bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
Hybrid Home Care Pilot Project
Authors: De Kesel Evelyn , Dingemans Ann 
Published: January 2024

1.The ‘Hybrid Home Care’ pilot project offers remote monitoring through video calls to eighty home care clients. The aim is to create an achievable and feasible ecosystem that integrates remote monitoring and home care services. The latter includes all types of non-medical support at home (e.g. cooking, personal hygiene) that help clients to live independently at home for as long as possible. The project is organised by three home care organizations (Familiehulp, Zorgband Leie & Schelde and i-mens) and Remote Carecenter Z-plus. It was funded by the Flemish Department of Welfare and the three participating organizations.
2.Eighty home-care clients have received a tablet or television with an internet connection. Each client is contacted at least once a week through video call by one our caregiver. In addition to these weekly scheduled calls, the client can contact us 24/7 for a video conversation with a Z-plus operator. The device also allows clients to keep in touch with their family. However, participating clients often lacked digital skills. Therefore, we opted for a 'warm installation'. Our partner Zorg & Meer visited each client at home to install and demonstrate the hardware and software. Additional support is available.
3.Our partner Artevelde University of Applied Sciences is researching the added value of Hybrid Home Care. Interim results are very encouraging and strengthen our believe that this hybrid form of care can be of tremendous value in many different ways.
The newly acquired digital skills open many doors for them and amongst other things reduces loneliness by providing them with a new way to be connected to relatives. Relatives worry less about their loved one. Participating clients say they feel heard and generally feel better supported.
The fact that our caregivers can see the client (as opposed to a telephone call) allows them to better assess the client's situation. This ensures that any needs will be picked up on sooner and any necessary preventive care measures can be implemented in time.
Not only the clients benefit from hybrid care. Our (video)team is very enthusiastic about the project as it allows them to combine their job as home-based care provider with less physically demanding desk work. They indicate that they enjoy really listening to the client, rather than engaging in superficial conversation while doing other tasks in the client’s home. Hybrid Home Care also allows caregivers to work from home.
4.Hybrid Home Care proves to be an opportunity to improve the quality of life for our clients, their loved ones and our employees. Our clients feel more connected to their caregivers and their family. Our employees can combine physically demanding work with working from home, improving their work-life balance.
5. Hybrid Care requires a reconsideration of how public care fundings are allocated. For that reason we are in consultation with the government throughout the project. While this pilot project has promising first results, we have yet to learn how clients will evaluate this remote care when it is no longer free.
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.
Identification of multimorbidity patterns in older adults receiving long-term care in Canada, Italy, Finland and New Zealand: results from the ICARE4OLD project
Authors: De Almeida Mello Johanna , Proost Bregtje , Damiano Cecilia , Vetrano Davide	L. , Declercq Anja , Nova1 Amanda 
Published: January 2024

Background: Older adults receiving home care (HC) services and living in long-term care homes (LTC) experience high levels of multimorbidity. In this project - called iCARE4OLD, we aimed first to identify and compare subgroups of care dependent individuals sharing the same patterns of chronic diseases. For these subgroups, we will identify care paths and try to make integration of services and continuity of care possible.
Settings and participants: We studied 102,000 individuals 60+ years receiving HC services or living in LTC homes in Canada, Italy, Finland and New Zealand.
Methods: This is a cross-sectional study including the baseline interRAI HC and LTCF assessments of older people in the period of 2014 until 2018. The project has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement number 965341 and from the New Frontiers Research Fund, grant number NFRFG-2020-00500.
Latent Class Analysis (LCA) was used to classify individuals according to their underlying diseases patterns starting from a list of 19 conditions.
Results: Mean age of the sample was 80 years (65% females). After assessing several fit parameters, a 5-class solution was chosen as the best model for both HC and LTC. The following 5 disease patterns were identified in all countries: (1) Alzheimer/dementia; (2) psychiatric diseases; (3) cardio-pulmonary diseases; (4) stroke/hemiplegia; (5) other dementias. The distribution of sociodemographic, clinical and functional characteristics varied across the different multimorbidity patterns, with the cardio-pulmonary disease and the stroke/hemiplegia patterns showing the highest complexity and impairment.
Results: Our results show that, by using a common assessment tool, it is possible to identify homogeneous morbidity patterns in older patients receiving long-term care. These may be useful to compare health status in care-dependent individuals across different settings and countries, as well as to predict health trajectories and care needs.
Discussion: By applying this methodology to whole populations, care paths can be drawn for home care and residential care clients in a more evidence-based way. The goals would be to use these algorithms to design more integrated care plans for older persons, so that clients and their families are better served, and policy makers can finance the right services and offer targeted care.
Building Collaborative Capacity through formalized and Imposed Cooperation: The Implementation of Health Care Communities in Norway
Authors: Krane Martin Sollund , Høyem Audhild 
Published: January 2024

Today, the nexus of ´co-ordination – co-production – co-creation´ constitutes the new political prism through which the ´wicked issues´ of the public sector is re-imagined, and by calling forth new cooperative endeavors stressing shared problem solving, the welfare state might signal a shift in mode of governance from New Public Management (NPM) to New Public Governance (NPG). In this paper we inquire into an empirical example from the Norwegian healthcare sector, namely the implementation of healthcare communities (HCCs).
Public healthcare is an essential part of the Nordic welfare state model. Being a multi-dimensional policy field, it is notoriously characterized by both ´wicked issues´ and complexity – in terms of service provision, organizing and governing. Often patients require several healthcare services from multiple providers. In Norway, healthcare is organized in two main parts, primary (municipalities) and specialized healthcare (central government). While this division in theory should lead to a clear assignment of tasks and responsibilities, it has built-in challenges of lack of continuity of care and the risk of services being fragmented. Furthermore, the NPM-reforms during the last three decades has contributed to organizational fragmentation. Problems of service and organizational fragmentation has served as a core focal point for several health sector reforms in Norway during the last three decades. The latest reform initiative is the implementation of 19 HCCs, where hospital trusts and municipalities, through imposed and formalized cooperation structures are expected to cooperate, as well as co-plan, service provision, aiming to make better, more efficient services, and give patients a more coherent and seamless experience.
We are interested in why and how NPG-inspired ideas of collaboration and co-creation are translated and articulated into the specific institutional context of Norwegian healthcare, and whether the HCC reform imply an actual break with the NPM-logics – or rather represents more of a continuation adding an extra reform layer, so to speak. In this paper the following research question guides our inquiry: In which ways does the HCC reform as an expression of the New Public Government paradigm represent a break or continuation with New Public Management logics in the healthcare sector in Norway, and how are the concepts of co-design, co-creation and collaborative capacity framed and constructed as the remedy for fragmentation by the policy makers?

Methodologically, this paper is based on critical discourse analysis of official documents central in the development of the reform, as well as a qualitative analysis of interviews with central and local actors, in addition to a study of relevant public governance literature.
Putting patients’ goals first: strategies and challenges through the eyes of primary care stakeholders
Authors: Haverals Reini , Boeykens Dagje , Sirimsi Mustafa	 Muhammed , Timmermans Lotte , Van de Velde Dominique , De Vriendt Patricia , Boeckxstaens Pauline 
Published: January 2024

Introduction: Primary care is in constant transformation to optimize integrated care delivery according the increase of people with multiple and long-term care needs. One of the suggested strategies is person centered integrated care (PC-IC). PC-IC has an explicit focus on patients’ personal goals. This should reorient care delivery from the focus on disease oriented quality indicators to outcomes that matter to people. To get this focus on patients goals implemented throughout the system, actions in practice, research, education and policy are required.
Aim: This study aims to explore the experiences of primary care providers, scholars and policy makers towards putting patients’ goals first in primary care, the strategies they use, and challenges they encounter.
Methods: Primary care stakeholders (n=41) - recruited via maximal variation purposive sampling- participated in six focus groups. Data were collected through a semi-structured interview guide, audio recorded, and analyzed following a phenomenological-hermeneutical philosophy of Lindseth and Norberg.
Results: All participants emphasized their fundamental commitment in putting patients' goals first. Participants who were active in patient care discussed how they enabled patients to talk about their values and personal stories in order to elicit their personal goals. They also attempted to establish a balanced relationship by integrating their medical expertise with the goals of their patients. Participants stated that they listened to the goals of patients' significant others in order to gain common understanding on goals and recognize everyone's contribution to the care process. Finally, they used patients’ personal goals as a focus for guiding interprofessional collaboration. Both the clinicians and scholars stressed that (future) care providers need more training to develop the competencies necessary to discuss patients' personal goals and integrate them into care delivery. According to policy, all types of participants agreed that there’s challenges related to organizational constraints, such as time restrictions and a lack of registration systems.
Discussion: The results of this study provide an integrated perspective on the strengths, weaknesses, opportunities and threats for adopting an explicit focus on patient goals throughout the system. In order to support primary care stakeholders to fully engage in the adoption of patients' personal goals in care delivery, the development of models of practice, training and policy plans from a person-centered integrated system approach are required.
Change management through upskilling and reskilling.
Authors: Ruszanov Anett 
Published: January 2024

BeWell is an Erasmus+ Funded project that kicked-off in July 2022 and will last for 4 years. BeWell is aiming to prepare the health workforce, and more broadly the health ecosystem, to cope with future challenges and the continuously changing societal expectations by developing a strategy on upskilling and reskilling the health workforce in the context of the green and digital transition.
BeWell stands for Blueprint alliance for a future hEalth Workforce stratEgy on digital and green skiLLs and serves the objectives of the European Skills Agenda 2020 that aims to support companies and individuals to develop better skills.
The way health and care is delivered is significantly changing due to a number of major trends. Just to mention a few: demographic change, the increasing number of non-communicable diseases, the consequences of our modern urban lifestyle, the use of digital technologies becoming prominent in all phases of care provision as well as becoming essential for horizontal and vertical integration of care, the ambition to reduce the environmental impact of the health sector activities, etc. To respond to these challenges and to manage these changes, health professionals need different sets of skills if they want to keep the quality of care provision consistently high. Appropriate education, lifelong learning, continuing professional development are the key in this equation.
BeWell offers to design, develop and implement a digital and green strategy in partnership with a large number of stakeholders representing VET providers, research, professional organisation, social partners, policy-makers, industry and many others. Having mapped the current and future skill needs, emerging occupations, education and training programmes towards the green and digital transitions will be developed and piloted first of all to provide solutions to health professionals, and second of all to help patients to have access to better care. The strategy will ensure that sporadic training initiatives will be coordinated under a long-term common vision addressing not only current skill needs but will also prepare the workforce for the unknown. The strategy will be implemented at local, national and European level through a large-scale partnership under the Pact for Skills.
All in all, this oral poster session aims to illustrate how health professionals working in primary, secondary, tertiary or informal care settings could benefit from the outputs of the project. Skills matching labour market demands in the context of digital and green transitions will enable health professionals to provide better integrated care services in all settings.