bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
Leading cultural change in health care: practice-based evidence.
Authors: Raes Ruth 
Published: January 2024

Background: Management literature provides bookshelves full of theory on how to lead change projects. Leading and facilitating change projects in such complex contexts as the implementation of integrated primary care zones or compassionate cities and communities however, asks for more than just a theory.
Objective: The workshop aims to present and discuss a hands-on model from a practice based evidence point of view. It is based upon and documented by the experiences and examples of both the change projects in Compassionate Bruges and Herzele and the transition project towards integrated care and the creation of primary healthcare zones in Flanders. The practice evidence is substantiated by a literature review of very different domains, amongst which that of implementation theory.
We start by presenting the frameworks, values and beliefs the facilitators/project teams used to start these projects and share the observations of where they stayed upright or rather failed. We discuss our observations on the causes of these results as well as the alternative strategies we developed to cope with the obstacles we encountered.
We than present a first framework in which we try to capture the key elements of leading change in complex systems and the levers for handling the interdependence between those elements. We invite participants to check their own experiences against ours and each other’s. This will happen in smaller discussion groups. By thoroughly debating experiences, we evaluate to which extent our model is coherent and applicable in other healthcare change contexts. We conclude with a plenary exchange and wrap-up.
Learning outcome: At the end of the workshop, participants will have obtained increased awareness of looking at change processes in health care from a complexity point of view; increased awareness of the underlying processes of cultural change; increased awareness of the key elements a leader/facilitator can steer upon to create the best possible context in which cultural change can take place; new inspiration through input of fellow participants on how to further implement the change process they themselves are in.