In solving systemic design challenges designers co-create with professionals from various fields. In the context of innovation in healthcare practices, this study investigates design abilities that healthcare professionals develop by participating in co-design projects. We conducted a mixed-methods research approach consisting of five retrospective interviews with healthcare researchers involved in co-design projects, and a multiple case study (three cases) on the collaboration between design researchers and healthcare professionals. The three cases all aimed at designing tools for healthcare innovation. The cases differ in the healthcare context and the professionals involved: Paediatric physical therapists in the treatment of babies (0-2 years), supervisors (e.g. in assisted living) of people with intellectual disabilities, and academic researchers in social sciences and design research developing e-health applications for elderly people with early stages of dementia. Literature states that healthcare professionals may be competent in specific abilities related to design, but they are not trained to mode-shift and to use two different ways of working for creativity. We found that the healthcare professionals involved in co-design projects developed design ability over time, and that the research setting was supportive. Based on design abilities that the five healthcare researchers explicated in the interviews as having adopted, we suggest eight mode-shift practices related to design, which we investigated in the cases. Findings of the case-study show that two mode-shift practices related to design and innovation are difficult to adopt for healthcare professionals: Generate and synthesize; and keeping track on overview and details. These two design abilities require more training and/or experience than the other six design abilities that ran smoothly in the cases, if healthcare professionals were facilitated in the process. Healthcare professionals specifically relate two of these practices to design: Collaboration and slow down – sprint. This study discusses these findings by referring to an analogy of kayaking on a wild water river: The collaboration aspect of switching between working in a group and by yourself, like a group of kayakers who collaborate in going down stream a river but peddle by themselves in their own boats; the slowdown and sprint aspect, like kayakers who oversee the river in turning waters and sprint in between, rather than go with the flow in a raft.
DOCUMENT
In solving systemic design challenges, designers co-create with professionals from various fields. In the context of innovation in healthcare practices, this study investigates design abilities that healthcare professionals develop by participating in co-design projects. We conducted a mixed-methods research approach consisting of five retrospective interviews with healthcare researchers involved in co-design projects, and a multiple case study (three cases) on the collaboration between design researchers and healthcare professionals. The three cases all aimed at designing tools for healthcare innovation. The cases differ in healthcare context and the professionals involved: Paediatric physical therapists in the treatment of babies (0-2 years), social workers and healthcare professionals in long-term care for people living with disabilities, and academic researchers in social behavioural sciences and design research developing e-health applications for elderly people with early stages of dementia.
DOCUMENT
To arrive at viable eHealth applications, it is important that future users are involved in research projects. In practice, however, it is difficult to involve potential users and keep them involved. In a multiple-case study, we investigate ten eHealth projects in which design researchers and healthcare researchers worked together. We focus on how they involved potential users and kept them involved. Both domains have a rich tradition of involving potential users and see their involvement of potential (future) users in the early stages of innovation as essential. Therefore it is interesting to investigate projects in which design researchers and healthcare researchers intensively work together. We discovered seven strategies to promote the involvement of potential users in eHealth research projects: (1) use research methods based on building personal relationships; (2) build trust before introducing research methods; (3) facilitate the preconditions around the moments of involvement; (4) facilitate by introducing a prototype as a boundary object; (5) choose the method that fits the research context; (6) integrate the values behind the eHealth tool into the research method; (7) involve proxies instead of the potential users. These strategies may guide future projects where design researchers and healthcare researchers work together with potential users.
DOCUMENT
Despite the increased use of activity trackers, little is known about how they can be used in healthcare settings. This study aimed to support healthcare professionals and patients with embedding an activity tracker in the daily clinical practice of a specialized mental healthcare center and gaining knowledge about the implementation process. An action research design was used to let healthcare professionals and patients learn about how and when they can use an activity tracker. Data collection was performed in the specialized center with audio recordings of conversations during therapy, reflection sessions with the therapists, and semi-structured interviews with the patients. Analyses were performed by directed content analyses. Twenty-eight conversations during therapy, four reflection sessions, and eleven interviews were recorded. Both healthcare professionals and patients were positive about the use of activity trackers and experienced it as an added value. Therapists formulated exclusion criteria for patients, a flowchart on when to use the activity tracker, defined goals, and guidance on how to discuss (the data of) the activity tracker. The action research approach was helpful to allow therapists to learn and reflect with each other and embed the activity trackers into their clinical practice at a specialized mental healthcare center.
DOCUMENT
Abstract from article: The Dutch healthcare system has changed towards a system of regulated competition to contain costs and to improve efficiency and quality of care. This paper provides: (1) a brief as-is overview of the changes for primary care, based on explorative literature reviews; (2) provides noteworthy remarks as for the way primary and secondary healthcare is organised; (3) an example of an E-health portal illustrating implemented processes within the Dutch context and (4) a proposed research agenda on various e-health topics. Noteworthy remarks are: (1) government, insurer, healthcare provider and patient are main actors within the Dutch healthcare system; (2) general practitioners (GP’s) are gatekeepers to secondary and other care providers; (3) the illustrated portal with a patient oriented design, provides access to applications implemented at care providers resulting in increased electronic availability and increased patient satisfaction; (4) a variety of fragmented information systems at health care providers exists, which leaves room for standardisation and increased efficiency. We end with suggestions for future research.
DOCUMENT
Objective: Effective healthcare innovations are often not adopted and implemented. An implementation strategy based on facilitators and barriers for use as perceived by healthcare professionals could increase adoption rates. This study therefore aimed to identify the most relevant facilitators and barriers for use of an innovative breast cancer aftercare decision aid (PtDA) in healthcare practice. Methods: Facilitators and barriers (related to the PtDA, adopter and healthcare organisation) were assessed among breast cancer aftercare health professionals (n = 81), using the MIDI questionnaire. For each category, a backward regression analysis was performed (dependent = intention to adopt). All significant factors were then added to a final regression analysis to identify to most relevant determinants of PtDA adoption. Results: Expecting higher compatibility with daily practice and clinical guidelines, more positive outcomes of use, higher perceived relevance for the patient and increased self-efficacy were significantly associated with a higher intention to adopt. Self-efficacy and perceived patient relevance remained significant in the final model. Conclusions: Low perceived self-efficacy and patient relevance are the most important barriers for health professions to adopt a breast cancer aftercare PtDA. Practice implications: To target self-efficacy and perceived patient relevance, the implementation strategy could apply health professional peer champions.
DOCUMENT
Abstract: This case study examines the use of an eHealth application for improving preoperative rehabilitation (prehabilitation). We have analysed healthcare professionals' motivators and drivers for adopting eHealth for a surgical procedure at academic medical facilities. The research focused on when and why healthcare professionals are inclined to adopt eHealth applications in their way of working? For this qualitative study, we selected 12 professionals involved in all levels of the organisation and stages of the medical process and conducted semi-structured interviews. Kotter’s transformational change model and the Technology Acceptance Model were used as analytical frameworks for the identification of the motivation of eHealth adoption. The findings suggest that contrary to Kotter’s change model, which argues that adoption of change is based on perceptions and feelings, the healthcare drivers are rational when it comes to deciding whether or not to adopt eHealth apps. This study further elaborates the observation made by the Dutch expertise centre on eHealth, Nictiz, that when the value of an eHealth pplication is clear for a stakeholder, the adoption process accelerates. Analysis of the motivations and drivers of the healthcare professionals show a strong relationship with an evidence-based grounding of usefulness and the responsibility these professionals have towards their patients. We found that healthcare professionals respond to the primary goal of improving healthcare. This is true if the eHealth application will innovate their work, but mainly when the application will improve the patient care they are responsible for. When eHealth applications are implemented, rational facts need to be collected in a study before deployment of eHealth applications on how these applications will improve the patient's health or wellbeing throughout their so-called medical journey for their treatment. Furthermore, the preference to learn about new eHealth applications from someone who speaks from authority through expertise on the subject matter, suggests adoption by healthcare professionals may be accelerated through peers. The result of this study may provide healthcare management with a different approach to their eHealth strategy. Future research is needed to validate the findings in different medical organisational settings such as regional healthcare facilities or for-profit centers which do not necessarily have an innovation focus but are driven by other strategic drivers.
DOCUMENT
This dissertation presents the results of a research project on unraveling the dynamics of facilitating workplace learning through pedagogic practices in healthcare placements. Supervisors are challenged to foster safe learning opportunities and fully utilize the learning potential of placement through stimulating active participation for students while ensuring quality patient care. In healthcare placements, staff shortages and work pressure may lead to stress when facilitating workplace learning. Enhancing pedagogic practices in healthcare placements seems essential to support students in challenging experiences, such as emotional challenges. This dissertation proposes approaches for optimizing learning experiences for students by highlighting the value of day-to-day work activities and interactions in healthcare placements, and shedding light on agency in workplace learning through supervisor- and student-strategies.
DOCUMENT
Background: Knee and hip osteoarthritis (OA) among older adults account for substantial disability and extensive healthcare use. Effective pain coping strategies help to deal with OA. This study aims to determine the long-term relationship between pain coping style and the course of healthcare use in patients with knee and/or hip OA over 10 years. Methods: Baseline and 10-year follow-up data of 861 Dutch participants with early knee and/or hip OA from the Cohort Hip and Cohort Knee (CHECK) cohort were used. The amount of healthcare use (HCU) and pain coping style were measured. Generalized Estimating Equations were used, adjusted for relevant confounders. Results: At baseline, 86.5% of the patients had an active pain coping style. Having an active pain coping style was significantly (p = 0.022) associated with an increase of 16.5% (95% CI, 2.0–32.7) in the number of used healthcare services over 10 years. Conclusion: Patients with early knee and/or hip OA with an active pain coping style use significantly more different healthcare services over 10 years, as opposed to those with a passive pain coping style. Further research should focus on altered treatment (e.g., focus on self-management) in patients with an active coping style, to reduce HCU.
DOCUMENT
Although many pilots with new eHealth products have been developed, only very few of these products reach widespread adoption within healthcare organisations. The literature mentions a wide range of bottlenecks for the acceptance of new technology in the healthcare industry, among which insufficient attention for change management and acceptance by intended users. In this paper, we argue that agile software development, with its practices for user involvement and product visibility, can be used as a change management approach in healthcare innovation projects. We compare agile methods with the change approach of Kotter (1995). As an illustration of our theoretical findings, we describe a development project of an innovative eHealth application to support the care for persons with intellectual disability.
DOCUMENT
