bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient partnership an integrated health system
Authors: Dayekh Alaa , Nasreddine Mohamad , Dakroub Fatima , Olliek Adel
Published: January 2024

The patient as partner approach is a modern model of patient engagement that integrates the patients’ knowledge and skills into managing their own health. This study aims to evaluate the benefits and barriers of patient partnership in a healthcare setting. It is a qualitative and interventional study that implemented a patient and family partnership committee (PFPC) at a Lebanese hospital during the COVID-19 pandemic. A purposeful guided

approach was used for sampling, and data was collected by structured questionnaire interviews. Seven PFPC team dynamics building blocks were generated: transparency, support,

motivation, comfortable communication, mutual understanding, equity in positions and

empowerment to participate. Both the patient partners (94%) and healthcare professionals (90%) were satisfied with the PFPC experience. The majority of the healthcare profession-

als (HP) reported a noticeable change in the quality improvement process (QIP) (89%) and approved to standardize the PFPC (93%). The patient partnership benefits were clear, and the PFPC was perceived positively by both patient partners (PP) and HP. PP experienced

distress relief (37%), gained ideas (41%) and felt that their opinion was heard (27%) after PFPC participation. PP reported benefits to hospitalized patients, including respect and

care (63%) and patient satisfaction (20%). The main challenges for PFPC implementation were time availability and conflicts. Lessons from patient partnership can be utilized to

improve the patient care policies in the Lebanese healthcare system. Moreover, developing countries can benefit from the patient partnership approach in their healthcare settings.
Facilitating the creation of compassionate cities in Flanders. The case of Bruges and Herzele.
Authors: Raes Ruth
Published: January 2024

This paper presents the case studies of Compassionate Bruges and Herzele, as experienced in the role of a project leader/facilitator. Two cities want to grow more solidarity and more carefulness for their citizens as an answer to social bitterness, coldness and isolation. Two PhD students search for an answer to the question ‘how can we develop and foster a civic approach that is complementary to institutional health care, improving the quality of life in situations of severe illness, dying and grieving?’. And to the question ‘how can we invite people to think and act differently to realise this social change?’.

The uniqueness of this testimonial lies in the top-down approach that was chosen to implement the compassionate city as well as the compassionate community aspect of this project. This is unlike a lot of international examples of compassionate community projects that are rather driven by an individual ‘sponsor’ or grassroots initiatives. In the top-down approach, we bring together partners like schools, employers, life stance groups,… In the bottom-up approach we work with civil society organisations and key figures in local networks. We aim at developing a compassionate community in Bruges Sint-Kruis as well as in Herzele-Centre.

We will give an overview of how the project was conceived and how both cities evolved in their own way, driven by local differences in policy making, social network dynamics and the people involved. We will present the tensions that emerged and what we did to try and manage these tensions, as well as to manage the complexity of the global context in which these projects deployed.

Since some of our interventions proved to be more successful than others, we will conclude with some learnings and reflections and a brief presentation of the ‘Navigation Triangle’ framework. This framework is the synthesis of the levers we experienced to be crucial to understand and use in the process of leading cultural change in a complex environment. This framework might inspire project leaders and facilitators in their navigation processes through the complexity of their own projects, trying to involve people from a top-down as well as a bottom-up point of view.
Engaging with autistic children and their families: Strategies for effective partnerships
Authors: Mullins Lhara
Published: January 2024

Background: Autism diagnoses for children are becoming more commonplace due to greater understanding and insight concerning neurodiversity and an increased awareness of the importance of inclusion. Consequently,  greater numbers of health and social care professionals, educators and practitioners in the community are more likely to find themselves supporting autistic children and their families. Understanding the needs, wishes and hopes of families who you interact with will enable you to plan your professional response to their needs more effectively.

Target audience: This presentation is intended for professionals responsible for supporting autistic children and their families within clinical, residential or community settings, in addition to those working in education settings. This presentation will explore the needs of autistic children and their families when they present at appointments or for services, and how you as the professional can make the most positive impact through your interactions.

Key messages: Supporting parents to support their children has fast become the mantra of disability support services here in Ireland. But what do parents universally really need from professionals to truly empower and enable them to support their autistic child?

A partnership approach between professionals and parents is instrumental in promoting more positive outcomes for autistic children. Yet what parents need more than anything else when they meet you is hope. They need to feel listened to, that their worries and concerns have been heard and they need to have hope that things can improve for their child and their family. You may not always be in a position to provide the level of service an autistic child truly needs. You can however maximise the effectiveness of your intervention with their family by establishing and developing good working relationships with their parents.

Learning outcomes: This presentation will provide you with strategies and tangible methods of supporting autistic children, via enabling and empowering parents. Actual case studies will be provided to demonstrate to attendees the effectiveness of active listening, being present and creating a space of hope, within interactions with parents. Examples of both effective and non-effective ways of engaging families will be presented, to maximise understanding and enhance positive outcomes.
EU NAVIGATE: Developing a European navigation intervention for older people with cancer and their family caregivers
Authors: Smets Tinne , Chambaere Kenneth , Miranda Rose , Pivodic Lara , Caluwaerts Anneleen , Vinckier Chelsea , Van Campe Fien , Van den Block Lieve
Published: January 2024

Background: Most people who have cancer are older people, and this affects millions of Europeans yearly. Integrating high-quality, equitable, and cost-effective care across the continuum of supportive, palliative, end-of-life, and survivorship care for both patients and family caregivers is highly relevant from a healthcare, prevention, and economic perspective.

Aims: EU NAVIGATE is an interdisciplinary, cross-country, and intersectoral project funded by the European Union and aiming to evaluate the effectiveness and cost-effectiveness of a patient and family navigation intervention (NavCare-EU) for older people with cancer and their family caregivers in different healthcare systems in Europe. It focuses on reaching underserved individuals, supporting and empowering them to access their own networks and available resources within their community. As the first step, the existing and promising Canadian Nav-Care intervention from will be adapted, contextualized, standardized and pilot-tested across six European countries.

Concept and methods and anticipated results: NavCare-EU is a person- and family-centered non-pharmacological intervention in which volunteer navigators collaborate with patients and families to facilitate timely and equitable access to health and social care services and resources as needed. The Nav-CARE intervention involves a navigation model, including international blended training, and various tools to support navigators. We will share the model, different roles involved and training packages. Following the ADAPT guidance, the Nav-Care intervention will be translated and adapted in close collaboration with Local Adaptation Teams diverse users, and other stakeholders (according to principles of Patient and Public Involvement). To contextualize the original intervention, we follow the extended Normalization Process Theory. An International Oversight Group will safeguard the original intervention’s integrity and key components using the Model for Adaptation Design and Impact (MADI) to guide decision-making around the design of adaptations. The feasibility of the Nav-CARE intervention within local settings will be reviewed across countries in a pilot study to understand the practicalities of implementation, maximize feasibility, and troubleshoot issues that arise during implementation. Effectiveness and cost-effectiveness will be evaluated through an international pragmatic randomized controlled trial.

Impact: The EU NAVIGATE will shift the state of the art of cancer care in Europe by providing an innovative solution to the complex care needs experienced by older cancer patients and their families. we pay particular attention to local healthcare contexts to ensure optimal implementation. We will present the final program ready for testing at the conference.
Exploratory Short Stay: Regaining Perspective on Optimal Home Care
Authors: Logist Rudi
Published: January 2024

A beautiful old age, at home in your own environment, enjoying life. But what if an acute crisis situation arises? Fortunately, this does not always have to be the end of the dream of living at home for as long as possible. An exploratory short stay in a residential care center can then be an appropriate solution.

The Exploratory Short Stay is aimed at elderly people who find themselves in a crisis situation, for example due to a fall, the sudden death of the partner or the loss of the caregiver. This new offer focuses on the future and a safe return home.

The elderly can count on the years of experience of experts here. A team of nurses, healthcare professionals, occupational therapists, physiotherapists, psychologists, general practitioners and social workers will set out the right trajectory in a multidisciplinary consultation. Offering the psychological component is precisely this added value compared to the classic short stay. Furthermore, the strength of this team is that it can respond flexibly to specific needs of the client.

On the basis of personalized and tailor-made advice, they offer the person perspective to return to their own environment. Even during that temporary stay in the residential care center, the home care services will examine how the necessary care and support can be organized at home. At the end of the stay, all possible future plans are discussed with the resident, family, informal carers and primary care staff.

An exploratory short stay opens up new perspectives for family and carers. Combined 'care' forms are possible without the client losing independence. If a return home is not the best option, the possibility of a long term stay is also open.

The Exploratory Short Stay was regulated by the Flemish government in 2020, building on years of experience in the elderly care sector. Crucial are the involvement of a multidisciplinary team in the residential care center on the one hand, and close cooperation with primary care actors and family/caregivers on the other.

 

Together we choose quality of life:

Comfort and social relationships, care and support in a trusted environment.
Utilizing Community Health Ambassadors to improve COVID-19 vaccine uptake in equity priority neighborhoods in Toronto, Canada
Authors: Shearkhani Sara , Wojtak Anne , Powis Jeff , Quinlan Jen
Published: January 2024

East Toronto Health Partners (ETHP) is comprised of 100+ health and social organizations, with a leadership council consisting of patient/caregivers and six anchor organizations representing the continuum of care.  During the pandemic ETHP implemented a Community Health Ambassador (CHA) Model to increase access to COVID19 vaccinations in underserved neighborhoods through health promotion activities and referral to COVID19 outreach Centers (CoCs).

The intervention focuses on equity priority neighborhoods with significant concentrations of underserved populations including but not limited to newcomers and households with low incomes.

Early in the COVID-19 pandemic it became apparent that the impact was disproportionally high in equity priority neighbourhoods. Once COVID19 vaccine became available to the public, it became evident that the wealth of knowledge residing within the community was essential to improve vaccine uptake, particularly in priority neighbourhoods. ETHP partnered with the community to co-design outreach strategies. A particularly meaningful partnership was the collaboration with community members who assisted us in designing our CHA model. The CHAs program was administered through one of the community ETHP health service providers.

CHAs were localized to the neigbourhood where they lived and utilized their knowledge of the community to identify and address misinformation and barriers to vaccination. CHAs were able to engage in individualized educational interventions locally and escalate systemic barriers to the ETHP. These issues were addressed through rapid cycle change quality improvement methodology by the members of the ETHP.

From December, 2021 to March, 2022, we engaged and deployed 197 CHAs to conduct outreach activities. They reached out to over 25,000 individuals in our priority neighbourhoods. Their work bridged the equity gap in vaccination. In September 2021, there was a 20% point difference in 1st dose coverage between the most vaccinated and least vaccinated neighborhoods in East Toronto; in March 2022, this difference decreased to 16% partly as the result of CHA outreach in priority neighborhoods.

Barriers to vaccine uptake could best be identified by hyper-local strategies implemented by CHA with a deep understanding of the local neighborhood. The barriers identified by CHAs could be addressed with the help of an integrated health system to improve equitable delivery of COVID-19 vaccine.

Based on the success of the CHA model were are co-designing a strategy to utilize CHAs to assist with health care recovery focusing on other preventive interventions that not equitably delivered such as cancer screening.
Development of a toolkit to improve interprofessional collaboration and integration in primary care using qualitative interviews and co-design workshops.
Authors: Sirimsi Muhammed Mustafa , De Loof Hans , Van den Broeck Kris , Van Bogaert Peter , De Vliegher Kristel
Published: January 2024

Introduction: Despite numerous attempts to improve interprofessional collaboration and integration in primary care, patients, care providers, researchers, and governments are still looking for tools and guidance to do this more efficiently. To address these issues, we decided to develop a generic toolkit, based on sociocracy and psychological safety principles, to guide care providers in their collaboration within and outside their practice. Finally, we reasoned that different strategies should be combined to obtain integrated primary care.

Who is it for, and who did we involve and engage with? The results of this study and subsequently the toolkit are ‘directly’ useful for care providers, academics and policymakers. Development of the toolkit consisted of a multiyear co-development process. Data originating from 65 care providers, through 13 in-depth interviews and five focus groups were analysed and subsequently evaluated in eight co-design workshop sessions, organised with a total of 40 academics, lecturers, care providers and members of the Flemish patient association. Findings from the qualitative interviews and co-design workshops were gradually, and inductively adapted and transformed into the content for the IPCI toolkit.

Results: Ten themes were identified: (i) awareness of the importance of interprofessional collaboration, (ii) the need for a self-assessment tool to measure team performance, (iii) preparing a team to use the toolkit, (iv) enhancing psychological safety, (v) developing and determining consultation techniques, (vi) shared decision making, (vii) developing workgroups to tackle specific (neighbourhood) problems, (viii) how to work patient-centred, (ix) how to integrate a new team member, and (x) getting ready to implement the IPCI toolkit. From these themes, we developed a generic toolkit, consisting of eight modules.

What is the learning for the international audience?

What are the next steps?

In this study, we describe the multiyear co-development process of a generic toolkit for the improvement of interprofessional collaboration and integrated care. Inspired by a mix of interventions from in and outside healthcare, a modular open toolkit was produced that includes aspects of Sociocracy, concepts such as psychological safety, a self-assessment tool and other modules concerned with meetings, decision-making, integrating new team members and person and population-centred care. Upon implementation, evaluation and further development and improvement, this compounded intervention should benefit the complex problem of interprofessional collaboration in primary care.
“Nothing about us, without us”. Practical elaboration of experience experts in primary care
Authors: Van Laere Stien
Published: January 2024

The health care sector sensed already for several years a shift in primary care to more complex situations and support questions. Tackling these challenges requires an integrated collaboration between health, wellbeing and social care. There was an urge to bring in a different approach of care.  In order to fulfill that need Flanders was defined into 60 geographical areas in 2020: ‘The primary care zones’. Capturing local needs and working bottom-up became the foundation of the organization. The focus on goal-oriented, customized and integrated care made it possible to fill out the gap created by more complex situations.

Representatives from health providers, welfare workers, local authorities and the person in need of care are brought together. The primary care zone promotes collaboration between these different partners. This extensive network ensures that primary care regions can as well pick up and unroll local needs as charges unrolled by the government.

Person-centered care is the key to success of this new approach. Care and support goals from the people itself, depending on their quality of life, are the starting point. This in combination with more recognition for informal care, makes sure that socially vulnerable people are able to take control of their own life and the necessary care to sustain this. In order to realize a care policy in function of person-centered care, we need to listen to the people who live in our primary care zone. There’s continually increased attention and effort to cocreate and build our organization with socially vulnerable people. Self-determination and autonomy are ever highly valuated. As organization there’s the expectation of building bridges between professionals, but also between the professional and the client.

The focus in the relationship between clients and professionals shifted the past years. There’s more attention for participation and democratic decision making and for the perspective of the people itself. Clients are not to be seen as passive recipients anymore. They say: ‘nothing about us, without us.’ and who are we to protest?

In order to do so we established a group of 15 experts. From October 22 until November 23 we will meet up monthly to exchange ideas. The group has experience in different domains: informal care, chronic illnesses, poverty, addiction, psychic vulnerability, elderly care and disabilities. The experts hope to dive deeper into our participation process to show and explain to you how to co-design a care journey that responds to people’s needs. 

Taking their experience in account, will help our board to pick up local needs and to adjust primary care to them. Focus on strength and possibilities of the people in the group are hereby necessary to accomplish our goal. Together with the group we strive to share the ownership on our plan of action We want them to have an impact on the policy and to cocreate an organization not only for them, but with them.
Towards more goal-oriented care through care coordination and care planning.
Authors: Fredrix Karen
Published: January 2024

The increasing aging of our society is putting increasing pressure on the current organization of care and support. This moved the Flemish government to a thorough reform of primary care in Flanders. This was started in 2017. The reform involves changes in terms of content, structural support and instrumental support. All these changes should lead to care and support that can be organized using the principles of integrated care and goal-oriented care. The major challenges are: 

- bring about a change in mentality among care providers toward these principles of integrated care and goal-oriented care;

- make a connection between health care and welfare care, as well as between primary care and more specialized care, and align the processes of care and support. 

In addition, it is necessary to translate the principles of goal-oriented care into practical tools and accelerate methodology development. We are working together with several partners in Flanders for this purpose. 

In goal-oriented care, an important role is reserved for the care coordinator. The care coordinator is the focal point of the care team who, as a member of the care team, takes on the task of: 

- maintain an overview of the care process; 

- ensure that all care and support, determined on the basis of the person's care or support needs and translated into life goals and care and support goals, is coordinated, monitored and evaluated. 

Care coordination in a care process maintains a focus on goals, both the person's own life goals and the care and support goals of the care team. 

For implementing qualitative care coordination, the care and support plan is an indispensable tool within the Flemish reform. This care and support plan must: 

- allow an overview of the sometimes multitude of care and support goals; 

- be a means of communication between the members of the care team (including the person himself and his informal care); 

- reflect the extent to which care agreements are met; 

- allow the care process to be monitored, evaluated and adjusted if necessary.  

 

 

 In the near future we want to design this care and support plan in a digital way. 

The care coordinator must have a wide range of competencies in order to coordinate the care process in a quality manner, including: 

- mastering to perfection the methodology of goal-oriented care, interview techniques, conflict management, process guidance, process analysis, coordination and organization skills; 

- being the point of contact for the person with a care and support need; 

- be able to play the bridge between the person, informal care and professional care providers. 

In this presentation, we focus on the role of the care coordinator throughout the care process and the planning aspect. We propose how the Flemish government want to develop this role in the future. We also reflect on the preconditions that are necessary to achieve a solid implementation of this role, and indicate what opportunities we see to promote and accelerate the change in mentality in this regard.
Impact of multimorbidity on health care utilisation in Australian older adults aged 45 years and over: a large population-based data linkage cohort study
Authors: Kabir A Y M Alamgir , Conway Damian , Rhee Joel , Ansari Sameera , Tran An , Barr Margo
Published: January 2024

Background: Multimorbidity (MM), co-occurrence of two or more chronic health conditions in an individual, is often used in the assessment of complex healthcare needs and their impact on health outcomes. Management of MM is complex, but little is known about the impact of MM on health care services.

Methods: We conducted a cross-sectional study among people aged 45+ years in New South Wales, Australia, who completed baseline questionnaires in the 45 and Up Study between 2005-2009. Baseline questionnaire data were linked to hospital, primary care Medicare billings, emergency department (ED), and deaths registry data. Our outcome of interest was high use of health care services within the 3-year baseline period (averaged over the years before, during and after recruitment). People who died during that period were excluded. High use was defined as: ≥11 General Practice (GP) visits, ≥2 ED visits, and ≥2 hospital admissions. Prevalence ratios (PRs) were used to measure the impact of MM, and Poisson regression models were used to estimate adjusted and unadjusted PRs with 95% confidence intervals.

Results: Among 251,689 participants (46.5% male, and 46.1% aged <60 years), the overall prevalence of MM was 44.1% and prevalence increased with age: 32.2% in 45-59 years, 50.3% in 60-74 years, and 63.3% in 75+ years.  After adjusting for confounding, MM was associated with high service use: adjusted PR (95% CI) was 2.27 (2.06-2.51) for high hospital use, 2.02 (1.98-2.06) for high GP use, and 2.04 (1.90-2.21) for high ED use. The impact of MM on health care utilisation was higher among the younger age group.

Conclusion: This study illustrates the burden of multimorbidity on service use within the health system. It also highlights the need to examine and rationalise service provision and utilisation across the health system to assist people with multimorbidity efficiently manage their conditions.
Vlaamse Patiënten Peiling
Authors: Le Roy Amelia , Deloffer Thomas
Published: January 2024

Flemish Patient Survey

Background: Giving patients a voice in their healthcare delivery process, patient participation. That's what the Flemish Patient Survey is all about. To make this possible, the Vlaams Patiëntenplatform vzw initiated a process about 10 years ago. Together with patients and care providers, a process was developed  that results in validated satisfaction questionnaires, the Flemish Patient Surveys.

Now 10 years later, numerous Flemish Patient Surveys have been developed for different subsectors in healthcare. For hospitals, there are the versions VPPeiling Classical Admissions, VPPeiling Day Hospital and the VPPeiling Pediatrics. These are used in all Flemish hospitals in Belgium. Different versions also exist for numerous facilities in the Mental Health sector.

Aim: To provide the sector with a supported and validated satisfaction questionnaire that gives patients a  voice in their care delivery process and allows caregivers to engage with its results.

Method: In order to arrive at a validated satisfaction questionnaire, there are several stages to be completed in the development process. First, a literature review of existing international scientific questionnaires is conducted. In addition, focus groups are organized to find out what patients and caregivers consider important to be included in the questionnaire. In the next phase, all these elements are put together to come up with a long list of possible questions. In the next phase, a first objective selection is made by two employees of the Vlaams Patiëntenplatform vzw using a double-blind method in order to arrive at a shortlist of questions. This shortlist will then be presented to both care providers and patients through a Delphi study. Simultaneously with the Delphi study, a measurement protocol is drawn up with a group of experts. The result of the Delphi study is transformed into a pilot version of the satisfaction questionnaire. This pilot version is then scientifically validated. In a final stage, a pilot study is conducted using the predetermined measurement protocol. If this pilot study is assessed as positive, the final result will be a Flemish Patient Survey that can be implemented in the broader health care sector.

Result: Going through the different phases in co-creation with both patients and caregivers leads to a strongly supported and validated measurement instrument that can be implemented by different healthcare institutions in the healthcare sector. This allows patients to have a voice in how they experienced their care.

Conclusion: The Flemish Patient Surveys contribute to an increase in quality in the Belgian health care system and also offer the opportunity to participate as a patient. How can we co-design care journeys that respond to people’s needs?
Case study of a health care center in Merchtem: a bridge between healthcare and welfare and a search for a different way of working to achieve a high quality and integrated care for our patients.
Authors: Yap Julie , Verté Emily
Published: January 2024

Case study of a health care center in Merchtem: A bridge between healthcare and welfare and a search for a different way of working to achieve a high quality and integrated care for our patients.

Introduction: The jobs of many healthcare workers has become extremely challenging. Consequences are that the drop out rate of healthcare workers is increasing and the feasibility to achieve qualitative care for patients becomes very difficult.  With this project we are trying out various ways of working together with different types of healthcare workers, we are looking for tools to facilitate these types of collaboration and we try to create a sustainable structural and financial system.
Using Integrative Thinking Techniques to Design Integrated care Programming in Ontario, Canada
Authors: Baker Ross , Nelson Michelle , Blackstien-Hirsch Paula , Fung Josie
Published: January 2024

Integrated Care connects care providers across sectors and often from different agencies or organizations to deliver more effective, efficient and client centered care. Creating new or redesigned programs to achieve these goals typically requires new care models delivered by a range of providers who have varying experiences and mental models about what is required for effective care. Effective care designs must also consider factors such as variations in populations, available services, and resources. Thus, creating care models for integrated care can be challenging, creating conflicts that can undermine efforts to arrive at effective delivery models.  Ontario Health Teams (OHTs), a new model for integrating care, launched in staged cohorts across the province in 2019, are developing new population health-focused care delivery models for specified target populations, and, eventually, for the 15 million people of Ontario, Canada. OHT leaders and staff come from a variety of agencies with varying care models, and, in some cases, limited prior collaborations with a mandate to integrate service delivery. Leaders in each OHT can design services to fit local needs, and their performance will be assessed on specified metrics. To assist in the design of new care models that meet patient needs and support providers from multiple and different agencies, a team from the ADVANCE program at the Dalla Lana School of Public Health and the Rotman School of Management at the University of Toronto have used Integrative Thinking approaches to help leaders to select and combine elements of opposing care designs to create more effective strategies for integrated care. Integrative Thinking is an innovative method developed by Roger Martin and Jennifer Riel that helps decision-makers to reframe decisions by shifting efforts away from seeking compromises among competing approaches, and, instead helps decision-makers to  identify the core elements of each potential model and then reassemble these components into a new, even better design. Integrative Thinking thus helps decision makers combine seemingly competitive solutions into a stronger option through a carefully structured, facilitated process. This presentation will describe the methods used for Integrative Thinking within the context of integrated care, and home care programming specifically, to better serve local populations in different care environments.
Building bridges between organisations and the local community
Authors: De Keersmaecker Filip , Liesenborghs Philippe
Published: January 2024

Introduction: People long for connection. Yet, our society is increasingly diverse and people can be vulnerable in a number of ways (poverty/(mental) illness/language barriers/...). There is an ever growing need for inclusion, for openness.

Objectives and methods: Since 2016, I seeked to improve my wellbeing - even to recover - by participating in activities outside of the mental health sector. A chance meeting led to a volunteering opportunity for opgewekTienen vzw, a citizen's initiative in my home town. This led to a string of other opportunities, both for myself and others. I helped members of the community - vulnerable or otherwise - to become participants or to enter this vast network of volunteers and witnessed others do the same. Partnerships were forged between the community, the city and a number of social organisations, between the informal and the formal sector, to increase inclusion, both among volunteers as well as participants.

Key findings: People can experience (social) recovery, an increased sense of purpose and belonging, as well as significant personal growth through volunteering.There is a degree of chance in entering the volunteer network. Bridges (bridge figures/partnerships) are helpful and often even instrumental in the participation of vulnerable groups, either as volunteers or participants. Bridges can be built starting from either side (citizens/professionals). However, more often than not it is the community that takes the lead. Employees can be volunteers after work without either the employee or the employer taking advantage of this existing link. Some of the strongest leaders in the volunteering community are employed in the social/mental health sector. Inclusion is not always easy for the network of volunteers. Support is welcome, but can be lacking.

Conclusions: Bridges foster inclusion. 

Implications: Be open as an organisation and look actively around for citizen's and community initiatives in your area. Even the smallest of informal initiatives can offer opportunities for inclusion.

Identify, reach out and connect with bridge figures and social entrepreneurs. Explore existing links: volunteers in your own workforce. Stimulate employees and clients to volunteer or participate. Foster interconnection.

Turn these links into a win-win situation and provide support, not by 'taking over' but by being present.

References: www.opgewektienen.be
COLOTEST Brussels
Authors: Herzeel Ann , Burrion Jean-Benoit , Candeur Michel
Published: January 2024

Introduction: Population screening for colorectal cancer is organized:

In Flanders by the "Centrum voor Kankeropsporing" (CvKO) since 2013

In Wallonia and Brussels by the Walloon “Centre Communautaire de Référence” (CCRéf) since 2009, based upon a collaboration with GP’s.

In Brussels, the Brussels Coordination Center for Cancer Screening (BruPrev) took over the project in October 2018. It is a pilot project based on a partnership with pharmacy.brussels and CCRéf. 

Scope of the project: The focus group is the Brussels population aged between 50 and 74. To be effective, a test must be performed every 2 years. The screening test is an iFOB test ( “Colotest”). The Colotests are available in all Brussels pharmacies, which supply them free of charge upon presentation of a personalized invitation letter or a medical prescription. The pharmacist also engages in active sensitization with eligible patients.

Partners: The project is a partnership between BruPrev, pharmacy.brussels and CCRéf. GP are also involved and informed. They can refer patients to the pharmacy with a medical prescription to retrieve an iFOB test. BruPrev is in charge of implementing and coordinating the project. CCRéf analyzes the iFOB tests and hosts the database.

Implementation: The citizen, belonging to the target group presents himself at the pharmacy and is handed the test, he performs the test at home and sends it to CCRéf accredited laboratory in a provided envelope (biological material, cat.B). CCRéf processes the incoming tests daily and reports the results twice a week to BruPrev via a secured server. Patients receive their result within 9 days of receiving the iFOB at CCRéf. GP are informed via their personal secured medical messaging. In case of positive result, a postal mail is sent as well. Results are also immediately available on the secured Brussels Health Network system (Abrumet).

Results: In 2019, 13 781 Colotests were realized. Considering the tests performed in 2018, the coverage of the eligible target group was 11%. The uptake (% Colotets performed vs. number of invitations sent) was 9.5

In 2020, the project's activities were suspended from 14/04 to 19/05. The number of invitations in 2020 was 39.9% lower than in 2019 and the number of tests performed was 11.7% lower than in 2019. The uptake increased however from 9.5% to 13.1%. In 2021, the project was boosted by an information campaign and the number of Colotests realized (23.107) rose to nearly twice the 2019 number.

Learnings: Access to Colotest through the pharmacy is satisfactory. Pharmacists indicated that after a sensitization interview it should be possible to immediately proceed with the delivery of a test providing patient eligibility is confirmed."
Development and first steps towards implementing population health management in Belgium.
Authors: Vaes Bert , Steenkamer Betty , Rietzschel Ernst , Simoens Steven
Published: January 2024

Background: Although the recent pilot projects on integrated care for the chronically ill fit within a population needs-based approach in Belgium, awareness and implementation of population health management is still limited and in its early stages. Therefore, this study aims to identify the views of Belgian stakeholders on hurdles and avenues to introduce population health management, to design a population health management approach to secondary prevention of atherosclerotic cardiovascular disease, and to propose actionable recommendations to roll out population health management in Belgium.

Methods: Eleven Belgian high-level decision makers in medicine, policy and science participated in two focus group sessions held between October and December 2021. Discussions were informed by a literature review and a semi-structured guide. Focus group sessions were recorded and discussions were transcribed ad verbatim. An inductive thematic analysis of discussions was carried out.

Results: Focus group participants highlighted multiple inter-related barriers and recommendations towards the introduction of population health management in Belgium. In particular, they referred to the responsibilities of the three policy levels within the Belgian political system, the shared accountability for the health of the population, the importance of a learning health system supporting population health management, the development of appropriate payment models, data and knowledge infrastructure, collaborative relationships and community involvement. These barriers and recommendations were illustrated by a case study setting up a population health management approach to secondary prevention of atherosclerotic cardiovascular disease in Belgium.

Conclusions: In order to speed up the introduction of population health management in Belgium, this study advocates: to instill a sense of urgency starting from a joint population-oriented vision; to move to a learning health system which makes use of a data and knowledge infrastructure; to set up new payment model pilots; to impose collaborative relationships and responsibilities; and to engage in continuous dialogue with communities of practice.
Assessment of a technological solution for helping elderly to monitor and mitigate frailty: case study of frAAgiLe project.
Authors: Shapoval Serhii , Garcia-Zapirain Soto Begoña , Colás Felix , Bartolomé Iñaki , Monasterio Juan Alberto , Oleagordia Ibon , Méndez Amaia
Published: January 2024

frAAgiLe is a health focused, digital based project that aims at becoming a holistic system for monitoring and dealing with the symptoms of frailty in senior users around Europe. Throughout the last 2 years, the digital solution has been tested in different healthcare and wellbeing centres in Europe. The users´feedback has been positive and the implementation of AI algorithms has become possible after the creation of the necessary databases. The algorithm allows for unification within personalisation, this is a key step in the harmonization of treatments in the European Union. Just as COVID 19 showed how there is a lack of coordination in the data collection process in the EU when it comes to health issues, frAAgiLe is showing how this can be translated to other non-COVID related health situations. In this case, frailty is monitored through a series of tests that rely on international scientific consensus and aim at creating a standard based on extensive testing. The combination and selection of weights for each of the scales within the final algorithm is a major contribution from the research teams involved. The tests have been divided in 3 sets: cognitive, nutritional and physical, each set has been given a specific weight in the formula for the final frailty score, and with each set, each test, depending on how holistic and relevant its content is, has been given a weight as well. Apart from this, an initial assessment has been created in order to harmonize the inclusion and exclusion criteria and how it is met.

Apart from contributing to the European panorama of digital solutions, especifically for health and wellbeing, frAAgiLe also contributes to the improvement of health and health systems. By aiming at early diagnosis and prevention of frailty, the platform is fighting against a burden that represents the previous step to serious health deterioration, dependency, and sometimes, death. frAAgiLe, therefore is key as a community service designed to enable self-management, as it is a tablet-based platform that anyone can use from home, thanks to the various co-creation sessions carried out. One of its main aims is to avoid hospitalisation, and future implementation will focus on this aspect. We expect more than 500 senior users to start dealing with their frailty in the near future, through the frAAgiLe solution in combination with traditional therapy and monitoring systems. This number of users, together with the perspectives for growth, will ensure the necessary impact on the European health systems as well as, together with the activities carried out for the digital development and the improvement of the AI system, the alignment with 2 of the main pillars of integrated care.
Safeguarding nursing homes in a pandemic: lessons learnt and implications for future workforce planning and development.
Authors: Quah Weiren Charles , Pang Shirlyn , Ee Ong Suan
Published: January 2024

Introduction: COVID-19 posed formidable challenges to Singapore’s nursing home (NH) sector. Singapore’s swift implementation of non-pharmaceutical interventions, staff management protocols, and rapid rollout of vaccinations and therapeutics successfully limited COVID-19 mortality and morbidity in the sector. Additionally, the pandemic highlighted the need to strengthen workforce resilience in a crisis. In this study, we identify challenges, opportunities and ways forward to inform the NH sector’s preparation for future outbreaks and ensure sustainability of actions. Here, we present findings on workforce capacity and capability-building.

Methods: We conducted a qualitative study in two parts to characterise the pandemic response in NHs in Singapore: (i) A rapid review of peer-reviewed and grey literature, including media reports, policy documents, and advisories to synthesise the public health measures implemented from Jan 2020 to Jun 2021 and (ii) n=42 semi-structured in-depth interviews with key stakeholders working in the NH, public health, healthcare, and integrated care sectors, with interview data thematically analysed.

Findings: The key challenges identified were NH sector reliance on foreign manpower, early introduction of interventions to curb transmission risks that were maintained for longer than restrictions in community settings, and high resource demands to facilitate implementation of and compliance to restrictions. Care staff reported fatigue, fear, and anxiety. Alongside, strict border controls, quarantine measures, and staff segregation policies limited the NH sector’s ability to flexibly respond to manpower attrition.

To cope with these challenges, NHs upskilled junior staff and cross-trained non-nursing staff to take on reassigned tasks and built new capabilities across surveillance and testing. Public hospital manpower supported the NH sector with infection prevention and control advice, tele-consultations, and knowledge-sharing on case management and diagnostics.

Opportunities for COVID-19 collaboration between the NH sector and health and integrated care agencies were grounded in social capital accumulated over many years of inter-agency partnerships and collaboration. Boundarylessness and open communication between organisations/agencies facilitated timely decision-making, information sharing, and flexible deployment of resources, including additional funding support. 

Ways forward: Moving forward, findings pointed to the pandemic providing impetus to build a strong local manpower core, invest in schemes to boost competitiveness and attractiveness, consider a review of existing staffing models, and increase resourcing support to enable the NH sector to keep up with policy changes and future demands. Findings also suggested the importance of greater investment into supporting healthier work environments and prioritising staff mental and physical health.