the developed solutions. Both companies also serve as multiplicator while utilizing promising technologies and methods in their work. Universities and universities of applied sciences utilize results through scientific publications and as base for further research. They also ensure the transfer to education as an important leverage to inspire and train future engineers towards wellbeing design of workplaces.
Climate change and the depletion of resources in the world are widely recognized as the greatest societal challenges. The building sector is responsible for 40% of the raw material consumption globally. The emissions related to construction materials are anticipated to double by 2050, if no new technologies are adopted (EC, 2021). Based on the environmental cost indicator, isolation has the second largest (after concrete) impact to the environment. In Mythic - Myterials for THermal Insulation in Construction goal is to develop (in co-creation with the work field) the best available mycelium biocomposite, which can be used as a circular, biodegradable insulation material for construction in the building sector. In recent research projects partners concluded that Mycelium biocomposites have a high potential to replace traditional fossil-based isolation materials, but further research on the thermal insulation and moisture absorption is needed to convince the construction market. In the project various partners will cooperate, both from the production side of mycelium composites, as well as from the application side. Some partners originate from previous projects, but others contacted Centre of Expertise for the Biobased Economy (CoEBBE) to build further on the existing network. There are several SME’s from the Netherlands, but also from abroad (Nylausn from Iceland, Mogu Srl from Italy and Corstyrene form France), as well as Branche organizations and knowledge institutes. Avans works together with HZ in CoEBBE and for the microbiological knowledge we cooperate with the University of Utrecht. For the market research CoEBBE cooperates with the lectorate New Marketing within Avans, focussing on sustainability via biomimicry. Mycelium composites and natural products for the building industry is the theme that binds all partners.
