Bipolar disorder is a severe mental illness with serious consequences for daily living of patients and their caregivers. Care as usual primarily consists of pharmacotherapy and supportive treatment. However, a substantial number of patients show a suboptimal response to treatment and still suffer from frequent episodes, persistent interepisodic symptoms and poor social functioning. Both psychiatric and somatic comorbid disorders are frequent, especially personality disorders, substance abuse, cardiovascular diseases and diabetes. Multidisciplinary collaboration of professionals is needed to combine all expertise in order to achieve high-quality integrated treatment. 'Collaborative Care' is a treatment method that could meet these needs. Several studies have shown promising effects of these integrated treatment programs for patients with bipolar disorder. In this article we describe a research protocol concerning a study on the effects of Collaborative Care for patients with bipolar disorder in the Netherlands.
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Abstract Background: Approximately one-third of all patients with schizophrenia are treatment resistant. Worldwide, undertreatment with clozapine and other effective treatment options exist for people with treatment-resistant schizophrenia (TRS). In this respect, it appears that regular health care models do not optimally fit this patient group. The Collaborative Care (CC) model has proven to be effective for patients with severe mental illness, both in primary care and in specialized mental health care facilities. The key principles of the CC model are that both patients and informal caregivers are part of the treatment team, that a structured treatment plan is put in place with planned evaluations by the team, and that the treatment approach is multidisciplinary in nature and uses evidence-based interventions. We developed a tailored CC program for patients with TRS. Objective: In this paper, we provide an overview of the research design for a potential study that seeks to gain insight into both the process of implementation and the preliminary effects of the CC program for patients with TRS. Moreover, we aim to gain insight into the experiences of professionals, patients, and informal caregivers with the program. Methods: This study will be underpinned by a multiple case study design (N=20) that uses a mixed methods approach. These case studies will focus on an Early Psychosis Intervention Team and 2 Flexible Assertive Community treatment teams in the Netherlands. Data will be collected from patient records as well as through questionnaires, individual interviews, and focus groups. Patient recruitment commenced from October 2020. Results: Recruitment of participants commenced from October 2020, with the aim of enrolling 20 patients over 2 years. Data collection will be completed by the end of 2023, and the results will be published once all data are available for reporting. Conclusions: The research design, framed within the process of developing and testing innovative interventions, is discussed in line with the aims of the study. The limitations in clinical practice and specific consequences of this study are explained.
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Horizontal collaborative purchasing (HCP) has often been cited as a way for hospitals to address the challenges of the rising healthcare costs. However, hospitals do not seem to utilize horizontal collaborative purchasing on any large scale, and recent initiatives have had mixed results. Focusing on Dutch hospitals, in this paper we present major impediments for collaborative purchasing, resulting in a first component of our proposed electronic horizontal collaborative purchasing model for hospitals; as a second component it contains a collaborative purchasing typology. A first validation round with hospital purchasing professionals, described separately in Kusters and Versendaal (2011), confirmed four applicable purchasing types and fourteen salient collaborative purchasing impediments. The model is operationalized by including possible information technology (IT) solutions that address the specific fourteen impediments. This model is validated through methodological triangulation of four different validation techniques. We conclude that IT has the potential to support, or overcome, the impediments of HCP. The validation also reveals the need to distinguish between more processrelated, as opposed to social-related, obstacles; the immediate potential for IT solutions is greater for the process-related impediments. Ultimately, we conclude that the collaborative epurchasing model (e-HCP) and implementation roadmap can be used by healthcare consortia, branche organizations, partnering healthcare institutes and multi-site healthcare institutes as a means to help identifying strategies to initiate, manage and evaluate collaborative purchasing practices
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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.
Het doel van dit interdisciplinaire SIA KIEM project Fluïde Eigenschap in de Creatieve Industrie is te onderzoeken of en hoe gedeelde vormen van eigenaarschap in de creatieve industrie kunnen bijdragen aan het creëren van een democratischer en duurzamer economie, waarin ook het MKB kan participeren in digitale innovatie. Het project geeft een overzicht van beschikbare vormen van (gedeeld) eigenaarschap, hun werking en hoe deze creatieve professionals kunnen ondersteunen bij de transitie naar de platformeconomie. Dit wordt toegepast op een concrete case, dat van een digitale breimachine. Naast het leveren van een goede praktijk, moet het project leiden tot een groter internationaal onderzoeksvoorstel over Fluid Ownership in the Creative Industry, dat dieper ingaat op de beschikbare eigendomsoplossingen en hoe deze waarde zullen creëren voor de creatieve professional.
