De digitalisering binnen de zorgsector heeft geleid tot aanzienlijke veranderingen in de manier waarop zorgdossiers worden beheerd. Voor verpleegkundigen in opleiding betekent dit dat zij moeten leren werken met deze digitale tools. Om hen hierop voor te bereiden, willen onderwijsinstellingen een zo realistisch en authentiek mogelijke leeromgeving creëren. Ondanks deze inspanningen blijven er uitdagingen bestaan bij de implementatie van didactische elektronische patiëntendossiers (EPD).
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Waar in verschillende landen al voortvarend wordt gewerkt met (varianten van) de persoonlijke gezondheidsomgeving (pgo), blijft Nederland achter. De overheid moet de regie oppakken en zorgverleners moeten stappen gaan zetten.
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Patiënten hebben het recht om hun eigen huisartsendossier in te zien. Dat heeft allerlei voordelen – zo krijgen patiënten een groter inzicht in hun eigen gezondheidstoestand en kunnen ze zich beter voorbereiden op het gesprek met de huisarts. Sommige huisartsen maken zich echter zorgen, want patiënten kunnen de informatie ook verkeerd begrijpen en nodeloos ongerust worden. Zijn dergelijke zorgen terecht?
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1e alinea column: Hoofdpijn of een wondermiddel? Huidige zorg efficiënter. Over weinig onderwerpen in de zorg is meer geschreven dan over hoe internet, mobiele data en sociale media de zorg goedkoper, beter en leuker zouden kunnen maken. Heel veel zaken zijn al beschreven de laatste 15 jaar en zitten in de pijplijn. Het inzicht is er. Het wachten is op de implementatie.
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Sinds enkele jaren is belevingsgericht werken een belangrijk concept bij het ontwikkelen van nieuwe visies omtrent zorgverlening. Ook bij de aandachtsgebieden wonen en welzijn wordt de beleving van de cliënt steeds meer als uitgangspunt genomen voor het professioneel handelen. Het project “Door denken naar doen” van het Talma Lectoraat van de Noordelijke Hogeschool Leeuwarden had betrekking op deze ontwikkeling (BGW – belevingsgericht werken). De Stichting Innovatie Alliantie (SIA) stelde hiervoor subsidie beschikbaar in het kader van de regeling Regionale Aandacht en Actie voor Kenniscirculatie (RAAK)
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This Article presents the PSO matrix as a tool for making choices in change projects – choices for simplicity or for complexity. A good process structure is essential for a simple organization, but it is the employees and the managers who are expected to take the lead in the changes and the improvement proposals. The PSO matrix is a useful and usable instrument that promotes simplicity and respects the intelligence that is already present in the organization, particularly that of the ordinary employees. The approach leads to drastic savings. Do as much nothing as possible.
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Aims: Prescribing medication is a complex process that, when done inappropriately, can lead to adverse drug events, resulting in patient harm and hospital admissions. Worldwide cost is estimated at 42 billion USD each year. Despite several efforts in the past years, medication-related harm has not declined. The aim was to determine whether a prescriber-focussed participatory action intervention, initiated by a multidisciplinary pharmacotherapy team, is able to reduce the number of in-hospital prescriptions containing ≥1 prescribing error (PE), by identifying and reducing challenges in appropriate prescribing. Methods: A prospective single-centre before- and after study was conducted in an academic hospital in the Netherlands. Twelve clinical wards (medical, surgical, mixed and paediatric) were recruited. Results: Overall, 321 patients with a total of 2978 prescriptions at baseline were compared with 201 patients with 2438 prescriptions postintervention. Of these, m456 prescriptions contained ≥1 PE (15.3%) at baseline and 357 prescriptions contained ≥1 PEs (14.6%) postintervention. PEs were determined in multidisciplinary consensus. On some study wards, a trend toward a decreasing number of PEs was observed. The intervention was associated with a nonsignificant difference in PEs (incidence rate ratio 0.96, 95% confidence interval 0.83–1.10), which was unaltered after correction. The most important identified challenges were insufficient knowledge beyond own expertise, unawareness of guidelines and a heavy workload. Conclusion: The tailored interventions developed with and implemented by stakeholders led to a statistically nonsignificant reduction in inappropriate in-hospital prescribing after a 6-month intervention period. Our prescriber-focussed participatory action intervention identified challenges in appropriate in-hospital prescribing on prescriber- and organizational level.
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Background Literature on self-management innovations has studied their characteristics and position in healthcare systems. However, less attention has been paid to factors that contribute to successful implementation. This paper aims to answer the question: which factors play a role in a successful implementation of self-management health innovations? Methods We conducted a narrative review of academic literature to explore factors related to successful implementation of self-management health innovations. We further investigated the factors in a qualitative multiple case study to analyse their role in implementation success. Data were collected from nine self-management health projects in the Netherlands. Results Nine factors were found in the literature that foster the implementation of self-management health innovations: 1) involvement of end-users, 2) involvement of local and business partners, 3) involvement of stakeholders within the larger system, 4) tailoring of the innovation, 5) utilisation of multiple disciplines, 6) feedback on effectiveness, 7) availability of a feasible business model, 8) adaption to organisational changes, and 9) anticipation of changes required in the healthcare system. In the case studies, on average six of these factors could be identified. Three projects achieved a successful implementation of a self-management health innovation, but only in one case were all factors present. Conclusions For successful implementation of self-management health innovation projects, the factors identified in the literature are neither necessary nor sufficient. Therefore, it might be insightful to study how successful implementation works instead of solely focusing on the factors that could be helpful in this process.
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This Article presents the PSO matrix as a tool for making choices in change projects – choices for simplicity or for complexity. A good process structure is essential for a simple organization, but it is the employees and the managers who are expected to take the lead in the changes and the improvement proposals. The PSO matrix is a useful and usable instrument that promotes simplicity and respects the intelligence that is already present in the organization, particularly that of the ordinary employees. The approach leads to drastic savings. Do as much nothing as possible.
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