bluuebunny/crossref_metadata_2025 huggingface dataset:
No compassion, together in action!
Authors: Pitteljon Grietje
Published: January 2024

Start a caring neighborhood from the direction of people with a specific vulnerability (autism) with the support of very diverse actors, it is possible!

De Vijver (organization that supports people with disabilities) went in search of interesting places in the neighborhood with people with autism and connects them to a short walk. Around those places we went together with schools in the neighborhood, the art academy, service centers for the elderly, to make texts, images, works of art and videos. These were canned and put behind a QR code. Anyone who takes the walk in the area can discover the many stories via the QR code at each spot. To launch the walking route, a work of art was made with neighbours at the starting point of the route for 4 weeks.

The objective of this approach was, on the one hand, to see vulnerable people not always as people seeking  for help, but as a very valuable actor in a neighbourhood. On the other hand, we also wanted to create the first basic condition for strengthening living together and caring for each other in a neighbourhood, namely getting to know each other organically by building something for the neighborhood together.

In this workshop we will show you how we succeeded.

We also zoom in on the difficulties we encountered and the keys to success. We let you enjoy live images of how everything came about.

Then we want to confront our approach with your experiences.

We end with some take home messages.
LGBTQ+ persons access to (person-centred) care according to posts on Twitter.
Authors: Van Diepen Cornelia , Rosales Diego
Published: January 2024

This project follows the premise of person-centred care (PCC) as a holistic model of care in which all persons are included, and their preference and needs are incorporated in the care process. A group for which this is particularly important are lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) healthcare seekers. They are often discriminated against and occasionally refused treatment because the healthcare system does not recognise their needs. This project aims to see their unique perspective on their healthcare treatment and the need for PCC. The study presented here is displaying voices that would otherwise go unheard and social media is a place where these marginalised groups interact express their opinions and experiences.

This study focuses on access to healthcare and what barriers and facilitators are present in the tweets on this subject. This study’s data are gathered through tweets as, although somewhat widespread in a population, the LGBTQ+ community comes together on social network platforms. For this study, both English and Spanish tweets are sought to investigate this issue as this is a trending topic in both the USA and Latin-America.

Public and Patient involvement was applied in this study so that a LGBTQ+ individual could help with the search terms and interpretation of the results. Another public partner was added for the translation of the Spanish tweets to ensure that the meaning behind the tweets was preserved. This last partner cowrote a pilot paper and was involved in writing this study too.

The results showed that most of the barriers can be found in society outside of healthcare. Political agendas, religious beliefs and xenophobia were at the forefront of the barriers. LGBTQ+ persons experience challenges with opposing legislation as well as stigma and misunderstandings. With the political debate the distance to receiving quality care increased. Most facilitators were only accessible when the person receives care. The healthcare providers were clear that societal opposition would not affect the hypocritic oath.

This study confirms that for this marginalised group, researching them once they are in healthcare is too late as much of the barriers are presented before. Research should be more inventive and finding different ways (such as through tweets) to reach these groups that need PCC but have difficulty getting there.

The next step is a larger project in which not only the tweets are analysed but the LGBTQ+ Twitter users are asked for interviews to uncover the context of the tweet and the entire experience of barriers and facilitators to healthcare.
"More than a visitor: Family participation in the hospitalized patient’s care process, as a partner in care."
Authors: Ameye Phoebe
Published: January 2024

Family participation is gaining importance as part of the Patient-Centered Care principle. Therefore, as part of the 'more than a visitor' project, family participation in taking care of the hospitalized patient is being explored.

The focus target group in this policy is mainly the patient and his family, (can also be the family caregiver) but should also relieve the workload on the nurses.

In response to the need to integrate this policy within the hospital, we started by creating a steering committee consisting of people from multidisciplinary branches. After concretizing the policy, it was implemented in our hospital starting with a pilot department.  Through our website, newspaper and other social media accounts, the new policy was brought to the attention of the larger public and announced to patients and their families.

The entire procedure was carried out according to the principles of the PDCA (Plan Do Check Act) quality cycle. A literature study was conducted on family participation through Dutch- and English-language scientific articles. Based on this, a questionnaire was prepared for patients, relatives and nurses. From these data, a prototype was developed, with an implementation and communication plan.

The literature study showed that everyone sees advantages and disadvantages in designating a partner in care. Further analysis in practice confirmed this result. In general, what emerges strongly during these observations is that family participation can be a valuable addition in guaranteeing continuity of care and thereby increasing the quality of care and reducing the length of hospitalization by average of 1 day since the start of integration. (data obtained in AZ Groeninge from 2017-2022)

The partner in care policy has shown to be effective if it is correctly applied on a multidisciplinary level within the departments.

While analyzing how the policy is understood within the wards, we noted that several factors need improvement. These include focusing on nurse knowledge of the policy through physical training, testimonials from patients and their families (whether partner in care or not), improved patient and family information resources on the topic. Further follow-up will be necessary to complete the policy in the long term.
Employment of working-age adults (18-65 year old) with a visual impairment at an ambulatory visual rehabilitation centre (de Markgrave) in Belgium
Authors: De Veuster Ilse , Bastiaens Caroline
Published: January 2024

Aim of the study: determining the rate of employment in adult people with a visual impairment who are using the services of de Markgrave. Examining associated characteristics and gathering data to better understand the problems (and improve our support to enhance their chances on the labour market. )

Methods: we review the records of adults between 18 and 65 years of age who consulted our visual rehabilitation centre between September the first 2020 and October the first 2022. Separate attention is given to the records of people who seek our support in case of a work-related care demand. The studied population is divided into three different age groups : 18 to 35 years of age, a second group of people between 36 and 50 years and the last group of 51 up to 65 years. 

Results: we look at the type of work, previous work experiences and employment status defined as paid work ( including self employment ) versus not employed ( no paid work including retirement, student, active work seeker, disability benefits, volunteered work, ..).  

Barriers to work or to continue working together with facilitators ( like social benefits for the employer) are being analyzed. We look separately at personal factors and work related issues. Visual problems are divided according to age of onset, stable or progressive, degree ( mild, moderate, severe) and associated with additional health problems. For the work related items architectural issues and mobility problems together with social difficulties ( conflicts with colleagues and leading ) and adaptation of the working place will be listed. 

Conclusion: the results of our study will give us insight in the problems visually impaired people encounter during their working age. The gathered / collected knowledge wil help us to improve/ ameliorate our support in their quest for more suitable working environments.
Advancing Collaborative Mental Health Care in Canada’s Primary Care Settings: A National Quality Framework with Recommended Measures
Authors: Ta Uyen
Published: January 2024

Collaborative mental health care involves primary care providers and mental health specialists working together in structured ways to improve access to care, quality of care and outcomes. Collaborative mental health care is a proven approach to improve timely access to evidence-informed care, individual health outcomes, patient experience of care, equitable health care delivery and outcomes across populations, and cost-effectiveness of care. However, its implementation in Canadian primary care settings is variable and do not necessarily align with research evidence. This has led to a knowledge-to-practice gap regarding the comparative effectiveness of the different collaborative mental health care practices that teams and organizations may use to achieve desired outcomes. The Mental Health Commission of Canada (MHCC) and its partners are pleased to share a pan-Canadian evidence-based framework for planning and measuring quality collaborative care. The report, “Advancing Collaborative Mental Health Care in Canada’s Primary Care Settings: A National Quality Framework with Recommended Measures” is the result of a two-year project led by the Quality Improvement for Collaborative Care (QI4CC) research team and is based on extensive consultations with providers, planners, and people with lived experience. A qualitative study was used to explore the current state of collaborative care across Canada and determine how to define and measure its quality and the project team engaged a multi-stakeholder group throughout the entire project to get feedback on the research process and findings and to refine and finalize the framework. The resulting revised Quality Improvement for Collaborative Care (QI4CC) framework was developed to assist stakeholders in organizing and delivering primary care mental health and addictions services. The framework is intended to help leaders in practice and policy put in place needed supports and structures to achieve successful implementation of good practices in collaborative care as well as recommending quality measures to prioritize when evaluating collaborative care initiatives in primary care practices.

Learning Objectives:

1. Have a better understanding of collaborative mental health care in primary care settings

2. Provide an overview of the Quality Improvement for Collaborative Care framework and the key components in delivery of effective collaborative mental health care

3. Identify recommended measures to evaluate and improve the quality of collaborative care in primary health settings

4. Explore opportunities to apply the QI4CC framework for an international audience 

Target Audience: health-care providers – especially those involved in delivering mental health care in primary care settings, administrative leaders of health services, policymakers, and champions of collaborative care in mental health and addictions services (includes people with lived and living experience)
Factors associated with the extent of nurses’ involvement in promotion of the nursing profession: A study among nurses working in diverse healthcare settings.
Authors: Rozani Violetta , Kagan Ilya
Published: January 2024

Aims and objectives: To examine factors associated with promotion of the nursing profession, to the nursing community, other healthcare professionals and the general public, by nurses employed in diverse healthcare settings.

Background: Little is known about the factors that contribute to nurses’ involvement in the promotion of the nursing profession.

Methods: The study population comprises a convenience sample of registered nurses (n=526) with ≥3 months’ experience in nursing, who are employed in internal and surgical units, pediatric wards, psychiatric wards, or in the community across Israel. Participants completed a self-administered questionnaire addressing socio-demographic, occupational and organizational factors relating to the nursing work environment and to the extent of nurses' involvement in promotion of the nursing profession. Descriptive statistics, one-way analysis of variance, Pearson's correlation analysis, and multivariate linear regression were performed.

Results: Nurses in all the surveyed healthcare settings reported relatively low levels of involvement in promotion of the profession, either to the nursing community or to other healthcare professionals and the public. Being a female-nurse was significantly negatively associated with nurses' involvement in promotion of the nursing profession. In contrast, holding a master’s degree in nursing, having a managerial role, and working in a supportive organizational nursing work environment were the principal factors associated with positive promotion of the nursing profession.

Conclusion: The extent of nurses' involvement in promotion of the nursing profession mainly depends on occupational factors and a supportive organizational nursing work environment.

Clinical Relevance: Healthcare managers may advance nurses’ involvement in promotion of the profession by modifying the organizational nursing work environment. Specifically, we recommend nurse leaders to dedicate efforts to make professional promotion an integral part of a nurse’s role.
Understanding inpatient acuity grading in hospitalised patients in an integrated care model
Authors: Bundele Anjali , Mukhopadhyay Amartya , Sumner Jennifer , Hong Wei Zhen
Published: January 2024

Background: An integrated care model was introduced at Alexandra hospital in 2018. A key feature of the model is the acuity grading system, wherein admitted patients are assigned to either L3(Acute), L2(subacute) and L1(non-acute and rehabilitation). Currently, acuity-grade is assigned based solely on the clinical judgement of the attending clinicians. The assigned acuity determines the frequency of parameter-monitoring and clinician contact time. The acuity level is evaluated daily and reassigned when indicated.

Aim:  To examine the consistency of acuity-grading in various clinical scenarios and explore the factors considered while assigning acuity.

Methods: We adopted a mixed-method approach. Physicians(n=66) from all medical specialities were surveyed on their decision making skills based on ten hypothetical scenarios. The data were used to determine agreement between physicians on their assessment of the severity and acuity-grade assignment.  Subsequently, focus group discussions are planned with clinicians to understand what factors influence their decisions, and how do they rank each of these factors in terms of value in determining acuity.

Results: The survey demonstrated good agreement among clinicians on assigning acuity-grades to the clinical scenarios presented to them. But understanding the factors that should be taken into consideration while acuity is decided is crucial for the success of the model of care. We aim to achieve this through the focus group discussions that will commence in the immediate future.

Conclusions: A clear understanding of factors and criteria that currently constitute a clinician’s “gut sense/clinical acumen” is essential to ensure the right acuity-assignment and the corresponding care of the hospitalized patients. This will enable optimum allocation and utilisation of resources.
Ageing well in place: EET as an answer to the need for integrated care and support
Authors: Dierckx Eva , Lauwereys Katrien , Haekens An , Abrahams Katrijn , Beyen Anne
Published: January 2024

Background: Older people prefer to stay as long as possible in their own home and environment. However, as people age, they are typically confronted with age-related declines on different domains; often leading to multidimensional (physical, psychological, social and environmental) frailty, which is associated with an increased vulnerability to adverse health outcomes and a decrease in wellbeing. In order to age well at home, one must shift from the (often) current fragmented, supply-driven support to a more integrated and multidisciplinary demand-driven support that focuses on the wants and needs of older people and their caregivers.

The Elder Expertise Team in Tienen (Belgium): Currently, as also mentioned by our stakeholders of informal caregivers, there is insufficient continuity and coherence between the different disciplines involved in the support and care at various echelons. This often leads to non-transparency, not only for older frail people but also for their informal and formal caregivers. As a result, the problems are not recognized, nor treated in time, leading to a threatening of the autonomy, participation in society, health and wellbeing and often leading to an admission into a residential care facility.

To address this need, in Tienen, the “Elderly Expertise Team (EET)” was established in 2019 with the objective of enabling frail elderly people to live at home for as long and as qualitatively as possible by offering the most appropriate care and support. The EET has a multidisciplinary, cross-sector and cross-organizational composition, using a network-oriented approach.  In order to give an answer to multidimensional frailty, besides healthcare partners also partners from welfare are part of the EET.

The EET serves as a “single point of entry” which coordinates care and support across a network of different care and support providers. The EET uses a stepped-care approach: (1) one starts with giving (general) advice by phone, (2) if there is a need for additional case-specific support an assessment and/or screening is  done, leading to case-specific tailored advice and a short-term treatment of up to 5 sessions is provided; (3) if necessary, a referral to more specialized care is done. Besides the care for older persons and their caregivers, the EET also provides coaching, trainings and intervisions for formal caregivers. This all results in better and integrated care and support, leading to reduced admissions to residential care and a better wellbeing for the older person and his/her context.

Future: Currently, the EET works mainly at the intervention level. However, in the future a more population-based approach using risk-profiles for multidimensional frailty and doing pro-active home visits might also lead to a better casefinding and prevention of frailty. Moreover, as the focus is now on clinical and service integration, the EET recognizes the need for functional integration by means of shared electronic patient records.
Coaching Leadership in Small Scale Normalized Living
Authors: Proost Antje , Robberechts Griet
Published: January 2024

Our human resources policy not only seeks to anticipate current developments but also wishes to play a pioneering role. This starts with a strong vision in which employees are partners in the organization of care and not mere suppliers of care. Where giving and taking responsibility, open communication and autonomy in connection are realized (and not hollow concepts). This also means that we are a flat organization where there are few or no hierarchical structures. The demand from employees for more collaboration, a different model of leadership, the convergence of responsibilities and authority was a clear message for us to tackle the organization thoroughly. A good organization is crucial for a company to function well. This includes having competent employees, sufficient finances and adequate equipment.

Innovative labor organization

According to the IAO (Innovative Labor Organization) method, we want to examine in each of the four residential care centers how we can come to a team that has sufficient  regulatory capacity to

work autonomously with responsible employees;

ensure the quality care that we use in our vision;

have sufficient manageability and flexibility for this;

create more innovative capacity;

with sufficient participation;

in mutual cooperation.

Step by step we discovered that the IAO fits seamlessly with the operating principles of Small Scale Normalized Living. From our strong belief in the power of the capacities and competencies of employees and the continuous will to invest in employees, the step to this new organizational model is a logical next step. An obvious choice that also led to confrontations: how do we distribute tasks and responsibilities in the organization today? Do we really give employees the necessary autonomy that they need? Do we let employees shine sufficiently in all their potential? Do we involve them in those processes in which they need to be involved? Which sub-processes run centrally or decentralized?

With a critical eye and the constant desire to improve, we laid the foundation for the care model of the future.
Social and Psychological Long-Term Consequences of NMDA Receptor Encephalitis (SAPIENCE) - from patients’ views to patient-centred care
Authors: Kurpas Donata , Duda-sikuła Marta , Finke Carsten , Dalmau Josep , Honnorat Jérôme , Heine Josephine , Mendes Álvaro , Howard Fuchsia
Published: January 2024

Background and target population: NMDA receptor encephalitis is a rare autoimmune disease with severe neurological and neuropsychiatric symptoms but typically a good functional neurological outcome. Nevertheless, most patients suffer long-term cognitive, psychological, and social impairments that have a significant impact on their well-being and occupational or educational activities-this is of particular concern given the young age of patients (median 21 years). However, because the disease was only recently discovered (2007), these psychosocial effects have not been systematically studied and the resulting impact on patients is not adequately appreciated. The SAPIENCE study is an international scientific project funded by the European Joint Program that aims to characterize the long-term cognitive and psychosocial consequences of this rare disease. The leader of the consortium is Prof. Carsten Finke, Charite Berlin. The Polish team, coordinated by Prof. Donata Kurpas, is responsible for the development of standard protocols, monitoring and training of staff in the study centers where the data are collected, and the corresponding qualitative data analysis.

Study Design/Methods: Patients will be extensively studied at three European study sites in three consecutive project levels. Stage 1 includes in-depth on-site interviews and focus groups (n=30). Stage 2 develops a semi-structured short-form interview and includes on-site neuropsychological testing (n=150). Stage 3 includes an international online survey of patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs), and disease progression information (n=300). Stages 1-3 will support each other in developing structured interviews, survey questions, and treatment guidelines.

Results/Outcomes: At Level 1, we will identify themes and narratives that influence patients' quality of life and their experience of coping with the disease. At Level 2, we will identify neuropsychological outcomes in the largest cohort of NMDAR encephalitis patients in the world to date, including executive function, memory, and spatial navigation performance, which have been identified as key areas of impairment. At Level 3, we will examine subjective outcomes and individual predictors of post-acute disease progression.

Based on Stages 1-3, we will develop international consensus guidelines for post-acute care of NMDARE patients.

Impact: This project is the first to bridge the gap between standardized assessment and individual patient experience in the long-term follow-up of patients with autoimmune encephalitis. By incorporating the patient perspective into medical decision-making, current and future NMDAR encephalitis patients will benefit from the implementation of the diagnostic and treatment guidelines developed in this project for patient-centered post-acut
Therapeutic impact of an intervention associating pharmacist counseling and the use of a mobile health application for type 2 diabetes patients
Authors: Attipoe Alfred , Santi Anne , Verrue Charlotte , Delhaye Nicolas , Willaert Marine , Tomas Marc , Philippe Geneviève
Published: January 2024

Background and objectives: Diabetes represents a real public health problem, due to its constantly increasing prevalence and many complications. Prevalence of type 2 diabetes is high in Belgium (estimated at over 8%, 1 patient out of 3 being unaware of their diagnosis). Management based on a change of lifestyle and the adoption of health-promoting behaviors, complemented if necessary by drug treatment, prevents complications, improves the patient's quality of life, and reduces mortality. It is essential to implement multidisciplinary patient support, in which the pharmacist can participate through pharmaceutical care, but also through the implementation of educational sessions promoting the involvement of the diabetic patient in the management of his or her health. Research suggests that the use of mobile technologies combined with health coaching can help patients with their daily life and disease management. This study, a collaboration between ULiège, Multipharma and Comunicare, aims at exploring the benefits of the use of mobile technologies combined with health coaching by the community pharmacist for type 2 diabetes patients. The intervention aimed to reinforce the patient's willingness to actively participate in the management of their disease and to adopt favorable health behaviors, in order to increase their level of therapeutic adherence.

Intervention and methods: This interventional study combined educational intervention and coaching sessions by the community pharmacist with the daily use of a mobile health application provided by Comunicare. This was a quantitative study established over a period of six months with three data collection periods (before, during and after the intervention). Primary outcomes (HbA1c and MARS-5 score), related to the level of medication adherence, and secondary outcomes (HDL cholesterol, LDL cholesterol, systolic and diastolic blood pressure, BMI and waist circumference), considered as cardiovascular risk factors, were analyzed.

Results: The baseline sample consisted of 66 patients, 50 of whom completed the study. Statistical analyses did not show an improvement in the level of medication adherence. However, significant results were observed for systolic blood pressure and waist circumference (both improving). All the other outcomes, including HbA1c, changed positively or stabilized between the beginning and end of the study.

Conclusion: This study showed that counseling by the community pharmacist, combined with the use of a mobile health application, can achieve the therapeutic intent of physician-initiated therapy and have a positive impact on the management of the type 2 diabetic patients as well as on outcomes considered as cardiovascular risk factors.
Innovating Health Governance in Australian Integrated Care
Authors: De Souza Alexandra , Schneider Carmen Huckel , Schierhout Gill , Peiris David
Published: January 2024

Background: Australia is one of many countries implementing integrated care initiatives to facilitate the Quadruple Aim (the improvement of health outcomes, patient experience, provider experience and health system sustainability). These initiatives can be complex while working within a fragmented and siloed health system. NSW Health has created the Patient Centred Collaborative Commissioning Groups (PCCGs) program facilitating Local Health Districts (LHDs) and Primary Health Networks (PHNs) to co-commission health initiatives targeting local populations and their specific health needs. These PCCGs are unique as they are comprised of stakeholders involved at all levels of government in addition those from the community and private sectors. The LHDs and PNHs collaborate with additional relevant and local stakeholders to co-design new service pathways and ensure collaboration within one local health system.

The literature evaluating integrated care aims at advancing knowledge of patient and provider experiences.  Both areas are vital to understanding the successes and failures of integrated care but are insufficient to understand the ‘how’ and ‘why’ of successful system integration. This study therefore focuses on the under-researched question of ‘is it possible to govern integrated care?’

In the Australian context, the governance of integrated care needs significant attention. In the context of this research, health system governance is defined as “the norms, structures, actors, institutions, and formal and informal relationships that shape authority and action in a health system”.

Methods: This qualitative study involves semi-structured interviews with key stakeholders involved in the PCCGs and reviewing the governance documents of each local program. Data collected is thematically analysed and compared to existing governance models to draw out aspects of the individual PCCG governance mechanisms. This is part of a larger study that aims to understand the stakeholders, partnerships, and governance in integrated care in Australia.

Implications for the future: This study will provide an in-depth understanding of the decision-making processes involved in the development (and subsequent use) of the governance models, as well as determining which actors have what roles and accountabilities within the PCCG. It is vital to determine what contributes to and facilitates each domain of health system governance (as defined above) to truly understand how we can achieve sustainable health care system reform. Traditional governance models are not sufficient to regulate the dynamic nature of integrated care initiatives, so they cannot facilitate the sustainability of these initiatives. As such, the overarching aim of this research is to create an ideal governance framework that can be replicated and applied across various integrated care initiatives.
Accuracy of THINK Center telephone triage in post-discharge patients: an observational study in real patients.
Authors: Chia Ching Yee , Ong Shu Fen , Huan Lydia Liu , Ashikin Biinte Shahri Nurul , Lee Ching Ching , Ang Yan Hoon , Tew Chee Wee
Published: January 2024

Objective:  Tele-health & Integrated Network (THINK) Centre is a telehealth centre which offers 24/7 urgent care hotline with telephone triage capabilities for post-discharge care and community support for patients discharged from Khoo Teck Puat Hospital (KTPH), Singapore. This study aims to assess the accuracy of THINK telephone triage in identifying the need for emergency care and also identify factors which affect triage accuracy.  

Methods: A retrospective observational cohort study. 195 inbound calls to KTPH THINK Center teleservice between 1 January to 30 June 2022 were included. These calls were handled by THINK telephone triage nurses who were trained in THINK workflow and tele-triage protocols adapted for post discharge patients. Accuracy of triage disposition was assessed by matching the nurse telephone triage tier compared to the gold standard triage tier (a consensus by a panel of doctor and nurses after reviewing of medical records, triaging symptoms and health service utilization within 1 week of triage call).

Outcome: THINK telephone triage had an overall accuracy of 89.74%. With regards to identifying the need for emergency care, THINK telephone triage had an overall 90.00% sensitivity (95% CI: 80.48% to 95.88%) and 98.40% specificity (95% CI: 94.34% to 99.81%). Multivariable analysis suggested cardiovascular complains (OR 7.605, 95% CI 1.118 to 51.722) and telephone triage nurses having community nursing experience (OR 18.606, 95% CI 1.279 to 270.77) are positive predictors of accurate triage. Non-emergency triage disposition (OR 0.143 95% CI 0.024 to 0.838) was associated with inaccurate triage - predominantly under-triage.

Conclusion: This study shows that THINK telephone triage has a good accuracy rates of 89.74%. While this suggest that the current triage protocols used is safe and effective, refinement can be explored to enhance its accuracy of distinguishing non-emergency triage dispositions. The findings of this study will guide triaging quality improvement as well as future scaling and replication of the service.
Service User Involvement In Integrated Care Research, Development And Innovation
Authors: Poverud Lars
Published: January 2024

The purpose for this workshop is to present and have a discussion on how much we have achieved on the area service user involvement in research, development and innovation in the field of integrated mental health and addiction services.

There are still a way to go before we can truly state that we have co-creation and co-production. We will present how we have done it on a research and mission-oriented innovation project about a integrated service model for people with concurrent severe mental illness (SMI) and substance use disorder (SUD) - INNOFACT.

Lessons learned, other experiences will be presented, and we will have a discussion in this regard that is also going on in Norway.

Programme outline: Introduction of the workshop and topic, with the use of experiences from the research and innovation project INNOFACT. Tor Helge Tjelta. 10 minutes.

User involvement presented by the three peer co-researchers in INNOFACT: Marie Eriksdatter Strifeldt (Erfaringssentrum), Lars Poverud (Mental Health Norway) and Fredrik Nilsson (RiO - Norwegian users’ association in the field of alcohol and drugs). 15 minutes.

Questions about and comments on the presentations, with introduction to the table/group discussion. All presenters. 5 minutes.

Table/group work with questions. Each table.15 minutes.

Discussion about the topic and questions. All presenters and

 workshop participants. 15 minutes.

We will summarize the discussion/findings and use it in our further RDI in INNOFACT.
Developing And Implementing an Interdisciplinary Quality Program In A Rehabilitation Hospital
Authors: Bernard Céline , De Brabant Sabine , Tommelein Eline
Published: January 2024

Background: Quality programs that step into the intrinsic motivation of healthcare providers (HCPs) are believed to be effective in improving quality of care. The fact that they are not part of an external regulatory or performance management process seems to be crucial. We therefore aimed to develop a quality program based on internal workflows and HCPs feedback.

Methods: The project took place at the rehabilitation hospital Koningin Elisabeth Instituut (RH-KEI) in Oostduinkerke (Belgium) during the years 2017-2022. A quality coordinator (QC) was appointed who subsequently developed and implemented an interdisciplinary quality program in concordance with the care strategic plan. The quality program was optimized through surveys among patients and caretakers on the one hand and employees on the other. Involved employees were physicians, nurses, physiotherapists, pharmacists and pharmacy technicians, occupational therapists, psychologists, speech therapists and employees of the facility departments (such as maintenance staff).

Results: The QC had to be an individual that could coach teams and would be trusted by all departments. This person also embodies independence from and neutrality towards staff and management, so HCPs would feel free to discuss any (institutional) hurdles towards quality of care. The developed quality program was subdivided in four domains with three key strategic objectives. This included that (1) RH-KEI ensures a continuous and dynamic improvement of quality of care based on a set of indicators, (2)  RH-KEI holds a culture of quality that is actively supported by all involved employees and (3) RH-KEI continuously improves and guarantees patient safety by developing a well-functioning safety management system. The program was first developed in 2017 for the period 2018 up to and including 2022. After five years, quality and safety is embedded in the culture of RH-KEI. Employees are proud of the progress and work together on an integrated quality story. As well, RH-KEI renewed the quality project for the period 2023-2027, with an even greater focus on patient and caretaker participation, care experience, communication and digitalization.

Conclusion: The active support by all involved employees turned out to be essential to secure the set objectives on the work floor and to make them part of the daily routine.
Interdisciplinary Teamworking in Rehabilitation: Key learnings and perceived challenges to change from healthcare professionals at a National Rehabilitation Hospital
Authors: Christophers Lauren , Torok Zsofia , Cornall Catherine , Henn Aoife , Hudson Clare , Whyte Theresa , Carroll Aine
Published: January 2024

In Ireland interdisciplinary healthcare teams have been recognised as a key component of integrated care and research recognises importance of teamwork for patient care and safety (Leonard, 2004; Manser, 2009; Forse et al., 2011; Sacks et al., 2015). Within rehabilitation care, teamwork is essential in addressing complex health challenges such as chronic impairments, co-morbidities and more complex problems (Ouwens et al., 2005; Wade, 2015). Yet research on teamwork in non-acute settings is far behind that of acute settings (Miller et al., 2018). In rehabilitation, healthcare teams naturally include a wide range of professions, from multiple disciplines (Wade, 2016), often in a multidisciplinary approach with different professions focused on different goals (Koroner, 2010). Little is known about how rehabilitation teams can optimise communication, work together to create common goals and effectively function as an interdisciplinary team. The complexity of creating this type of change and shifting to new models of teamwork is captured in this study, which details the efforts of a self-organised “grassroots” group of healthcare professionals who created and implemented an interdisciplinary teams framework within a national rehabilitation hospital. A focus group was utilised to capture the shared lived experience of the participants and thematic analysis with a critical approach (Braun & Clarke, 2006) was selected as an appropriate method for the purposes of constructing latent themes around key challenges and perceived barriers to change. Participants described resistance to shifting to an IDT model of care as stemming from cultural issues of hierarchy, power and control, disciplinary loyalty and identity. Key learnings are drawn from these experiences to form recommendations for organisational efforts to shift to interdisciplinary and transdisciplinary ways of working. This study is part of a larger action research project, and embedded academic researchers worked collaboratively with the participants as co-researchers to design this study and others focused on teamwork. The co-research team deemed this study’s topic a priority due to its potential significance for other healthcare professionals seeking to create change and collaborative working in their organisations.
Working relationship between care and wellfare is 1 + 1 = 3
Authors: Engelen Marieken
Published: January 2024

There is no health care without wellbeing. The quality of life for someone is defined by different dimensions such as a physical, a psychological and a social dimension. These different dimensions influence each other. This is why our government wants policy to decompartmentalize actors active in health care and in wellbeing. Quality of life for someone is key.

To further work towards more quality of life, we count on care givers in the field: the first line. This ‘first line’ are local caregivers who are closest to the people who need care and support. They are the primary point of contact for people with questions about health care and wellbeing. These caregivers are family doctors, nurses, pharmacists, physiotherapists, social workers from health insurance companies, social workers from local authorities, and other social workers, etc…

Traditional health care focusses on the physical dimension: it relates to the need for care, support or treatment of issues caused by illness, age, disability or psychological problems.

The sector wellbeing focusses on the mental dimension: having a sense of wellbeing is key to feeling good. Wellbeing will always look for the strength that people have within themselves: social network, meaningful daily activities, volunteer work, the chance to interact with others, active participation to society, being able to count on help or support when things get tough. The goal is to give everyone the chance to develop themselves and make sure you have broad access to help when you need it, whether you’re a citizen, elder, newcomer or person with a disability.

In turn, the physical and mental dimensions can’t exist without linking on to the social context of people. Being connected through strong social relations and being able to participate in society are signs of good social health and contribute to better mental and physical health.

To make sure someone can fulfill the quality of life that they desire, it is important that health care and wellbeing work together and we pay attention to the different dimensions.

Social Work , in all it’s diversity, is key to keeping the focus on the mental and social dimension within the First line. That makes social workers essential partners in the care provided by other caregivers.
Improving Diagnostic Safety through Integrated Care
Authors: Smith Kelly , Haskell Helen , Davis Giardina Traber , Hill Mary , Washington Christopher , Miller Kristen E.
Published: January 2024

Introduction: Diagnostic errors in care are a global public health challenge. Published rates of diagnostic errors range from approximately 5% in ambulatory care settings up to about 10% of in-hospital stays and it is estimated that every person in their lifetime will experience a diagnostic error. The wicked problem of diagnostic errors is multifactorial with failures occurring at every point of entry to the system. Integrated systems of care provide an important opportunity for studying and codesigning solutions to diagnostic errors and are uniquely positioned to address the gaps in access and care delivery that lead to diagnostic errors.

In this workshop, we will explore the challenges of diagnostic error and the promise of diagnostic safety solutions along the nine pillars of integrated care.

Audience: Patients, patient advocates, caregivers, clinicians, health systems leaders, policymakers, and payers.

Learning Objectives: By the end of the workshop, participants will be able to:

1.Describe diagnostic errors within the context of an integrated healthcare system.

2.Discuss unique opportunities for integrated healthcare systems to mitigate diagnostic errors and promote diagnostic safety.

3.Align opportunities to improve diagnostic safety along each of the nine pillars of integrated care.

Workshop Approach: The workshop will include a mix of short theory bursts and small working groups. Theory bursts will level-set on the current state of the science of diagnostic errors and strategies to improve diagnosis while working groups have the goal of ascribing challenges and opportunities for improving diagnostic safety along the diagnostic continuum. The workshop will employ engagement and learning strategies including interactive polls, briefing and debriefing, hands-on deliberative practice, and small group facilitation. Information co-created by workshop participants will be captured using web-enabled and live brainstorming tools.

Workshop Agenda:

1.10 minutes: Introduction and review agenda; Online interactive session of who is in the room.

2.10 minutes: Theory Burst – What we know about diagnostic errors and an introduction to the diagnostic error sociotechnical system.

3.5 minutes: Introduction to the brainstorming approaches and technology

4.45 Minutes: Small Group Break Outs (each group will address one pillar in each session)

a.Session 1: Pillars 1-3

b.Session 2: Pillars 4-6

c.Session 3: Pillars 7-9

5.15-Minute Debrief: Review of information generated by different small groups along the nine principles of integrated care; Opportunity for participants from other groups to contribute to the other session’s responses

6.5 minutes: wrap up and next steps

Lessons Learned: Take-home messages will be summarized by expert faculty using online polling and word cloud codesign by participants and through the co-created brainstorming outcomes. Participants will be invited to contribute to a white paper from the workshop.
An orientation model for implementing and sustaining integrated health and social care hubs for early childhood development.
Authors: Hodgins Michael , Ostojic Katarina , Wang Si , Lyle Kim , Lawson Kenny , Rimes Tania , Woolfenden Sue
Published: January 2024

Evidence is emerging on the efficacy of Integrated Health and Social Care (IHSC) hubs to improve the early detection and intervention of developmental vulnerability in children from culturally and linguistically diverse and/or socioeconomically disadvantaged backgrounds. IHSC hub models typically involve co-located child and family health services and non-government organisations, which deliver a range of psychosocial services, for example playgroups, domestic violence support, mental health support, early childhood education. However, there remains a dearth of evidence on how to successfully implement and sustain the integration of health and social care. Our project aimed to evaluate the impact and implementation of IHSC hubs for migrant and refugee populations in three sites in New South Wales, Australia with high proportions of migrant and refugee communities. To help implement and sustain IHSC hubs, we developed an orientation model detailing the operational principles required for successful integration of IHSC hubs. This presentation is based on a qualitative exploration of the barriers and enablers to implementing IHSC hubs in three sites in New South Wales, Australia guided by the Consolidated Framework for Implementation Research. Development of the orientation model involved semi-structured interviews and five workshops with 25 participants including clinicians, providers, and managers from child and family health services and non—government social services to understand their perspectives on the barriers and facilitators to implementing an IHSC hub. Important findings from this work included the need for tangible guidelines that detail the activities that best enable the successful integration of services within a hub model. Our orientation model details the operational principles of integrating health and social services for early childhood health. These include the setting up phase activities of buy-in which details approaches for developing a common agenda and partnership development, which outlines mechanisms for fostering collaboration between health and social services. Following this, our orientation model articulates the need to establish connecting support, including infrastructure governance and resources that support integration between services; ongoing integration activities such as the feedback mechanisms and ongoing communication channels necessary for successful integration; and activities that enhance a hubs relevance for the community it services. This model establishes key components for implementing IHSC hubs, which are garnering increasing attention in early childhood contexts globally. Future work will involve disseminating the orientation model broadly across child and family health and social services and evaluating the uptake of the model in broader contexts.