bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parkinson's care innovation through the learning glass
Authors: Stap Thieme , Van Woezik Tamara , Engbers Rik , Laan Roland , Munneke Marten , Bloem Bas , Koksma Jur 
Published: January 2024

Increasingly, successful healthcare innovation is understood to rely on learning processes of all those involved. Quality depends on persons in healthcare practice and the environment they enact together. Nevertheless, how people learn in innovation, and how these learning processes contribute, is still understudied. The convictional dimensions of such a mindset change imply a crucial role for transformative learning. From this position we studied healthcare innovation, based on the following research question: What kind of transformative learning processes, if any, did people go through, when they were involved in a highly innovative healthcare context that has person-centered care as the core of its mission and vision?
We conducted a retrospective, multi-level stakeholder analysis of an innovative center focused on Parkinson’s care (2004-). We did semi-systematic observations at the workplace (2018-2022), and conducted 22 in-depth interviews on the levels of healthcare practitioners in a network organization, employees of a center of expertise, and the managers overseeing both. Through grounded analysis, six themes were constructed: 1. Reflections about learning and education; 2. Reflections about change and innovation; 3. Convictions about care; 4. Vision; 5. Practice and community; 6. Personal leadership. The six themes are presented in four sections, all with their own specific focus on forms of learning: A) Formal Learning; B) Learning in the Workplace; C) Learning across Borders; D) Transformative Learning.
We found that formal learning plays a big role, providing structure for the development of professionals. Nevertheless, it also hinders learning in the workplace. Taking on ownership is a goal presented by management, yet employees found it hard to create a learning path for themselves in that direction. Strikingly, a lot of learning across borders happen in this innovative environment. Nonetheless, not many transformative learning processes were captured. But then again, we did observe a central paradox which pivots around perspective transformation: to be able to gain a broader perspective, one needs to be in the appropriate environment. But to become that appropriate environment, that broader perspective is necessary.
Suicide prevention in Flemish pharmacies
Authors: Verboven Barbara , Deneyer Hilde 
Published: January 2024

Introduction: In Flanders, the Flemish Pharmacists Network (VAN), in collaboration with the Flemish Centre of Expertise in Suicide Prevention (VLESP), wants to explore how pharmacists and pharmacist assistants in the public pharmacy can play an active role in suicide prevention in collaboration with other health care providers.
Background: Mental health is an important area of focus in health care. Numbers from the Care and Health Agency tell us that nearly 1,000 people die of suicide in Flanders every year. By 2030, the Flemish Health objective is to reduce deaths by suicide by 10% compared to 2020. Poisoning is a common method of suicide and medication is used in the majority of suicide attempts. There is strong scientific evidence that when commonly used methods are made less lethal or accessible, the number of suicides using that method as well as other methods decreases. Restricting access to substances for suicide is a very effective prevention method. Pharmacists occupy a crucial role in society regarding the distribution of medication and are among the most trusted professions. Thus, they are pre-eminent key figures who can play a role in suicide prevention.
Who is it for? The objective is to assessing and questioning actively the suicide risk of citizens in pharmacy.
Who did you involve and engage with? In 2022 VAN launched a project among Flemish pharmacists in collaboration with VLESP and with the support of the Flemish government.
What did you do? In the first phase, a literature review was conducted and a large group of experts from different healthcare professions was assembled. A survey was launched and the results are being analyzed by VLESP. These will be used for the further elaboration of the training and the launch of a pilot project in early 2023.
Knowledge improvement within the sector is crucial to take an active role in suicide prevention. Pharmacists should be aware of existing help and support possibilities and referral options to other health care providers. Agreements with other health care providers should be made for this purpose. Pharmacists must be taught the tools to recognize and question signs of suicidal behavior so that they can then raise awareness about medication management, provide appropriate advice, make appropriate delivery and referrals.
What results did you get? Around 50 pharmacies will start the pilot project in early 2023, which will be evaluated on a regular basis. Conclusions and recommendations will be written out by the end of 2023.
What is the learning for the international audience? For the international audience, it is interesting to know how pharmacies can play an active role and what elements are necessary to promote this. The conclusions and recommendations can serve as a guide for application in other countries. This project can be an important step to a more integrated approach around this topic
What are the next steps? After the pilot project, the objective is to extend the active role within all Flemish pharmacies and then within Belgium.
From research to practice: an evidence-based and participatory approach to suicide prevention.
Authors: Dumon Eva , Portzky Gwendolyn 
Published: January 2024

Introduction: Suicide is a major public health concern, and its prevention is complex, challenging multiple stakeholders from research, policy, and practice to work together in order to develop multi-level interventions. Since 2006, an extensive Suicide Prevention Strategy has been implemented in Flanders, Belgium, aiming to decrease the suicide rates and support everyone affected by it. Using evidence-based methods and involving multiple stakeholders are the key strengths of this strategy.
Method: The Suicide Prevention Strategy in Flanders is developed with the support of the Flemish government and in cooperation with various stakeholders, including researchers, policymakers, healthcare workers, and people with lived experience. Key criteria for the development and implementation processes of new interventions in the Strategy are: tailored to the target group’s needs, evidence-based, innovative, monitored and evaluated in terms of their outreach, usability and effectiveness.
Results: The Strategy includes various interventions. In this presentation, the development process of two innovative evidence-based interventions will be presented, as well as their impact on clinical practice.
1)The development and implementation of clinical guidelines and an e-learning course for health professionals on the detection and treatment of suicidal behaviour;
2)The development and implementation of online tools, such as an online self-help course and smartphone application for suicidal individuals.
Conclusion: In order to build solid suicide prevention strategies and interventions, cooperation between various stakeholders is essential. Implementing evidence-based and innovative tools in clinical practice, tailored to the needs of clinicians and people with lived experience, is a key strategy which can enhance the quality of care in suicide prevention.
Guidelines for disclosure of TM use to AMPs by patients who use both TM and AM: Perspectives of AMPs in Gauteng, South Africa
Authors: Gumede Lindiwe , Nkosi Busisiwe , Sibiya Nokuthula 
Published: January 2024

Background: Concurrent use of traditional medicine (TM) and allopathic medicine (AM) is frequently not disclosed to allopathic medicine practitioners (AMPs) during a consultation in Gauteng, South Africa. To promote person-centred care and allow patients to be forthcoming about the details of their choice, AMPs could strive for longer engagements with patients who use both TM and AM during consultations. The TM clinical setting allows for longer patient engagement as well as empathic, individual-centred approaches that are characteristic of traditional medicine practitioners (TMPs), whereas the AM clinical setting is limited by shorter patient engagements, limited progressive care, and less individual-centred care by AMPs. Guidelines for disclosure could help patients who use both TM and AM to disclose their use of TM.
Objectives: To explore and describe AMPs' perceptions of patients who use both TM and AM without disclosing TM use to AMPs, to eventually develop guidelines for disclosing TM use to AMPs in Gauteng, South Africa.
Methods: An exploratory, descriptive, qualitative research design was followed. The research population comprised 14 participants representing a group of AMPs. Non-probability, purposive sampling was used. Data collection was achieved through one-on-one, semi-structured interviews and qualitative observations.
Results: Results indicate that the use of both TM and AM presents challenges that are associated with lack of scientific evidence; unspecified dosage of TM; non-adherence to the AMPs treatment plan and complications because of interaction between TM and AM. The disclosure was deemed critical to effectively ensure improved treatment outcomes from the prescribed AM treatment. Participants made recommendations to inform the development of guidelines to encourage the disclosure of TM use.
Conclusions: Given the realities of negative interactions caused by patients' concurrent use of TM and AM in Gauteng, South Africa, facilitating disclosure to AMPs is advised. The recommendations could be used to develop strategies to encourage voluntary disclosure by gently probing patients who use both TM and AM to ensure that they receive the best treatment for their condition.
Implication to practice: TM use among patients who consult AMPs is not uncommon therefore the developed guidelines could inform the disclosure procedures during AMP consultations with patients in South Africa.
Pediatric behavioral health care utilization in integrated primary care and hospital-based clinics during the pandemic – Implications for virtual care
Authors: Cook Andrew , Birnbaum Richard , Turnier Luke 
Published: January 2024

Introduction: The COVID-19 pandemic forced health care organizations and providers to adapt innovative approaches to ensure patient care needs are met. In particular, improving patient access to behavioral health services is essential to improving population health.
Methods and Aims: Clinical visit volume and utilization data were analyzed via the Tableau platform for behavioral health visits by providers within the division of Pediatric Psychology at the University of Michigan Health (UM) during the pandemic through the present. UM is a publicly funded academic medical center that manages a total of approximately 2.5 million patient visits per year. Psychologists provide care within hospital-based specialty clinics or primary care clinics, both of which utilize integrated models of care. Unprecedented changes were made with regards to care delivery format and workforce allocation, and the present paper examines the corresponding impact on patient behavior health care.
Results: During Fiscal Year 22 (July 2021 to June 2022), 24 pediatric psychology providers completed a total of 8,252 visits within 12,802 available patient slots, a utilization rate of 64.5%. Utilization was significantly higher in primary care clinics (80.9%) than in hospital-based clinics (51.6%), Z = 34.47, p < .00001. Services were delivered virtually in 100% of the 4549 visits completed in primary care and 72.6% of the 3703 completed hospital visits. These data are currently being analyzed for the present Fiscal Year 23. Patient satisfaction data revealed barriers impacting access to care, including scheduling issues, setting up virtual care and managing, technology problems.
Conclusions: Utilization data provides strong support for delivery of behavioral health services in primary care via virtual care means. However, patients area likely to encounter significant barriers to initiating and participating in care when systems are designed to exclusively or primarily support remote users.
Shared medical appointments (SMA) for metabolic syndrome patients in the Hague, the Netherlands
Authors: Jacz-Kruithof Loïse , Vos Rimke , Breas Martin , Samlal Anil 
Published: January 2024

The pilot with the Shared Medical Appointment (SMA)started in januari 2021 in the Schilderswijk which is a deprived area of the Hague , with low health literacy and high prevelence of metabolic syndrome . This group of patients are are seen in the SMA together with a multidisciplinair Team (MDT) of professionals and scientists.
The patient journey of the participants starts at population care towards customized patient orientated care.
This proactive, integrative towards personalized care migth benefit applying a quadruple or quintuple aim.
The study desing is a quasi experimental population based controlled cohort trial
The study employs a dif -in -dif design using a regional control group on non participating GP ‘s
Good collaboration is important between the primary care , the social care , welvare , and science.
A shared shavings contract could proved financial incentives to realize efficiency gain value based competition.
The SMA will be evaluated in 2023-2024 to measure the effects of the Sma intervention.
Thank you In behalf of the team members
Loïse Jacz, GP, Msc PHM i.o
Rimke Vos , ass Prof
Martin Bread , sportcoach
Emma Witte : student Sportscience
Maud Verhoeven : Msc PHM i.o
Anil Samlal: experience expert
Frank Kanhai : walking coach NDC
Younes Bouadi: NDC coordinator
Co-designing collaborative health deterioration prevention together with older people, civic society, and community health and social care
Authors: Flink Maria , Strehlenert Helena , Lindgren Christofer , Karlsson Eva , Klinga Charlotte , Meinow Bettina , Wallcook Sarah , Johansson Karin , Goliath Ida 
Published: January 2024

Introduction: As the population ages, the number of older people whose health is at risk of deteriorating is expected to increase. This may imply decreased quality of life for the individual and rising costs for social and health care. This project acknowledges that health in older people is a complex matter, that includes physical, social, and psychological dimensions, and needs to be targeted at individual, societal and structural levels. Thereby, we recognize that collaborative efforts by diverse actors are necessary to prevent the deterioration of health. Development of collaboration, defined as cross-organizational integration in networks, accomplished through agreements, adjustments, and a willingness to work together, requires the substantial efforts of all stakeholders. We therefore use experience-based co-design to develop collaborative prevention. We will present findings from co-design processes aiming at developing collaborative prevention of deterioration of health.
Method: This multiple case design study is performed in Stockholm, Sweden. A case is defined as a community social care unit and its interacting partners who currently are – or potentially could be – involved in collaborative prevention. In each of the project’s three cases, a series of six co-design workshops is conducted. Participants in these workshops are older people and participants from community social care, health care, and civic society (e.g., voluntary and faith/religious organisations). In each case, the participants explore their current collaboration, define their collaborative challenges and work together to develop and test ideas and solutions for improved collaboration to prevent deterioration of health for older people. The workshops are led by researchers.
During the workshops, data on the outcomes and process are collected using audio-recordings and field notes. Between workshops, individual and dyad semi-structured interviews are conducted with participants on their perspectives of the outcomes and process. Data are analyzed with qualitative content analysis.
Results: The co-design series are ongoing and at the conference we will present 1) participants’ reasonings about participation, 2) strengths/opportunities/solutions in collaboration identified by the participants, 3) the co-designed collaborative models and 4) factors that were imperative for the development of these new models, 5) the development of collaborative governance regarded as important for sustainability. We will also critically discuss 6) lessons learned about researcher facilitation of co-design processes.
Next step: The three cases will be longitudinally evaluated regarding the impact and structures of the collaborative process.
Patient information handover between care providers
Authors: Verheirstraeten Emma , Notebaert Melissa 
Published: January 2024

The handover of patient information between care providers is a big challenge. Important information is easily missed or the interpretation may differ among care providers. Structured transfer methods are used in the hospital to avoid this.
In the hospital AZ Sint-Lucas (Ghent; Belgium), we have implemented three different methods based on literature. First, during the handover we use the SBAR-method. Whit this method, patient information about ‘Situation-Background-Assessment-Recommendation’ is given to each other. The Second, in line with the SBAR is the ‘Identification-Situation-Background-Assessment-Recommendation-Readback’ (ISBARR) method we use for the telephone communication between nurses and physicians. So there is extra focus on the ‘identification’ of the care provider and ‘readback’ of the physician orders. As a third method, ‘Bedside shift reporting’ (BSR) is used on the nurse departments in the hospital. This means that the handover is carried out in the room of the patient which improves patient participation on the nursing wards. In general, it gives patients more chance to interact with nurses, providing them more notice of the information that is handed over. During the patient intake, the BSR method is explained to the patient and his preference for BSR is noted in the patient file.
Several months we did observations on the nursing wards during the handover moments from the early to the late shifts. The focus of these observations was on the performance of BSR and the use of the SBAR method. After the observations feedback was given immediately to the nurses and findings were documented in a report. These observations indicated which wards used the methods on a daily basis and what the points of attention were, to plan additional support or training.
For physicians, file scans are used to evaluate whether they consistently create tour notes. There is a noticeable increase of the fill-in rate since the implementation of the central patient file across the different specialties. The central patient file was enrolled in several stages over the specialties from 2017 until 2019. In 2021 the integrated patient file over the different discipline was introduced, where patient information is shared between the different care providers. In the integrated patient file, the component 'multidisciplinary communication' was positively received. In this component findings about the patient or questions addressed to the physician can be noted. Physicians can also note certain instructions aimed at the nurse in this component. The findings in this component are often further discusses verbally between the responsible nurse and the attending physician.
In sum, we can conclude that a good documentation in the integrated patient file and the use of different methods like SBAR can help us to provide a structured patient handover, reducing the risk that crucial information will be lost during handover. Nevertheless, further monitoring is needed.
Nature by prescription
Authors: Archie Petra , Vyncke Benoit , Huys Virginie 
Published: January 2024

Az groeninge hospital is located in an extensive nature domain. With the 'nature on prescription' project, the hospital brings patients, visitors, employees, and residents closer to nature. And to each other.
The project is a collaboration with the city of Kortrijk, Doerak, Intercommunale Leiedal, Natuurpunt, Stadlandschap Leie en Schelde, Province of West-Flanders and Agency for Nature and Forest.
It has been proven: nature has an important influence on our health. Fifteen minutes of nature a day is enough to lower the stress hormone cortisol. Depressive feelings are also reduced if you get out into nature. In addition, exercise in green spaces stimulates social interaction with others.
This project ensures that the urban green reserve Marionettes, the Kennedy forest and the green area around the hospital can maximize their added value for visitors, patients, employees, and the local community. Doctors can prescribe a walk in nature. Waiting during consultations takes less time if you can get outside for a moment.
Nature in your neighborhood. Something for everyone
Az groeninge's garden is split into different zones with various thematic corners. The area around Zibi's tree house - a therapy room for children - is a zone where biodiversity is encouraged by smart mowing management. Other areas of grass remain untouched so that nature can take its course.
Attached to the House of Movement are an orchard and a meadow where donkeys are at home. Animals are often a good distraction and are also used during therapy sessions. Care greenery in the context of therapy works on the state of mind. Patients find peace and distraction.
Employees of az groeninge who are also beekeepers take care of bees in the bee hotel in their spare time. Those bees also provide delicious az groeninge honey.
A visit to the hospital is often an unpleasant experience for children. An obstacle course is set up in the courtyard, we have a climbing wall adapted for children and the educational center "Doerak" near the hospital organizes various activities.
The Koesterplek
From the rainbow garden with all kinds of ecologically grown flowers, a path leads to the place where we cherish our lost ones. Here people can retreat into nature to remember someone. People can leave a message in a locked mailbox or hang a name disc in the tree as a voice of remembrance.
Theme routes
Through an app or the website, people can also follow a number of interactive routes around different themes such as stress reduction and children's yoga.
Everyone Welcome
Through integrated cooperation with different partners, we have succeeded in connecting people with nature and with each other: not only patients, visitors, and employees from the neighborhood but also residents from the region are welcome. Each partner has placed accents in the project from its own core business. Care, nature conservation, education and experience go hand in hand.
Nature is good for body and mind. With "nature by prescription" we open the door to our gardens. Everyone is always welcome! Even without a prescription.