Assistive technology supports maintenance or improvement of an individual’s functioning and independence, though for people in need the access to assistive products is not always guaranteed. This paper presents a generic quality framework for assistive technology service delivery that can be used independent of the setting, context, legislative framework, or type of technology. Based on available literature and a series of discussions among the authors, a framework was developed. It consists of 7 general quality criteria and four indicators for each of these criteria. The criteria are: accessibility; competence; coordination; efficiency; flexibility; user centeredness, and infrastructure. This framework can be used at a micro level (processes around individual users), meso level (the service delivery scheme or programme) or at a macro level (the whole country). It aims to help identify in an easy way the main strengths and weaknesses of a system or process, and thus guide possible improvements. As a next step in the development of this quality framework the authors propose to organise a global consultancy process to obtain responses from stakeholders across the world and to plan a number of case studies in which the framework is applied to different service delivery systems and processes in different countries.
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More than 25!years after Moore’s first introduction of the public value concept in 995, the concept is now widely used, but its operationalization is still considered difficult. This paper presents the empirical results of a study analyzing the application of the public value concept in Higher Education Institutions, thereby focusing on how to account for public value. The paper shows how Dutch universities of applied sciences operationalize the concept ‘public value’, and how they report on the outcome achievements. The official strategy plans and annual reports for FY2016 through FY2018 of the ten largest institutions were used. While we find that all the institutions selected aim to deliver public value, they still use performance indicators that have a more narrow orientation, and are primarily focused on processes, outputs, and service delivery quality. However, we also observe that they use narratives to show the public value they created. In this way this paper contributes to the literature on public value accounting.
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Background:Following the onset of the COVID-19 pandemic, telerehabilitation (TR) has been expanding to address the challenges and risks of in-person delivery. It is likely that a level of TR delivery will continue after the pandemic because of its advantages, such as reducing geographical barriers to service. Many pandemic-related TR initiatives were put in place quickly. Therefore, we have little understanding of current TR delivery, barriers and facilitators, and how therapists anticipate integrating TR into current practice. Knowing this information will allow the incorporation of competencies specifically related to the use and provision of TR into professional profiles and entry-to-practice education, thereby promoting high-quality TR care.Objective:This study aimed to obtain a descriptive overview of current TR practice among rehabilitation therapists in Canada and the Netherlands and identify perceived barriers to and facilitators of practice.Methods:A web-based cross-sectional survey was conducted with occupational, physical, and respiratory therapists and dietitians in Canada (in French and English) and the Netherlands (in Dutch and English) between November 2021 and March 2022. Recruitment was conducted through advertisements on social media platforms and email invitations facilitated by regulatory and professional bodies. The survey included demographic and practice setting information; whether respondents delivered TR, and if so, components of delivery; confidence and satisfaction ratings with delivery; and barriers to and facilitators of use. TR satisfaction and uptake were measured using the Telehealth Usability Questionnaire and modified Technology Acceptance Model. Data were first summarized descriptively, and then, comparisons were conducted between professions.Results:Overall, 723 survey responses were received, mostly from Canada (n=666, 92.1%) and occupational therapists (n=434, 60%). Only 28.1% (203/723) reported receiving specific training in TR, with 1.2% (9/723) indicating that it was part of their professional education. Approximately 19.5% (139/712) reported not using TR at all, whereas most participants (366/712, 51.4%) had been using this approach for 1 to 2 years. Services delivered were primarily teleconsultation and teletreatment with individuals. Respondents offering TR were moderately satisfied with their service delivery and found it to be effective; 90.1% (498/553) indicated that they were likely to continue offering TR after the pandemic. Technology access, confidence, and setup were rated the highest as facilitators, whereas technology issues and the clinical need for physical contact were the most common barriers.Conclusions:Professional practice and experience with TR were similar in both countries, suggesting the potential for common strategic approaches. The high prevalence of current practice and strong indicators of TR uptake suggest that therapists are likely to continue TR delivery after the pandemic; however, most therapists (461/712, 64.7%) felt ill prepared for practice, and the need to target TR competencies during professional and postprofessional education is critical. Future studies should explore best practice for preparatory and continuing education.
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Service design is literally the design of services. Service designers improve existing services or design completely new ones. Nothing new so far. Services have been around for centuries, and every service was conceived and designed by someone. However, service design takes a different angle; a different perspective as its starting point: it is a process of creative inquiry aimed at the experiences of the individual user. ‘Service design, insights from 9 case studies’ is the final publication of the Innovation in Services programme. During this programme, creative design agencies applied the methods of service design in nine different projects.
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The vast literature on accountability in the public sector (usually called ‘public accountability’originating from political science and public administration tends to emphasize the positive dimension of holding authorities to account. As formulated by one prominent scholar in the field, ‘[a]ccountability has become an icon for good governance’: it is perceived as ‘a Good Thing, and, so it seems, we can’t have enough of it’ (Bovens, 2005: 182, 183). Accountability has, thus, become one of the central values of democratic rule – varying on a well-known American slogan one could phrase this as ‘no public responsi bility without accountability’.
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The Dutch government, in alignment with the Paris climate agreement, has expressed the ambition to reduce CO 2 emissions in the Netherlands by 49% in 2030 compared to 1990. As freight transport is recognized as a serious CO 2 emitter, this sector is confronted with a substantial part of the target. For cities, the reduction of the urban freight transport emissions is, next to the CO 2 reduction, also important to improve the air quality. Dutch municipalities take an active role in coordination, facilitation and acceleration of the emission reduction processes, not only via regulation but also by using their public procurement power. This paper describes the City of Rotterdam's experiences from the EU Horizon 2020 BuyZET project. This project was launched in November 2016 and includes the cities of Rotterdam, Oslo and Copenhagen. The project aims at understanding and optimising the impact of public procurement activities on transport patterns and emissions in cities as well as to find innovative and sustainable delivery solutions for goods and services-related transport in order to reduce emissions.
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Abstract Objective: To describe changes in the health service delivery process experienced by professionals, patients and informal caregivers during implementation of a national programme to improve quality of care of geriatric rehabilitation by improving integration of health service delivery processes. Study setting: Sixteen skilled nursing facilities. Study design: Prospective study, comparing three consecutive cohorts. Data collection: Professionals (elderly care physicians, physiotherapists and nursing staff) rated four domains of health service delivery at admission and at discharge of 1075 patients. In addition, these patients [median age 79 (Interquartile range 71–85) years, 63% females] and their informal caregivers rated their experiences on these domains 4 weeks after discharge. Principal findings: During the three consecutive cohorts, professionals reported improvement on the domain team cooperation, including assessment for intensive treatment and information transfer among professionals. Fewer improvements were reported within the domains alignment with patients’ needs, care coordination and care quality. Between the cohorts, according to patients (n = 521) and informal caregivers (n = 319) there were no changes in the four domains of health service delivery. Conclusion: This national programme resulted in small improvements in team cooperation as reported by the professionals. No effects were found on patients’ and informal caregivers’ perceptions of health service delivery.
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De focus binnen het lectoraat is gericht op botsende waarden. Publieke organisaties onderscheiden zich op vele punten van private organisaties en hebben unieke publieke waarden. In vele westerse en niet westerse landen zien wij New Public Management opkomen. De kern van deze benadering is dat de verschillen tussen publieke en private organisaties helemaal niet zo groot zijn en dat publieke organisaties kunnen leren van het bedrijfsleven. In het onderzoek van het lectoraat wordt, aan de hand van het thema prestatiemeting, nagegaan in hoeverre er sprake is van botsende waarden, hoe deze botsing tot uitdrukking komt en welke alternatieven er zijn. Het onderzoek van het lectoraat richt zich vooral op prestatiemeting in de publieke sector, waarbij prestatiemeting zowel wordt beschouwd op het niveau van de individuele werknemer als op het niveau van de publieke organisatie als geheel.
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The definition of ‘Assistive Technology’ (AT) includes both assistive products and the services or actions necessary for safe and effective provision of the assistive products to people who need them. International standards and product specifications exist for assistive products. Despite huge unmet need for effective AT provision, a variety of service delivery models across different countries, and a shortage of personnel trained in this field, nowidely useable and accepted AT service provision guidelines currently exist. Aligned with contemporary global initiatives to improve access to AT, a scoping review was commissioned to inform the development of globally useable provision guidance. The aim was to deliver a rapid scoping review of the literature regarding quality guidelines for AT service provision. Method: The rapid scoping review utilised a two-tiered approach to identifying relevant publications: 1) systematic search of academic databases; 2) consultation with assistive technology organisations. The review was conducted in March 2023 across four databases (Medline, CINAHL, SCOPUS and Google Scholar) with no date limitations. Systematic outreach to international and global AT networks was used to access expert informants. Non-English publications were included utilizing Google Translate and support from expert informants to verify content. Analysis was guided by the body of work on quality AT provision and service delivery processes in Europe, as well as the World Health Organization-GATE 5P framework for strengthening access to AT. Results: The search strategies yielded 41 publications from diverse countries, and directed at differing assistive products, personnel and provision contexts. Results are reported from the charted data through to the data extraction framework, including type of publication, study design, audience and reach. We report on the type of AT and the AT provision ecosystem elements discussed, and service delivery process or steps and quality criteria service delivery. Conclusion: This review did not find established guidelines or standards for service provision, but it did identify key service delivery steps which may form part of such guidelines, and many of the 3 publications included mentioned the need for practice guidelines. Despite different contexts such as type of assistive product, recipient of the guidance, language, location and authorship, core elements of AT provision including service delivery steps can be identified. Consideration regarding the nuances of vocabulary, of process, and of enabling flexible foci, is recommended in systematizing globally applicable guidance. This review offers a strong starting point for developing guidance for assistive technology provision to meet global need.
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Introduction: Nowadays the Western mental health system is in transformation to recovery-oriented and trauma informed care in which experiential knowledge becomes incorporated. An important development in this context is that traditional mental health professionals came to the fore with their lived experiences. From 2017 to 2021, a research project was conducted in the Netherlands in three mental health organizations, focussing on how service users perceive the professional use of experiential knowledge. Aims: This paper aims to explore service users’ perspectives regarding their healthcare professionals’ use of experiential knowledge and the users’ perceptions of how this contributes to their personal recovery. Methods: As part of the qualitative research, 22 service users were interviewed. A thematic analysis was employed to derive themes and patterns from the interview transcripts. Results: The use of experiential knowledge manifests in the quality of a compassionate user-professional relationship in which personal disclosures of the professional’s distress and resilience are embedded. This often stimulates users’ recovery process. Conclusions: Findings suggest that the use of experiential knowledge by mental health professionals like social workers, nurses and humanistic counselors, demonstrates an overall positive value as an additional (re)source.
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