In most countries, maternal and newborn care is fragmented and focused on identification and treatment of pathology that affects only the minority of women and babies. Recently, a framework for quality maternal and newborn care was developed, which encourages a system-level shift to provide skilled care for all.This care includes preventive and supportive care that works to strengthen women’s capabilities and focuses on promotion of normal reproductive processes while ensuring access to emergency treatment when needed. Midwifery care is pivotal in this framework, which contains several elements that resonate with the main dimensions of primary care. Primary health care is the first level of contact with the health system where most of the population’s curative and preventive health needs can be fulfilled as close as possible to where people live and work. In this paper, we argue that midwifery as described in the framework requires the application of a primary care philosophy for all childbearing women and infants. Evaluation of the implementation of the framework should therefore include tools to monitor the performance of primary midwifery care.
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Physiotherapy, Dietetics and Occupational Therapy have been collaborating over recent years to develop an optimal healthcare programme for patients with Post Intensive Care Syndrome (PICS). This case is an example of PICS symptomatology and focuses on the collaboration between Physiotherapy and Dietetics. What is PICS? Owing to healthcare improvements, more and more patients are surviving the intensive Care Unit (ICU), and recovery during and after ICU stay has been receiving more attention [1, 2]. Approximately 30% of the patients admitted to an ICU have persistent symptoms including muscle weakness, reduced walking ability, fatigue, concentration deficits, memory problems, malnutrition, sleep and mood disorders sometimes even years after discharge [3-8]. Since 2012, this combination of physical, cognitive and psychiatric manifestations and reduced quality of life after staying in an ICU has been recognised as Post Intensive Care Syndrome (PICS) [9]. The impact of PICS is often not limited to the patient as it may also impact the mental status of the patient’s immediate family. This is known as PICS-Family (PICS-F) [10-12]. Treatment of PICS: Approximately 80% of PICS patients need primary care physiotherapy. Physiotherapists and GPs are often the only primary care professionals involved in the recovery process of these patients after hospital discharge [13, 14]. Both patients and healthcare professionals report a number of difficulties, e.g. limited transmural continuity in healthcare, coordination of multidisciplinary activities, supportive treatment guidelines and specific knowledge of pathology, treatment and prognosis. Patients report that they are not adequately supported when resuming their professional activities and that medical and allied healthcare treatments do not fully meet their needs at that time [15-18]. The REACH project: In order to improve the situation, the REACH project (REhabilitation After Critical illness and Hospital discharge) was started in Amsterdam region in the Netherlands. Within REACH, a Community of Practice – consisting of professionals (physiotherapists, occupational therapists, dieticians), those who live or have lived with the condition and researchers – has developed a transmural rehab programme. A special attribute of this programme is the integration of the concept of “positive health”. The case in this article describes the treatment of a PICS patient treated within the REACH network.
The complexity of Information Technology (IT) is increasing; so are customer expectations. Consequently it is not easy for especially small and medium enterprises (SMEs) to keep track of all IT-developments, let alone leverage them in business operations with the aim to satisfy increasingly demanding customers. This also holds for the health care sector. This research is focussed on first line health care, and deals with the following research question; ‘which IT capabilities do SMEs within the first line health care sector need to have at their disposal in order to reach Business/IT-Alignment (BITA) maturity?’ Using the best practices ITIL, ASL and BiSL (cf. Bon, et al. 2007), IT capabilities are formulated. Based on the theory of Luftman (2000) business/IT-alignment and maturity is measured. Quantitative research of 123 first line health care SMEs in the Netherlands, confirms a moderate to strong correlation between the IT capability constructs ‘Organisation’, ‘Processes’, ‘Knowledge’ and ‘People’ on the one hand, and BITA maturity on the other. The results indicate that SMEs within the first line health care sector should invest in IT capabilities related to the enterprise's ‘Organisation’ and ‘Processes’ to strive for increased business and IT maturity.
Value-based healthcare (VBHC) kent een aandoening-specifieke aanpak, gericht op een zorgpad na diagnose en start van behandeling. De aanpak is nog sterk ziekenhuiszorg- georiënteerd en zou zich meer op de volledige zorgcyclus moeten richten. In dit project gaan we onderzoeken hoe preventie geïntegreerd kan worden in de VBHC-benadering. Hiervoor gaan we voor hartrevalidatie in kaart brengen hoe uitkomstinformatie, inclusief patiënt-gerapporteerde uitkomsten, ingezet kan worden bij het samen beslissen over gepersonaliseerde zorg en preventie. Het consortium bestaat uit MKB-partner PRO-F (e-health hartrevalidatie), praktijkpartners Medisch Spectrum Twente (Santeon-Ziekenhuis, thoraxcentrum) en Santeon (samenwerkingsverband zeven topklinische ziekenhuizen), Saxion lectoraten Verpleegkunde en Waarde van Reclasseren (maatschappelijke impact) en Hanzehogeschool lector Waardegedreven Zorg. Door middel van literatuuronderzoek en kwalitatief onderzoek wordt verkend waar de kansen liggen voor het integreren van secundaire preventie in de VBHC-benadering in de hartrevalidatie. Aan de hand van drie focusgroepen met patiënten, verpleegkundigen/artsen en experts worden de voor de patiënt relevante zorguitkomsten verhelderd. Op basis hiervan wordt de vertaalslag gemaakt naar gepersonaliseerde zorguitkomsten en hoe e-health oplossingen dit proces kunnen ondersteunen. Hiermee bieden we (1) inzicht in de mogelijkheden voor preventie binnen de VBHC-werkwijze, (2) kennis over hoe gepersonaliseerde zorg en samen beslissen gefaciliteerd kunnen worden, (3) inzicht in de rol die e-health oplossingen kunnen spelen, (4) kennis over de rol van de verpleegkundige in dit vraagstuk, en (5) een kwalitatief beeld van de impact hiervan.
